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Home My Public Portal About9547 WEDGEWOOD ST_Building__ DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES BUILDING t l -0 WM. J. FOX, CHIEF ENGINEER � FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING7}rr DISTRIC'T.N0. PLAN CK. NO./� PERMIT NO. ADDRESS / l / .. .4e,w 6 d :'. LOCALITY RECEIVED BY DATE OF APF L. DATE ISSUED �a NEAREST M CROSS ST. BUILDING J U ADDRESS �i�/ OWNER f MAIL {;. , NEAREST CITY - _ ' �� FIRES ST. ` NO. OF I�TYPE I GROUP .T ARCHITECT OR TEL. ZONE PLANS ENGINEER NO. BLDG. 1,R"04 SETBACK L /��(/ ADDRESS � OVED / /�TEL. BY DATE , CONTRACTOR r,d N.. t,�.lA1,; l 0-NO. ��3 I USE ,Q APPROVED ZONE / r BY ,(. DATE ADDRESS! �/(� HOUSE NUMBERING LEGAL DESCRIPTION I LOT NO. I BLOCK MAP NUMBER a-OD _FIELD CHECK BY TRACT ��., 6 �.�/ NO. ASSIGNED BY nATE_ r 1 NO. OF BLDGS. CORRECTIONS SIZE OF LOT 0 Q I NOW ON LOT O a'� USE OF I NO. OF EXISTING BLDG. FAMILIES e� DESCRIPTION OF WORK _ Z S NEW I ALTERATION I I ADDITION I •o 2 jo REPAIR I •.DEMOLITION SQ. FT.. . _ "�► - NO. OF - , SIZE - ROOMS STORIES D EXT. WALL ROOF _ ` 17 COVERING ( COVERING I �• �f"/�{/i USE OF STRUC URE I � �fi a - � I— SZ Lek . „ APPROVALS INSPECTOR'S SIGNAT RE DATE 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FOUNDATION: LOCATION PLICATION AND STATE THAT THE INFORMATION GIVEN IS FORMS, MATERIALS CORRECT. - I AGREE TO COMPLY WITH THE CORRECTIONS LISTED FRAME: FIRE STOPS, HEREON AND WITH ALL COUNTY ORDINANCES AND STATE BRACING, BOLTS LAWS REGULATING BUIL IN CONST UCTION. FURNACE: LOCATION, SIGNATURE OF _` GAS VENT, DUCTS PERT _TE ` LATH, INT. ADDRESS i LATH, EXT. Y AUTHORIZED AGT. .01 PLASTER, INT. 76A698A, OBS3 10-50P. C. $ FEE �� PLASTER, EXT. VALUATION.. {„7" ' FEE $ 3 0_ G /' FINAL ra / la f WORKERS'COMPENSATION DECLARATION 1 hereby affirm that I have certificate of consent to self APPLICATION FOR BUILDING PERMIT insure, or a certificate of Workers'Compensation Insurance, or a certified copy thereof (Sec. 3800, Lab. C.) i COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. 1 n461�ifiGompany State Fttnd BUILDING Certified copy is hereby furnished. I FOR APPLICANT TO FILL IN �• ADDRESS EDCertified copy is filed with the county building inspec- BUILDING tion department. ADDRESS 9547 Wedgewood, Temple City el Date 11-1-88 Applicant Randol Roofing CITY ZIP91 7ROLocALITw— �i ✓✓ CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. NEARES 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($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL OWNER Barbara Wetton USE ZONE MAP �,_ I certify that in the performance of the work for which this NO. permit is issued, I shall not employ any person in any manner ADDRESS 9547 WedgeWOOd CONDITIONS SPECIAL so as to become subject to the Workers'Compensation Laws. U Dore 9-7-8.8 Applicant Randol roofing CITY Temple Cit Ca. ZIP 91780 0 NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE R ESSED BY O ENGINEER NO. CONST. ZONE I1-- Exemption, Exemption, you should become subject to the Workers' Q 0 Compensation provisions of the Labor Code, you must forth- ADDRESS O —I N✓ 1.1 ELI with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. CON CA)deemed revoked. CONTRACTOR Randol RoofingNO. 288-40 0 Z LICENSED CONTRACTORS DECLARATION L1C. CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 529 E. Valley Blvd NO 451937 (commencing with Section 7000)of Division 3 of the Business and LIC SEWER MAP Professions Code, and my license is in full force and effect. CITY San Gabriel, C a. CLASS C-39 VALIDATION SQ.FT. NO.OF NO.OF CHECK PG. Number 451937 Lic Class C-39 SIZE STORIES FAMILIES ONE �Eyy VALUATION Contractor Randol Roofing DO}e 9-7-88 DESCRIPTION OF WORK — ADD 1$ 1929.00 I am exempt under Sec. with Barth Tile, Class A. Roof. ALTER B.BP.C. for this reason REPAIR ® $ Date: USE OF EXISTING BLDG. SED DEMOL ❑ Signature APPLICANT TEL. FINAL / PRINT andol RoofingNo. 288-4040 OWNER-BUILDER DECLARATION DATE I hereby affirm that I am exempt from the Contractor's License ADDRESS E. Valley Blvd. S.G. 91776 FIN Law for the following reason (Section 7031.5, Business and Professions Code): r B ❑ BUILDING I, as owner of the property, ormy employees with ADDRESS wages as their sole compensation,will do the work and LOCALITY 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. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). REQUIRED YARD HWY TOTAL SETBACK CONSTRUCTION LENDING AGENCY SET BACK PROP. LINE WIDTH YY 4r Eg I hereby affirm 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 / q P.L. 7 ff Lender's Name m P.C.Fee$ Permit Fee LDMA Ref. # Lender's Address I certify that I have read this application and state that the 10.50 c fy pp Issuance Fee � kLD P/C# above information is correct. I agree to comply with all County Investigation Fee 2,— q ordinances and State laws relating to building construction, oral Fee $49.88 LAMA Perm. # $ and e y aur oriz representatives of this Count to enter u t a o -m oned op for inspe n urp ses. 7 SEE REVERSE FOR EXPLANATORY LANGUAGE , Signature o Applicant or Agent D