HomeMy Public PortalAbout5017 BALDWIN AVE_Building__ (2) 76A638A CE;P 803162 APPLICATION FOR BUILDING P &MIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER jADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST
WILLIAM A JENSEN SUP T OF BUILDING CROSS ST
DISTRICT NO GROUP TYPECESSED BY/
FOR APPLICANT TO FILL IN re -- D BY
BUILDINGSTATISTICAL CLASSIFICATION WER MAP
ADDRESS "BK
CLASS NO DWELL UNITS
LOT NO B WATER
irp
CERTIFICATENO REQUIRED RECEIVED ❑
TRACT MAP / HIGHWAY STAT AJOR COND LOCAL
NO OF BLDGS NO ! (CIRCLE)
SIZE OF LOT Jr NOW ON LOT USE ZONE SPECIAL
USE OF !�/ CONDITIONS
EXISTING BLDG
� TEL /
7p, _OWNER1,7 NO BUILDING YARD HWY STREET NAME EXIST
y SETBACK WIDTH
-ADDRESS b f u� � FRONT x
,qh ' ARCHITECT OR TEL P L
c
ENGINEER �Q NO SIDE
P L
ADDRESS O
CONTRACTOR NO V , �!� /� � �
ADDRESS / v O
DESCRIPTION OF WORK A .'- ' v
CL
tan
NEW ADD ALTER REPAIR DEMOLISHy )� ��. _Z
SQ FT NO OF NO OFSIZ ,.�J �d� I ..
USE EOF STORIES FAMILIES /�J/n4/ 1� ��p?�+r+�' ;!� .i�li.h ,�
STRUCTURE d/ ° �t � y,i �
SIGNATU I7�/'S/fi 7
APPLICANT
VALUATION
C.J APPROVALS DATE/ INSPECT R S SICK, V URE
PMT FOUNDATION LOCATION
F E $ e � ()�s FEE $ `a FORMS MATERIALS A �/
FRAME FIRE STOPS !
I 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 �V
BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK J14
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT +r N
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT
ING TO IZlllKMENS COMPENSATION IN CE s..-
—y LATH EXTSIGNA' URE /A4
d //�
NUMBER
PERMITTEE OF HRECT AND POS OUSE TE
41 ?/41�',1 ,I
ADDRESS 'T 7,7' FINAL 6,11
M o cnsH _ JOHN F LEWIS PRINCIPAL ST URAL ENGINEER
PLAN CHECK VALIDATION6.1
PERMIT VALIDATION CK M O LAC03 AUG3023 D 28.50A
(ACOz5 5 3 9 OCT 152 3 D 1.75 '�—
' r LAL,0554U:a OCT15 1 D 6050-
,WORKERS' COMPENSATION DECLARATION
hereby affirm f I have a certificate of consent to self APPLICATION FOR BUILDING PERMIT
insure,.or a certificate of Workers' Compensation Insurance,
or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. Company
BUILDING
❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS /c= wC�Ill� i�t/
❑ Certified copy is filed with the county building inspec- BUILDING
Tion department. ADDRESS f- Jif 7/(/•� �G(
Date Applicant CITY Cfn ZIP 7a� LOCALITY
NO. OF BLDGS. NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT ?0 NOW ON LOT CROSS ST.
COMPENSATION INSURANCE ASSESSOR / Q.�''
(This section need not be completed if the permit is for one TRACT 7 BLOCK" `^" LOT NO. Z MAP BOOK. PAGE W PARCELd�d
hundred dollars($100)or'less.) TE
OWNER - O}( N . �lZ USE ZONE "P
1 certify that in the performance of the work for which this . NO.
permit is issued, I shall not employ any person in any manner ADDRESS t N. �—/ SPECIAL d
CONDITIONS
so as to'become subject to the Workers' Compensation.Laws. O
CITY (3-,Vy ZIP Q U
Date Applicant ARCHITECT OR TEL.
NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER - t NO. DISTRICT GROUP TYPE FIRE PROCESSED BY
CONST. ZONE
Exemption, you should become subject to the Workers' p / u
Compensation provisions of the Labor Code, you must forth- ADDRESS a
with comply with such provisions or this permit shall beTEL. STATISTICAL CLASSIFICATION APT. CONDO. N
deemed revoked. CONTRACTOR NO.
Z
LICENSED CONTRACTORS DECLARATIONLIC. CLASS NO. DWELL. UNITS
—
I hereby affirm that I am licensed under provisions'of Cha r 9 ADDRESS ,�Oj D f NO.
(commencing with Section 7000)of Division 3 of the Bu in ss
LIC. SEWER MAP
and Professions Code,and my license is in full force and ffe T. CITY CLASS BK �� �� VALIDATION
SQ. F . NO. OF CHECK
License Number Lic. Class SIZE S FAMILIES ONE
❑ VALUATION
Contractor Date DESCRIPTION OF`WORK NEW i
$
ADD ❑ / 6r� ,
❑1 am exempt under Sec.
ALTER ❑
B.&P.C. for this reasonREPAIR ❑ $
Dare: U OF '
EXISTING BLDG. 1441mile DEMOL ❑
Signature APPLICANT P TEL FINAL
OWNER-BUILDER DECLARATION (PRINT) �/ �' _
I hereby affirm that I am exempt from the Contractor's License ✓ DATE —
?ZJ'
Law for the following reason (Section 7031.5, Business and ADDRESS QCT' FINALP A�j-( =...1 zF
Pro essions Code): PRESENT By 7,720-7
BUILDING - �
I, as owner of the property; or my employees with ADDRESS
f...« ».,
wages as their sole compensation,will do the work and y;F t t}
the structure is not intended or offered for sale(Section LOCALITY
.F i-t^••s s ---•yam:.
7044; Business and Professions Code.) MOVING TEL. 0 3qE,
❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. -�;•. --
with licensed contractors to construct the project.(Sec- r-i''` 7'i°'y.
tion 7044, Business and Professions Code.) ADDRESS ,_f�','�f)`�f��
CONSTRUCTION LENDING AGENCY SET..BACKD YARD HWY TOTAPROPALINEFROM 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• I!}'• i}-4fII_}
(Sec. 3097, Civ: C.). SIDE
Lender's Name -
LDMA Ref. #
P.C. Fee$ Permit Fee
Lender's Address ,
1 certify that I have read this application and state that the Issuance Fee U LD AA P/C#
8 above infocmat' corre ogre comply with all County Investigation Fee yA
R ordinances d S to ell�� to building construction, Total Fee D• O LDMA Perm. #
a and her out, riz es ves of this County to enter
upon a e- ti erty for inspection purposes.
yyy !� SEE REVERSE FOR EXPLANATORY LANGUAGE
Si t of Aplicont r Agent Date
COUNTY OF LOS ANGELES i 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 0511290056
PHONE (626) 285-0488 EXT
LEGAL ID NO OF CONST BUILDING ADDRESS
ON FILE SQ FT STORIES TYPE 5017 BALDWIN AV
STRUCTURE 2000 VN TEMP CA 917804011
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET
8589-026 028 THOMAS PAGE 597 GRID B4 LOCALITY TEMPLE CITY C
TENANT EXIST BLDG USE RESID USE ZONE R-1 ISSUED ON PROCESSED BY EXPIRES ON
EXIST OCC GRP 11/29/05 JK 11/24/06
OWNER TEL NO BLDGS NOW ON LOT VALUATION FINAL DATE FIFAL BY CODE
TANG WENDY 5 000 -
5017 BALDWIN AV
TEMP 917804011 FEES PAID DESCRIPTION OF WORK
TEAR OFF OLD ROOF W NEW 30 YRS COMPOSITION SHINGLES
FEE DESCRIPTION QUANTITY UOM AMOUNT HOUSE AND GARAGE
APPLICANT TEL NO
RHEE (323) 864 7388 AA BLDG PERMIT ISSUANCE 27 75
1415 S GRAMERCY PL AC STRONG MOTION RESID 5000 00 VAL 0 50 SPECIAL CONDITIONS
LOS ANGELES CA 90019 D2 PERMIT W/O EN-HC 5000 00 VAL 132 60
TOTAL FEES 160 85
CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE
MACIEL ROOF (323) 864-7388-
1415 S GRAMERCY PLACE LIC NO LOCATION AND SETBACKS
LOS ANGELES CA 90019 829737B
SOILS ENGINEER APPROVAL
ARCHITECT OR ENGINEER TEL NO FOUNDATION TRENCH FORMS
LIC NO SLAB/UNDER FLOOR
RAISED FLOOR FRAMING
MAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP UNDERFLOOR INSULATION
144H269 3 01
FLOOR SHEATHING
NO OF FAMILIES DWELLING UNITS APT COND STAT CLASS
NO 21 ROOF SHEATHING
SCHOOL WITHIN HAZARDOUS SHEAZ PANELS /b
AIR QUALITi 1000 FEET MATERIALS
NO NO NO FRAM INSPECTION
REQUIRED TOTAL SETBACK FROM EXIST FIRE SPRINKLER HANGERS
SET BACK YARD HWY PROP LINE WIDTH
FRONT PL INSULATION/WEATHER STRIP
SIDE PL
INTERIOR LATH DRYWALL
EXTE-ZIOR LATH
RATED FLOOR/CEIL ASSEM
RATED WALL ASSEMBLIES
RATED SHAFTS/OPENINGS
T-BAR CEILINGS
LOT DRAINAGE
REPORT ID DPR261 ROUTE TO BS0508
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 1304080021
PHONE (626) 285 0488 EXT
LEGAL ID I NO OF CONST BUILDING ADDRESS
I ON FILE I SQ FT STORIES TYPE 5017 BALDWIN AV
I ISTRUCTURE V B t TEMP CA 917804011
(ASSESSOR INFORMATION NUMBER ,, - NEAREST CROSS STREET
18589 026 028 THOMAS PAGE 597 GRID B4 LOCALITY TEMPLE CITY CAI
I I
TENANT (EXIST BLDG USE RESID USE ZONE R1 11SSUED ON PROCESSED BY
1EXIST OCC GRP 104/08/13 SR
OWNER TEL NO 1BLDGS NOW ON LOT VALUATION IFI/I�/L DATE FINAL^LBBY CODE
IWAI CHUNG TANG (626) 757 5500 1 3 800 1 K�3 `'
5017 BALDWIN AV _ � ��(/� +�
ITEMP 917804011 FEES PAID IDESCRIPTION OF WORK li
I I IKITCHEN REMODEL TO INCLUDE NEW CABINETS FLOORING AND
IFEE DESCRIPTION QUANTITY UOM AMOUNT ICOUNTER TOP BATHROOM REMODEL TO INCLUDE SHOWER FLOORING I
(APPLICANT TEL NO I (AND VANITY I
1CABRERA CALEB (626) 378 2393 IAA BLDG PERMIT ISSUANCE 27 80 I I
11167 E BROOKPORT ST IAB STATE GREEN BLDG FEE 3800 00 VAL 1 00 (SPECIAL CONDITIONS I
ICOVINA CA 91724 IAC STRONG MOTION RESID 3800 00 VAL 0 50 I
1 B2 PERMIT W/ENERGY 3800 00 VAL 127 40
1 TOTAL FEES 156 70
1CONTRACTOR TEL NO IAPPROJALS DATE INSPECTOR SIGNATURE
1ELITE CONSTRUCTION (626) 378-2393
11167 E BROOKPORT STREET LIC NO ILOCATION AND SETBACKS i I
ICOVINA CA 91724 841247 * I
I I ISOILS ENGINEER APPROVAL
(ARCHITECT OR ENGINEER TEL NO I IFOUNDATION/TRENCH FORMS
LIC NO ISLAB/UNDER FLOOR I I
I '+ IRAISED FLOOR FRAMING
IMAP NO SEWER MAP BOOK PAGE FIRE ZONE CMD I (UNDERFLOOR INSULATION I
3 OOi i IFLOOR SHEATHING 1 I
INO OF FAMILIES DWELLING UNITS APT/GOND STAT CLASS I N 1
NO 21 1 IROOF SHEATHING
1 SCHOOL WITHIN HAZARDOUS 1
1 (SHEAR PANELS I I I
1AIR QUALITY 1000 FEET MATERIALS I I 1 I
I NO NO NO IFRAME INSPECTION
I I I
I IFIRE SPRINKLER HANGERS I i
(INSULATION/WEATHER STRIPI I I
Y I L `(INTERIOR LATH/DRYWALL I I I
I I I I I I
(EXTERIOR LATH I I I
I IRATED FLOOR/CELL ASSEM I
IRATED WALL ASSEMBLIES
I I I
IRATED SHAFTS/OPENINGS I I I
I I I
' I iT BAR CEILINGS
* ADDITIONAL DATA ON FILE
1 I ILOT DRAINAGE I I I
I IREPORT IDJ DPR261 ROUTE TO BS0508
1 I I I I I
4
)
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