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Home My Public Portal About5632 GLICKMAN AVE_BUILDING_6/19/1997_ (2)COUNTY OF LOS ANGELES TEMPLE CITY k 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9706190001 PHONE: (818) 285-0488 EXT: L ON FILE NO. SQ. FT STORIES STRUCTURE: 0 OF CONST TYPE VN BUILDING ADDRESS: 5632 GLICKMAN AV TEMP CA 917802710 NEAREST CROSS STREET: LIVE OAK THOMAS PAGE: 597 GRID: B3 LOCALITY: TEMPLE CITY ASSESSOR0 B 8586-016-002 TENANT: EXIST BLDG S EXIST OCC GRP: U ZONE: R-1 ISSUED ON: PROCESSED BY: EXF44itl-om-� 06/19/97 TC 6/19/98 OWNER: ALLEN ALBERT;MARGARET TRS 5632 GLICK14AN AV TEMP 917802710 TEL. (818) 447-4775- BLDGS. NOW ON LOT: 1 VALUATION: 6,300 FIN D FIN j BY: CEDE: .J1 FEE DESCRIPTION: AA BLDG PERMIT ISSUANCE AC STRONG MOTION RESID D2 PERMIT W/O EN -HC I I REPORT ID: DPR261 FEES PAID QUANTITY: LION: 6300.00 VAL 6300.00 VAL TOTAL FEES ROUTE TO: SS0508 AMOUNT: 27.75 0.63 166.95 195.33 DE*RIFI TEAR OFF APPLY `1/2' CDX, GAF TIMBERLINE 25YR. COMP. SHI LE APPLICANT: TEL. NO: EAGLE ROOFING (626) 291-5700- NS: CONTRACTOR: TEL. EAGLE ROOFING (818) 291-5700- 6327 W LIVIA AVE LIC. NOOCATL�D TEMPLE CITY CA 91780 698529 C39 APPROVALS DATE INSPECTOR G E S TBA KS SOILS ENGINEER APPROVAL ENGINEER:ARCHITECT OR _ NO: LIC. NO: FOUNDATION/TRENCH 0 MS SLAB/UNDER FLOOR MAP NO: SEWER MAP BOOK: PAGE: FIRE 20NE: CMP: 150H273 3 01 UNDERFLOOR INSULATION FLOOR SHEATHING . OF FAMILIES: DWELLING N / 0 D: STAT CLASS: NO 21 - ROOF SHEATHINGSCHOOL G WITHIN HADMU699- AIR QUALITY: 1000 FEET MATERIALS NO NO NO SHEAR FRAME INS EC ION FIRE SPRINKLER N S REQUIRED TOTAL T A IST SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- SIDE PL- INSULATION/WEATHER STRIP INTERIOR L /IrRPGAL(-- EXTERIOR LATH A D TC -PR- RATED WALL ASSEM LI S T -BAR CEILINGS LOT DRAINAGE u LICENSED CONTRACTOR'S DECLARATION I hereby affinn under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. rLicense lass4-JLic. No. Con cto s SiDate OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to constnx;l. alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ 1 am exempt under Sec. , BA P.C. for this reason: [ Electrical, Plumbing & Sewer Permits Only ] ❑ I, as owner of the property, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does Trot apply to an owner of property who Wilds or improves thereon, and who does such work himself or herself, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). [ All Other Permits I ❑ [,as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sod within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Cocil Contractors License Law does not apply to an ownerof property who builds or improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the Contractors License Law.). r� WORKER'S COMPENSATIQU D4CLI'4.T04NI, I hereby affirm under penalty of perjury one of the following ciltions: re �� M ❑ 1 have and will maintain a certificate of consent to self -insure for workers compensation, as provided for by Section 3700 of the Labor Code. for the performance of the work for which this permit is issued. ❑ I have and will maintain workers compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers compensation insurance carrier and policy number are: Policy Number `"y'C/ O 7 ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers compensation laws of California, and agree that if I should become subject to the workers compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Applicant Signature Dale WARNING: FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST, AND ATTORNEY'S FEES. LOBBYIST ORDINANCE CERTIFICATION Complete this section for permits in unincorporated Los Angeles County only, This is to certify that I, as permit applicant, am familiar with the requirements of Los Angeles County Code Chapter 2.160 at seq., (relating to the Los Angeles County Lobbyist Ordinance) and that all persons acting on behalf of myself complied and will continue to comply therewith through the application process. Applicant (Print Name) Applicant Signature Owner Signature Date Company Name (if employed by an entity/agency) Date JOB ADDRESS 'a LOCALITY HAZARDOUS MATERIAL DECLARATION Will the applicant or future Wilding occupant handle a hazardous material or a mixture containing a ham rdous material equal to or greater than the amount specified on the hazardous materials infonnation guide? Yes ❑ No ❑ Will the intended use of the building by the applicant or future Wilding occupant require a permit for construction or modification from the South Coast Air Quality Management District (SCAQMD)? See permitting checklist for guidelines. Yes ❑ No ❑ I have read the hazardous materials information guide and the SCAOMD permitting checklist, I understand my requirements updei the Los Angeles County Code Title 2, Chapter 220 Sections 220.1 �0 through 220.140 concerning hazardous material reporting and for obtaining a permit from the SCAOMD. ASBESTOS NOTIFICATION ❑ Notification letter sent to SCAOMD or EPA ❑ 1 declare that notification of asbestos removal is not applicable to addressed project - CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ.C.). Lender's Name Lenders Address N� I certify that I have read this application and state under the penalty of perjury that the above information is correct. I agree to comply with all City and County ordinances and State laws relating to building construction, and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. 6 �;7 '*4 icant or Ajil Signature Date