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Home My Public Portal About5419 BALDWIN AVE_Building__ (2) WO' RWAMPENSATION DECLARATION hereby affier ifica I have a certificate of consent to self APPLICATION- FOR BUILDING PERMIT C_, insure or G certificate of Workers Compensation Insurance 1 or a Certified copy thereof (Sec`3800 Lab C ) `- _ � COUNTY OF LOS ANGELES BUILDINGNAND SAFETY + Policy No Company - Certified copy is hereby furnished FOR APPLICANT TO FILL IN BUILDING ❑ - ADDRESS Certified'copy is filed with the county building inspec BUILDING �j �J t tion department ; ADDRESS �f�� p Gt Jr,�J6L Y J/Z Date b Applicant CITY ZIP !� LOCALITY A la CERTIFICATE OF EXEMPTION FROM WORKERS NO OF BLDGS - - NEAREST '. + COMPENSATION INSURANCE , SIZE OF LOT NOW ON LOT CROSS ST q (This section need+not be completed if the permit is for oneTRACT BLOCK' LOT NO - ASSESSOR t a hundred dollars ($100)or less ) MAP BOOK ! PAGE+ PARCEL Q NO TEL �� OWNER ��t3s USE ZONE MAP' I certify that in the,performancei� of the work for which this "� f� r NO gL permit is issued I shall not employ any person in any manner _ Iw - SPECIAL - - - . - so as to become subject To The Workers Compensation Laws ADDRESS- / uJ�6 CONDITIONS t t V s a +s CITY �-/ — 'ZIP j �j C)_ -_ _ _ _ __ U Date/' Z�' PPlicant — �� - # 0 cc ARCHITECT OR TEL DISTRICT GROUP TYPE FIRE PROC SED BY_ NOTICE TO APPLI ANT If after mal ng this Cer ificate of _ F- ENGINEER NO V Exemption you should become C j, to th ,Workers /� CONST ZONE Compensation provisions of the Labor Code you must forth LU ADDRESS 51.v Q g _ d with comply with such provisions or this permit shall be _ ,- _ y N deemed revoked TEL STATISTICAL CLASSIFI ATION APT C Z CONTRACTOR NO LICENSED CONTRACTORS DECLARATION b " - - - -- - LIC CLASS NO Z DWELL 1 UNITS I hereby affirm,that I am licensed under provisions of Chapter 9 ADDRESS NO (commencing with Section 7000)of Division 3 of the Business and _ _ _ LIC - __ SEWER MAP Professions Code and my license is'\n full force and effect CITY- CLASS BK - _ -' t VALIDATION SQ FT NO OF NO OF _CHECK License Numbe i `' Lic Class{ PG SIZE ` STORIES ' FAMILIES' -1 ONE ,VAIUAT O � 13r- - Contractor Date DESCRIPTION OF WORK - NEW ❑ ; j %G a3 j ADD ❑ I am exempt under Sec _ eta , ", yr ALTER B&P C for this reason __ O JvL ❑ $ - - - — ..__ REPAIR Date USE OF f EXISTING BLDG DEMOL ❑ ' tiAPPLICANT TEL Signature FINAL OWNER BUILDER DECLARATION PRINT ^��I !�/�� NO Z• DAT /z r 1 -1 hereby affirm that I am exempt from the Contractors License - J Jy Law for the following reason (Section 7031 5 Business and ADDRESS FI -Professions Code) PRESENT BUILDING �9 BA�d�iw �� 4 2 7 8 V® - / _ I as owner of the property or my employees with ADDRESS r + ages as Their sole compensation will do the work and 'T - wi- # • • • • • the structure is not intended or offered for sale(Section LOCALITY - 1 r' 7044 Business and Professions Code) - MOVING - ' TEL- - - ` - 2,3738 ❑ I as owner of the property am exclusively contracting CONTRACTOR NO with licensed contractors to construct the project (Sec - - " o - 2373 8= tion 7044 Business and Professions Code) ADDRESS 4 L ) v REQUIRED_ TOTAL SETBACK FROM 03.21 -86 ^ CONSTRUCTION LENDING AGENCY _ SET BACK YARD HWY- PROP LINE WIDTH r 1 hereby affirm that there is a construction lending agency for FRONT y t the performance of the-work for which this permit is issued P L I (Sec 3097 Civ C ) SIDE , m - ` PL Lender s Name _ r LDMA Ref # c s y - $ -Lender sAddressIT-- -- - --^ P C-Fee$ -- Permit Fee - - t - - - -- - - - � > I certify that I have read this application and state that the Issuance Fee r% `� LDMA P/C# - V �' -- t above information`is correct I agree to comply with all County Investigation Fee S ordinances and State laws relating to building+construction Total Fee -3 �- LDMA Perm a - - - - and hereby authorize representatives of this County to enter upon the above mentioned property for inspection purposes o SEE REVERSE FOR EXPLANATORY LANGUAGE gnatu plicant or Age - D e 1 I r � 1 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9610180010 i PHONE (818) 285 0488 EXT S ' -tEGAL ID t NO OF CONST BUILDING ADDRESS ON FILE SQ FT STORIES TYPE 5419 BALDWIN AV STRUCTURE 0 V TEMP CA 917802625 ASSESSOR INFORMATION B NEAREST CROSS STREET OLIVE 8588 019 024 THOMAS PAGE 597 GRID B4 LOCALITY TEMPLE CITY TENANT F EXIST BLDG USERESID USE ZONE R I TSs[ED ON PROCESSED BY EXPIRES ON EXIST OCC GRP 10/18/96 TC 10/18/97 F OWNER TEL NO j BLDGS NOW ON LOT VALUATION FINAL DATE FINAL BY CODE CHENG YIN LUNG,JENNY (818) 330 2878 1 1 1,000 _ 15614 TALOGA ST t HACH 917456045 t FEES PAID DER ION OF WORK 1 $ REPLACE WINDOWS IN TOOL ROOM I_ FEE DESCRIPTION OUANTTrY'0UOMi 11 AMOUNT c nt t`t APPLICANT EL 0 � � SAME AS OWNER AA BLDG PERMIT ISSUANCES�-X �° 27 75 AC STRONG MOTION RESID' 1000-00-VAL 0OA 50 SPE(FAL CONDITIONS D2 PERMIT W/0 EN`H�� 1000-00~VAL 65'25 O�j TOTAL FEES 93,*59 3. CONTRACTOR TEL NO + Q �APPFOVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC Nt, iy cl 0 �FONRTIONAND SETBACKS SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER TEL NO s l(Qj 0U V U 0�l e n lJ FO f DAT /TRENCFORMS i LIC NO TL-AE/UNDER FLOOR Itl 111 Will U FLOOR FRAMING MNO SEWER MAP BOOK PAGE FIRE ZONE (;t M0 � UNDERFLOOR INSU LATION 147H269 E 1 F1� 2 SHEATHING N FAMILIES DWELLING NI AP /CO ST CL -g- NO 21 � R001 SHEATHING SCHOOL WITHIN HAZARDOUS \tel\ SffD F PANELS D _ AIR DUALITY 1000 FEET MATERIALS y NO NO NO FPA}E INSPECTION REQUIRED TOAL TBA FROM XIS TIRE SPRINKLER HANG S SET BACK YARD HWY PROP LINE WIDTH FRONT PL + INSILATION/WEATHER STRIP SIDE PL t TITER OR LAT YWAL EATERIOR LATH F RATED L OR/CEIL A-S-SEff- RJAMED WALL ASSEMBLIES ATE AFTS/OPE GS a ' I T BFR CEILINGS lOTJDRAINAGER J REPORT ID DPR261 ROUTE TO BS0508 1 1Fi i 1 + . 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 9906030070 PHONE (626) 285 0488 EXT LEGAL D NO OF CONST BUILDING ON FILE SQ FT STORIES TYPE 5419 BALDWIN AV STRUCTURE 0 VN TEMP CA 917802625 ASSESSORINFORMATION NUMBER NEAREST CROSS STREET OLIVE 8588 019 024 THOMAS PAGE 597 GRID B4 LOCALITY TEMPLE CITY TENANT EXIST BLDG USE RESID USE ZONE R 1 ISSUEDON PROCESSED BY EXPIRES EXIST OCC GRP 06/03/99 UT 11/30/99 OWNER TEL NO BLDGS NOW ON LOT VALUATION FINAL DATE FINAL BY CHENG YIN LUNG,JENNY (818) 330 2878 1 3,000 15614 TALOGA ST HACH 917456045 FEES PAID DESCRIPTION CHANGL ROOF TO PITCH ROOF AND COV TH NEW SHEATHING APPLICANT FEE DESCRIPTION QUANTITY UOM AMOUNT SAME AS OWNER AA BLDG PERMIT ISSUANCE 27 75 AC STRONG MOTION_RESID 3000 00 VAL 0 50 SPECIAL CONDITIONS AX BUILDING REVIEW—FEE 54 54 70 D2 PERMIToW%O:E`QCE L E-3000 00 VAL 99 00 TOTAL��EES 181 95 CONTRACTOR TOWNER TEL NO �� M�.� ATPROlfALS DATE INSPECTOR SIGNATURE SAME A LIC NO LbZA^[ON AND SETBACKS SOILS ENGINEER APPROVAL i ARC CT OR ENGINEERDITION LIC NO V 11III�I SLAB/UNDER FLOOR 7 RAISE U FLOOR FRAMING MAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP01- I`l%JJ FNOOR INSULATION 147H269 3 ' L � W® K 3 S4S HEATHING 0 S NG UNITS T CLAS NO 21 �\ g R�-5N T G WITHIN HAZARDOUS ! *� ww PANELS AIR QUALITY 1000 FEET MATERIALS 1 Q NO NO NO ) D ® e ®� FRAME INSPECTION REQUIRED TOTAL SETBACK �✓(j ElFIRE S R HANGERS SET BACK YARD HWY PROP LINE WIDTH FRONT PL Service'6ha�� INSULi1 0 /WEATHER STRIP SIDE PL ) TAMIOR LATH/DRYWALL EXTER OR LATH i RAT 0 SEM RATED WALL ASSEMBLIES AT AF T BAR CEILINGS LOT DRAINAGE REPORT ID DPR261 ROUTE TO BS0508 1