HomeMy Public PortalAbout9069 WOOLLEY ST_Building__ r APPLICATION FOR BUILDING_ PERMIT �Jt 1I
FOR APPLICANT TO FILL IN (Print or type only) I I
BUILDING BUILDING LJ
ADDRESS 06 WOOLLEY ADDRESS 9067 WOOLLEY
CITY TEMPLE CITY ZIP ()1780 LOCALITY TEMPM CITY
A `, NO.OF BLDGS.
SIZE OF LOT (XJ Jc 37 NOW ON LOT NEAREST
r / CROSS ST.
ASSESSOR
TRACT�$�Q'Id BLOCK LOT NO 4 MAP BOOK PAGE PARCEL
OWNER
RIAM THIEB NOL2 - DISTRICT G CYP T ZFIRE OC SED BY
ADDRESS 9067 WOOLLEY • ,01,-orr
STATISTICAL CLASSIFICATION SEWER AP
CITY TEMPLE CITY ZIP Ca78O
ARCHITECT ORBARRY BARON TEL RR (� CLASS NO-3�DWELL.UNITS BK PG
ENGINEER NO. 788-019 a ZQNE MA NOP t!1 G�
ADDRESS 13824 VENTURA SHERMAN OASPECIAL
IT ONS
CONTRACTOR AQUATIC POOLS NOL•446-466
ROAD D PARTMENT APPROVAL REQUIRED YES❑ NO❑
ADDRESS101 E. HUNTINGTOI�io. 3111 620 BLDG. ETBACK FROM
CITY ARCADIA,CA LIC.CLA —53 FRON PROP.LINE OF (STREET)
HIGH Y + YARD - TOTAL SETBACK FROM TYPE OF EXISTING
CONSTRUCTION LENDER FRONT PROP. LINE HIGHWAY WIDTH
NAME AND BRANCH
ADDRESS CITY
SQ. FT. NO. OF NO. OF CHECK BLDG.SETBACK FRO c'
CD
SIZE STORIES FAMILIES ONE SIDE PROP.LINE OF (STREET)
V
DES'CRI.PTION OF WORK NEW ❑ HIGHWAY + YARD = TOT L ETB. ROM TYPE OF EXISTING
SIDE PR P. LINE HIGHWAY WIDTH CD
SWIMM:ENG POOL 42() DD ❑ v
Lu
LTER ❑ +
n N
7:2I _ CORNER CUTOFF YES ❑ NO ❑
REPAIR[]
USE OF
EXISTING BLDG, DEMOL ❑ IN OPEN SPACE YES ❑ NO ❑
APPLICANT TEL IN COASTAL ZONE YES ❑ NO ❑
(PRINT) NO.
CATEGORICAL EXEMPTION YES❑ NO ❑
BY (SIGNATURE) ENVIRONMENTAL
4 ) 200 ^^ z/6D_ IMPACT EXEMPTION DECLARATION SIGNED (DATE)
VALUATION i� • IMPACT REPORT PROCESSED (DATE)
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION. IC
THAT IN DOING THE WORK AUTHORIZED
HEREBY i WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
LABORWORKMEN'SOCOMPETHET STATE INS F CALIFORNIA IN RELATING TO 9 /A _ .r� r^r 01-T e,
QUAT POO FINAL 1BY
��r1 /`a
SIGNATURE O f�o
PERMITTEE _ DATE -� -�
ADDRESS 101 s HUNTINGTON DRIVE FEE FEEPMT.
$ '/
TEL 7S
CITY
PLAN CHECK VALIDATION CK.` M.O. CASH PERMIT VALIDATION K. M.O. CASH
2.7 81-- dUN 2821 0 1 4.6 3
_ 2 7 9 19Z-Jt1N 28 1 0 4 $7 5 ,M
76A538B CERS03A 5/73 (,-N? �? � - - -
�y APPLICATION FOR BUILDING PERMIT
FOR-APPLICANT TO FILL IN (Print or type only)
COUNTY OF LOS ANGELES
BUIL G
ADDRESS DEPARTMENT OF COUNTY ENGINEER
IT z BUILDING AND SAFETY DIVISION
No.OF:BLDGS. BUILDING
SIZE OF LOT / NOW ON LOT ADDRESS ,
TRACT 8�U Wit/ BLOCK LOT O. LOCALITY
TEL. NEAREST
OWNEV7L Na CROSS ST.
ASSESSOR
ADDRESSMAP BOOK PAGE PARCEL
DISTRICT I GROUP TYPE IRE CESSED BY
-CITY ZIP !, �J CON 7 ZONE
ARCHITECT OR TEL. ,v !/ j
ENGINEER NO. STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS CLASS NO. DWELL.UNITS BK PG
- -
CONTRACTOR TEL. -O. - US ZONE MAP
LIC. / NO.
ADDRESS N SPECIAL
LIC. ]� �_ O CONDITIONS
CITY CLASS B^ I ROAD DEPARTMEJVT APPROVAL REQUIRED YES ❑ NO ❑
CONSTRUCTION LENDER
NAME AND BRANCH BLDG.SETBAC FROM
FRONT PROP. NEOF (STREET)
ADDRESS CITY TOTAL SETBACK FROM TYPE OF EXISTING
SQ.FT. NO.OF NO.OF CHECK HIGHWAY + YARD = FRONT PROP.LINE HIGHWAY WIDTH
SIZE Q STORIES FAMILIES ONE }
CL
DES PTION OF WORK NEW ❑ - O
ADD BLDG.SETBACK FROM ix
SIDE PROP.LINE OF (STREET) O
ALTER ❑ TOTAL SETBACK FR TYPE OF I EXISTING Ij
HIGHWAY + YARD = SIDE PROP.LINE 2tQGHWAYl WIDTH y
USE OF REPAIR 13Z
EXISTING BLDG. I'DEMOL El +
APPLICANT TEL CORNER CUTOFF YES ❑ NO ❑
(PRINT) NO.
_ IN OPEN SPACE YES ❑ NO ❑
BY(SIGNATURE) �j COASTAL PERMIT ZONE YES ❑ NO ❑
VALUATION$
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES
AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM-
PENSATION INSURANCE.
SIGNATURE '
PERMITTEE
ADDRESS
FINAL ..� �- BY
CITY NO. DATE
MAKE CHECKS PAYABL TO: F E FET $
HARVEY T.BRANDT.COUNTY ENGINEER ����
PLAN CHECK VALIDATION CK. M.O. CASH .; PERMIT VALIDATIO CK. M.O. CASH
3 7 2tiBPt. 16 1 U 2 8.5 G d
®s 76A638A CE#803 3.75' ��