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Home My Public Portal About6208 TEMPLE CITY BLVD_Building__ y ' APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN ING ADD ESS I hereby affirm that I have a certificate of consent to self insure, BUDDING ADDffSS ,T �' /_ give � �for a certificate of Workers'Compensation Insurance,or a certified `4O l -elk CILT^`�Fr copy thereof(Sec.3800,Lab.C.) iw CITY LL �i ZI l ( '7 g �� [L? OCALITY Policy No. r Company Q�C6+Q7TS CO. SIZE OF LOT I NO.OF BLDGS.NOW ON LOT 1-3 Certified copy is hereby furnished. I NEAREST CROS ST. Certified copy is filed with the ty building. spection TRACT BLOCK LOT NO. depa men USE ZONE MAP NO. Date Appli t �� ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE EXEMPTION FROM ORKERS' OW (�!R TEL_` /� /) / �y CO PENSATION INSURA 4 Cil T 'c- PTL t✓1% ,'1�. ;;IS 7—0�jiG J WITHIN 1000 FT.OF SCHOOL? YES NO (This s@ction need of be completed if the permit is for one hundred ADpRE;S r v / DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY dollars($100)or ss.) IFCJ cT 11L I certify that in the performance of the work for which this permit CITY -) 17 L ' is issued, I shall not employ any person in any manner so as to ti become subject to the Workers'Compensation Laws. ARCHITECT R ENGINEER TEL NO. STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO.t-42 4 DWELL UNITS NOTICE TO APPLICANT If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CONTRACTOR w TEL NO. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith olow C�/sS a"aw 301a 10 FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL 1*9 LICENSED CONTRACTORS DECLARATION � ' IIS "� NA-11D. 7,3%4 SIDE I hereby affirm that I am licensed underprovisions of Chapter 9 CIT e�V` '`®1B uC.CLAS P L (commencing with Section 7000)of Division 3 of the Business and s0.FT.SIZE NO.OF STORIES NO OF FAMILIES SEWER MAP a Professions Code,a d my lice n a is in full force and effect. NEW ❑ BK PG `C DES RIPTION OF WORK VALUATION License Number � Lic.Class ADD ❑ o: (gB,&P.C. Date It • ALTER ❑ $ ®® � ®� L p LL • al REP P• REPAIR a 7for er e . $ rr so �P L)C 0 17.49 , DEMOL ❑ z LDMA P/C# Date: USE OF EXISTING RLDG URM ❑ Signature e C-9— P ICANT(PRINT) TEL NO. LDMA Perm# ❑ 1,as owner of the property, or my employees with wages as AD ESS FUt, A. 7 —C 6 S ZO their sole compensation, will do the work and the structure is �7— I not intended or offered for sale (Section 7044, Business and Zl 0 ! 6 1 V FINAL DATE a ^�i�_.; ;�T.2 Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIALEl 1,1, as owner of the OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE property, am exclusively contracting 44, AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? Q FINAL BY —,.y- licensed contractors t0 construct the project (Section 7044, YES❑ NOX =•� 2 Business and Professions Code.) 7� , WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING .r - OCCUPANT _ oiu OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMDI SEE PERMITTING CHECKUST FOR GUIDELINES CHANGE o 1.IJ I hereby affirm that there is a construction lending agency for YES❑ No Tv the performance of the work for which this permit is issued(Sec. ��/ VVV TA I HAVE READ THE HAZARDOUS MATERIALS INFO ON GUIDE AND THE SCAOMDPERMITTING _�. * N 3097,CIV.C.) CHECKLIST I UND STAND MY REQUIREME R THE LOS A QES COUNTY CODE, I-I{I[I-1� 11$('( t j TITLE Z CHAPT 0 SECTIONS 2 UN- Lender's O ING HAZARDOUS L Lender's Name MATER R G AND FOR OBTAININ IT OMT CAQMD. i'77 ft �r o S o Lender's Address 61 p 0WVE NT cI certify that I have read this application and state under penalty of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE N wit county ordin nces and State laws relating b 'Iding Q m nstruct n, and her authorize representatives of is unty (ISSUANCE FEE / �® ato ant utl n the abov - n' ned propert t' n pu a (� (0 INVESTIGATION FEE TOTAL FEE O /I Avprc�nl ar AwlON SEE REVERSE FOR EXPLANATORY LANGUAGE APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATIONFOR APPLICANT TO FILL IN suILD r A JfJss` I hereby affirm that I have a certificate of consent to self insure, BUILDI gRES� / @( or a certificate of Workers'Compensation Insurance,or a certified ' copy thereof(Sec.3800,Lab.C.) CITY �` Z Policy No. Company t° `�r� � // E740 l7 LOCALITY SIZE OF Lrfr NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. NEAREST CROSS ST. ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. USE ZONE MAP NO. Date Applicant ASSESSOR I PAGE PARoCE� V SPECIAL CONDITIONS `\ CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER /� ( r rICO. • U COMPENSATION INSURANCE P is RGk W F� WITHIN 1000 FT.OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred ADDRESS dollars($100)or less.) 152/� e ,f DISTRICT GROUP TYPE CONST. K PROCESSED BY CITY ZIP I certify that h the performance of the work for which this permit , /e C-fit 9 7 o— 7 � O� , is issued, I shall not employ any person in any manner so as to ARCHITECT O ENGINEER TEL NO. ��// become subject to the Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject t0 the Workers' CONTRACTOR TEL NO. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. p L LICENSED CONTRACTORS DECLARATION SIDE CRY LIC.CLASS PL I hereby affirm that I am licensed underprovisions of Chapter 9 a (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF ST RIES NO.OF FAMILIES SEWER MAP Professions Code,and my license is in full force and effect. � NEW ❑ BK PG ® v ADD License Number Lic.Class DESCRIPTION OF WORK CC ❑ VALUATION Q Contractor Date Paw" Fz ALTER $ Ate- w la me/ CGO -, ❑ I am exempt under Sec. EPAIR ❑ � � BAP.C.for this reason -® MeVfeA, e , 10,C4 l-90 DEMOL J& USE OF EXISTING BLDG. URM El LDMA P/C# Signature RL �- APPLICANT(PRINT) TEL NO. LDMA Perm# ' n- I,as owner of the property, or my employees with wages as Z -�=o their sole compensation, will do the work and the structure is ADDRESS O not intended or offered for sale (Section 7044, Business and FINAL DATE Q _i"IAit:7t E_ .1 J WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL = Professions Code.) •�'�� OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE ❑ 1, as owner of the property, am exclusively contracting With AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? ((J_._ licensed contractors to construct the project (Section 7044, FINAL BY \` , c VES❑ NO❑ Business and Professions Code.) =_l_t_j_-?_l1i1•` ?;' y} ;;+ WALL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING ' OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUAUTY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR qqqq ~� `' + IWI t1•a�1 GUIDELINES I hereby affirm that there is a construction lending agency for YES❑ NO❑ I� 1 athe performance of the work for which this permit is issued(Sec. 0 I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING N 3097,CIV.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, TITLE 2.CHAPTER 2 20 SECTIONS 2 20.100 THROUGH 2 20.140 CONCERNING HAZARDOUS Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. o Lender's Address O OWNER OR AGENT oI certify that I have read this application and state under penalty of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE 42 Pr A N L/ with all county ordinances and State laws relating to building construction, and hereby authorize representatives of this County ISSUANCE FEE, b' to ter upon the above-m tinned property for inspection purposes. L, `f q�1 , INVESTIGATION FEE TOTAL FEE i'X saNn=ol AM SEE REVERSE FOR EXPLANATORY LANGUAGE APPLICATION FOR PERMIT Ty ajETARTMEN'T OF BUILDING AND SAFE C WM. J. FOX. CHIC'F ICNGINCCR OUNTY CIF LOS ANGELES 6'.N DISTRICT NO. PLAN COC. NO, PKRMtT NO. CJP lILQCl' ------ "0**p E;�=I ORTBACK LINK rifte APPROVED [-20"llt T9 RECEIVED ov DATE OF APDL. DATKI89UZO USK:f e7:1 ,USK& APPROVED raw � 320 Ily,,.- DAT A111111CANT F I.I. Ii41 HEAVILY glall-AMED—POUTION_GNIX MAM2 ILDING ;6, g �.QSA�1:7Y_...L1 A � � NCARCOT ITATIR Tm still N2, I 2 MAIL APPRUS T91L. CITY NO. I %ICR91!2Y ACXMOWL9DG9 THAT 8 MAVIS READ THIS v APPLICATION AND GTATIC THAT THE ABOV19 IS CORRECT STATIC TSL. AND ACRE& TO COMPLY WITH ALL COUNTY ORDINANCES LIC AND STATE LAWS REGULATING 13UILDIMG CONUTRUCTION. mf3x N2 N21 .i J L5 2) ~l GICHATURC or Lm ma, jil K OFF LOT OWN&R. NO.OF IDLDGS. AUTHORIZIZO ACT. :222&0 e J4 • ez-.tL Now QtLlmel 33Ar,-r 4'Ll3 - /3 z.--.— CORRECTIONS ust OF DLCI�G. N ON LOT 3 L• iA-a DESCRTIMON OF WORK Ulot air 0 Nirw .- TYPEEROUP m !Lq NO.Ov NO.OF ALTIRALTIoti ROOMS JIES size - IXPAIR .2c WALL OV RI (I C. cl �EMOAM ROOR NQ P.c OU XINA -'APPjft6VAL' !t FEZ .INSPECTOR' thi OAT -3 F1 re, S NAMIC DIVISION OF BUILDING AND SAFETY U I L Department of County Engineerty of Lm Angeles APPLICATION WM. J. FOX, COUNTY ENGINEER !dIlmawdlitalm" - FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTRICT NO. PLAN CK.OR Rea.No. BUILDING e -I-- e e ,�2ox 7 ADDRES13 a,4tt4 C;r, CEIVKD By DATE OF APPL. DATEIBSUIED LOCALITY KEARKST CROBB ST. BUILD N -) ADDRa � ,a r W_a-:)7� OWNER UV -fZe;Z,7 L c-12e v-_l LOCALITY I—, Cei 7' f MAIL NlEAREST DORE1313 CROSS ST. j2pntl TICL. P, L C IMAIL U D 0 R 3W 0 0 A I I A3 L R A R 3, N IL ADDRESS 0 E L K 8 ER I 2 EN IT rr I T 1313 3 Y CITY Le 7 _'p(j C�_t, No. FIRE NO.OF— 7 ZONE PLANS A HIT r TYT RDHITlEcT OW TEL. r —ENGINEER NIL BLDG. SETBAC "m AC LINE C M r ADORE.8 U13EX,.-&,. APPROVED TEL ZON Y DATE CONTRARACTO, NO. HOUSE NUMBERING ADDRESS MAP NUMBE D.3 NO. ASSIGNED BY LEGALCORRECTIONS DESCRIPTION LOT NO. BLOCK TRACT S-, '5TMY NO Or BLO180. SIZE OF LOT 90 X /-'IZ NOW OU LOT USE OF t6 %t4g4 I No.,cr —EXISTING BLDG. _.�& FAM LIcs j 0 DESCRIPTION Or WORK ✓ 11", R S" ADDITI ,I ?X-6��_ > NEW ALTERATIONI REPAIR'.) DEMOLITION SIZE FT. No OF SIZE A f) ROOMS I STORIES W/?v 0 n,) iForf EXT.WALL I Roor COVERING -A6-4�� —013VERING USE OF STRUCTURE 1 ) 91 I v //o 4 3 4415 A M_ A APPROVALS INBPECTION FOR tJ INSPECTOR'S SIGNATURE DATE OCCUPANCY AS FOUNDATION: LOCATION FTIRM96 MATERIALS IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FIRE STOPS, PLICATION AND STATE THAT THE INFORMATION GIVEN 18 FRAME: CORRECT. BRACING,BOLTS IAIREE TO COMPLY WITH ALL CmumTy ORDINANCES FURNACE: LOCATION, AND STATE LAWS REGULATING BUILDING CONSTRUCTION. GAS VENT ,_DUCTS SIGNATURE or LATH, INT. PER.,TTEE LATH, EXT. ADORE PLASTER, INT. AUTHORIZED AST. PLASTER, IOCr. P.C.0 HousENUMBERCOR- FEE RECT AND POSTED VALUATION )IWO FEE F'IFiAL JT121 52 76AG38A DOS 3 I-S2 ;GA859A CE#60311.87 APPLICA'T'ION FOR BUILDING PF;RM1.T' '1• COUNTY- OF "LOS ANGELES BUILDING ' DEPARTNIENNT OF COUNTY ENGINEER ADDRESS a BUMDING=AND SAFETY DIWSION LOCALITY I JOHN A.LAMBIE.COUNTY ENGINEER " NEAREST i CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST. DI= GROUP TYPE - EWER MAP FOR APPLICANT TO FILL IN --els -r G CONST, BUILDING ADDRESS 6208 Teinple City Blvd. STATISTICAL CLASSIFICATION I CLASS.NO.&aDWELL.UNITS ® AI LOT NO. 3 --, Y�._ (ufBLOCK YES O . � MAP STATE TRACTRancho San Francis into NUMBER HWY. USE ZONE SPECIAL NO.OF BLDGS. 2 CONDITIONS SIZE OF LOT 7� NOW ON LOT "USE OF EXISTING BLDGDwelling.& Storage Bldg, BUItD NG. EXIST. SETBACK YARD HWY STREET NAME WIDTH OWNER Edwin. A. Sanders FRONT y. npDREss 6208 Temple City Blvd. P L. ) SIDE CITY Temple City N 't 61585 P.L. 00, ARCHITECT OR TEL. INSPECTION RECORD ENGINEER NO. ADDRESS � CONTRACTOR Marshall Blds. N '1 30910 ADDRESS8428 Melrose Place LA 46 DESCRIPTION OF WORK NEW X ADD ALTER REPAIR DEMOLISH /�� 0z ilrp.Al f* R// SQ.FT. 36- NO.OF ]� NO.OF l A AA_r/9 !1/lD Q/ SIZE STORIES FAMILIES USE OF STRUCTURE -Detached Garage r SIGNATURE OAPPROVALS APPLICANT"Marshall Builders 842.8; Melrose Plabe LA 46 , DATE INSPECTOR'S SIGNATURE ADDRESS FOUNDATION: LOCATION FORMS,MATERIALS $ P.C. $ FRAME: FIRE STOPS. FEE BRACING,BOLTS /a�.1��L►d VALUATION / $ FURNACE: LOCATION, Iffinegm :�mj FEE GAS VENT,DUCTS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH,INT. PLICATION ANAGREE TO D STATE THAT ,THE�ABOVE IS CORRECT AND J STATE LAWS l £alit°A9�QP16,L L4G11TI �7UCTINCES AND ON. LATH,EXT. ..'� �Idd.�Id SIGNATURE OF ° HOUSE NUMBER COR- PER.mITTFw RECT AND POSTED ADDRES 8428 Melrose ace LA 46 FINAL - `"S CLYDE N.DIRLAM,PRINCIPALISTRU_QTURAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION c1c n°.o, CASH . X01:2 $' 20=0 DEC 23 1 A 006-00 ;F