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HomeMy Public PortalAbout9734 WEDGEWOOD ST_Building__ . -r- _,r 7GA638A CE•r'SO- 6-62 APPLICATION FOR BUILDING PERMIT +� COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A.JENSEN,SUP'T OF BUILDING• CROSS ST. DISTRICT-NO.O. GROUP TYPEPROCESSED BY FOR APPLICANT TO FILL IN CONST. • BUILDING � STATISTICAL'CLASSIFICATION SEWER MAP , ADDRESS ^ � i BK PG / CLASS. NO. DWELL.UNITS LOT NO. BLOCK WATER NOT REQUIRED ❑ RECEIVED ❑ CERTIFICATE: TRACT MAP HIGHWAY NO.OF BLDGS. NO. Q .(CIRCLE) STATE MAJOR SECOND,LOCAL SIZE OF LOT NOW ON LOT USE ZONE SPECIAL USE OF CONDITIONS EXISTING BLDG. � A d(7 r� TEL. 6V OWNER O �x NO. BUILDING EXIST. SETBACK YARD HWY STREET NAME WIDTH ADDRESS FRONT ARCHITECT OR TEL. P. L. ENGINEER NO. SIDE > P. L.i a n ! A C ADDRESS j �y� y,� �_ TEL i A rA /J� J !;`f=ti' Rs` + s2-0 P,. e_1 3�XJ L CONTRACTOR NO. • / .' ti v • v ADDRESS �`'� /•':,t'>l. 1 r 3!sCr�! f I. DESCRIPTION OF WORK "'`{ "'`'� `% L LL NEW AD ALTER REPAIR DEMOLISH ! / v SQ.FT. NO.OF fv NO.OF =!1�r'�y >. " ��Ir•//f� p SIZE + STORIES FAMILIESUSE OF Aa- STRUCTURE p STR CTURE l�/� �/I CEJ Tp G iY +7f°`fi ' � !J.'y_"' .srE� V SIGNATURE OF (I Aj, e`��+ ' APPLICANT '�•Irsl� llf✓�`�':dl....�r. ....r�i. ��y'CNCY-] l�/.�:�G:�:1r{ l r� �:� VALUATION $ Q O -r � � - - !Y APPROVALS- DATE INSPECTOR'S SIGNATURE P.C. PMT. `` p 0 FOUNDATION: LOCATION FEE $ S FEE'$ /Y FORMS, MATERIALS �) FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ' FURNACE: LOCATION, 'y.�..s'" t WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS BUILD INGCONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- LATH. INT. /.'P �r;� `/✓;.+;yi[.�'�f'r r ING TO WORKMEN'S COMPENSATION INSURANCE. / .7 �'' p• �- •i , LATH.EXT. ' / f%" .s.r .':`-.• ^,Y SIGNATURE OF HOUSE NUMBER COR- PERMITTEE RECT AND POSTED A/V p,~ T( +�_ ,JA M ADDRESS FINAL A wo° �v';F' JOHN F. LEW15, PRINCIPAL RUCTURAL 8'NG)N ER PIAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH TES 76A638A CE#8032-63 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST Jf WILLIAM A.JENSEN,SUPT OF BUILDING CROSS ST. DISTR T N_P_ GROUP TYPE ESSED BY FOR APPLICANT TO FILL IN OY CONST: BUILDING /✓ �/ STATISTICAL CLASSIFICATION S ER MAP ADDRESS / 7� BK P CLASS..NO. DWELL.UNITS LOT NO. 17 v BLOCK WATER NOT REQUIRED RECEIVED ❑ _ TRACT �/J -CERTIFICATE: NAP (/ ({CI CVL AY NO..OF BLDGS. ,• E) STATE MAJOR SECOND, CA ' SIZE OF.LOT NOW ON LOT USE ZONE. SPECIAL. USE OF CONDITIONS EXISTING BLDG. /ll.. TEL.[[�� OWNER Q NO. / BUILDING EXIST. SETBACK YARD HWY STR T NAME WIDTH ADDRESS FRONT ARCHITECT O TEL. kP• L• - ENGINEER NO. SIDE ADDRESS O i TEL. V CONTRACTOR W/✓�'jL._ NO. ADDRESS . O DESCRIPTION OF WORKLud N NEW ADD ALTER REPAIR DEMOLISH Z SQ.FT. / J NO.OF NO.OF L- - SIZE STORIES., FAMILIES USE OF ti®� STRUCTURE 1/✓ SIGNATURE OF APPLICANT VALUATION $ APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. FOUNDATION: LOCATION FEE $ FEE $ _ FORMS, MATERIALS FRAME: FIRE STOPS, r ✓,r: vj I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS ,¢`•' _J _;` i' AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. 'Iv ` ' r - WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK ` AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- AUTHOR LATH, INT., TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- \ ING TO WORKMEN'S COMPENS TION INSURANCE. LATH, EXT. SIGNATURE OF HOUSE NUMBER COR- PERM ITTEF OR-PERMITTEE RECT AND POSTED ti y� r r f FINAL ,r ,��rFl ADDRESS �, JOHN F. LEWIS. PFi~INCIFAL'ST.R TURAL EC.�A..)PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. LJAC0 3 6 2 1 GO DEC 17 - 1 D 6.0 0- 76A638A CE#803 6-62 APPLICATION- FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS F 7-044 BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE.COUNTY ENGINEER NEAREST WILLIAM A.JENSEN,SUPT OF BUILDING CROSS ST. DISTRICT NO. G P TYPE P S FOR APPLICANT TO FILL IN CONST. BUILDINGC STATISTICAL CLA ]CATION S ER MAP ADDRESS 3 aDc7L n0 Sr BK ZG CLASS.NO. DWELL.UNITS L'OT NO. BLOCK WATER CERTIFICATE: NOT REQUIRE RECEIVED 11 TRACT MAPHIGHWAY STATE MAJOR SECOND, OCAL NO.OF BLDGS. NO. (CIRCLE) SIZE OF LOT//0 yof NOW ON LOT USE ZONE SPECIAL USE OF ^wiF"'A( G A— 1 CONDITIONS EXISTING BLDG. ,(J TEL. '7 OWNER E Sd NO. / BUILDING YARD HWY STREET NAME EXIST. SETBACK WIDTH' ADDRESS '77.3-ot- b Sr FRONT71 ARCHITECT OR TEL. P. L. au-) ENGINEER NO. SIRE �- ADDRESS P. 4�yQ 7r ; �A I/� ) Q pp�•� TEL. lfJ 1).. .�144`.b t 4 1 y.s_'ly..f ��, CONTRACTOR e/LV N L NO. 4 C A eJ�°1j�� �Q° �1 ADDRESS v� . a � a. DESCRIPTION OF WORK �'� ''�;,^"p, -y °'°t�A^ LL t'' fir, 0 ADD ALTER REPAIR DEMOLISH "h .,�1f+r fq Y. ?" v 1. t�.�?i:! .�� '��t%/ . �C C i"'✓ate - ' e Z SQ.FT. �/ NO.OF NO.OF . xs SIZE 4-�j�© STORIES FAMILIES f / USE OF 'r ✓ STRUCTURE G t r .- SIGNATURE OF APPLICANT VALUATION $ 3w 0-0 APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. FOUNDATION: LOCATION /7 � •!' , j,�°k FEE $ FEE $ -'<© FORMS, MATERIALS FRAME: FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS •/� AND STATE THAT THE ABOVE IS 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 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- LATHINTf^ ��'^'"-' "'�� TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT. LATH. INT. 0 I ING TO WORKMEN'S COMPENSATION IN ~NCE. LATH, EXT. � F/ / �3 SIGNATURE O 1 ` HOUSE NUMBER COR- .e PERMITTEE A1C RECT AND POSTED ADDRESS FINAL h A5 JOHN F. LEWIS. PRINCIPAL STRUCTURAL EN R PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH �"j" 3 0 2 1 Z" A;R 3 1 D 11 ,50- -tk'MOLE CITY • - ti 4 FQ1nn C8 hot.I-e1, APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING 93 DEPARTMENT-OF COUNTY ENGRUM ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST WILLIAM,A.JENSEN SUPT OF BUILDING CROSS ST. DISTRION GR fypE I O Y FOR APPLICANT TO FILL IN (//1 coNsr. BUILDING z ll,n. -STATISTICAL C IFICATION SEWER MAP ADDRESS K CCAS,S.NO. DWELL.UNITS� LOT NO. • / BLOCK WATER NOT REQUIRED RECEIVED CERTIFICATE: rIT=l� �� TRACT //-/.3 I MAP /I D HSG-WEA STATE MAJOR SECOND CAL ® NO.OF BLDGS. NO. (/ SIZE OF.LOT•I�� Y- if v I NOW ON LOT USE ZONE SPECIAL USE OF CONDITIONS EXISTING BLDG. TEL. OWNER NO. BUILDING EXIST. f . SETBACK YARD HWY STREET NAME WIDTH` ADORES w FRONT Q ARCHITECT-OR TEL.- P.L. N C! ENGINEER NO. FIDE ADDRESS } TEL. VVINSPECTION RECORD a CONTRACTOR NO. c, >/-1 + f. O 9144 U ADDRESS ` � OG DESCRIPTION OF WORK ' � +�% � /..4 0 SC=I.e-- �0.mLi Oi 1• ��]��� ' a NEW ADD ALTER REPAIR DEMOLISH SQ.FT. NO.OF NO.OF C Cet7 -F,, z SIZE STORIES FAMILIES USE OF , — STRUCTURE Kmst SIGNATUREOF S ? r dr APPLICANT J _ 'Ckls` V y yr VALUATION$ "f-a���_ � °i � ,/�:"t:'��1`•' �J �� I •� APPROVALS DATE I NSPECTOR'S.SIA NATURE FEE $ FEE'53 , FOUNDATION'LOCA ION FORMS,MATERIALS / FRAME:FIRE STOPS; .1 HEREBY.ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS AND STATE:THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE'LOCATION. (�J /�' ,f�� ^ y� WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS /JI)?/,"iR` ,✓ �+t .i BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH,.INT. / \' �• 1� TION OF THE L48OR CODE OF THE STATE OF CALIFORNIA RELAT- ING TO WORKMEN'S COMPENSATION 1 �SURANCE. � f LATH,EXT. d \ SIGNATURE OF HOUSE NUMBER COR- r �,�.� PERMITTE RECT AND POSTED f a ADORES FINAL 7/, Jd w. �.•+ r , CLYDE N. DIRLAM, PF{INCIPAL STRUCTURAL.EN PLAN CHECK VALIDATION cH, m.o.' cAsR PERM VALIDATION cK. m-O. 2 7 SEP �. S I~ lf' r APPLICATION FOR BUILDING PERMIT F JR APP;� a LICANT TO FILL IN (Print or type only) COUNTY OF LOS ANGELES BUIL"Ll ADDRESS 3 sa 4 o c r > ' DEPARTMENT OF COUNTY ENGINEER CITYi C r-'►Pt_A C IT zip 917rs-. 0 BUILDING AND SAFETY�DyIV�IIS�IOO�N NO.OF BLDGS. BUILDING SIZE OF LOT j<Z O jR ,� 'G NOW ON LOT ADDRESS �/ I■AE4We/ (COD TRACT �` BLOCK LOT NO. LOCALITY NEAREST OWNER IVI:V)L' . �Y-� i�J�O QNO.? C OSSST. ASSESSOR ADDRESS A$ a i!JC, MAP BOOK PAGE PARCEL DISTRICT I GROUP ' TYPE FIRE nPSED BY .CITY ' !Z r' 6i C'1 7 ZIP 9) -7 ES C1 b4CONST ZONEARCHITECT OR TEL. ° J_ ENGINEER NO. STATISTICAL CLASSIFI TION SEWER MAP ADDRESS –' CLASS NO. DWELL.UNITS N BK TEL. CONTRACTOR ' NO. USE ZONE NOP �� LIC. SPECIAL ADDRESS NO. LIC. CONDITIONS CITY - - CLASS- ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ CONSTRUCTION LENDER_ NAME AND BRANCH —�� BLDG.SETBACK FROM FRONT PROP.LINE OF �N�A40�0,& ISTREET) ADDRESS- CITY TOTAL SETBACK FROM TYPE OF EXISTING SQ.FT., NO.OF NO.OF CHECK HIGHWAY +70ARD = FRONT PROP.LINE HIGHWAY WIDTH SIZE G23 STORIES FAMILIES f ONE vv DESCRIPTION OF WORK `-~ NEW ❑ +\ C/ O .P 11 ADD ❑ BLDG.SETBACK FROM )STREET) O S3 G �ZY' ) SIDE POP.LINE OF D ALTER TOTAL SETBACK FOM TYPE OF EXISTING G �. C,. 1 %=Sco F.K HIGHWAY + YARD = SIDE PROP.LINE HIGHWAY WIDTH • y USEOF �RTN orJn REPAIR ❑ Z EXISTING BLDG. }�6 DEMOL ❑ + APPLICANT !I IN OPEN SPACE YES ❑ NO ❑ BY(SIGNATURE) 1 N"_ IN COASTAL PERMIT ZONE YES ❑ NO ❑ VALUATION$ 3, Got / I THE HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE '6 ' ANDTHALAWS REGULATINVE IS G BUILDING DATE O MAKE CHECKS PAYABLE TO: FEE $ FET HARVEY T.BRANDT,COUNTY ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION cz. M.O. CASH 8 9 9 Lr.'APR 2:6 -1 D 28.5.0 A°;3 06 76A638A CE#803 3.75' WORKERS'COMPENSATION DECLARATION 880317 SB insure,oraffirm that te of Workers' Compensation eInsuran elf APPLICATION FOR BUILDING PERMIT or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy NW0007 146 Campa4eaver Ins. ❑ BUILDING Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS ) ® Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS 9734 E. Wedgewood Date 7/1/88 Applican�1t irgin Roof Co. CITY Tpmplp City, CA ZIP 91780 LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. NEAREST 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 TEL. USE OWNER Mrs. Radford ONE MAP I certify that in the performance of the work for which this NO. NO. permit is issued, I shall not employ any person in any manner SPECIAL , so as to become subject to the Workers'Compensation Laws. ADDRESS as above CONDITIONS C) CITY ZIP V Date Applicant TEL.ARCHITECT OR M NOTICE TO APPLICANT: If, after making this Certificate of DISTRICT OUP TYPE FIRE PROCESSED Y O Exemption, you should become subject to the WorkersENGINEER NO. CONST. ZONE ~3 / C Compensation provisions of the Labor Code, you must forth- ADDRESS y G W with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. CONDO . CL deemed revoked. CONTRACTO NO. Z LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS — I BOX J I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. 160650 (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 CA CLASS C39 BK PG VALIDATION 160650 C39 SQ. FT.33OO NO.OF 1 NO. OF CHECK License Number Lic.Class SIZE STORIES FAMILIES ONE r� Contractor_ Virgin Roof Co.Dat�130/89 DESCRIPTIONOFWORK Tear off existing NEW ❑ $A�ttG/LL��pp�T��pp.U0 ❑I am exempt under Sec. except new addition, apply ADD ❑ pill.❑ B.BP.C. for this reason Cl "C" Heavy Shakes. 33 sqs. REPAIR ❑ $ Date: USE OF EXISTING BLDG. dwelling DEMOL ❑ Signature APPLICANT TEL. FINALS OWNER-BUILDER DECLARATION PRI NO. — DAT�-/ ` ` ;201 7. 5A I hereby affirm that I am exempt from the Contractor's License PO BOX JSan Gabriel, CA 9 1778 Law for the following reason (Section 7031.5, Business and ADDRESSPO FINA # • • • • •+1 Professions Code): P By E] BUILDING 1 e tJ 2 4,8 8 I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY ' ,+ �� SS • • 124,885 7044, Business and Professions Code). MOVING TEL. j)7, 1 3­88 ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. y� with licensed contractors to construct the project (Sec- ADDRESS dry tion 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY SET�BACKK YARD HWY ED TOTAPROP.IINE WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.I. (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name 3 P.C. Fee$ Permit Fee 1 14 .38 LDMA Ref. N Lender's Address ' I certify that I hove read this application and state that the Issuance Fee 10.50 LDMA P/C N 2 above information is correct. I agree to comply with all County Investigation fee ordinances and State laws relating to building construction, Total Fee 124 .88 LDMA Perm. N Z and here y authorize representatives o his County to enter upo th above.mentoned pr rt fo in ection p rposa . o f1 SEE REVERSE FOR EXPLANATORY LANGUAGE Si Gre of App+ ant or Agent Dote WORKERS'COMPENSATION DECLARATION .I hereby affirm that I have certificate of consent to self APPLICATION FOR BUILDING PERMIT •insure, ori`certificate of Workers'Compensation Insurance, or a cert�ifi�copy thereof(Sec. 800, Lab. C.) Policy N6l�AD740%' pa COUNTY OF LOS ANGELES BUILDING AND SAFETY ❑ Certified copy is hereby fu is ed. FOR APPLICANT T FILL IN BUILDING �� Q� ❑ Certified copy is filed with t county bui i spec- BUILDING / ADDRESS �C/ tion department. ADDRESS � �j A 41 A Dato- %_ � Applicant d CITY % ZIP �� LOCALITY CERTIFICATE OF EXEMPTION FR M ERS' NO.OF BLDGS. NEAREST COMPENSATION INSURA SIZE OF LOT NOW ON LOT CROSS ST. (This section need not be completed if f e permit is for one ASSESSOR hundred dollars ($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL TEL. USE ZONE MAP I certify that in the performance of the work for which this i OWNER 097,311 & �.-y y-'r NO. NO permit is issued, I shall not employ any person in any manner ADDRESS '9 /� C/ �-,� SPECIAL so as to become subject to the Workers'Compensation Laws. _ `/ CONDITIONS CITY I Fi/�! G�J �l%T ZIP 9��g 99 Date Applicant 99 NOTICE TO APPLICANT: If, after makingthis Certificate of ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PR C ED BY O ENGINEER d 'r NO�Q3 CONST. ZONE U Exemption, you should become subject to the Workers' /)Y � Compensation provisions of the Labor Code, you must forth- ADDRESS L(f,0 , L//J �r� I✓ with comply with such provisions or this permit shall be deemed revoked. EL... STATISTICAL CLAS I TION APT. CON 29 /,� �SZS CONTRACTOR LICENSED CONTRACTORS DECLARATION CLASS NO. DWELL. UNITS - 1 hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 31M6�lsA (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. CITYCLASS VALIDATION r, /)/`� SQ.FT. r/� NO.OF / NO.OF CHECK BK' PG' License Numb r Lic.Class c-�J, SIZE ��G STORIES / FAMILIES ONE 9 9�� DESCRIPTION OF WORK Al VALUAT Contractor 6 NEW xx ❑ ADD ❑ $ Q. �V `� 2g7,2 I am exe t under Sec. , ALTER ❑ A B.BP.C. for h reason USE OF REPAIR ❑ $ '0 0 c0 0 10�nQ 1111119' Date: EXISTING BLDG. DEMOL ❑ O Signature APPLICANT TEL. FINAL / # a a o 0 o OWNER-B DECLARATION (PRINT) NO. / /i 1 hereby affirm that I a tempt from the Contractor's License DATE 'l Fi ( o o59,25 Law for the following reason (Section 7031.5, Business and ADDRESS FINAL Professions Code): PRESENT By a a a 5 9.2 5'0 E] BUILDING 09.09-85 I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and , 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. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK FR XI CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP.LINE WIDTH 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 a P.L. Q Lender's Name Permit Fee � LDMA Ref. # Le er's Address P.C.Fee$ - ' r I ify that I have ead application and state that the Issuance Fee LDMA P/C# ab information i corr I agree to comply with all County Investigation Fee or in nces and St e I relating to building construction, Total Fee (� LDMA Perm. # an reby outh z esentatives of this County to enter upo a above- d property for inspection purposes. a �—g e SEE REVERSE FOR EXPLANATORY LANGUAGE Signatu Applicant or Agent Date I O i • COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1406190065 PHONE: (626) 285-0488 EXT: [LEGAL ID: I NO. OF CONST I BUILDING ADDRESS: [ [TR: 11131 LT: 7 [ SQ. FT STORIES TYPE [ 9734 WEDGEWOOD ST [ ISTRUCTURE: V-B [ TEMP CA 917802535 I [ASSESSOR INFORMATION NUMBER: [ [ NEAREST CROSS STREET: GOLDEN WEST [ 18588-010-001 1 1 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY, Cl [TENANT: [EXIST BLDG USE: RESID USE ZONE: R-1 [ISSUED ON: PROCESSED BY: [ IEXIST OCC GRP: 106/19/14 SR [OWNER: TEL. NO: IBLDGS. NOW ON IAT: VALUATION: IF FINAL BY: CODE: AL DAT [ [FU/DONG, JENNIFER/PAUL ( [ 8,000 I �� [ 19734 WEDGEWOOD ST [ _1_ J [ [TEMP 917802535 [ FEES PAID ID SCRIPTIO OF WORK I [ IBATHROOM REMODEL - REPLACE ALL FIXTURES, WATER CLOSET, TUB, IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:[SHOWER, LAVATORIE. REPLACE 4 WINDOWS 1 SLIDING DOOR [ [APPLICANT: TEL. NO: I I [ ISAME AS OWNER - IAA BLDG PERMIT ISSUANCE 27.80 [ [ [AB STATE GREEN BLDG FEE 8000.00 VAL 1.00 ISPECIAL CONDITIONS: [ [ IAC STRONG MOTION REBID 8000.00 VAL 0.80 [ [ IB1 PLANCHECK W/ENBRGY 8000.00 VAL 171.20 [ [ [ [B2 PERMIT W/ENERGY 8000.00 VAL 201.30 [ [ [CONTRACTOR: TEL. NO: I TOTAL FEES 402.10 [APPROVALS DATE INSPECTOR SIGNATURE [ [SAME AS OWNER - I I I I LIC. NO [ [LOCATION AND SETBACKS [ [ [ [ [ ISOILS ENGINEER APPROVAL [ I [ARCHITECT OR ENGINEER: TEL. NO: [ [FOUNDATION/TRENCH FORMS I I I LIC. NO: [ [SLAB/UNDER FLOOR I I I [ [RAISED FLOOR FRAMING I I I I I I [MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:[ [UNDERFLOOR INSULATION I I 1147H269 3 001 I [ 1 [ I IFLOOR SHEATHING I I [ [NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I [ I [ [ 0 NO 21 [ [ROOF SHEATHING [ [ [ SCHOOL WITHIN HAZARDOUS [ [SHEAR PANELS [ 1 [ [AIR QUALITY: 1000 FEET MATERIALS [ NO NO NO [ [FRAME INSPECTION I I [ IFIRE SPRINKLER HANGERS [ [ [ I I I I I [ [INSULATION/WEATHER STRIP[ [ [ [ [ [INTERIOR LATH/DRYWALL [ [ [ [ I [EXTERIOR LATH [ [ [ [ [ [RATED FLOOR/CEIL ASSEM. [ [ [ [ [ IRATED WALL ASSEMBLIES [ [ [ [ [ [RATED SHAFTS/OPENINGS [ [ [ [T-BAR CEILINGS [ [ [ 1 [ I I [ [ [LOT DRAINAGE I I [ [REPORT ID: DPR261 ROUTE TO: BS0508 [ I [ [ I I I I I r COUNTY OF IAS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1005120001 PHONE: (626) 285-0488 EXT: ILEGAL ID: NO. OF CONST BUILDING ADDRESS: ITR: 11131 LT: 7 1 SQ, FT STORIES TYPE 9734 WEDGEWOOD ST I (STRUCTURE: V-B TEMP CA 917802535 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: GOLDEN WEST 18588-010-001 1 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY, Cl ITT EXIST BLDG USE: RESID USE ZONE: R-1 JISSUED ON: PROCESSED BY: EXIST OCC GRP: 105/12/10 SR 1 (OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: IF T FINAL BY: CODE: IFU, JENNIFER JILIN ( I 7,000 I ''i 9734 WSDGEWOOD ST I I /3 TEMP 917802535 FEES PAID IDESCRIPTION OF WORK I IBATHROOM REMODEL IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT:1 1 (APPLICANT: TEL. NO: [ ISAME AS OWNER - IAA BLDG PERMIT ISSUANCE 27.75 I I I �AB STATE GREEN BLDG FEE 7000.00 VAL 1.00 ISPECIAL CONDITIONS: [ AC STRONG MOTION RESID 7000.00 VAL 0.70 I I 1 B2 PERMIT W/ENERGY 7000.00 VAL 182.82 [ I (CONTRACTOR: TOTAL FEES 212.27 I I TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE I [SAME AS OWNER - II 1 LIC. NO 1 ILOCATION AND SETBACKS I 1 1 ISOILS ENGINEER APPROVAL [ I I 1ARCHITECT OR ENGINEER: TEL. NO: - 1 1FOUNDATION/TRENCH FORMS I I I 1 LIC. NO: 1 [SLAB/UNDER FLOOR I I o I IRAISED FLOOR FRAMING I 9 1MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP-1 1UNDERFLOOR INSULATION I I I147H269 3 001 I I IFLOOR SHEATHING I I I INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I NO 21 —1 ytp�` 1 f/ IROOF SHEATHING I I I SCHOOL WITHIN HAZARDOUS ISHEAR PANELS I I I IAIR QUALITY: 1000 FEET MATERIALS [ I I 1 NO NO NO IFRAME INSPECTION I I I 1 IFIRE SPRINKLER HANGERS [ [ [ 1 1 IINSULATION/WEATHER STRIP( I I 1 1 11NTERIOR LATH/DRYWALL I I (EXTERIOR LATH I I If I IRATED FLOOR/CEIL ASSEM. I 1 IRATED WALL ASSEMBLIES I I I I 1 IRATED SHAFTS/OPENINGS 1 I I I I 1T-BAR CEILINGS 1 1 LOT DRAINAGE I I I 1 IREPORT ID: DPR261 ROUTE TO: BS0508 I I I I I WORKERS'COMPENSATION DECLARATION • 1 v hereby affirm that ! .have a certificate of consent to self Fi® �L I CAT I®N F® I L D I N G PERMIT tsure,or a certificate*Workers'Compenstion Insurance,or certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGEL6 BUILDING AND SAFETY :)I icy No. Company BUILDING Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS r- _ E I D O C! JCertified copy is filed with the county building inspec- BUILDING tion department. ADDRESS P I +` • �� ��v�u - ; LOCALITY �� C� NEAREST .r ate Applicant CITY I�� <.F ( ( ZIP / 7$Q CROSS ST. j, JC CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. ASSESSOR aj P COMPENSATION INSURANCE SIZE OF LOT X NOW ON LOT d N� MAP BOOK PAGE 7'�O PARCEL section need not be completed if the permit is for one f TRA 1.1 �5� BLOCK LOT NO-Pt U ON �SPEZCDIAL" P1�we 11K MA undyed dollars($100)or less.) •�\c TEL. NS ermit is issued, I shall not employ any person in any mannerci (STRICT GROUP TYPE FIRE CE BY as to become subject to the Workers'Compensation Laws. ADDRESS I D1 �— �V � Wo�('i •�[ /�^� CONST. / Z CITY 1 C-!8(�E C- I ZIP 1 (7 �c .10 ff/ ate Applicant STATISTICAL CLASSIFICATION rA1111­, CONDO. c r [ CLASS NO. DWELL. UNITS IL cemption, you should become subject to the Workers' y� ompensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP ,ith comply with such provisions or this permit shall be e eemed revoked. t. CONTRACTOR S ^ BK. / VALIDATION LICENSED CONTRACTORS DECLARATIONt L hereby affirm that I am licensed under provisions of Chapter 9 t ADDRESS O. VALUATION :ommencing with Section 7000)of Division 3 of the Business and LIC. •ofessions Code, and my license is in full force and effect. CITY CLASS $ SQ. FT.G c,l NO.OF NO.OF CHECK cense Number Lic.Class SIZE v /'F STORIES ( FAMILIES 1 ONE F ] $ ontractor Date DESCRIPTION OF WORK FAM �+, NEW ��/ J' 0 0 0 0 2 ? I am exempt from the licensing requirements as I am a `� d ADD . / 0 1 O 2 r C licensed architect or a registered professional engineer ALTER ❑ FINAL 7' d?;lactin in m rofessional ca acit Section 7051, IIREPAIR DATE Z � o o " r 3 9 Y P capacity +;: ❑ 1 Business and Professions Code). USE OF FINAL EXISTING BLDG. kO T'� DEMOL ❑ By C � 205-82 c.or Reg.No. Date APPLICANT TEL. OWNER-BUILDER DECLARATION PRINT) �VIJ Ad % N0" ` hereby affirm that I am exempt from the Contractor's License ADDRESS �eJ 4 G a J1 � / �w for t�^following reason (Section 7031.5, Business and I rof sTons Code): " BREEDING qtr �) I, as owner of the property, or my employees with ADDRESS °s r*- k � wages as their sole compensation,will do the work and If the structure is not intended or offered for sale(Section LOCALITY z `-" G 7044, Business and Professions Code). MOVING TEL. C. I,as owner of the property, am exclusive) contracting CONTRACTOR NO. Q� P P y y g H o o 0 0 0 � with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). j 0 z 7 7 G REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. INE DTH hereby affirm that there is a construction lending agency for FRONT ie.performance of the work for which this permit is issued P L. iec. 3097, Civ. C.). -SIDE 2 0 F—n :. P.L. snder's Name ender's Address P.C. Fee$��Vee ✓ ( Permit Fee !(/✓ certify that I have read this application and state that the /4 eggIssuanceFee �V bove information is correct. I agree to comply with all County Investigation rdinances and State laws relating to building construction, nd hereby authorize rep esentatives of this County to nter To Fee r Pon t e abov -me n. pro rty for inspection pu set. III r .. �� SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant Agenl Dot ®s