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HomeMy Public PortalAbout9124 WOOLLEY ST_Building__ ` TEMPLE CITY 76A638A CE 0803 12/69 - -APPLICATION' FOR BUILDING PERMIT COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER • ADDRESS COLEMAN W. JENKINS, SUPT OF BUILDIA�" LOCALITY FOR APPLICANT TO FILL IN NEAREST Print or tvoe onl CROSS ST. - BUILDING DISTRICT NO. GROUP TYPE PRO SSED BY ADDRESS CONST. LOT NO. BLOCK STATISTICAL CL SSIFICATION' SEWER MAP CLASS NO.� DWELL.UNITS BK PG TRACT NE MAP NO.OF BLDGS. .. ] NO. SIZE OF LOT NOW ON-LOT I SPECIAL USE OF CONDITIONS EXISTING BLDG. EL OWNER T . NO. — LDG.SETBACK FROM ADDRESS 9124 E . W o o l l e S t. RONT PROP.LINE OF (STREET) TYP EXISTING SETBACK HIGHWAY + YARD = TOTAL CITY HIGHWA 14NIDTH FROM C.L. ARCHITECT OR TEL. •+ _ ENGINEER NO. BLDG.SETBACK FRO ADDRESS I� pp SIDE PROP.LINE OF (STREET) CONTRACTOR H . L . Randol CONOL 288-`I.0 HI HWAYEWSDTIHGI SETBACK FROMC.L, HIGH } YARD = TOTAL ADDRESS 529 E . Vale Blvd .NO. 186086. + _ CITY San Gabriel Cal . CLASS C-39 CORNER CUTOFF YES ❑ C CONSTRUCTION LENDER NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVAL ADDRESS C SQ. FT. NO. OF NO. OF NEW ❑ 's SIZE STORIES FAMILIES USE OF ADD ❑ STRUCTURERP—roof ALTER ❑ with F G 6mp . REPAIR SIGNATURE OF APPLICANT DEMOL ❑ VALUATION S APPROVALS DATE INSPECTOR'S SIGNATURE P. ON t7- FEES FEE'S 1 2-0 0 + 7 rOFORMS!MATERIAALS FRAME: FIRE STOPS, AND I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL' ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS STRUCTION. 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED ' HEREBY I WILL NOT EMPLOY ANY PERSON IOLATION OF THE LATH, INT. LABOR CODE OF THE S A E OF •CALIF RNI IN ATI TO WORKMEN'S C.MPENSAT ! NSU CE. LATH, EXT. SIGNATURE �` 11-1 HOUSE NUMBER COR- PERMITTEE RECT AND-POSTED , o ADDRESS 529 E . Val lei B d . San Gab . FINAL 1f2_P-7 L_ / ( JOHN F. LEWIS. PRINCIPAL STURAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDAT cK. M.O. ' CASH 1'.a 2, M a r B BUILDING V BUILDING �j �Is UILDIADDRES9 f f/ APPLICATION LOCALITY T; r DIVISION OF BUILDING AND SAFETY NEAREST en / 1/•lh (� "A'; CROSS BT. (/-9� v-r V CJI r Department of County Engineer DIBTRI��CT�NO. RECEIPT NO. PERT(/aSIO. County of Los Angeles WM. J. FOX, COUNTY ENGINEER GR OU DATE RECEIVED DATE ISSUED CASSATT D. GRIFFIN, 3UP•T OF BUILDING x A' ;�/ FOR APPLICANT TO FILL IN TYPE CONST. RECEIVED BY ISSUED BY ojcdAyr c `'77,) 44--a0 MAILOWNER ' NUMAP MBER ,.. C® STATE VAS. -O-/7 ` ADDRESS I /� v USEZo E SPECIAL TE C1=i�IiLMA7.�J/ I..IA�U NO. /'f'y� ' CONDITIONS �� ARCHITECT OR TEL. W-F A'-a-v ENGINEER NO. BUILDING YARD HWY STREET NAME EXIST. SETBACK WIDTH ADDRESS FRONT CONTRACTOR //��l(�{•(�JVYI 1 7 - SIDE ADDRESS \X VVwJ�.1 JJ BUILDING r DATE CORRECTIONS INSPECTOR ADDRESS zs- v LOT NO. e BLOCK TRACT �? .!-) , •� NO.OF BLDG9. SIZE OF LOT D / NOW OOT N L USE OF EXISTING BLDG. ���l /L `r�7 /rJL�►'1.r.� DESCRIPTION OF WORK a la NEW ADD ALTER REPAIR DEMOLISH ' Z 9q.FT. NO.OF NO.OF r SIZE STORIES FAMILIES USE OF STRUCTURE 0 0 d �"�l ,t,Uvwa,t:Q✓ NO.OF EMPLOYEES 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- PLICATION AND STATE THAT THE INFORMATION GIVEN IS APPROVALS INSPECTOR'S SIGNATURE DATE CORRECT. 1AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION' LOCATION AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FORMS,MATERIALS FRAME' FIRE STOPS, SIGNATURE OF / BRACING,BOLTS PERMITTEE_D ��- J 141-A.1FURNACE' LOCATION, ADDRES Q . (DOM I d4j,I4� GAS VENT.DUCTS y AUTHORIZED ear. '\_[yW -!I.UN �w, LATH, INT. � � LATH. EXT. S P.0.5 HOUSE NUMBER COR_ f i So FEE RECT AND POSTED �,/ / FEE VALUATION ss �OO FINAL (!v/vy�/LJ'c � fG zt-/ 76A6313A DBS 3 12-53 \ A DMSION OF BUMDING AND SAFETY DepDrftent of County Engineer =uILDING County. of Los Angeles WM. J. FOX, COUNTY ENGINEER APPLICATION FOR APPLICANT TO FILL IPI. " ADDRESS •'Z BUILDING ® ADDRESS e„ Q ' ,� LOCALITY / / Gr ✓ �fP• 6® �+� - , Ah ,. ® NEAREST Zllw, �7.7 LOCALITY JVD ACROSS ST. l .NEAREST e t yam', DISTRICT NO. ' Pu►R CK.OR REc.No.. PERMIT NO. CROSS ST. pp f ,fe (� � ���� OWNER -i 4� rh ,z/t l3, sRREE�CEIV B• DATE OF APPL. D TF.ISSUED MAIL ®d C/✓ �� �� •. ADDRESS 6iN r; L USE ZONE.' 'O. OF • TYPE GRO FRE ZONE TEL. til PLANS - CITY NO. ARCHITECT OR TEL.. v ZONING 27 D ENGINEER NO. APPROVED BY BUILDING,. �' RD.N ADDRESS SEB TACK LINE: ppm TEL. ' APPROVED � CONTRACTOR NO. �' BY: .;j �� { HOUW, NUMBERING OF ADDRESS MAP AP NUMBER . - NO. ASSIGNED BY DESCRIPTAL IO-N7 LOT NO. / I BLOCK E DATE I CORRECTIONS I INSPECTdR TRACT / //✓ SIZE OF LOT )G 1 3 401 NO. OF SLOGS. USE 0 '�//INO. OF t NOW ON LOT ETC STING BLDG. *IVI FAMILIES I I p DESCRIPTION OF WORK y� 'x NEW l ALTERATION ADDITION f r REPAIR DEMOLITION I I S SQ EA ROOMS STORIES ROO COVERINGOWALL'A L�I COVERING wil4km I. USE OF STRUCTURE � I s ' zAPPROVALS INSPECTOR'S SIGNATURE. DATE FOUNDATIFORMS, MOATERIALSN: LOCATION I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP-1 FRAME: FIRE STOPS, a PLICATION AND STATE THAT THE INFORMATION GIVEN IS'• / ` j /� 7�a..� , CORRECT. BRACING, BOLTS I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES. FURNACE: LOCATION, AND STATE LAWS REGULATING UILDING CONSTRU ION. GAS VENT, DUCTS SIGNATURE OF' PERMIT TE / or a LATH, INT. ADDRESS f/ "v .LATH, EXT. -PLASTER, .INT. AUTHORIZED AGT. PLASTER, .EXT. L3l//�//���� FEE HOUSE NUMBER COR- �../ ✓ REC.T AND.POSTED. VALUATION. FEE , FINAL /I FL� (.C�f�' I D' G z 78A...A DBS 8 2-53u...1....sn i WORKERS' COMPENSATION DECLARATION affirm thaial;ure bop a certif catte of Worke s'tCompensat on Insurance, APPLICATION FOR BUILDING P E RM I T ori certified co% py thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company ElBUILDING Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS 2 ❑ Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS Gy L' ►!v ��• /+�7 Date Applicant I CITY iG� T ZIP LOCALITY NO. OF BLDGS. / NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT / CROSS ST. COMPENSATION INSURANCE ASSESSOR J ,7 (This section need not be completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK / 3 O Z PAGE 2 PARCEL hundred dollars ($100)or less.) OWNER I certify that in the performance of the work for which this NO. USE ZONE MAP permit is issued, I shall not employ any person in any manner i ADDRESS �( , � / – SPECIAL }a CONDITIONS so as to become subject to the Workers'Compensation Laws. O CITY �� ZIP e Date Applicant ARCHITECT O TEL. DISTRICT GROUP TYPE FIRE P CESSED BY D< NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. CONST. ZONE Exemption, you should become subject to the Workers' rU Compensation provisions'of the Labor Code, you must forth- ADDRESS .� a f+Q? 3 V f , a- with comply with such provisions or this permit shall be TEL STATISTICAL CLASSIFICATION APT. CONDO. N deemed revoked. CONTRACTORS 4sL: NO. & 6 Z LICENSED CONTRACTORS DECLARATIONLIC. CLASS NO. DWELL. UNITS I hereby affirm thai I am licensed under provisions of Chapter 9 ADDRESS l2' %C--&,"44NO. (commencing with Section 7000)of Division 3 of the Business /_ LIC. SEWER MAP and Professions Code,and my license is in full force and effect. CITY 4e W� CLASS BK PG VALIDATION SQ. FT. NO. Oil NO. OF CHECK License Number Lic. Class SIZE I STORIES FAMILIES ONE • i j,� VALUATION Contractor Date I DESCRIPTION OF WORK L!/ ADD ❑ $ /PDt}. ®� ► ❑1 am exempt under Sec. rl ALTER ❑ B.BP.C. for this reason REPAIR ❑ $ USE OF Date: EXISTING BLDG. DEMOL ❑ Si nature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION (PRINT) NO. I hery affDATE irm that I am exempt from the Contractor's License Law r the following reason (Sectiori 7031.5, Business and ADDRESS FINAL Professions Code): PRESENT By BUILDINGEl 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 T T— I,as owner of the property,am exclusively contracting CONTRACTOR NO. z I CNIS with licensed contractors to construct the project (Sec- ADDRESS !I p^'L 913 63 tion 7044, Business and Professions Code.) REQUIRED TOTAL SETBACK FROM EXIST. I.I-l�'1 n,_.1 CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT ^ CHANGE AL the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE P.L. I _ Lender's Name si„I'I $ D ' LDMA Ref.# r.�t, ,c,- P.C. Fee$ Permit Fee Cvvt _ Al•I oily Lender's Address 7 0 1 certify that I have read this application and state that the Issuance Fee LDMA P/C# 8 above information is correct.I agree to comply with all County Investigation Fee 0 ordinances and State laws relating to building construction, Total Fee • LDMA Perm. # and hereby authorize representatives of this County to enter up the above-mentioned roperty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE i S' ature of Applicant o (gent Date' WORKERS. COMPENSATION DECLARATION • I i o affirm that I have r certificate of consent to,Self APPLICATION FOR BUILDING 'P E RM I T in:/ or.P cert)ficate of Workers' Compensation Insurance, or certif(ed cdpy thereof(Sec. 31300, Lab. C.) COUNTY OF LOS ANGELES i BUILDING AND SAFETY Rlicy No. Company i BUILDING ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS Gr/ ❑ Certified copy is filed with the••county building inspec- BUILDING tion department. ADDRESS Z Date. Applicant' CIN' L ZIP /71XMD LOCALITY NO.OF BLDGS. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' F SIZE OF LOT NOW ON LOT CROSS ST. COMPENSATION INSURANCE I a ASSESSOR .yy (This section need not be completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK �j 8 2. AGE© fvARCEL Da hundred dollars ($100)or less.) R G JCU�,I` /' N y V0 /ql USE ZONE MAP NO. s9p ef OWNE41W V e0 [ I certify that in the performance of the work for which'this / SPECIAL permit is Issued,•I shall not employ any person in any manner ADDRESS C.U Zr j&tCa I ` CONDITIONS so as to become subject to the Workers'Compensation Laws. Q-7 CITY �AZ Of 7 zip G� �� /.� UU Date Applicant ARCRITECT'OR TEL DISTRICT GROUP TYPE FIRE PROCESSED BY Q NOTICE TO APPLICANT: If, after making this Certificate-of ENGINEER �, 9�vG. YJy&J.ZJ¢,ttdt- NO.' Z,&5, CONST. ZONE Exemption, you should become subject to the Workers' f! ri �� Compensation provisions of the Labor Code, you must forth- ADDRESS QrZ . E • �i Ov LU with comply with such provisions or this permit shall be TEL• STATISTICAL CLASSIFICATION APT. CONDO. u) Z deemed revoked.. CONTRACTOR "42V"S„�( G La. . 1 LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS� I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS q/2Y•C• NO. (commencing with Section 7000)of Division 3 of the Business LIC. SEWER MAP , and Professions Code,and my license is in full force and effect. CITY• �C ilk LLQ'C/Z CLASS BK. 41 PG. VALIDATION SQ. FT. NO.OF NO. OF CHECK License Number Lic: Class SIZE �� STORIES FAMILIES ONE VALUATION Contractor. Date DESCRIPTION OF WORK NEW ❑ $ 0 I am exempt under Sec. Nit✓ /I? 'Z E� ADD ► ALTER El �jD B.&P.C. for this reason $ l�J t9 REPAIR ❑ / d• . Date: USE'OF. EXISTING BLDG. DEMOL ❑ Signature APPLICANT TEL. O—q OWNER-BUILDER DECLARATION (PRINT) NO. FINAL PATE hereby affirm that I am exempt from the Contractor's License Law for the following reason_(Section 7031.5, Business and ADDRESS FINAL C- 4 Professions Code): PRESENT. BY ° ❑ I, as owner of theproperty, or m em to ees with BUILDING Y P Y ADDRESS _ r wages as their sole compensation,wall do the work and LOCALITY Jy �,5 ? ��t5°79 the structure is.not intended or offered for sale(Section t_ 7044,•Business-and Professions Code.) MOVING TEL. I ITEMS I,as owner of the property,am exclusively contracting CONTRACTOR. NO. with licensed contractors to construct the project (Sec- TOTAL 245. 79 ADDRESS tion 7044, Business and Professions Code.) i' r h'� 9 REQUIRED TOTAL SETBACK FROM EXIST. L•t iEii 1-�f'J°7 CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency'for FRONT r° tj� °013 the performance of the work for which this permit is issued P.L. (Sec: 3097, Civ. C.). SIDE P.L. Lenders Name /� 0l!C!0—�I�U s �� 7/911 P.C.Fee$ Permit Fee per • I LDMA Ref. Rv i e I1E� Lender's Address , 1 I certify that I have read this application and state that the Issuance FeeA3 D 4) LDMA P/C# above information is correct.I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, Total Fee Pf J11 LDMA perm, q and hereby authorize representatives of this County to enter uponntth�e above-mentioned pro erty for inspection purposes. CIG(,( Alt A SEE REVERSE FOR EXPLANATORY LANGUAGE SignatV of Applicator Age Date