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Home My Public Portal About6456 TEMPLE CITY BLVD_Building__ ' C;,AB35A CE R803 1/7I : APPLICATION FOR BUILDIN6 PERMIT f1 'CQUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION BUILDING 6#,s-e. u /✓M CE�i {� ADDRESS COLEMAN W JENKINS, SUIT of eU1LDIN. LOCALITY / FOR APPLICANT TO FILL IN NEARESoss srT � I cR BUILDING �� /�J % / l DISTRICT ti0, GR OU CONST P D BY TYPE ADDRESS YJ SV�1 Jy STATISTICAL CLA SIFICA TION SEWER MAP LOT NO BLOCK CLASS NO DWELL UNITS_ BK EP TRACT1222ZY,221USE ZONE MAP - Na OF BLOCS NO SIZE OF LOT NOW ON LOT SPECIAL USE OF CONDITIONS EXISTING BLDG TE OWNER L W. Sjry/7V NOL S/S/L/3U7 BLDG SETBACK FROM ADDRESS SCJ FRONT PROP LINEOF (STREET) TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL CITY `C HIGHWAY WIDTH FROM CL R ACHITECT vFt TEL } ENGINEER NO BLDG SETBACK FR ADDRESS SIDEPROP LINEOF (STREET) TEL TYPE OF EXISTING SETBACK HIGHWAY YARD = TOTAL CONTRACTOR NO HIGHWAY WIDTH FROM C LLIC 8 ADDRESS NO + O LIC CITY CLASS CORNER CUTOFF YES ❑ NO ❑ W CONSTRUCTION LENDER a NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS ADDRESS SO FT �j� NO OF NEW ❑ d� -3 417 SIZE J STORIES USE OF ADO -1 STRUCTUREAmAftAe ALTER 7 T REPAIR[F] b AIPPLICANE OF DEMOL ❑ /� C VAL UATIO 5 APPROVALS DATE IH TOR•a fIGNA iU KC PC PMT FOUNDATION LOCATION FEE S FEE S FORMS MATERIALS I( FRAME FIRE STOPS I R HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BACING T5 AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE TION WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON GAS VEN STRUC TION 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH INT LABOR CODE OF THE AT[ OF CALIFORNIA IN Rf LA INC TO WORKMEN'S [OMPE MB N INSURANCE /l, LATH EXT WCAM TEL- 11 JAP, SIGNATURE OF �^�. HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS FINAL PLAN CHECK VALIDATION CK MO CASHJOHN F LEWIS PRINCIPAL STR ldft ALAENGINEER _ PERMIT VALIDAITON CK M GASH ux,o 3 3 a 2� NOV 22� i D 4 '8.7 5- < �I U 76�638A C[ 8-64-APPLICATION FOR BUILDING ERMIT U ' COUNTY OF LOS ANGELES BUILD""' i DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY Ty JOHN A LAMBIE COUNTY ENGINEER NEAREST COLEMAN W JENKINS,SUP T OF BUILDING CROSS ST DISTRICT NO 1 GROUP TYPE PR EDlED BY FOR APPLICANT TO FILL IN �j', CONST aUILOINO /,1 / / ' /' STATISTICAL CLASSIFICATION SEWER MAP ADDRESS 6�S1, 7�m/'LE C�/ �y./J" SK PO CLASS NO DWELL VNI T! LOT NO BLOCK USE ZONE MAP TRACT SPECIAL NDITIONS SIZE OF LOT ^ ISO 1 MOWDO/N�BLOT[ Z USE OF //[R�SF AND �7 SON ■ OAC[ FROM TEL FRONT PROP GIM[ 01 ✓ (STRI[T) OWN R �/I!/TI>/ NO '/1/7-ZZ TYPE OF EXISTING S[TNACK HIGHWAY YARD = TOTAL ADDRESS 27// IX [(/ C L rJ 0 / ✓ 30 + = S CITY C C� F e DL ![TSACK IROM ARCHITECT OR TEL ENGINEER NO SIO[ PROP LIKE 01 STREET TYPE OF EXISTING S[TEACX HIGHWAY + YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C L I y IE CONTRACTOR/,Z&,/Oe oom NOLAT 67/32 + Ou AODR E89 7 N cXIC OG" W LO CORNER CUTOFF YES NO O CITY E �", gz LIC SEE REVERSE SIDE FOR SPECIAL APP&OVALS DESCRIPTION OF WORK !� ��< Z NEW (ADD ALTER REPAIR DEMOLISH 1' I A 1.� //`• l ZET 330 STORIES I FAMIILINO Of ,1.0IF �j�•} USE OF STRUCTURE / - 4opo 41 ✓ 11,G� SIGNATURE OF ''''' 'Oe'a E APPLICANT IeJ1�L/[�/u� VALUATIO $ APPROVAL! PATE INSPECTOR'S SIO URE P C PMT E f FOUNDATION FORMSMATERIALS ATI FEE N FEE$ PE $ FRAME E, FIRE !TOPS, I NCR[TY THAT THE 15 I HAVECORRECT AND GRE APPLICATION FURNACE BOLT -Zb-6 S AND !TATE TNU TX[ORDINANCES 1E CAND STATE AND AGN[[ E COMING FURNACE LD D TION WrtX ALL CO ONSTRU TION I CSR AXO HATI LAWS REGULATING WO..O 0 A VENT DUCT! •U ILOIRIZ CO NBTNUCTION 1 NOT EY THAT IN DOING THE VIOLA TION THE XCK[EY 1 WILL NOT EMPLOY ANY CALIFORNIAN IN VIOLA LATH INT TION OP THC LAGOR COD OP T STATE 01 ALIIRLLAT ING TO WORKMEN S COI ISATION INSURANCE LATH EXT SIGNATURE O HOUSE NUMBER COR- PERMITTEE q T ADDRESS F I N A L (.L JOHN F LEWIS PRINCIPAL STR AL ENGINEER PLAN CHECK VALIDATION CK MD CASH _ PERNIIT VALIDATION LcK MO CASH ;IJ � � 7„ ; ,i D 5Gv� , APPLICATION FOR COUNTY OF LOS ANGELES BUILDING PERMIT DEPARTMENT BUILDING AND SAFETY DIIMICOUNTY O N BUILDING F OR APPLICANT TO FILL IN ADDRESS (% LOCALITY ad A NEAREST ZIP CROSS ST OF SLOGS ASSESSOR SIZET NOW ON LOT MAP BOOK PAGE PARCEL DISTRICT G P TY E FIRE OC VD Y BLOCK LOT NO O O STS TEL v NO STATISTICAL CLAS IFICATION _/ WERM ADDRESS (p �.6 _ V CL455 NO DWELL UNITSBKZ G 21P D U ZONE MAP `' NO OR TEL SPECIAL ENGINEER NO CONDITIONS ADDRESS NO DEPARTMENT APPROVAL REQUIRED YES NO ❑ CONTRACTOR TE0.L LIC %G G SETBACK FROM F NT PROP LINEOF (STREET) LIC ADDRESS U L �D�_ NI Y } YARD TOTAL SETBA FROM TYPE OF EXISTING CITY FRONT PROP HIGHWAY WIDTH CLASS CONSTRUCTION LENDER + y NAME AND BRANCH BLDG SETBACK FROM - O ADDRESS CITY SIDEPROP LINEOF EET) U SO FT O OF NO OF CHECK HIGHWAY } YAM TOTAL SETBACK FROM TYPE OF TING 512E SNTORIES FAMILIES ONE SIDE PROP LINE HIGHWAY WI DESCRIPTION OF WORK NEW + B. h DD ❑ CORNER CUTOFF YES ❑ NO ❑ LTER a IN OPEN SPACE YES ❑ NO ❑ USE OF REPAIR EXISTING BLDG PMOL ❑ IN COASTAL PERMIT ZONE YES ❑ NO ❑ APPLICANT TEL / PRINT) NO BY (SIGNATURE) 1 HEREBY ACKNOWLE THAT I HAVE READ THIS APPLICATION AND STAT[ THAT THE OV[ IS CORRECT AND AGREE TO COMPLY WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON- BY RUC TION I CERTIFY THAT IM DOING THE WORK AUTHORISED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE 01 THE STATE OF CALIFOR MIA IN RELATING TO WORKMEN'S COMPS ION INS NCE SIGNATURE OF ♦ FINAL BY PERMITTEE DATE ADDRESS M126 ZAts ♦ c rE L CITY NO PC Fee$ 6p Permit Fee V- • SU lownce Fee _ a VALUATION$ //%/ I ` _ J+ I �-_ 'W _ _ • h I Total Fee .J-7) Y-t PLAN CHECK VALIDATION CK _ o AEH PERMIT VALIDATIO cN O CASH 8 3 01Z AL 27 21 0 16.65 8 3 1�JIJL 27 1 0 55-50 AO�tl "ABABA CEISOSB TE/TE WORKERS COMPENSATION DECLARATION herebroffirm that I helve a cenificote of consent to self APPLICATION FOR BUI'LDI'NG HERMIT -, surw0a certificate of Workers Compensation Insurance or me,r43 combed ccolpry.thheerreof (Sec 3800,—Lab .�sC-) N COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No/_29( 0 Company 5 •�•r�GA� ❑ Certified copy is hereby furnished FOR APPLICANT TO FILL INADpRESS (/Q Certified copy is filed with the county building inspec- BUILDING _ ADDRESS �h�/on�dep�ort�finent �•s � ��a� � Date b3:::J _(f—Applicci ��M (-Jt�'T LiTy—ram PLC r 174 ZIPJjj� LOCALITY r NO OF NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT =SST COMPENSATION INSURANCE pS,<,OR ^y, (This section need not be completed if the permit is far one TRACT BLOCK LOT NO Z rpm PAGE O J PARCEL OI hundred dollars ($100) or less ) nn TEL 115E ZOO MAP OWNER F � NOINO I certify that in the performance of the work for which this •, SPECIAL Y permit is issued, I shall not employ any person in any manner ADDRESS f/�_ _ CONDITIONS 0- so as to become subject to the Workers' Compensation Lows OV CITY ZIP Dote Applicant 2Tiar E OR TEL DISTRICT GROUP TYPE PROCESSED BY d' NOTICE TO APPLICANT If, after making this Certificate of ENGINEER NO CONST ZONE r Exemption, you should become subject to the Workers' LJ Compensation provisions of the labor Code, you must forth- ADDRESS '� - �Lu with comply with such provisions w this permit shall be ' TEL STATISTICAL CLASSIFICATION APT CONDO Z deemed revoked CONTRACTOR NO �J / LICENSED CONTRACTORS DECLARATION UC CLASS NO DWELL UNITS — I hereby affirm that 1 am licensed under provisions of Chapter 9 ADDRESSL61 NO 4tf1Cf4V SEWER MAP (commencing with Section 7000)of Division 3 of the Business LIC and Professions Code,and my lice n in full force a(nd'elect CI ` CLASS SK PG VALIDATION License Number�Llc Clan�/ SIZEFT NO OF CHECK STORIES FAMILIES ONE _� /� ' y(/Jy� � VALUATION Contractor rom t�Date _ DESCRIPTION OF WORK ❑ 1, $ ❑1 am exempt under Sec IhV ❑ / w ► I B 8P C for this reasonPSE REPAIR ❑ s Dote I L� DEMOL ❑ - IXISTItdG BLDG G �L Signature APPL NT t TEL OWNER BUILDER DECLARATION I DATE 1 hereby affirm that I am exempt from the Contractor's License ASG •�• RNAI Law for the following reason (Section 7031 5, Business and ADDRESS Professions Code) PRESENT f/ ❑ I as owner of thero BUILDING e� IV p pony, or my employees with ADDRESS L ALI wages as their sole compensation,will do the work and \ w i (. •T the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code ) MOVING TEL ❑ I, as owner of the property,am exclusively contracting CONTRACTOR NO 1 ITE01 with licensed contractors to construct the project (Sec- ADDRESS . i tion 704 Busmen and Professions Code ) , 1 'i tITN� 307 cy CONSTRUCTION LENDING AGENCY SET YARD HWY TOTAL ROP IINCEFROM IDT r I hereby affirm that there is a construction lending agency for FRONT LNELK �Qy•56the performance of the work for which this permit is issued PL CHANGE ,ilsl (Sec 3097 Civ C ) SIDE PL Lender's Name �f • LDMA Ref Y� PC Fee$ Pon rmFee Lender s Address �5 I certify that I have read this application and state that the issuance Fee _ LDMA P/C 0 ► 3530 1 Art 7:i!: above information n correct I agree to comply with all County Invmegotion Fee 2 ordinances and State jaws relating to building construction, Total Fee d ` and hereby authorize representatives of this County to enter pY upon the a-Ment rse ropeny for inspection purposes f SEE REVERSE FOR EXPLANATORY LANGUAGE linif Signature of ATphcont or Age Date 'WORKERS COMPENSATION DECLARATION 1 hereby affirm that I have w certificate of consent to "If APPLICATION FOR BUILDING PERMIT •insure a certificate of Workers' CompensationtionInsurance or a certified cop thereof (Sec 3800, Lab C ) Y COUNTY OF LOS ANGELES - BUILDING AND SAFETY Policy No Comport �¢j�y� BUILDING Vila El copy a hereby furnished FOR APPLICANT TO FILL IN ADDR (�, Certtfred copy is filed with the county building irapec- A�DIDLRIES'S -r Wf L tion department Dat&Q Applicant CITY s ZIP LOCALITY 1 NO OF BLDGS NEAREST CERTIFICATE OF ATIO N RA NCE WORKERS' SIZE OF LOT NOW ON LOT CROSS ST COMPENSATION INSURANCE �A 2 �1 (This section need not be completed if the permit is for one TRACE BLOCK LOT NO MAP BOOK PAGB:/ % PARCEu./ hundred dollars ($I00)or less ) OWSER NO V TEL USE ZONE MP. I certify that in the performance of the work for which this fJ /us AIC:7616� permit is issued, I shall not employ any person in any manner ADDRESS _ ff,C> /C SPECTBIONS a so as to become subject to the Workers Compensation Lows CONDO CITY •GL ZIP - Date Applicant ARCHI C TEL DISTRICT GROUPTYPE FIRE PROCESSED BY K NOTICE TO APPLICANT If, after making thin Certificate of ENGINEER NO CONST ' ZONE O Exemption, you should become subject to the Workers' n 1' 17) Compensation provisions of the Labor Code you must forth- ADDRESS 10� - 3 I1,5 with comply with such Provisions or this permit shall be TEL STATISTICAL CLASSIFICATION APT (UNDO Z deemed revoked CONTRACTOR IUJCO CLASS NODWELL UNITS_ LICENSED m licensed un DECLARATION I here off that I am hcemed under ass ��Yh4 � SEWER MAP � by provisions of Chapter 9 SSC (commencing with Section 7000)of Division 3 of the Business and Professions Code,and my Irce u in full force and ect Cm ' �'' CUSS PG VALIDATION / 3 SLD FT NO OF NO F CHECK License Number / Lrc Class S1ZE STORIES FAMLotES ONE VALUATION Contractor Date '� DESCRIPTION OF WORK NEW s GUG' L-tJ ❑I am exempt under SecIF ADD ❑ ► ALTER ❑ B&P C for this reason REPAIR ❑ E Date115E OF EXISTING BLDG DEMOL ❑ Signature APPLICANT TEL I FINAL OWNER-BUILDER DECLARATION (PRINT) - AftNO DATE 3 3 y I hereby affirm that I am exempt from the Contractor's License Low for the following reason (Section 7031 5, Business and ADDRESS '� ' FINAL 1 Professions Code) ELDIN _ BY EJBUILDING rAll .i I, as owner of the property or my employees with ADDRESS wages as their sole compensation,will do the work and LOCALITY ► 3;; 17 I'v'y',�l. the structure is not intended or offered for sale(Section 7044 Business and Professions Code ) MOVING TEL ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO i 11 CFu- E I�- with licensed contractors to construct the project (Sec ADDRESS - TOTAL 189 _ 08 hon 7044 Business and Profesmons Code ) _ LC CONSTRUCTION LENDING AGENCY SETB CK YARD HWy TO INEFROM E I '_HELY 2-Z.IJi: WIDTH I hereby affirm that there is a construction lending agency for FRONT (Wa-E •Lkl the performance of the work for which this permit is issued P L (Sec 3097 Civ C ) SIDE PL Lender s Name LDMA.Ref N I'7 Vu-13001 10/ 4/Q 1 P C Fee f Permit Fee /nom 4v 1 AM D Lender s Address q�/ v.14 a I certify that I have read this application and state that the Issuance Fee P7• LD LA P/C N 0 above information is correct I agree to comply with all County Invesngaum Fee ordinances and State jaws relating to building construction Total Fee IS • LDMA Perm N < and hereby authorize representatives of this County to anter YA upo e-ElSdve-me a property for inspectio EEE REVERSE FOR EXPLANATORY LANGUAGE +gnoture o imnt or Dote