HomeMy Public PortalAbout6317 TEMPLE CITY BLVD_Building__ .e--APPLICATIONFc� QbUNTYOFLOSANGELES
DEPARTMENT
BUILDING PERMIT ULDINGANDSAFETYDIIVSIONK
FOR APPLICANT TO FILL IN AUDDRESS 1
BUILDING �1 T O(gLITY
ADDRESS 1
f� NEAREST
CITY \(� ZIPla) CROSSST
NO OF BLDG5 ASSESSOR
SIZE QF LOT NOW ON LOT MAP BOOK PAGE PARCEL
n //'' DISTRICT GROUP TYPE FIRE BY
TRACT .0 LO LOT NO �— tSy Q CON5T V/ jE
OWNER Y
CLASSIFICATION-�• STATISTICALCLASSIFICATIONSEWER^MAP/
ADDRESS 1 CLASS NO • DWELL UNITS BK d`-PBS
r ((T�-�
pTV `75 ZIP , USE ZONE O O3
ARCHITECT OR _ TEL
ENGINEER NO SPECIAL
ONDITIONS
ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO❑
TEL
CONTRACTOR NO BLDG SETBACK FROM
LIC FRONT PROP LINE OF (STREET)
ADDRESS NO HIGHWAY + YARD TOTAL SETBACK FROM TYPE Of EXISTING
LIC EF FRONT PROP LINE HIGHWAY WIDTH
CITY CLASS
CONSTRUCTION LENDER +
NAME AND BRANCH BLDG SETBACK FROM V
ADDRESS CITY SIDE PROP LINE OF (STREET) Q
$O FTNO OF NO OF CHECK HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING r
SIZE {�j-STORIES FAMILIES ONE SIDE PROP LINE HIGHWAY WIDTH 9
DESCRI ION OF 1d04L S NEW + Z
AE3 CORNER CUTOFF VES ❑ NO ❑
ALTER IN OPEN SPACE YES ❑ NO ❑
REPAIR
USE OF IN COASTAL PERMIT ZONE YES ❑ NO ❑
EXISTING BLDG DEMOL
APPLICANT
(PRINT) NO
-2-S
BY(SIGNATURE)
IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES
AND LAWS REGULATING BULDING CCNSTRUCTKIN I CERTIFY PMT IN DOING THE
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WoftwA I S COM
PENSADON INSURANCE
SIGNATURE OF J-kjFINAL �� BY
PERMITTEE DATE
ADDRESS
Qxq TEL P C Fee$ PermH Fee
CITY NO
Issu me Fee
VALUATION$ h O
V Total F
PLAN CHECK VALIDATION c1c r o CASH PERMIT VALIDATION CK o CASH
6 1 9�MAY 24 1 0 3 4.0 O_A`-a
(at 76"MACBI=1^8 77 ^
78A635A CERB09 SDS APPLICATION FOR BUILDING PEF3MIT, LJ
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST
WILLIAM A JENSEN SUR T OR BUILDING CROSS ST
DISTRI T Gfi011e SSED BY
FOR APPLICANT TO FILL IN CY ST
BUILDING STATISTICAL CLASSIFICATION S ER MAP
ADDRESS ��'
631 7AnqelesFRONT
CLASS NO DWELL UNITS_ BK P
LOT NOS• /' Q ATER NOT REQUIRED to RECEIVED
ERTIFICATE
TRACT AP HIGHw6r
NO ONO O ICIRCLEI STATE MAJOR SECOND OC L
SIZE OF LOT NOW SE ZONE SPECIAL
USE OF CONDITIONS
EXISTING BLDG
OWNER ILDING EXIST
ETBACK YARDHWYWIDT
ADDRESS Valle Blvd. E. LFRONTARCHITECT OR P LENGINEER SIDEP LADDRESS0
U
CONTRACTOR KADDRESS 600 SO. San Gabrie287-09
ab p
DESCRIPTION OF WORK
d
N
NEW ADD ALTER EPAIR DEMOLISH z
SO FT NO NO OF
SIZE STORIES FAMILIES
USE Reroof rear res. only, with
STRUCTURE
9 s ate. o K 5
SIGNATURE OF
APPLICANT
VALUATION E
APPROVALS DAT INpRECTOR 881GNATlIRE
PC PMT FOUNDATION LOCATION J 1
FEE $��- FEES FORMS MATERIALS I
FRAME FIRE STOPS
I HER Ker ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS /
AND STATE THAT THE ABOVE 15
CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS / f
SUILOING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT
TION OF THE LABOR OE OF THE STATE OF CALIFORNIA RELAT
IMG TO WORKMEN S CO NSATION INSIIFANC ` I
LATH EXT
SIGNATURE OF HOUSE NUMBER COR V
PERMITTEE RECT AND POSTED
Marcia en, ect y. 3
ADDRESS F NALAAj
JOHN F LEWI$ PRINCIPAL $T RAL ENGIN
PLAN CHECK VALIDATION CK M D CASH PERMIT VALIDATION :CKD NO CASH
I .0 8T1 6 O—� DEC20 1 D 4.00'"
7GA538A C9re033-54APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING /�/ �JO CY/
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY T G -
JOHN A LAMBIE COUNTY ENGINEER NEAREST
COLEMAN W JENKIN99UP T OF BUILDING CROSS ST
DISTRICT NOOR TYPE PROCESSED BY -
FOR APPLICANT TO FILL IN S10ITCH T�
p UILDING STATISTICAL SSI PI CATION SEWER MAP '
ADO R ESS 3/ CLASS NO �y_ UNI T9 9K EPG 2C
LOT NO A-0 A'- BLOCK USE ZONE MAP �f�0� C
NO f�V
TRACT ;� v ?� SPECIAL
NO OF BLDG$ Rr
SIZE Of LOT NOW ON LOT
USE Of l� j 'J /'
OWNER F NO L siI FROIF
NT PROfA CLIME 01 �� — -'LE `� (!TR[[T)
TYPE Of EXISTING SETBACK HIONWAY t YARD = TOTAL
ADDRESS WIDTH FROM C L
T Z�
CITY
ARCHITECT OR EL SLD SSTSACK FROM
EN GINGER NO CID PROP LIN[ OF STREET
TYPE 0f [IISTINO l[TBACK HISHWAY + YARD = TOTAL r
ADDRESS HIGHWAY WIDTK FROM C L D_
0
CONTRACTOR
LIC CORNER CUTOFF YES NO K
ADOR ESB NO O
LID SEE REVERSE SIDE FOR SPECIAL APPROVALS
DESCRIPTION OF WORK Z
NEW ALTER RE DEMOLISH
BO FT NO OF NO Of
SIZE STORIES FAMILIES
Val of L
STRUCTURE
SIGNATURE OF
APPLICANT
VALUATION. OD `
APPROVALS GATE INlF[C TORT lI0 NAT0R[
FOUNDATION, LOCATION
HHS FBHO
a �.� FORMS MATERIALS
FIRAMH, FIR. .7
'V.
D,
I HEREBY ACKNOWLEDGE THAT I HAVE R[AD THIS APPLICATION BRACING BOLTII
AND STAT[ THAT THE ABOVE IS CORRECT AND ACRE& TO COMPLY FURNACE LOCATION
WITH L
AL COUNTY OROINANC[G AND STATS LAWS REGULATING OAS VENT DUCTS
%UILOINa CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY ""ON IN VIOLA LATH INT
TION OF THE LABOR COO[ OF THE STATE OF CALIFORNIA R[LAT
ING TO WORKMEN S CnMPENSATION INSURANCE LATH EXT
61GNATURE OFHOUSE NUMBER COR-
PEIIMITTE! p
ADDRESS FINAL L+pfftT 11 1T� ,�r� —
PLAN CHECK VALIDATION CK MO CASH _
JOHN
PERMIT VALIDATION STRUCTURAL MLO EN
LAAO 4 8 9 6 SEP 2 2 1 D 4.0 0
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TSABSSACR$BOS "ZAPPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
UI EIN 3 /
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST
WILLIAM A JENSEN BUR T OF BUILDING CROSS ST
FOR APPLICANT TO FILL IN DIST OCT yO GROUP TYO t P ESSED BY
BUILDING STATISTICAL CLASSIFICATION I SEWER MAP
ADDRESS G
El
TRJO CLASS NO DWELL UNITS
S.L, BLOCK WATER
O �/O CERTIFICATE NOT REQUIRED RECEIVED
TRACT MAP HIGHWAY
NO F BLDGS NO ICINCL[I STATE MAJOR E D
SIZE OF LOT NOW ON LOT USE ZONE SPECIAL
USE OFCONDITIONS
EXISTING BLDG n
TEL IN
OWNER NO 6- BUIL NG EXIST
SETBACK YARD HWY TREET NAM WIDTH
ADDRESS G FRONT
ARCHITECT OR P L
ENGINEER — O SIDE
P L )
ADDRESSTEL
d
CONTRACTOR NO O
ADDRESS N
C
D CAIIr1TON OF WORK O
NEW ADD ALTER REPAIR DEMOLISH D-
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60 FTNO OF NO OF Z
SIZE STORIES FAM ILI E6
U5E OF
STRUCTURE A
SIGNATURE OF
APPLICANT
VALUATION SV G
Cl APPROVALS DATE INSPECTOR t SIGNATURE
PC PMT FPUNOATION LOCATION
FEE S FEE S FORMS MATERIALS
FRAME FIRE STOPS
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE 1E CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IGAS VENT DUCTS
BUILDING CONSTRUCTION 1 CERTIFY THAT IN DOING THE WORK
AUTHORIZED HERESY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA L TH INT
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT
ING TO WORKMEN B COMPENSATION INSURANCE
(' p TH EXT
SIGNATURE OF Lf./ LJ^�/^�"L/.li�f H USE NUMBER COR
PERMITTEE gECT AND POSTED
ADDRESS F NAL
1 JOHN F LEWI5 PRINCIPAL STRUCTURAL EN ft
PLAN CHECK VALIDATION Co M-O/ CASH L I PERMIT VALIDATION CK NO
CASH
,, - LALQ 5 5 9 1 n 19 1 0 4.0 0 "
FrAPPLICATION
FOR BUILDING PERMIT
' % COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUILDING
ADDRESS
rOF
"L LOCALITY
NEAREST
vZ(P CROSSST MNO OF BLDGS ASSESSOR
O NOW ON LOT MAP BOOK PAGE PARCEL
DISTRICT GROUP TYPE FIRE BY
BLOCK \ LO`NO � n y� CONST � Z CF"C 2. NO G, •\ V
( STAiISTICALCLA�SSIFIICATION
Ef EW M.9P
ADDRESS !l5 O C CLASS NO DWELL UNITS G B (�G
CITY ( ZIP nS
ARCHITECT OR TEL VALUATION $ �rf
ENGINEER NO
ADDRESS BLOG SET BACK FROM
TEL FRONT PROP LINE OF (STREET)
CONTRACTOR NO HIGHWAY + YARD TOTAL SETBACK FROM7 TYPE OF E%(STING
LICI FRONT PROP LINE IHIGHWAY WIDTH
ADDRESS NO
LIC +
CITY CLASS BLDG SETBACK FROM
CONSTRUCTION LENDER SIDE PROP LINE OF (STREETI
NAME AND BRANCH y
HIGHWAY + YARD TOTAL SETBACK FROM TYPE Eo6
ADDRESS CITY SIDE PROP LINE HIGHWAY WIDTH
SO FT NO CI NO OF CHECK + - Y
SIZE b STORIES FAMILIES ONE
DESCRIPTION OF WORK 0 K NEW PC Fee$ Perm11 Fee
ADD ❑ Issuance Fee
O U( 1 Li O
O J F+ REPAIR Total Fee
USE OF 'C
EXISTINGBLDGy £
APPLICANT TEL _ FV
(PRINT) rt NO
BY(SIGNATURE( 6;
HEREBY ACKNO E T I IS APPLQ TON AND STATE yY
THAT THE ABOVE IS RME NO A REE MPL W ALL OgpINANCFi LSI
AND LAWS REGULATI G WI I 1 RT Y THAT IN DOING THE
WORK AUTHORIZED HEREBY I LL V A P IN VIOLATION OF
THE AfOR STA OF UAIN N iO WORKMEN SCOM
PFNSATgN INWRANCE ;23812P
Z O 1 2 n
SIGNATURE OF �� p • e • • . I
PERMITTEE
AESS Zp 2 e - 7 0 0 0
DDR
TEL p 1' . ' 70003
rFINAL
NO G
USEZONE MAP 3 O Q` 1 7 -7 9
NO
�- SPECIAL
CONDITIONS
BY
WORKERS'COMPENSATION DECLARATION ri
hereby affirm that I have r certificate Comte of tionconsent to ,elf APPLICATIOA FOR BUILDING PERMIT
insure, or a certificate of Workers' Compensation Insurance, v
ora certified ropy thereof (Sec 3800, Lab C ) COUNTY ilF LO*NGELES BUILDING AND SAFETY
Policy No Company
Pr y ADDDRJss
❑ Certified co is hereby furnished FOR APPLICANT TO FILL IN v
❑
Certified copy Is filed with the county budding mspec- BUILDING E AaZ f7 IC G t P�/ 7omP/t �A 9/��
tion department A�ItE55
Date Applicant
c•� zip 9!7 O - LOCALITY
CERTIFICATE OF E7(EMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT NO OF BLDGS
NEAREST
CROSS ST A/
COMPENSATION INSURANCE AISESSCRr
(This section need not be completed if the permit n for one TRACE BLOCK LOT NO MAP d3 PAGE 0z PARCEL Q 0
hundred dollars ($I00) or leu )
owrf:R H,9559/'7— FAKHRo J 309 USE zoNErowP
I certify that in the performance of the work for which this r`
permit is issued, I shall not employ any person in any manner ADDRESS 63I
17 4yPlc G`-` L LY AL CONDITIONS d
so as to become subject to the Workers'Compensation Lows / o q O
zip /r 7 _ U
Date Applicant ARCHITECT OR TELK
DISTRICT GROUP TYPE FIRE PROaW BY
NOTICE TO APPLICANT If, after making this Certificate of ENGINEER NO - CONST ZON O
Exemption, you should become subject to the Workers'
Compensation provisions of the Labor Code, you must forth- ADDRESS r _L ^490111�7
with comply with such provisions or this permit shall be TEL STATISTICAL CLASSIFICATION APT I CONDO 2
deemed revoked CONTRACTOR NO _
LICENSED CONTRACTORS DECLARATION �� LCLASS NO DWELL UNITS_
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS
NO
(commencing with Section 70D0)of Division 3 of the Business LIC SEWER MAP
and Professions Code,and my license Is in full farce and effect CITY CLASS BK PG VALIDATION
SO FT INC) OF NO OF CHECK
License Number Lic Class SIZE ^� STORIES FAMILIES ONE
VALUATION �
Contractor Dote DESCRIPTION OF WORK L,yry(0NEW ElS / t) D� 611- -
❑1 am exempt under Sec ADD ❑ ►
�ITER El
B BP C for this reason REPAIR $
Date USE OF
EXISTING BLDG [ DEAAOL ❑
Signature APPLICANT TEL FINAL
OWNER-BUILDER DECLARATION (PRINT) ND
I hereby affirm that I am exempt from the Contractor's
actor's License - -
Law for the following reason (Section 7031 5, Busmen and ADDRESS FINAL 3307 .01
Ptcjessions Code) NT By
ING ER-COR
1, as owner of the property, or my employees with �RE5SS
wages as their sole compensation,will do the work and LOCALITY ► 3307 —.01
so
the structure is not intended or offered for le(Section
7044, Business and Professions Code ) MOVING TEL 1
❑ 1, as owner of the property,am exclusively contracting CONTRACTOR NO A
with licensed contractors to construct the project (Sec- ACCT.r
tion 7044, Business and Profeuions Code ) ADDRESS -
3307 10'3.94
CONSTRUCTION LENDING AGENCY RED YARD HWY TOTAL O(EF I
hereby affirm that there is a construction lending agency for FRONT 1 ITEMS
the performance of the work for which this permit Is Issued P IL - TOTAL 10 r.
(Sec 3D97, Civ C ) SIDE c.
94
Lenders Name P` CFECK 105.94
DMA ief N .
Lenders Address PC Fee f Permit 0[1
pop.
I certify that I have read this application and state that the - Issuance Fee LDA4A.P/C N mit
O above Information is correct I agree to comply with all County Investigation Fee r 0000-MOI 12I 9I9�
R4 ordinances and State laws relating to building construction, Total Fee LDMA Perm 07�
and hereby a thorize representatives of this County to enter 45 1 AM q:,ry
upo ve-mentione pr for inspectionqurpcossas
n IZ ( _S Z EEE REVll FOR EXPLANATORY LANGUAGE
Signature of API011 or Agent Date
r COUNTY OF LOS ANGELES TEMPLE CITY N 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD/ALT/RSP
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0701180035
PHONE (626) 285-0488 EXT
LEGAL ID NO OF CONST NEW BUILDING ADDRESS
ON FILE SO FT STORIES TYPE OCCUP GROUP 6317 TEMPLE CITY SL 19
STRUCTURE 584 1 VN R3 TEMP CA 917801431
(ASSESSOR INFORMATION NUMBER - GARAGE NEAREST CROSS STREET
5382-022-060 OTHER 156 1 VN R3 THOMAS PAGE 596 GRID J2 LOCALITY TEMPLE CITY, Cl
TENANT EXIST BLDG USE USE ZONE ISSUED ON PROCESSED BY EXPIRES ON
EXIST OCC GRP 02/28/07 JK
JK 02/23/08
FAKHRO GHASSAN Y RATA G,KHALED (626L3099---0680- BIlX:S NOW ON IAT VALUATION
70,580 / ,' FI�yjy�Y CODE
16317 TEMPLE CITY BL I
ITFMP 917801431 I FEES PAID ESSCRIPTIOS OF FORK
ACID 2BR/1BA (E) DEN/DINING ROHM TO BE NEW DEN (E) KITCHEN
CR
IEE DESIPTION QUANTITY UOM AMOUNT ITO BE REMODEL (E) BEDRM 6 COMPUTER RM TO BE REMOVED NEW IBR/
APPLICANT TEL NO I
KANDJIAN (816) 242-1431- IB1 PLANCHECK W/ENERGY 70580 00 VAL 943 17
811 PELANCONI AVE IAA BLDG PERNT ISSUANCE 27 75 SPECIAL CONDITIONS
IGLFNDALE CA 91202 IAC STRONG MOTION REBID 70580 00 VAL 7 06
JB2 PERMIT W/ENERGY 70580 00 VAL 1 109 63
I TOTAL FEES 2 087 61
ICONTRACTOR TEL NO I APPROVALS
DATE INSPECTOR SIGNATURE I
IFAKHRO GHASSAN (626) 309-0680- I
I6317 TEMPLE CITY BLVD LIC NO I UJCATION AND SETBACKS
TEMPL,E CITY, CA 91780 NONE I I
I (SOILS ENGINEER APPROVAL I
(ARCHITECT OR ENGINEER TEL NO I FOUNDATION TRENCH FORMS
LIC NO I SLAB/UNDER FLOOR
RAISED FLOOR FRAMING
I MAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP (UNDERFLOOR INSULATION , I
3 01 (1ST LEVEL FLOOR SHEATH I
INO OF FAMILIES DWELLING UNITS APT COND STAT CLASS ( I
NO 21 2ND LEVEL FLOOR SHEATH
SCHOOL WITHIN HAZARDOUS I (ROOF SHEATHING I I
(AIR QUALITY 1000 FEET MATERIALS
NO NO NO IFIRE DEPT FRAME INSPECf
I
REQUIRED TOTAL SETBACK FROM EXIST IBLLO DEPT FRAME INSPECT
SET BACK YARD HWY PROP LINE WIDTH I
FRONT PL- I SHEAR PANELS /
SIDE PL- I
(INSULATION/WEATHER STRIP
!-CA- �S ANTERIOR LATH/DRYWALL
I ^�ry QCt•� I EXTERIOR LATH /
LOT DRAINAGE
ISMOKE DETECTION DEVICES
FIRE DEPARTMENT APPROVAL(
• ADDITIONAL DATA ON FILE I I
I I
(REPORT ID DPR261 ROUTE TO BS0508