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Home My Public Portal About6350 TEMPLE CITY BLVD_Building__ S + r3 'o ° 11 61 eF1-OTto T6AGSBAtBUHDING aoaaaaAPPLICATION FOR BUILDING PERM lJ COUNTY OF LOS ANGELES BUILDING i ARTMENT OF COUNTY ENGINEER ADDRESS r, AND SAFETY DIVISION LOCALITY OHN A LAMBIE COUNTY ENGINEER NEAREST ,._ WILLIAM A JENSEN SUP T OF BUILDING CROSS ST G°'7Z� I DISTRICT NO GROUP TYPE P SED BY F OR APPLICANT TO FELL IN J coN ADD .] FANole /l r ATISTICAL CLASSIFICATION SE KR MAG G CLASS NO DWELL UNITS 61;LOCK WATER NOT REQUIRED RECEIVED CERTIFICATE MAP HIGHWAYvNO OF BLDGS NOC, ICIRCLEI STATE MAJOR COND LOCAL X ,J NOW ON LOT USE ZONE SPECIAL CONDITIONS EXISTING BLDG _ .I TEL '� OWNER ry NO BU L INC EXIST /1 SETBACK YARD HWY REST AME WIDTH ADDRESS O, G FRONT / ARCHITE OR TEL P L rVA ENGINEER NO SIDE P L ADDRESS I t L CONTRACTOR O I V ADDRESS Im CU DESCRIIrTION OF WORE ND PARKW Y TREE REQU ED s r1l ADD ALTER REPAIR DEMOLISH N NO OF NO OF Nefe OR FAMILIES a tions should taken out of o L A Co Road Dept, AN ena URE 1 m la a IS O Or O Olddole SurVe & Desk, n work, fak s Elmo aounfd ermrf has been owed Apply fm parkway free perms} MUR F A AS APPLICA T 6� m 01 VALUATION :Z T�� / APPROVALS 6VP� DATE INSPECTOR 9SIG T E PC IFEES FEE $ ( r �� FOUNDATION LOCATION / FORME MATERIALS FRAME FIRE STOPS I I HEREMY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE la CORRECT AND AGREE TO COMPLY FURNACE LOCATION WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VOLA LATH INT O TION OF THELASOR CODE THE STATE OF CALIFORNIA RE T ING TO WON K MEN S C PE TION INSURANCE LATH EXT SIGNATURE OF HOUSE NUMBER COR IT PERMTEE RECT AND POSTED E� ADDRESS g FINAL JOHN F LEMS PRINCIPAL STR RAL ENGINEER PLAN CHECK VALIDATION CK M O CASH PERMT VALIDATION CK No CASH Lt,o :5G99`6 NOV 927) D 33.751 �, � L�ifl7 1 8 4 OEC 31 1 D 667.50- 1 � TeABseA eLAeos a-eS APPLICATlOTIOP Q FOR BUIL IMG PERMIT COUNTY OF LOS ANGELES BUILDING _ DEPARTMENT OF COUNTY ENGINEER ADO.ESE f BUILDING AND SAFETY DIVISION LOCALITY ` JOHN A LAMBIE COUNTY ENGINEER NEAREST ) COLEMAN W JHNNINS AUPT DI BUILDING CROSS ST DISTRICT NO GROUP TYPH P CESSED BY FOR APPLICANT TO FILL IN CONST BUILDING _ /l 9 TATIETICALyyC,LFASSIFICATION SEWER MAP AO Q99 3 0 /Q C( CLASS NO gL.J_DW ELL UNITS ` BK -PO f LO O (y BLOCK USE ZONE MAP -O3 TRACT / SPECIAL CONDITIONS SIZE OF LOTS TIL / so, NOW ON LOTa OF / UBE OF "MING BLDG, BLDG SETBACK FROM S ( n NO FRONT PROP LINE OF [TART) OW E TYPE OF EXISTING SSTSACR HIGHWAY YARD = TOTAL ADDRBBS 5r O t �(� CITY [LOS SITSACX FROM C I T O TEL ENGINEER NO SIDE PROP LIN[OF STAT T TYPE OF I[MISTING SLT/ACX MIOHWAY } YARD = TOTAL ADDRESS HIGHWAY WIDTX IRO.C L _ 0 CONTRACTOR NOL + LI LIC ADDRESS NO CORNER CUTOFF YES El NO O uc SEE REVERSE SIDE FOR SPECIAL APPROVALS DESCRIPTION OF WORK Z NE ADD ALTER REPAIR DEMOLISH BID PT NO OF NO OF SIZE STORIES FAMILIES USE OF D STRUCTURES 10 a f kde /.,?- YI � T, I 910NATURE OF APPLICANT VALUATION$ APPROVALS DATE INSPECTOR'/SIGNATURE P CPMT FOUNDATION, MATERIALS N, OCION / \ FEE S -� FEES FRAME, FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE 19 CORRECT AND AOREL TO COMPLY FURNACE LOCATION WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS 1 9UILDINO CONSTRUCTION I CERTIFY THAT IN DOING TME WORK AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT TION OF THE LABOR COO OF THE STATE OF LIFORNIA RELAY IN0 TO WORKMEN S COM�NSATION INBURAN� _ LATH EXT I SIGNATURE O B ✓ HOUSE NUMBER COR- V PERMITTER R99.T AND POSTED ADDRESSFINAL L JOHN F LEWI$ PRI IPAL $TRU CTURAL ENGIN PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CX M G CASH xACO 2 4 6 2lo JUN 9 1 D 5.00- APPLICATION FOR BUILDING PERMIT COUNTY OF LOS 4NGELES ^ BUILDING AND SAFETY WORKER S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDMO ADDRESS 9 I hereby affirm that I have a certificate Of consent to self insure BULDW DRESS G /N or a c tihcate of Wbrkers Compensation Insurance or a certified 7' M G� ciry cGlyy hereof (Sec 0 lab C) CITY ZIP 4 )� spam 6 ,/� �,ll C/7' / LOCALIiv ,''rflyv/,, —�--� SIE CF NO OF BLDGS NOW ON LOT cedrl-ed Copy Is hereby furnished NEAREST CROSS ST ❑ C hfied copy is filed with the county bulk! B I action TRACT BLOCK LOT NO departtryienl=- USE ZONE MAP NO Data2'v a ASSESSOR MAP BOOK PAGE PARCEL /-f-f SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS OWNER / TELNO COMPENSATION INSURANCE �-ee .2—4/`S// wITHIN 1000 FT OF SCHOOLS S NO (This section need not be completed if the permit is for one hundred ADORES �/ )+ DISTRICT GROUP C IE PROCESSED BY dollars($100) less I t I certify that in the pertamance of the cork for which this permitCITY IP /� �i ✓[ s Issued I shall not employ any person In any manner so as to ^ 0 become subject to the Workers Compensation Laws ARCTTITEPIC11 INEER TEL NO •J• J� 0 STATISTICAL C FlGATION APT CONDO Date Applicant qp CLASS NO DWELL UNITS NOTICE TO APPLICANT If after making the Certificate of REQUIRED TOTAL SETBACK FROM EXIST R Exemption you should become subject to the Workers CO=t p TEL NO SET BP.GK YARD HWY PROP LINE WIDTH Compensation provrswns of the Labor Code you must forthwith J J-3 ' 00 1 f FRON comply with such provisions or this permit shall be tleemed revoked ADDRESS .r /�� LJC N�/ � PL LICENSED CONTRACTORS DECLARATION /V C SIDE r CRY A LK; CtA55 PL I hereby affirm that I am licensed undemmvswre of Chapter 9 G SEWER MAP (commencing with Section in 7000)of Division 3 Of the Business and SO FT SIZE NO OF S IES I NO OF FAMILIES Professors Code and my ken"gq is in full force and effectNEW ❑ BK PG d Ler, icense Numb �l _ Lrc Class G - , DESCWTqkOF WORK ADD ❑ VALUATION , Q 9 . Contractor Date / ALTER ❑ $ d O dams "� ❑ I em exempt under Sec ew° N REPAIR El BAR for this reason a I DEMOL ❑ LrxN PIC 0 E OF EXISTING BLDG ! 1 URM ❑ EL I III ft e�tInature _ 1 cif) APPLICANT(PRINT) - ;rEL'NO \ I_DAW Perms Z El as owner of the pmperty or my employees with wages as \ Z their sole compensation volt do the work and the structure is ADDRESS O A' not Intended or offered for sale (Section 7044 Business and FINAL ATE 0 3303 149.5 PI'pfeeelprl5 COdO) Y I THE MFUCAKT OR FUNPE& AG OCCUPANT KWRE A W1ZAi S ANTEqN� — � 1 ITEM: property am exclusNely Contracting With CH A MIXTWE CON QN A HAZARDOUS WTERML Eg41 TO OR OREATER TWN THE ❑ ee owner of the a ANOINTS SPEGFED ON THE H Doug WTERIAUS VORWn GUIDE? Fl BY licensed contractors to Code) the protect (Section 7044 YES❑ No❑ CAECH 14 Busxoss and Prolessrons Cade) w THE r HOED USE OF THE aupuNO er THE APRICANr oR F URE euL '"A`H ION F�THE SOUTH 149.25 COAST AA OUALRY WNAGEWNT OSTRICrT IS D)SEERUC�OR EP RMTnTING CC ECKUST FOR CONSTRUCTION LENDING AGENCY GumuN s S CHANGE .U:I I hereby affirmnc that there s e c which this p lending agency for rEs❑ �❑ rym the performance 01 the work for which this permit IB issJed(Sec rH ECI<USD I UNDERSIAND REQUI EWNIT UNDER THE OG TIESCA COUNTY CODA �O 3097 CN D) THLE 2 ST TER 220 M Ti NS 2 NEAENT9 UNDER THE LOS ANGELES GOUNV CODE _ ' I _JV V i �� 9�9I ry TIRE 2 CINPTER TING AND OR OFRU 100 THROUGHERUFT2RC r40 GaJCE W HAZARDpUe AM LBrrt�fS Nam MATERVLS REPORTING/JID FOR OHWNNG A PEiAtlT FROM THE 9GIQAro O J J 1 1 rq 1 7:It` o Lenders Address - 0 owcA w raNr .. - I certify that I have read this application and state under penalty g of penury that the above tion IS Correct I agree to Comply PC FEE PERMIT FEE i?. vnih all county o es a Stats laws relating to binding S corsbon representatives of this C eseivesoftis ISSUANCE FEE�4ions upon a d property for imp a �O INWEBi1GAT10N FEE TOTAL FEE a de w SEE REVERSE FOR EXPLANATORY LANGUAGE • APPLICATION FOR BUILDING PERMIT �] COUNTY OF LOS ANGELES BUILDING AND SAFETY r WORKER S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN eulLgNf1 ADDR I hereby affirm that I have a certificate of consent to self insure BUILDING ADDRESS �d or a certificate of Workers Compensation Insurance or a certified 416 95 4,0 copy thereof (Sec 3800 Lab C) CITYPolicy No— 'A ZJP V 1 LCCA Y Company SIZE LO� NO OF BLDGS NOW ON LOT 11 Certified copy is hereby furnished I NEAREST CROSS Sr ❑ Certified copy is filed with the county building supection 'TR*ar 54,Aj % A LOT NO department •�.�N b USE ZONE MAP NO Date Applicant ASSESSOR MAP PAGE C h/ I PARGEI,,, / 1 SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS OWAER TEL NO y COMPENSATION INSURANCE ,A91 • WITHIN 1000 FT OF SCHOOL? YES NO (This section need not be completed If the permit Is for One hundred ADDRESS / DISTRICT GROUP TYPE CONST FIRE ZONE PROCESSED BY dollars($100)or less) I I certify that in the performance of the work for which the permit CITY �N Zw , 3 Y �� 2 /J 3 Is issued I shall not employ any person In any manner so as to J become subject to the Workers CORlpensatm Laws ARCHITECT OR ENGINEER TEL NOF STATISTICALC IFlCATIQN APT CONDO USS Date Applicant ADDRESS CNO DWELL UNITS NOTICE TO APPLICANT If after making this Certificate of REWIRED TOTAL SETBACK FROM EXIST Exemplm you should became subject t0 the Workers CONTRACTOR oe TEL NO SET BACK YARD MY PROP UNE WIDTH Compereaton prwlatons of the Labor Cade you must forthwith FRONT comply with such provisions or the permit shall be deemADDRESS LIG NO P ed revoked visiL L LICENSED CONTRACTORS DECLARATIONSIDE CTTY LIG CLASS P L I hereby affirm that I am Ipensed underprovelorls of Chapter 9 SEWER MAR (commencing with Section 7000)of Division 3 Of the Business and SO FT SIZE NO OFSTO 5 NO (IF FAMIUES Professions Code and my license a In full farce and effect 1 NEW ❑ eK PG , a License Number ILC Class DESCRIPTION OF WORK ADD •)K VALUATION 0 Contractor Date l IN CO ALTER ❑ $ 1 _ ¢ ❑ I am exempt under Sec REPAIR ❑ $ ' -----ACCT-t 0 .r B&PC for this reason DEMOL ❑ LDMA P/C Date USE OF EXISTING BLDG URM ❑ l _ 3M M6.601L Signature (CANT(PROIT) TEL NO 7/ LDMA Perm• _ a 23 m ❑ I as owner of the property a my employees with wages as 12Sd of =O t �ACCT'r their sole compereatK will do the work and the structure Is Al]DRESS F -yT�--- Cn net intended or offered for sale (Section 7044 Busness and GN FINAL DATE Q 333 �T��r. ly.� Professions Code) w THE APRJG OR FUTURE euLDNQ occuw+T RA4DIE A Hn DCKJS MATE 7 2 ITEMS L�/ I� I as ONn2f Of the CH A MIXTURE CCNtMN A HAZARG;IIS ANTERIPL Eg TO OR GREATER RNN THE ui property am the project cSecti tlnX) with WOUN73 SPEDFED ON THE HAZARDOUS MATERws INFOFWnON GLCE' FINAL BY ✓ > I i licensed contractors cf construct the Protect (Sectwn 7044 YES❑ No❑ �% - TOTAL 357_ 1Q Business and Professions Code 1 -- _hLiC/4l M7.1D OCOWILL TIE NEQUEO USE CE THE BJIDJ�eV THE A F!Oi OR F OTO T 61 SOUTH r 4nG�\..II�� 1 OOAST MR OUAUTYUiRE A f£RE FOR cis RICT KTKN.'OR EEPERWT F C THE FOR (� CONSTRUCTION LENDING AGENCY OOART MR auaJTv MAANQEAENr asrRicr IscraMo)SEE PERMrTuw CHECKLIST FOR — - .� GUOUN EES I hereby affirm that there Is a coretructnn lending agency for YES NO❑ i a the performance of the work for which this permit is issued(Sec _ __ _RETHESWTE _ m DEAND 3097 Civ C) c EH CKUST UNDE TPS aU MY REQUIREMENTS UNDEROTI OS ANOEIUESGOIAJTY CODE7TUV VLIrJ—WD{ 5/27/9 Lerder s Name I ERIFLS REPORTING FAO FOR OBTNMNG A PEERWIT FROM T s(:AOAm 2 20 140 G WSARa0119 J Lenders Address 9977 1 All 9:12 O wver+on A�Nr _— I certify that I have mad this applpabon and state under penalty O of penury that the aboie information is correct I agree to comply PC FEE A�O PERMIT FEE with all county ordinances and State laws relating to building construct �n and hereby authanxe representatives of this County ISSUANCE FEE / to eller on the above- entioned property for Inspect. rp e 5 i m �-2 NVESDGATION FEE TOTAL FEE D /• / �i SEE REVERSE FOR EXPLANATORY LANGUAGE