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Home My Public Portal About6243 TEMPLE CITY BLVD_Building__ GITYo�"T� MPL� C /TY n TeAeseA cE+eoa �67 APPLICATION FOR BUILDING PERMIT u COUNTY OF LOS ANGELES f ILDING DEPARTMENT OF COUNTY ENGINEERDRESS PCE C/T BUILDING AND SAFETY DMSIONCALITY pL CiT JOHN A LAMBIE, COUNTY ENGINEERAREST COLEMAN W JENKI NS, SUIT of BUILDINGOSS ST FOR APPLICANT TO FILL N TRICT NO GR P TYPE sseD By Print 0, a GGI �, Q CONS BUILDING / /e �C/}'�/ ST5-, NO ATISTFCAL CLASSDWELL UNITS BK SPG ADORES$ (G (z LOT NO BLOCK ZONE MAP NO TRACT SPECIAL NO OF BLDGS CONDITIONS S1ZE OF LOT .S O NOW ON LOT USE F EXISTING BLDGDG SETBACK FROM NNOL .� ONT PROP LINE OF (STREET) TYPE OF EX ISTIN SETBACK HIGHWAY YARD = TOTAL ADDRESSjq cm S HIGHWAY WIDTH FROM C L } _ CITY No,, O✓/ BLDG SETBACK FROM ARCHITECT OR TEL SIDE PROP LINEOF —STREET) ENGINEER NO TYPE OF EXISTING SETBA HIGHWAY } YARD = TOTAL ADDRESS HIGHWAY WIDTH P L TEL CONTRACTOR O } ADDRESS O NER CUTOFF YES ❑ NO ❑ V C c1Tv classCD SEE REVERSE SIDE FOR SPECIAL APPROVALS DESCRIPTION OF WORK C7 NEW ADD ALTER REPAIR DEMOLISH SO FT NO OF NO OF SIZE STORI S FAMILIES USE OF STRUCTURE 44 SIGNATURE OF APPLICANT VALUATION S 3Dp� APPROVALS DATE INSPECTOR'S SIGNATURE P C PMT Q QQ FOUNDATION LOCATION FEES FEE S / FORMS MATERIALS FRAME FIRE STOPS I HEREBY AC RNOYfLEDGE THAT I HAVE READ THIS APPLICATION I BRACING BOLTS AND STATE THAT THE ABOVE Ie CORRECT AND AGREE TO COMPLY l FURNACE LOCATION WITH ALL COUNTY ORDINANCES AND STATE awe REGULATING GAS VENT DUCTS BUILDING 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, INO TO WORKMEN S COMI ENVA ION INSURANC --E` LATH EXT SIGNATURE O HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS FINAL PLAN CHECK VALIDATION CK wo CASH JOHN F LEWIS PR INCI AL STR RAL ENGINEER PERMIT VALIDATIONcK wo CASH LAL.0 4 7-; APR 19 1 D 9.00- IN (REV 11/78) APPL ICAT I01 FOR BISTLDING/PERMIT llliii COUNTY OF LOS ANGELES BUILDING AND SAFETY �/^�� ^ FOR APPLICANT TO FILL IN ADILUINU 'V DRESS ((/aT C ! / //� DING /Y DDRESS v V 1� LOCALITY C� NEAREST y CITY LE / IP CROSS ST C NO OF BLDGS ASSESSOR 51ZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE P ESSED BY TRACT BLOCK LOT NO/� �7 CONST Z OWNER EL-G-ARP TEL �tOO/ �O STATISTICAL ICATION SEWER MAP ADDRESS E LE r +- U !J -- (� ''ll CLASS NO DWELL UNITS B&L CITY Elµ Le C \ ZIP MA u ARCHITECT OR TEL VALUATION $ ��a ENGINEER NO ADDRESS BLDG SETBACK FROM TEL FRONT PROP LINEOF �� (STREET] CONTRACTOR NO HIGHWAY } YARD _ TOTAL SETBACK FROM TYPE6F EXISTING LIC FRONT PROP LINE HIGHWAY WIDTH ADDRESS + /� /� LIC CITY CLASS NAME ALI LENDER BLDG SETBACK FROM NAMEAND BRANCH ANCH SIDE PROP LINE OF ]STREET] HIGHWAY } YARD TOTAL SETBACK FROM TYPEOF EXISTING ADDRESS CITY SIDE PROP LINE HIGHWAY WIDTH SO FT Y01a NOF NO OF CHECK + = V SIZE STORIES FAMILIES ONE USE ZONE MAP DESCRIPTION Of ORK NEW NO �K7 SPKIAL R A TI U oG F ADD 1 CONDITIONS ADA S X N IZOoF ALTER FINAL BY REPAIR DATE I( / 74) EXISTING e ^� DEMOL EXISTTING BIDG Z APPLICANT TEL ,^ 2 (PRINT] /-�, E FKE£ R NO -too, fiVd �o BY 15IGNATURE) _ ; IHEREBY ACKNOWLEDGE THAT I HAVE THIS APPLICATION AND STATE u� THAT THE ABOVE IS CORRECT AND A COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING C N I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIAN TING iO WORKMMMjjj[NHl S COM 7, PENSATK>J I NSURANCE SS /(::�r �7589A SIGNATURE OF PERMITTEE # . N• . . 1 E ADDRESS L L E TEL ,+ 2,• • 34.00 CITY ry NO _ 07 • • 3400c�i PC Fee$ PefmrtF _ > 1 105-79 Issuance Fee Total Fee - DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES ® ' ® � WM. J. FOX. CHIEr ENGINEER U NG FOR APPLICANT TO FILL IN �� FOR OFFICE USE ONLY BUILDING _ DISTRICT NO -i PLAN CK NO PERMIT MO ADDR[nH 3 S f I39 LOCALITY RECEIVED BY DATE Or APPL DATE ISSUED / NEAREST v�S 6 I (- SLIMING OWNER ADDRESS MZ3 4 AIL y/ LOCALITY5:6 7 I L ADDRESS // • TEL NEAREST CROSS STCITY Z 40 /-U E ARCHITECT OR TEL ZONE -� PLANS` TYPE )/ ORO P ENGINEER NO Y BLDG ORD NO ADD SETBACK LIN[ 1 APPROVED TEL CONTRAOTDStejoeI NO C9 BY DATE ADDRM3 UEE APPROVED ZONE BY DAT[ LEGAL CORRECTIONS ' DESCRIPTION LOYND B /LOCK TRACT / (� BIZ[OF LOT X/ Z NOW ON LOT unit or NO Orr NO OTS' W D21 -FAM1094 ROOMS DESCRIPTION OF WORK Y NEW ALTERATION ADDITION -\ O a REPAIR MOVING DEMOLISH p s nize ROOMS STORIES > WALL ROOF r COVERING COVERING uSi Or NEW BUILDING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION LOCATION INSPECTOR DAT[ FORME,MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION ` FRAM[, rIRE STOPS. SIGNATURE Or BRACINGBOLTS P[RNITT[ LATH, INT JF AUTHORIZED AOT' LATH. EXT - TeA4'�A.a 9rP OD P C.• PLASTER.INT FEE PLASTER.EXT. vwiuwnoN r[E FINAL 37 YS DEPARTMENT OF BUILDING AND SAFETY 1 L-D 1 fV-G COUNTY OF LOS ANGELES WM. J. FOX. CHIEF ENGINEER APPLICATION _ FOR APPLICANT TO FILL IN FOR OFFICE-USE ONLY �7 1 r /� �y DIBTRI N6 PUN Cc OR R[a No PERMIT NO ADORERS Z LF_ C C!I z�r LOCALITY . PL-JE REC//41VED BY DATE OF APPL E DATE ISSUD NEAREST O/I'�/ N i-30 BUILDING �1 ADDRfSD OWNER .MR f. R/ M , COR-r LS LOCALITY MAIL ADDRfae 9 P M ir OW BY C Lb r4G D 6/v O No E FIR[ MO OF TYP GROUP ZONE �� PLANR ENGARCINEER OR TEL _ ENGINEER BLDG b - BETUACK LINE CC TC, LVv 1 44 ADDR UBCAPPROVED TEL ZONE BY I DAT[ CONTRACTOR NO HOUSE NUMBERING ADDRESS MAP NUMBER-ZOD3 ANO ASSIGNED BY LEGAL CORRECTIONS DESCRIPTION LOT NO F BLOCK _ TRACT 137 NO Or size OF LOT I NOW ON BLCT 2 ,�/, 'L--z P",Y"c Cj nii' d N FR e%IEBTIN BLDG RAS -T 9-»R FA. Ll" / DESCRIPTION OF WORK °a NEW ALTERATION ADDITION X -7 C f't T F/ ef�l< REPAIR DEMOLITION r RD FT NO OF BIZ[ ROOMS STORIES DOVERIND J/D) N( COVERING ( OMJ)• USE OF RUCTUp[ INSPECTION FOR APPROVALS OCCUPANCY AS INSPECTORDDIDNATURE DATE FOUNDATION LOCATION FORMS, MATERIALS 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- PLICATION AND STATE THAT THE INFORMATION GIVEN IS FRANC FIRESTOPE6 CORRECT BRACING, DOLTS i O 1 AGREE TO COMPLY WITH ALL COUNTY OR INANOCB FURNACE LOCATION, AND STATE LAWS REGULATING BUILDING CON UCTION GAS VENT DUCTS SIGNATURE OF A, A LATH. INT � LATH. O(T 1VC ADDREB C7 PLASTER, INT AUTHORIZED AGT PLASTER, CCT. 2-100-7-. n D/DDDE HOUSE NUMBER CDR- RCCT AND POSTED VAWATIGN EEFINAL TaA�A RSR, 7!1 76AGSBA CCOSOS B-ST ✓/71� riLV �(/ . APPLICATION FOR BUILDI G PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS �Er IF BUILDING AND SAFETY DIVISION LOCALITY JOHN A LAMBIEI COUNTY ENGINEER COLEMAN W JENKINS, SVrT OF BVILDINO NEAREST / CROSS ST DISTRICT NO GR TYPE BY FOR APPLICANT TO FILL N `� d CONST % � ° Pn Rt.r . .GI c7 t/ BUILDING STATISTICAL CL SIFICATION SEWER MAP ADDRESS �e� J CLASS NO DWELL UNITS_ BK PG LOT NO BLOCK USE ZONE MAP NO TRACT SPECIAL NO OF BLDGS CONDITIONS SIZE OF LOT NOW ON LOT USE O EXISTING BLDG BLDG SETBACK FROM TEL ONTPROP LINEOF (STREET) OWNER NO TVP F ISTING SETBACK NIGMWAV } YARD = TOTAL ADDRESS NIGHW WIOTX FROM C L } CITY ARCHITECT OR TEL BLDG SETBACK F ENGINEER NO SIDE PROP LINE OF (STREET( TYPE ISTIHG SETBACK HI V } YARD = TOTAL ADDRESS p HIGHWAA Y WIDTX FROM C L CONTRACTOR $�/ON NOTEL Ht-& T } _ LI O ADDRESS CORNER CUTOFF YES ElNO t..O C CITY CLASS C- SEE REVERSE SIDE FOR SPECIAL APPROVALS 13 DESCRIPTION OF WORK a N Z NEW ADD � ALTER DEMOLISH SO FT NO OF NO OF S1ZE STORIES FAMILIES USE STRUCTURE Peg/dZ,/N d6I ! B7 *3'0— SIGNATURE APPLICANT VALUATIO APPROVALS DATE INa PE OR a 514 T D P C PMT FOUNDATION LOCATION FEES FEES . FORMS MATERIALS FRAME FIRE STOPS 1 HEREBY ACKNOWLE000 THAT 1 HAVE READ THIS AKuurmN BRACING BOLTS T AND STATE THAT THE ABOVE I. CORRECT AND AGREE TO COMPLY FURNACE LOCATION WITH ALL COUNTY ORDINANCES AND STATE LAW. REGULATING GAS VENT DUCTS SU ILOINO CONSTRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED HERO SY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT TION OF THE LABOR CODE E STATE OF R!1' IIA RELAT ING TO WORKMEN SATION E LATH EXT 1 SIGNATURE O HOUSE NUMBER COR- PERMITTEE POSTED ADDRESS FINAL �j JOHN �Fp�LEWIS PRINCIPAL STR RAL ENGINEER PLAN CHECK VALIDATION CK NO CASH PERM( VALIDATIO CK M O CASH LA�o4 3 5 1S APR 22 1 D 9.00- Q DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OFLOS ANGELES BUILDING A I !L�' 1 WM J. FOX. CHIEF ENGINEER G V FOR APPLICANT TO ML IN FOR OFFICE USE ONLY BUILDING DISTRICT NO PLAN`O PERMIT NO ADDRE88Mid Jrs- 2 qlx/ 11 LOCALITY REC/EN.y'ED BY DATE OF APFL DATEISBUED NEAREST J% J —�� J CROSS ST BUILDING ADDRESS (. 3 /V t/-n •e �IT OWNER MAIL , LOCALITY r" -e C , ft, ADDRESS NEAREST LL TEL. CROSS BT ft O- l'y CITY I NO 5 FIRE NOOF TYPE V GROUP ARCHI CT OR TEL ZONE PLANE ENGINEER i NO BLDG ORD NO SETBACK LINE ADDRESS APPROVED TEL BY DATE CONTRACTOR NOUBe N 2 APPROVED ZOE BY DATE ADDRESS u HOUSE NUMBERING LEGAL DESCRIPTION LOT NO . BLOCK MAP NUMBERFIELD CHECK BY TRACT NO ASSIGNED BY DAT NO OF BL GS CORRECTIONS SIZE OF NOW ON LOT Usmor NO OF EXISTING BLDG FAM,UKu DESCRIPTION OF WORK NEW I ALTERATION I I ADDITION O REPAIR DEMOLITION T SG FT NO OF SIZE ROOMS STORIES EXT WALL ROOF T' COVERING J / rJ COVERING &o— 0 USE OF STRUCTURE N1� r-tiL APPROVALS INSPECTOR 5 SIGNATURE DATE I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FOUNDATION LOCATION r PLICATION AND STATE THAT THE INFORMATION GIVEN IS FORMS, MATERIALS V CORRECT 1 AGREE TO COMPLY WITH THE CORRECTIONS LISTED FRAME FIRESTOPS, HEREON AND WITH ALL COUNTY ORDINANCES AND STATE BRACING BOLTS LAWS REGULATING BUILDING CON RU ON FURNACE LOCATION. SIGNATURE OF GAS VENT, DUCTS P[RMITTBF /// jQ� it LATH, INT ADDRESS LATH. EXT AUTHORIZED AOT PLASTER, INT TCApEA oW t0-w s d P C ® d FEE �• P ER. EXT VALUATION FEE FINAL MAXIMUM A CUAIPLISHED 8. 15-51 ,• WORKERS COMPENSATION DECLARATION 1 hereby affirm that I have o certificate of consent to ra ,elf — APPLICATION FOR BUILDING PERMIT insure or a certificate of Workers Compensation Insurance I v or a certified copy thereof (Sec' 3800 Lob C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company- Certified copy is hereby furnished FOR PLI NT TO FILL IN P�DID u T L Certified copy is filed with the county budding mspec BUILDING hon department r s / AOO�rSS Date Applicant / CITY ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS - _ NO-OF&DGS - - NEAREST COMPENSATION INSURANCE / SIZE OF LOT Now ON LOT CROSS ST (This section need not be completed if the permit is for one - - - ASSESSOR ' hundred dollars ($100)or less ) TRA K LOT MAP BOP( _ PAGE' PARCEL TEL USE ZONE I certify that in the performs of the ark f titch this � O 7 } permit is issued, 1 shall not ploy any n i a y manner / Ill 3 SPECIAL IL O so as to become subject t e Wo r s Compen tion Laws RE V� CONDITIOfJS u Da -� CITY —77/,C? BL NOTICE TO APPLICANT If er making this ote of , ARCIF OR L DISTRICT GROUP TYPE FIRE PROCESSED BY O HFE Exemption you should b ome subject to orkers' CONS ZONE G Compensation provisions the Labor Code ou ust forth- ADDRESS ` .-11 Trd with comply with such provisions or this permit shall be deemed revoked I CONTRACTOR Np STATISTICAL CLASSIFICATION APT CONDO N? 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 VALIDATION SO FT NO OF _ NO OF CHECK BK PG Laronse Number Lic Class SIZE STORIES FAMILIES ONE z NEW VALUATION Contractor - Date ION OF WORK /r f/9r f ADD , I am exempt under Sec - ALTER B BP C for this reason ! ! REPAIR $ - Date USE FUXOF BLDG �iK DEMOL I Signature - APPLICANT TE FINAL DATE /± -99627A OWNER-BUILDER DECLARATION PRINT NO (0-17_'8 I hereby affirm that I am exempt from the Contractor s License Law for the following reason (Section 7031 5 Business and CRESS FINAL- Professions Code) "' i By -U �• - 9675 D - I as owner of the property, or my employees with BUILDINGc�i wages their sole compensation will • • • 9-6 7 5 l o the work and ; the structure for is not intended or offered for safe(Section LOCALITY 0 3, 1 2—8 4 - 7044 Business and Professions Code) - MOVING � - TEL - I as owner of the property am exclusively contracting CONTRACTOR NO with licensed contractors to construct the Project (Sec- ADDRESS tion 7044, Business and Professions Code) ' CONSTRUCTION LENDING AGENCY REOuIRSETBACK FR SET BACK YARD HWY TOT PROP LINE WIDTH I hereby offum 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 — 8 PL - Lender s Name �� LDMA Ret N ' Lender s Address PC Fees Permit Fee PF I I have 5oq this application and state that the - Is.uance Fee D tDMA P/C N above info tion i t I agree to comply with all County Investigation Fee ordinance and St t relating to budding construction d and her y autho a esentatives of this County to enter Total Fee LDMq perm N u th above-men oned property r i pection purposes - - � fid fEVElSE X� FOS EIANATORY IANGUAO! Signature 0 p t or Agent Date WORKERS'COMPENSATION DECLARATION _ 4 hereby affirm that 1 have r certificate of tionconsent to self APPLICATION FOR BUILDING PERMIT insure are copy atethe of Workers 0, Lob Compensation Insurance, ar a candied copy thereof (Sec 3800, Lab C ) � - COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company Certified copy is hereby furnished BUILDING FOR APPLICANT TO FILL IN ADDRESS Certified copy is filed with the county building inspec- BUILDING // yy7� hon department ADDRESS[O 10/_ LOCALITY NEAREST Date Applicant CITY ZIP CROSS Si CERTIFICATE OF EXEMPTION FROM WORKERS NO OF&DGS i1 ASSESSOR COMPENSATION INSURANCE SIZE OF LOTNSA NOW ON LOT .Ci MAP BOOK I PAGE PARCEL (This BLOCK section need not be completed if the permit is for one TRACT LOT NO USE ZONE NO hundred dollars($100)or less ) 1 TEL SPECIAL T I certify that in the performa of the ork for his OWNER .y NO CONDRIONS G• permit is issued I shall not a ploy any n in to ner DISTRICT GROUP TYPE FIRE PROCESSED BY 'so as to become subject t e War ompen io WS SS 1 � CONST Z E Lin/ ZIP D /J `QOte tic ARCHITECT OR �y�` 7 O ATISTICAL CLASSIFICATION CONDO O / NOTICE r making t rficar f V Exemption, you should me subject to the W ENGINEER NO CUSS NO DWELL UNITS_ W a Compensation provisions the Labor Code you mus Orth- ADDRESS SEWER MAP Z with comply with such ovisions or this permit shall be deemed revoked TEL CONTRACTOR j, BK PG VALIDATION LICENSED CONTRACTORS DECLARATION LIC I hereby off cm,that I am licensed under provisions of Chapter 9 ADDRESS NO VALUATION (commencing with Section 70DO)of Division 3 of the Business and LIC Professions Code and my license is in full farce and effect CITY CLASS $ , SQ FT tJ0 OF NO OF CHECK License Number Lic Class SIZE STORIES FAMILIES ONE $ ' Contractor Done DESCRIPTION OF WORK a NE ❑❑ ADD 1 am exempt under Sec TER DLATEL �iis e 2 3 B 8P C for this reason s REPAIR '� Dote OFEXISTING BLDG 09' DEMOL B NAL Q J Signature APPLICANT TEL Y Z, 2 8 5 OWNER-BUILDER DECLARATION PRINT NO i ie,e i 0 J i 1 hereby affirm that I am exempt from the Contractor's License pole0 0 0 2 8 Q .- Law fa the following reason (Section 7031 5, Business and O iz'2 7-84 Professions Code) I, of owner of the property or my employees with BUILDING ADDRESS wages as thea sale compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 7D", Business and Professions Code) MOWNG�� TEL I,as owner of the property am exclusively contracting with licensed contractors to construct the project (Sec CONO COORF55 hss on 70" Business and Professions Code) REQUIRED TOTAL SETBACK FROM EXIST CONSTRUCTION LENDING AGENCY sET ggpj YARD Hwy_ — WIDTH , L hereby affirm that there is a construction lending agency for FRONT PROP LINE the performance of the work for which this permit is issued P L JSec 3097, Civ C ) SIDE - PL ' Lender s Name Larder s Address P C Fee{ Permit Fee ®� �y I certify that I have t u application a d stats that the Issuance Fee ation is c I agree to comply with all County Investigoilan Poe ordinan and Sta relating to building construction, Total Fee and h by author rs esentatives of this County to enter upo ve-rd6riti ad property for sony n purposes k ��y sff R9VQfi FOR IMPIANATORY LANGUAGE - gnature o Applin Agent Date ms WORKERS COMPENSATION DECLARATION hereby affirm that I have certificate of tint to self APPLICATION FOR BUILDING PERMIT insure, or o certificate of Workers Compensation on Ins}irance or a certified copy thereof (Sec 3800, Lob C ) COUNTY OF LOS ANGELES I BUILDING AND SAFETY Policy No Company BUILDING L� Certified copy is hereby furnished FOR APPLICANT TO FILL IN ADDRESS Certified copy is filed with the county building inspec BUILDING y� hon department s ADDRESS G TC/ ht 6 kwti LOCALm - Date Apphcam y CITY NEAREST ea Z 7 D CROSS ST CERTIFICATE OF EXEMPTION FROM WORKERS' / NO OF SLINGS ASSESSOR COMPENSATION INSURANCE SIZE OF LOT 749/ NOW ON Loi MAP BOOK PAGE PARCEL (This section need not be completed If the permit Is for one TT BLOCLOT NO USE ZONE NNO RACO a OO 3 hundred dollars ($I00)or less ) _ TEL SPECIAL j. I certify that In the perfgemp the w or i thu OWNER NO CONDTIONS d permit Ii Issued, I shall nny pe in y neer ADOItE55 DISTRICT GROUP COMST ZIP B Q so as to become aubja eri pensot n Laws - a 0 Dat ARCHITECT OR CjTy ZIP TEL STATISTICAL CLASSIIFFIIC'ATION- APT CYXJDO O NOTICE TO APPLICANT If offer mold g this Corti r • of ENGINEER NO CLASS NO -2/ UNITS_ Exemption, you should ome subject to th orkers' d Compensation povisio of the Labor Code y st forth- ADDRESS SEWER MAP with-comply with s provisions or this p mit shall be TEL / L ? deemed revoked CONTRACTOR NO - SK GPO, a' " VALIDATION LICENSED CONTRACTORS DECLARATION V LIC I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS VALUATION (commencing with Section 7000)of Division 3 of the Business and Professions Code and my license is in full force and effect CITY LASS $ , SO FT OF CH License Number LIC Class SIZE DRIES FAMIL Contractor Dote IPT ADO I am exempt under S" ALTER FINAL B&P C far this reason REPAIR DATE 7� USE OF y� FINAL Date ExisriNG BLDG /14' DEMa By r Signature nwvn TEL OWNER-BUILDER DECLARATION PRIM NO I hereby affirm that I am exempt from the Contractors License , Low for the following reason (Section 7031 5, Business and Professions Code) 1, as owner of the o y employees ORDING 0'J �' Q prop", or m em to with ADDRESS wages as their sole compensation,will do the work and the structure is not Intended or offered for sale(Section LOCALITY 7041, Business and Professions Code) MOVING TEL i - 2850 1 as owner of the property, am exclusively comrocting CONTRACTOR NO ° ° ° 2 R 5 0 Cx with licensed contractors to construct the project (Sec ADDRESS tion 7041, Business and Professions Code) �ou CONSTRUCTION LENDING AGENCY SET BA217-84 CIDL YARD tTWY TOTALP�CK FROM EXIST H I hereby affirm that there Iso construction lending agency for FRONT ► the performance of the work for which this permit is Issued P L (Sec 3097, Civ C ) SIDE 3 Lenders Name 8 Lenders Address P C Fee S Permit Fee !/ 4agne r this hcation and state that the Issuance Fee O Is I ee to comply with all CounHInvesigation Fee to I Ing to budding construction, Total Feer rep tatives of this County to enter opshon aperty fort ctionpurposes /� fE!RiV9Sf FW U(►LANAT0111'IANGUA6E Applicant or nt Date f WORKERS'COMPENSATION DECLARATION �L 1 hereby affirm that I have r certificate Comp of consentInt to self APPLICATION FOR BUILDING PERMIT LI IS msue�'or a rertrfimte of Workers' Compensation Insurance, or ocbmfieacopy thereof (Sec 38W, Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company BUILDING Certified copy is hereby furnished FOR APPLICANT TO FlU. IN ADDRESS ❑ Certified copy is filed with the county budding mspec BUILDING , non department ADDRESS 1 LOCALITY NEAREST Date Applicant CITY ZIP CROSSS CERTIFICATE OF EXEMPTION FROM WORKERS' OF BIDGS ASSE COMPENSATION INSURANCE SIZE OF LOT5�9 Now OfJ LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one TRACT BLOCK LOT NO U NONE P hundred dollars ($100)or len ) TEL SPECIAL I certify that in the performance of work far i is OWNE tJ0 CONDITIONS d permit is issued, I shall not employ y non i er D ICT UP PE FIRE PROCESSED BY O w as to become wbjer,t to the oat an sus ADDRESS IC' NST _.s-r ZONE cc Date�Applit ARCH OR CITY / ZIP / 8Q STATISTICAL CIAS��54FK-AjTION O TEL Exemption, TO APPLICANT If, she making th s Cist1n is cat ENGINEER NO CLASS NO�.¢�DWELL UNITS_ W ' Exemption, you should beco a subject to rhe ty Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP Z with comply with such provisions or this permit shall be deemed revoked CONTRACTOR TEL BK PG VALIDATION LICENSED CONTRACTORS DECLARATION LC I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO VALUATION (commencing with Section 7000)of Drvaan 3 of the Business and UC Professions Code and my license is in full force and effect CITY CLASS f h,::)U loop. FT NO OF NO OF CHECK' License Number Lic ClassSIZE STORIES FAMILIES ONE Contractor Dote DESCRIPTION OF WORK NEW ❑ S ❑ I am exempt under Sec AW ALTER ❑ FINAL DATE B 8P C for this reason REPAIR ❑ USE OF ❑ FINAL ! Date EXISTING BLDG DEMOL FI Signature APPLICANT TEL By OWNER-BUILDER DECLARATION PRIM NO I hereby affirm that I am exempt from the Contractor's License , Low for the following reason (Section 7031 5, Business and Professions Code) BUILDING I, as owner of the property, or my employees with ADDRESS wages as their sale compensation will do the work and LOCALITY b:�- r the structure n not intended or offered for sole(Section 7044, Business and Professions Code) MOVING TEL _ ❑ I,as owner of the property am exclusively contracting CONTRACTOR NO with licensed contractors to construct the project(Sec- ADDRESS tion 7044, Business and Professions Code) CONSTRUCTION LENDING AGENCY SET BACK YARD HWY TOTAL SETBACK FROM LSETyDTH I herebyaffirm that there iso construction lending agency for FRONT the performance of the work for which this permit is issued P L (Sec 3097, Civ C ) SIDE PL m Lenders Name $ PC Fee S Permit Fee Lender s Address �y I cert, that I have r this bcation and state that the Issuance Fee O a on is ect I to comply with all County Investigation Fee o roan and S ows to ng to building construction Total Fee nd y outIn a rep Ives of this County to enter upon obpve- tioned Penn for in ion purposes SEE REVERSE FOR E1LPl/1WAT0lY LANGUAGE ignaNr of licant or Dote es COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1010250037 PHONE (626) 285-0488 EXT LEGAL ID NO OF CONST BUILDING ADDRESS ON FILE SQ FT STORIES TYPE 6243 TEMPLE CITY BL ISTRUCTURE 3000 V-B TEMP CA 917801750 ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET IAN®EN 5365-011-003 THOMAS PAGE 596 GRID J2 LOCALITY TEMPLE CITY, C TENANT EXIST BLDG USE REBID USE ZONE R-3 ISSUED ON PROCESSED BY EXIST OCC GRP 10/25/10 SR OWNER TEL NO BLDGS NOW ON LOT VALUATION FINAL DATE FINAL BY CODE FREEGARD ALICE R (626) 285-6007- 61000 (h?—(() / to .�YY1 6243 TEMPLE CITY BL — / m TEMP 917801750 FEES PAID DDESCRIPTION OF WORK ITEAR OFF AMID REROOF WITH COMPOSITION SHINGLES ]FEE DESCRIPTION QUANTITY DOM AMOUNT I APPLICANT TEL NO I SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27 80 AB STATE GREEN BLDG FEE 6000 00 VAL 1 00 SPECIAL CONDITIONS AC STRONG MOTION RESID 6000 00 VAL 0 60 ID2 PERMIT W/O EN-HC 6000 00 VAL 149 70 _ FEES 179 10 CONTRACTOR TEL NO (APPROVALS DATE INSPECTOR SIGNATURE , SANE AS OWNER - LIC NO I LOCATION AND SETBACKS SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER TEL NO FOUNDATION/TRENCH FORMS LIC NO SLAB UNDER FLOOR I I IRAISED FLOOR FRAMING MAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP (UNDERFLOOR INSULATION 153H265 3 OOI IFLOOR SHEATHING NO OF FAMIILI85 OWELuINC ONIT9 AYGOND STAT CUSS NO NO 21 ROOF 8H8ATHING SCHOOL WITHIN HAZARDOUS SHEAR PANELS AIR QUALITY 1000 FEET MATERIALS I NO NO NO (FRAME INSPECTION FIRE SPRINKLER HANGERS I IIHBUfATIDN/WEATHER STRIP IITPERIOR LATH/DRYWALL EXTERIOR LATH RATED FLOOR/CELL ASSEM RATED FALL ASSEMBLIES RATED SHAFTS OPENINGS IT-BAR CEILINGS (LOT DRAINAGE (REPORT ID DPP261 ROUTE TO BS0508