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Home My Public Portal About6445 TEMPLE CITY BLVD_Building__ DEPARtMENT OF BUILDING AND SAFETY / APPLICATION FOR PERMIT ' COUNTY OF LOS ANGELES ,I 7 D ' WM. J. FOX. CHIEF ENGINEER I J NG FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY i BUILDING s g DISTRICTHO PLANCK NO PERRMITNO all LOCALITY a 5/ir7 C P. [ RECEIVED BY li DATE OF APPL DATE ISSUE NEAREST rR...ST. C OWNER qq V/P , as h qq N n a, 7 q 1 ADDRESS „I ADD REBS L�2J� �C1 O 77 ! L // y ru LOQALITY rcad� C'aCef �o v -S'�df o�� L .� NIr m FIRE 1 NO OF TYPE GROUPI ARCHITECT OR �e 20Ne PLANS �S ENGINEER B LOS I I / __ I ORD NO DDR SETBACK LINE _ APPROVeD �' '^'••' 4 I I CONTRACTOR NGL BY I I I DATE ' uee APPROVED ADDq ZONE P BY DATE I LEGAL ` �J p CORRECTIONS DESCRIPTION LBT N[f - SLOQK 0� TRACT 141 - G HO OF BL S BIZ[OF LOT O X� O NOW ON LOT USE Of XIST p NO OF .f NO OF I T/7— Fwwl I RO _ DESCRIPTION OFWORKi✓!f/E�742 OA/NEW ALTERATION ADDITION !• �� / � /_ • /V y✓ �/ �� ^_ 0 REPAIR X MOVING DEMOLISH OG✓ 'R '.! �OA�G�.P 1t o BO FT NO OF D� ��! �� . Yet {� Z SIZE 1 ROONS STORI EB WALL ROOF :Q 57"1•1 I 4 COVERING 3 COVERING use orc•n �y.y� , r BUILDING NEW �, ILtil 0.I11A W�, RL� : T/L/, /✓`/ BUILDING G PRdhPeES- PALL FI/,P /VAff o l� 'S'7� I lrl D ILL I ESS Cd (✓F 0 1,J 65T C 7 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS �11-•fes. APPLICATION AND STATE THAT THE ABOVE IB CQRRICT FOUNDATION LOCATION INSPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION /) (RAMCFIS. if�1/" r7 SIGNATURE OF �'f BRACING.,BOLTS BOLTS 7 PERMITTEE V �Aw�!> LATH. INT S AUTHORIZED AST LATH. EXT >fA6TYA 9N 13 B 3 G@A GLTG !s P Q PLASTER. INT. p4 FEE PLASTER,EXT VALUATION B '��A FEe G��I FINAL / �(M�c�.t;U 9 27-s- APPLICATION FOR BUILDING PERMIT FOFR AP ICANT.TO FILL IN (PHDI o, type o,,w BUILDINGE E COUNTY OF LOS ANGELES ADDRESS .J DEPARTMENT OF COUNTY ENGINEER CITU ^ T F"GI zlP , y �., BUILDING AND SAFETY DIVISION N ,O BLDG •A' n$ BUILDING SIZE OF LOT,�Q/� /.7•�/ NOW ON LOT ADDRESS ' if - f -,3`I , . J 2ZM. LOCALITY OWNER A/ TEL NEAREST Aeh47/ CROSS ST ASSESSOR ADDRESS 7v " (�.AA`` h Qti n� MAP BOOK PAGE CEL CITY -\ Q(J � f�np DISTRICT GROUP CONST, /� ZONE'IRE ROC SED Y ARCHITECT ENGNOR N� ��— NEL A STATISTICAL CLAAS''SIFICATION SEWER M P P CLASS NOt�nDWELL UNITS BK PG CONTRACTOR TEL 22/yIY US ZONE MAOP Q ADDRESS A /t d L �� SPECIAL I CITY Z-4 24,02- LICtAS�^ — CONDITIONS y CONSTRUCTION LENDER ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ NAME AND BRANCH /rte(/ BLDG SETBACK FROM ADDSS FRONTPROP LINEOF (STREET) �•" \('� NO OF., NOlOF CHEtK - IGMWAY } YARD o TOTAL ETBACK FROMI GVENI BT STORI FAMILIES ONE FRONT PROP LINE M � WIDTH 'A +❑DESCRIP BLDG SETBACK FROM G� (/CCA IDEPROP LINEOF STREET) z 11G� EA)� A�NRK� + LT HIGHWAY } YARD = TOTAL SETBACK FROM TYPE OF EXISTING G I(�� IR SIDE PROP LINE HIOHWAV WIDTH W EXISTING BLDGSIlgL �Il• EMOL } a APPLICANT NoLA/ CORNER CUTOFF YES ❑ NO ❑ L (PRINT) 7f-/ 7 BY (SIGNATURIN OPEN SPACE YES 1:1NO E] IN COASTAL PERMIT ZONE ( YES ❑ NO,[] VALUATION Q 1 HEREBY A HOWL OE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY v WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON STRUCTI ON I CERTIFY THAT IN DOING THE WORK AUTHORIZED XEREBY I WILL NOT EMPLOY ANY PERSON VIOLATION OR THE {� LABOR CODE OF THE ! AL MIA IN RELATING TO 1 1 WORKMEN'! COMP[ME X R C SIGNATURE OF PERMITTEE ADDRESS7. �(/V�� L ` FINAL CITYNO �� 2�� DATE ` I ,NA AE CHLCIKS PA)AHL6 10 PC $ FEEPMT $ --� HARVEY T SRANDT COUNTY ENGINEER y PLAN CHECK VALIDATION CK Mo CASH -PERMIT VALIDATION cK C CASH 0 8 9'-MT 10 1 3 D_ /•I/'4 2.0 0 •`� \ 79ASMA C¢4,101!/74 WORKERS' COMPENSATION DECLARATION hereby affirm that I have ccertificate of consent to nee, -APPLICATION FOR BUILDING PERMIT insure, or o certificate of Worr kers Compensation Insurance, - Or a certified copy thereof (Sec 3000, Lob C ) ,_ - COUNTY OF LOS ANGELES — BUILDING AND SAFETY - Policy No PCompany BUILDING _ ❑ Certified copy is hereby furnished � FOR APPLICANT TO FILL IN ADDRESS !/ Certified copy is filed with the c m=buildingi BUILDING e/ tion department ADDRESS G L 4L� Date/_Applicant CITY IP LOCALITY CROSS NO'OF S d 'CERTIFICATE OF IXEMPTI N FROM WOR SIZE OF TOT NOW ON LOT 02055 ST ° COMPENSATION INSURANCE - ASSESSOR (This section need not be completed If the permit is far one TRACT BIOOL LO7 NO ASSESSOR BOOK PAGE PARCEL hundred dollars (,100)Or less ) OWNER TEL NO �!„ USE ZONE MAP I certify that in the performance of the work for which thisSPECIAL / /� AY //r permit is issued, I shall not employ any person in any manner ADDRESS T r, (� , y ICONDITIONSCa so as to become subject to the Workers'Compensation Laws _ O CITY - ZIP _ _ U Date Applicant ARCHITECT OR TEL - d' NOTICE TO APPLICANT If, cher making this Certificate of ENGINEER �_ DISTRICT- GROUP TYPE FIRE SSED BY O Exemption, you should become subject to the Workers ' P CONST Z NE rr Compensation provisions of the Labor Code, you must forth- ADDRESS - �DO —� 3 N with comply with such,provluons or this pelma shall be TEL STATISTICAL CLASSIFICATION APT I CONDO Z deemed revoked CONTRACTOR NO LICENSED CONTRACTORS DECLARATION �p L CLASS NODWELL UNITS_ I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS/, SEWER MAP s (commencing with Section 7000)of Division 3 of the Business �J n LIC and Professions Code,and my lice'rrt e)is in full force and effect CITU `r C CLASS a IX pG VALIDATION .�Z Q3i/ K SQ FT SO OF OF CHECK , , License Number is CIOss SIZE STORIES FAMILIES ONE �Pa�� .,r2— NEW ❑ VALUATION Contract a DESCRIPTION OF WORK ❑I am exempt under Sec A00 ❑ _ _ _ -_ , _ - - - ALTER ❑ , E 8P C for this reasonubt 2 REPAIR ❑ $ Mie EXISTING BLDG _ _ .❑ i Signature APP(IPR NiNij L FINAL OWNER-BUILDER DECLARATION DATE I hereby affirm that I am exempt from the Contractor's License /� - Sys0 Law for the following reason(Section 7031 5, Business and I ADDRESS `� "d 1)Lo 0FINAL Prof ions party, p or my employees with ons Code) _. - B - 7 as owner of the property, BUILDING T 117, 3?11 7.... ADDRESS wages as their sole compensation will do the work and a I=IM the structure is not intended w offered for sale(Section LOCALITY f 7044, Business;and Professions Code )' MOVING - TEL - , • ' - - ri1 E AL 98 � V U ❑ I as owner of the property am exclusively contracting CONTRACTOR t}�H _ '7�.�.. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code ) C HAKriE ,EI l CONSTRUCTION LENDING AGENCY ' SET I D YARD F1VIY TOTAL SETBACPROP K FROM I ' WIDTHI I hereby affirm that there is a construction lending agency for RONT _ _ the performance of the work for which this permit is issued P L - i�l]i]IJ-I;QI]1 ^/ 4,"' (Sec 3097 Civ C ) SIDE P L Lender's Nome _i�_1t L h�l _ - 107e Ref e -- - Lender s Address P C Fee f Permit Fee L t PV I certify that 1 have read this application and state that the Issuance Fee a S iDAVt P/C 0 a above mfwmahon,s correct I agree to comply with oil County _ Investigation Fee _ _ _p Ordinances and State laws relatln building construction, Total Fee - LDMA Perm 0 g and her outhori rwitien v of this County to enter _ g upon ove-m y foLr inspection purposes 2 r fEE REVUW FOR EXPLANATORY LANGUAGE_. y Signature of Applicant or Agent D.Ir