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Home My Public Portal About6022-6024 TEMPLE CITY BLVD_Building__ DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES V ' C D ' G WM. J. FOX. CHIEF ENGINEER FOR APPLICANIT TO FILLJN IN t FOR OFFICE USE ONLY BUILDING { A ISTRICT�N O. PLANCK.NO. PERMIT NO.. ADDRE89 7 n .�d/f �O«i ted:nil j ib: ! ! r LOCALITY .l�l--1„, f (� i- o RECEIVED BY DATE OFAPPL. DATE ISSUED NEAREST / I��,y y . CROSS ST. ! / . ! csrs (/ �/4 > j ILDING /lV OWNER,` r /MAILP DRESSADDRESS ( "' ' CALITY r N'EAREST NOL r7/1 d�I CROSS ST. j,.l s CITY ,iil.' • FIRE NO.CF TJIP GROUP rT ARCHITECT OR TEL. ZONE PLANS / ENGINEER NO. BLDGY ORD.NO. ADDRESS SETBACK LINE evo APPROVED TEL By DATE CONTRACTOR NO. \, UBEAPPROVED ADDRESS / ^� ZONE/? 11 BY DATE LEGAL DESCRIPTION 1LOTNO. L Gt 61 BLOCK ter, ?'�� / CORRECTIONS TRACT \ r NO.OF BLDGS. SIZE OF LOT C J �! I NOW ON LOT USE OF �/ NO.DF O.OF EXISTING BLDG. Y I FAMILIES N I I ROOMS DESCRIPTION OF WORK NEW ALTERATION I ADDITION C REPAIR MOVING DEMOLISH O Sq. `` NO.OF Z SIZE -..f.. ROOMS STORIES y WALL ROOF r COVERING I COVERING USE OF NEW BUILDING /' /�•�`-k )t ( 'r i 'tet . •,. 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION INSPECTOR DATE AND AGREE TO MPLY WITH ALL COUNTY O DINANCES FORMS,MATERIALS AND STATE LAW_ EGULA 13UILDIN13 CO TRUCTION. / FRAME: FIRE STOPS, SIGNATURE OF f BRACING,BOLTS PERM ITTE 1 � LATH, INT. AUTHORIZED AGT I V, LATH, EXT. I�,�J" , 75A638A 9-48 V DBS-3 SOM BETS $ P.C,6 PLASTER,INT. �) FEE l PLASTER,EXT. iAl,v VALUATIONFEE (� r V FINAL V I�. DMSION OF BUILDING AND SAFETY Deposiment of County Engineer BUILDING1 County of Los Angeles WM. J. FOX, COUNTY ENGINEER `APPLICATIONBUILDING p` FOR APPLICANT TO ML M ,ADDRESS C00 X' M 1171" C 1 UILDING ADDRESS W6 � �h�� / --�(j1/ i r�C/ f LOCALITY�1 : l.) _ NEARIEST LOCALITY / ,[� L-t�t/i�l�� G✓`� / ter:�G/_.� CROSS ST. �Kk.)'�(r- u 4-7 1 DISTRICT NO: PLAN CK.OR REC.No: PERMIT NO. NEAREST /l�+�;�,, _ �' CROSS S/T.s: /! /.it .�:�'�:i•t ''/ % / ��_ OWNER ` 1 �L^l,-�, y(!"� t/ � F" fi/ RECEIVED BY DATE OF APPL. DATE ISSUED ADDRESS /} USE ZONE NO. OF �TYPA GROUP l rRF.�OUE CITY /�C,.,=tt�Jl `��[r`�(.%/ Np-af�/(_a / ! t)-1 ARCHITECT OR f TEL. ZONING �\ DATED ENGINEER NO. APPROVED BY-t'(J: 'BUILDING ADDRESS / SETBA K LINE / �: / � `/�F, 60i �: ORD TM41, TELACONTRACTOR hNO.• BYPROVED '�"CE_C�r71 DATE H�UBE NUMBERING ADDRESS / LEGAL S �✓i MAP NUMBER .CDC'D—) NO: ASSIGNED BY_�/s a DESCRIPTION BLOCK DATE i CORRECTIONS I INSPECTOR TRACT c' SIZE OF LOT X f NOW ON LOT NO. OF LOT 3 Cl 4`i USE OF NO. 010 EXISTING BLDG.I_Q.1_4111-_ CX G1.P2GC I AMILIES4 O DESCRIPTION OF WORK z NEW ALTERATION ADDITION I REPAIR DEMOLITION I I SQ. FT. NO. OF I SIZE ROOMS STORIES(1 EXT. WALL I ROOF (S'L (/7/ I COVERING COVERING /�Q_A i A USE OF STRUCTURE V ( Ire � INSPECTOR'S ROVSIS'GNATURE DATE FOUNDATION: LOCATION FORMS, MATERIALS 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FRAME: FIRE STOPS, PLICATION AND STATE THAT THE INFORMATION GIVEN 1S CORRECT. BRACING, BOLTS 1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE. LOCATION, AND STATE LAWS REGULATING BUILDING CONSTRUCTION... GAS VENT, DUCTS SIGN ATUREO _,` �/(i(i`r f7 LATH, INT. PERM ITTE 4, (J�/ U►/,-�/—��., r ADDRESS /'ti r !/i1 f - ` 4 0 LATH, EXT. PLASTER, TNT. AUTHORIZED AGT. PLASTER, EXT. $ G FEE �^ HOUSE NUMBER COR- RECT AND POSTED 4 VALUATION FEE Z- FINAL .76A688A Des 6 8-58 - 75AG38A CE#803 3-6.6APPLIC A ` ION FOR BUILD G PE M" R I COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS (� BUILDING AND SAFETY DMSION LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST COLEMAN W. JENKINSSUP•T OF;BUILDING CROSS ST. SIGN DIIN¢a/ G TYPE . S BY FOR APPLICANT TO FILL IN ((f�� CONST. FAD G STATISTICAL C A IFICATION SE R AP, A p2 CLASS NO.�DWIELL UNITS .-BK t P- (/!) S—_5 O ` BLOCK USE ZONE MAP QO .— � NO. TRACT/, [-IFE—CIAL NO. OF SLOGS. CONDI IONS LOT NOW ON LOT BLDG. SETBACK FROM NOL � %J FRONT PROP. LINE OF — (STREET) TYPE OF EXISTING SETBACK HIGHWAY YARD — TOTAL v ADDRESS D OC HIGHWAY WIDTH FROM C.L. c + _ CITY BLDG. SETBACK FROM ARCHITECT OR TEL. SIDE PROP. LINE OF (STREET) ENGINEER NO. TYPE OR I EXISTING SETBACK HIGHWAY } YARD = TOTAL ADDRESS ry HIGHWAY IWIDTH FROM C.L. + CONTRACTO L ll r J ADDRESSL 4 ` CORNER CUTOFF YES E] NO C CITY 0-' /'' I` SS SEE REVERSE SIDE FOR SPECIAL APPROVALS SCRIPTION Of WORK L G.%Y L.�. ♦003 NEW ADD ALTER EPAIR DEMOLISH ,f�j J SQ.FT. NO. O NO. OF '°'2G `�! C"sS L°^r�"?°� e SIZE STORIES FAMILIES �� USE OF STRUCTURE i SIGNATURE OF r APPLICANT , VALUATION$v 46 1 .00 1.b , APPROVALS DATE INSPECTOR'S SIGNATURE = FOUNDATION, LOCATION FEE$ FEE$ E/ FORMS,MATERIALS - FRAME, FIRE STOPS,- y �yyc I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT �� d• °' :+�J +:+.+� AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLYFURNACE: LOCATION WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS GUILDING CONSTRUCTION. I CERTIFY THAT. IN DOING THE WORK ---• AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- ING TO WORKMEN'S COMPEN/$/p TION INSURANCE. LATH. EXT. , SIGNATURE OF , 7 HOUSE NUM HORSE AND POSTED ADDRESS r 1- Yl NAL i JOHN F. LEWIS. PRINCIPAL STTU AL ENGINEER PLAN CHECK VALIDATION CK. M.D. CASH _ PERMIT VALIDATION CK. • M.O CASH . .JAN 11. 1 D 1 8.5 0- q ` WORKERS'COMPENSATION DECLARATION re,- affirm Haat I have certificate of consent to self APPLICATION FOR BUILDING PERMIT t!,insusure,-cSr a certificate of Workers'Compensation Insurance, or a certified cop*,thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company BUILDING Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS A0.1Q pC Certified copy is filed with the county building inspec- BUILDING ,� /7J� tion department. ADDRESSAav C Date Applicant CITY p 141 ZIP �.LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT b / NOW ON LOT CROSS ST. (This section need not be completed if the permit is for one ASSESSOR hundred dollars($100)or less.) TRACT BLOCK LOT NO. MAP BOOK f1l I PAGE PARCEL TEL' USE ZONE MAP I certify that in the performance of the work for which this OWNER NO. r NO. y_ permit is issued, I shall not employ an person in an manner // SPECIAL @� so as to become subject to the Workers'Compensation Laws. ADDRESS v �urJpp CONDITIONS O ZIP ac 29 Date Applicant ��-_ _ ` CITY r NOTICE TO APPLICANT: If, after m g this Certificate of ARCHITECT OR EL. DISTRICT GROUP TYPE FIRE PROCESSED BY 0 ENGINEER /NO. CONST. ZONE Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forth- ADDRESS with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. DO.' deemed revoked. CONTRACTOR NO. ''''rr LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. SEWER MAP (commencing with Section 7000)of Division 3 of the Business and LIC. Professions Code, and my license is in full force and effect. CITY CLASSBK VALIDATION SQ.FT. NO.OF NO.OF CHECK License Number Lic.Class SIZE STORIES FAMILIES ONE // � VALUATION Contractor pate DESCRIPTION OF WORK /rrp r;Ul�/?�YrJ NEW ❑•s $� 000 11!!,❑ �/� /7l�OY� aYf d ADD ❑'-, , I am exempt under Sec. `` ALTER ❑ B.&P.C. for this reason L�llY 3�7^�P �/7� REPAIR IZA $ USE OF Date: EXISTING BLDG. DEMOL Signature APPLICANTw &,m NO�JG! TEL. FINAL OWNER-BUILDER DECLARATION (PRINT) 9,6-4w - DATE I hereby affirm that I am exempt from the Contractor's Licensey� Law for the following reason (Section 7031.5, Business and ADDRESS / FI Professions 4 7 A Professions Code): PRESENT BUILDING I, as owner of the property, or my employees with ADDRESS # 0 0 0 0 0 wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY ® o o ]8 (]Q 7044, Business and Professions Code). MOVING TEL. I, as owner of the property,am exclusively contracting CONTRACTOR NO. o 0 0 ']8. _0 0 0 with licensed contractors to construct the project (Sec- ADDRESS ' \ tion 7044, Business and Professions Code). 7 Jc_ b TOTA SETB CONSTRUCTION LENDING AGENCY SETT BACK YARD HWY PROP. LINE NEFROM WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE io P.L. Lender's Name $ �� LDMA Ref. # P.C. Fee$ Permit Fee 'V Lender's Address I certify that I have read this application and state that the Issuance Fee [ D�J� LDMA P/C# ¢ above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, Total Fee .D D LDMA Perm. # U and hereby authorize representatives of this County to enter upon the above-mentioq d property for inspection purposes. ¢ /7 / SEE REVERSE FOR EXPLANATORY LANGUAGE a O ' SignaSignat�ure of Appli49 cgic ca or ent �J � DcOLC � � WORKERS'COMPENSATION DECLARATION ` I hereby affirm that I have certificate of consent to self A P P L I CAT I N ®� BUILDING PERMIT •t,insure;cRF a certificate of Workers'Compensation Insurance, or a certified copythereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. �. Company . BUILDING ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL INADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS "--? C Y/ Date Applicant CITY Al ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT b y / NOW ON LOT CROSS ST. (This section need not be completed if the permit is for one ASSESSOR TRACT hundred dollars($100)or less.) BLOCK LOT NO. MAP BOOK PAGE PARCEL TEL. OWNER O USE ZONE MAP I certify that in the performance of the work for which this ` N/ �3 SPECIAL � permit is issued, I shall not employ any person in any manner ADDRESS v !�N• CONDITIONS O so as to become subject to the Workers'Compensation Laws. OO U Date Applicant _ _ "CITY T C�i ZIP J9,, 4.1: Rd NOTICE TO APPLICANT: If, after m ' g this Certificate of ARCHITECT OR EL. DISTRICT GROUP TYPE FIRE PROCESSED BY Exemption, you should become subject to the Workers' ENGINEER /NO. CONST. ZONE Compensation provisions of the Labor Code, you must forth- ADDRESS S•6d k-3 5 with comply with such provisions or this permit shall be TEL. .STATISTICAL CLASSIFICATION APT. DO.' us deemed revoked. CONTRACTOR NO. ''/ LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. (commencing with Section 7000)of Division 3 of the Business and LIC SEWER MAP Professions Code,and my license is in full force and effect. CITY CLASS BK PG VALIDATION SQ.FT. NO.OF NO.OF CHECK License Number Lic.Class SIZE STORIES FAMILIES ONE / VALUATION Contractor Date DESCRIPTION OF WORK Plalehrto (,()[we7eeJ NEW ❑. L, ❑ k 14 /'a[�Y� 25! cI ADD ❑ (/r/v I am exempt under Sec. ! /� ALTER ❑ B.&P.C. for this reason wely'?V '>^•P ?/'Y—' REPAIR I $ USE OF ❑ Date: EXISTING BLDG. DEMOL Signature APPLICANT / TEL. FINAL _ OWNER-BUILDER DECLARATION PRINT) O 7/ WM N NO.U4/6—Al DATE I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS Professions Code): PRESENT sl ;25O4.7A BUILDING I7X_' I, as owner of the property, or my employees with ADDRESS # 0 0 0 0 0 wages as their sole compensation,will do the work and LOCALITY the structure is not intended or offered for sale(Section LO ® ( o o 7 a 0 0 7044, Business and Professions Code). MOVING TEL. I, as owner of the property, am exclusively contracting CONTRACTOR__ NO. o 0 0 7$•v 0 u with licensed contractors to construct the project (Sec- ADDRESS \ tion 7044, Business and Professions Code). TOTAL SETBACK FR0 7, 1 5-86 YARD HWY REQUIRED O CONSTRUCTION LENDING AGENCY SET BACK PROP. LINE WIDTH �+ I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name � LDMA Ref. q Lender's Address P.C.Fee$ Permit Fee �d 1 certify that I have read this application and state that the Issuance Fee �Dr SCJ LDMA P/C# Pool above information is correct. I agree to comply with all County Investigation Fee I ordinances and State laws relating to building construction, Total Fee 0 O LDMA Perm. # d and hereby authorize representatives of this County to enter $ u on th above-mentioq'd property for inspection purposes. a �� SEE REVERSE FOR EXPLANATORY LANGUAGE '' Sign t re of Applio or enf � DaJ ®�