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HomeMy Public PortalAbout4905 BALDWIN AVE_Building__ (2) �'�P P L I CAT t O N FOR COUNTY OF LOS ANGELES J " k '', OF COUNTY BUILDING PERMIT ' DEPARTMENT BUILD NG AND SAFETY SIONBU ENGINEER T _ gFORAPPLIIICANT TO FILL �FILL IN ADIDRESS LDING ADDRESSBUILDING t Oc7rl> W 1 \ � LOCALITY r Y 7 MPLE 1= NEAREST CITY 1 �• { ZIP CROSS ST � l NO OF BLDGS /L ASSESSOR SIZE OF LOT � 'I O " NOW ON LOT AP BOOK PAGE V PARCEL DISTRICT GROUP TYPE FIRE ESSQD Y TRACT `' BLOCK '^j - LOP t�L �.J, CONST��• �CLG r OWNER 0{�N L W L,A� NO '4't6 Z! STATISTICCLASSIFICATION IL— SEWER MAP ADDRESS 1t. 8641I.S �N AVE CLASS NO DWELL UNITS BK G CITY T�Irlp�� GI ZIP USE ZONE MAP ARCHITECT OR - rr TEL - c ENGINEER �/ NO SPECIAL + CONDITIONS ADDRESS r ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ gg Jf f�� � CONTRACTOR f ita, NWy•W. ONO G BLDG SETBACK FROM LIC FRONT PROP LINE OF ISTREETI -� ADDRESS ' WpcSItlNI. TOTAL SETBACK FROM TYPE OF EXISTING `t, tt�yn� {{jj HIGH AY + YARD = FRONT PROP LINE HIGHWAY WIDTH CITY �•"lk V 1� CLASS 15-1- - _ CONSTRUCTION LENDER + _ } NAME AND BRANCHBLDG S TBACK FROM i OU SIDE PRO LINEOF (STREET) Q� ADDRESS CITY i O SQ FT NO OF ` NO OF I CHECK HIGHWAY YARD = TOTAL SETBACK FROM TYPE OF EXISTING SIZE STORIES 1 FAMILIES Y ONE SIDE PROP LINE HIGHWAY WIDTH DESCRIPTION OFWORK ,1 �s{4� t NEW ❑ + Z /'�DI110N I)Af fl �+ ADD CORNER CUTOFF t YES ❑ NO rjS D FAMILI N50 W ALTER ❑ IN OPEN SPACE , I YES ❑ NO [:1 USE OFREPAIR ElIN COASTAL PERMIT ZONE YES ❑ NO E]BL EXISTINGDG bv,(�WjINt� DEMOL ❑ APPLICANTylhD1r Q4 ✓►NO 2,/ J 1 (PRINT) " ` • fI��VIV BY(SIGNATURE) Y I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE` THAT THEABOVE 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 OF FINAL ✓/79 BY PERMITTEE DATE ADDRESS TEL (01-2/6301 P C Fee$ Permit Fee Z CITY NO _ r De ) .�. Issuance Fee VALUATION$ e l / � Total Fee--//&/ " PLAN CHECK VALIDATION CK MC, CASH _ PERMIT VALIDATI CK \ MO CASH --WORKeRS COMPENSATION v _ 1 1 1 6.2 5 ®�b 0 9 5�SE� c8 D _ a POLICY HOLDER -- ©s 76A63BA CE N803A 6/76 T A� ,PC:[IC'Y iVLIMRER Q� Vo ----------- 'Z/ 76A699A CIE#803G 58 APPLICATION FOR BUILDING PERMIT 1 COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS C BUILDING AND SAFETY DIVISION LOCALITY t JOHN A LAMBIE COUNTY ENGINEER NEAREST L CASSATT O GRIFFIN SUP T OF BUILDING CROSS ST DISTRICT NO O P TYPE SSED BY FOR APPLIC T FILL IN CONST ADDRESS /f/✓\./ STATISTICAL CLASSIFICATION �+ I BER MAPP i CLASS NO DWELL cUNITS_L_.L— w�< LOT NO BLOCK MAP STAT 'r NUMBER HWY YESNO + TRACT USE ZONE SPECIAL NO OF BLDGS r CONDITIONS SIZE OF LOT NOW ON LOT (/ USE OF EXISTING,B DG BUILDINGEXIST SETBACK YARD HWY STREEhT NAME WIDTH OWNER FRONT P Tr MAIL ADDRESS SIDE TEL P L NO INSPECTION RECORD ARCHITECT OA TEL ENGINEER NO / ADDRESS ro5a '?1R..�— CONTRACTOR 0)L W02-111K E d2.I1 ADDRESS _ DESCRIPTIOW OF WORK NEW ADD ALTER REPAIR DEMOLISH SQ FT NO OF NO OF SIZE 41STORIES FAMILIES U F CTURE SIGNATURE OF APPROVALS APPLICANT DATE INSPECTOR S SIGNATURE ADDRESS FOUNDATION LOCATION FORMS MATERIALS OIA� P C $ FRAME FIRE STOPS FEE BRACING BOLTS VALUATION S � _ FURNACE LOCATION FEE GAS VENT DUCTS 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP LATH INT PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CO NTY OR NANCES AND LATH EXT STATE LAWS REG EATING B DING NSTRUCTION SIGNATURE OF HOUSE NUMBER COR PERMI'rr;70 RECT AND POSTED c ADDRESS FINAL CLYDE N DIRLAM PRINCIPAL STRUCTURAL ENG PLAN CMCK VALIDATION CK mo CASH PERMIT VALIDATION CK M O CASH t ",x[;02 2 5.2 t �Aff 2$ 1-A 3:0 0 Or WO,RKf'RS (W,-JPENSATION DECLARATION hnerek,y ca amlr�certific.: nave a certificate of consent to self APPLICATION y� `1���1 O 1� FORBUILDING PERMIT insure or a certificatelof Workers Compensation Insurance /""� or a certified'copy thereof(Sec 3800 Lab C-) 1 t t `. COUNTY, OF�OS�ANGELES BUILDING AND SAFETY Policy No Company _ r ; - _ ❑c Certified copy is hereby furnished 5 FOR_APPLICANT TO FILL-INT `� BUILDING ADDRESS ❑ Certifiedtcopy is filed with the county building mspec - BUILDING tion department + ADDRESS T . Date-1 3 Applicant CITY ZIP /� LOCALITY 1 t l CERTIFICATE OF EXEMPTION FROM WORKERS - - NO OF BLDGS - NEAREST -- COMPENSATION INSURANCE SIZE OF LOT /��} X NOW ON LOT I CROSS ST +J I ea S/r? /3/¢r l ltd + (This' section need not belcompleted if the permit is for one t ASSESSOR hundred dollars ($100)or less7) f _ TRACT BLOCK LOT NOMAP BOOK r PAGE PARCEL _ r TEL d SE ZONE MAP --`'''+ ` � � n h r OWNER NO �p 'r�/� � 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 �f�� SPECIAL d so as to become subject to the Workers mpensation L w ` ADDRESS �� L�JIR-1 /�Tf ~��� CONDITIONS y i3 1 O ty " A I��'S f , t " /�� - 1 1 V 4 _ CITY /�L el ZIP G - - - _' W. Date L pplica ARCHI ECT OR TEL 0 NOTICE TO APPLICANT If T making this Certificate of DISTRICT GROUP TYPE FIRE PRES ED BY_ ENGINEER ) NO CONSV ZONE Exemption you should b me sublect to the Workers a ^r Compensation provisions of the Labor'Code you must forth ADDRESS ✓t�/ _t 9111.1 with comply~th such provisions orrthis permit shall be - - __ W deemed revoked a , i F - TEL �J��p �" TATISTICAL CLASSIFICATION APT COI`90 CONTRACTOR / NO 7 Y O ��/ _ LICENSED CONTRACTORS DECLARATION - - LIC CLASS'NO DWELL UNITS - ' I he affirm thatil am licensed under provisions of Chapter 9 -� ADDRESS s C NO t (commenting wrth Section 7000)of Division 3 of The Business and _ _ _ _ _ SEWER MAP t Professions Code and r license is in full force and effect CITY LIC- t w y CLASSF PG VALIDATION `_t SQ FT NO OF NO OF _ CHECK BK License Number Lic Class SIZE STORIES FAMILIES ONE ,r , its s -VALUATION b ,- r DESCRIPTION OF WORK NEW -❑ ; /Y`/�h� / * 2 0 8.9 A' 41 Contractor Dare ADD ❑ I am exempt under Sec Cji7'l - - c -8 t ; ni ALTER ❑ t t # • • • o e 1 B&P C for this reasonREPAIR -- - - - - - /V L Com• ❑ $ - - - Date _ - USE OI F BLDG / DEMOL ❑ Y ( • 1 7 1 7 5 EXISignature APPLICANT TEL t t _ ) OWNER BUILDER DECLARATION ' PRINT L NO 'Z�� FINAL L 1 0 . 1 7 1 7 t _— DATE I hereby affirm that I am exempt from the Contractor s License L , Law for the following reason (Section 7031 5 Business and ADDRESS 7Td /�'Li�GCFINA0 5 2,2,:-,8,5 J{/GJ � � t t Professions Code) PRESENT - By ; ' - BUILDING I as owner of The property or my employees with ADDRESS j a wages as their sole compensation will do the work and `- _ - - a _tJ t f^D \''f the structure is not intended or offered for sale(Section LOCALITY 4 T ri _ 7044 Business and Professions Code) - - I MOVING - TEL 1 ❑ rt CONTRACTOR NO - I as owner of the property am exclusively contracting } with licensed contractors to construct the project (Sec ADDRESS^ - tion 7044 Business and Professions Code) ' �J CONSTRUCTION LENDING AGENCY - REQUIRED YARD HWY TOTAL SETBACK F SET BACK PROP LINE WIDTH y I hereby affirm that there is a construction lending agency for FRONT L the performance of the work for which thisspermit is issued - P L ' -- - -' - - (Sec 3097 Civ C ) SIDE m _ _ PL o Lender s Name �� - ' - - P C Fee$ - - - Permit Fee t f DMA Ref #1 Lender s Address `` /� t I certify that I have read this application and state that the Issuance Fee - O c J V kMA P/C# '- above information is correct I agree to comply with all County Investigation Fee t + g ordinances and State laws relating to building construction __ _ 5 m 1 'td t u and hereby authorize representatives of this County to enter - Total Fee LDMA Perm # — , upon the above entto pr Rer f inspection purposes t " SEE REVERSE FOR EXPLANATORY LANGUAGE I Y t -'Signature of Applicant or Agent pate _ L 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 0306100038 PHONE (626) 285 0488 EXT LEGAL ID NO OF CONST BUILDING TR 9848 LT 19 SO FT STORIES TYPE 4905 BALDWIN AV STRUCTURE VN TEMP CA 917804009 ASSESSOR INFORMATIONB NEAREST CROSS STREET LOWER AZUSA 8589 025 015 THOMAS PAGE 597 GRID B5 LOCALITY TEMPLE CITY TENANT EXIST BLDG USE RESID USE ZONE R 1 ISSUEDON PROCESSED BY EXPIRES EXIST OCC GRP 06/10/03 JK 06/04/04 OWNER TEL NO BLDGS NOW ON LOT VALUATION FI AL DATE FINAL BY CODE WILDE JOHN L,BETSY N (626) 448 2125 7 000 �\� L/ � 4905 BALDWIN AV 651 TEMP 917804009 TEES PAID DESCRIPTION OF WORK T/O HSE & GARAGE INSTALL SOME NEW SHEETING & REROOF FEE DESCRIPTION QUANTITY UOM AMOUNT APPLICANT 0 SAME AS OWNER AA BLDG PERMIT ISSUANCE 27 75 AC STRONG MOTION RESID 7000 00 VAL 0 70 SPECIAL CONDITIONS D2 PERMIT W/0 EN HC 7000 00 VAL 166 20 TOTAL FEES 194 65 CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - LIC NO LOCATION A SOILS ENGINEER APPROVAL I ARCHITECT OR ENGINEER TEL LIC NO I SLAB/UNDER FLOOR ---- 1 RAISED FLOOR FRAMING MAP NO SEWER MAP BOOK-PAGE FIRE ZONE CMP UNDERFLOOR INSULATION 144H269 3 01 FLOOR SHEATHING NO OF ES DWELLflTUONITS APT/COND STAT CLUS'- NO 21 ROOF SHEATHING 3 7 SCHOOL DO S SHEAR PANEL AIR QUALITY 1000 FEET MATERIALS NO NO NO FRAME INSPECTION REQUIRED TOTAL N SET BACK YARD HWY PROP LINE WIDTH FRONT PL INSULATION/WEATHER STRIP SIDE PL INTERIORLATH/DRYWALL EXTERIOR LATH RATM L RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T BAR CEILINGS LOT DRAINAGE REPORT ID DPR261 ROUTE TO BS0508