HomeMy Public PortalAbout5516 BALDWIN AVE_Building__ (2) DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES p I G 1
W4.,j. FOX. CHIEF ENGINEER
FOR APPLICANT TO FILL IN FOR OFFICE USE.ONLY
j.- DISTRICT O. PLAN�'CK._NO. PERMIT NO.
BUILDINGADDRESS 'A BaldWi Avenue �]''� /J} /�J� `� /e�'
LOCALITY Los Angeles CAU 7}.'.V RECEIVED B DATE.GFAPP'. DATE ISSUED
NEAREST Live Oak Avenue � .j� LS �b A. A--a
CROBH ST.
BUILDING
DWNER -�feef Finance & Development Carla® ADDRESS G� G•//6
ADDRESS 232 Soo Beverly Drive LOCALITY �Z'-! '�`-l��C._ ` _ ^L✓
�� NEAREST ! C?
CITYBeverly Hllls9 Calif NO.� C$ 5-'r 55 CROSS ST.
FIRE NO.OF TYPE f GROUP.
ARCHITECT QI�„,e as above NEOL. ZONE PLANS 1/ �' -r•./
ENGINEER `ulaalm '
BLDG. //��� O[RD NO.'
ADDRESS SETBACK LINE
APPROVED
CONTRACTOR Same as above EL. BY A x COTE
USE APPROVED
. DATr
ADDRESS
ZON -/' By
LEGALCORRECTION'S
6
DESCRIPTION LOT NO. BLOCK
TRACT 16957
NO.OF
SIZE OF LOT 55405 I NOW ON LOTS.none
USE OF NO.OF NO.OF .
EXISTING BLDG. FAMILIE6 ROOMS
DESCRIPTION OF WORD
NEW x I ALTERATION ADDITION O
A
REPAIR MOVING DEMOLISH G_
5.4•FT. `" NO.OF Z
SIZE " ROOMS 6 STORIES 1•
WALL Stucco ROOF
COVERING I COVERING Dolomite
B U.I LD I USEDFIVNEG W Dvre7l.ing and detached garage
Plan 117.-B
�7-- `07>
�S -- 4 71
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS/
APPLICATION AND STATE THAT THE ABOVE IS CORRECTINSPECTOR DATE
OOOFORMS,
AND AGREE TCOMPLY WITH ALL COUNTY ORDINANCES FLOCATION
FORMS,MATERIALS �i
AND STATE'LAWS REGULATING BUILDING CONSTRUCTION.
f a•• FRAME. FIRE STOPS,
SIGMA TURE'OF -1 BRACING,BOLTS
PERM I'R E Znden el ent
LATH, INT.
AUTHDRI - � �` !' LATH, EXT.
:AEP A son. ons , na
76A63BA-3 7-49P.O,N 661;
PLAFEE "! PLA5TER.EXT. /-.......... .
VALUATION � ... / ,,//�✓��/
FEE 'rFINAL ✓/nf.Gv`� +./J/(o//I ... .
i
I
WORKERS' COMPENSATION DECLARATION
insl&d,bora certificate of Workers' Compensat on1.have a'certificate of con5ent Insuran to e, AP P L I CAT I-O N FOR BUILDING., PERMIT
- a
.; .�y��
or a certified copy thereof (Sec: 3800, Ldb. C:) COUNTY-;OF LOS ANGELES BUILDING AND SAFETY
Policy Na.� �� Company ����•d ` b
BUILDING
❑ Certified copy is hereby furnished. " FOR APPLICANT TO FILL IN ADDRESS
ertified copy is filed with the county building inspec- BUILDING
n department. ADDRESS
DateT �F_*APPlicant Cr/%�/�/1� �� � CITY' %Td / GG G• T� ZIP ( ��'� LOCALITY —
NO. OF BLDGS. NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST.
COMPENSATION INSURANCEASSESSOR
(This section need not be completed if the permit is forone TRACT BLOCK LOT NO. MAP BOOK PAGE I PARCEL
hundred dollars ($100) or less.) OWNER 41 NO. 4"111.3 ��� USE ZONE MAP '
NO.
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 �/a��G✓��fffj� CONDITIONS
so as to become subject to The Workers'Compensation Laws. O
CITY zip U
Date Applicant ARCHITECT OR TEL. DISTRICT GROUP P s IRE PROCESSED BY
NOTICE TO APPLICANT: If;•,after making this Certificate of ENGINEER- NO. ZONE O0
Exemption, you should become subject to the Workers` q w '
Compensation provisions of the Labor Code, you must forth- ADDRESS' n.
With comply with such provisions.or this permit shall be n TEL. e3 STATISTICAL CLASSIFICATION APT. CONDO. N
deemed revoked. CONTRACTOR ��/ di�9 �Crl�� NO. `1 r Z
LICENSED CONTRACTORS DECLARATION // LIC. r CLASS NO. DWELL.-UNITS '^
I hereby affirm that I am licensed under provisions of Chapter-9 ADDRESS l/� .JY• U%k NO.�� S'J c�T
(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. CJTY' «°f/'Le'® Gam/` a CLASS 3/ BK PG VALIDATION
SQ:FT. NO: OF"' NO. OF CHECK
License Number/-� Lic. Class SIZE STORIES FAMILIES ONE
s�� VALUATION
s�it� �9 Date y' �� DESCRIPTION.OFWORK�,Q�Q / �y£ NEW ❑ s GA
Contractor a7
❑I am exempt under Se'
c. �' � p°�j✓��jr'� '��� ADD- ❑ ►
ALTER ❑
B.&P.C..for this reason, 1z.,vtss kg vv�l- �!'�� REPAIR ❑ $
Date:. USE OF
EXISTING BLDG. DEMO, ❑
Signature APP(RAf T, NO. FINAL y
OWNER-BUILDER DECLARATION DATE t/
I hereby affirm that I am exempt from the Contractor's License
Law for the following reason (Section;7031.5, Business and ADDRESS FINAL
Professions Code): PRESENT By-'. A I-r-`i 4
El1,I, as owner of the property, or my employees with ADDRESS" --1� � ='I
wages as their sole compensation,will do the work and � ��� !_-r s °'
the structure is not intended or offered for sale(Section LOCALITY
phc-
7044, Business and Professions-Code.-) MOVING TEL. , 1 1T
CONTRACTOR NO.
❑ I, as owner of the property,am exclusively contracting 1-1^i AL � 1.7 m 90
with licensed contractors to construct the project-(Sec- _
tion 7044, Business and Professions Code. ADDRESS �_p L' 117,911
REQUIRED TOTAL SETBACK FROM EXIST.
�:!-iECK
CONSTRUCTION LENDING AGENCY - SET BACK YARD HWY PROP. LINE WIDTH ,4�1�
I hereby affirm that there is a construction lending agency for FRONT t-'H'NGFE
the performance of the work for which this permit is issued P.L.
(Sec. 3097, Civ. C.). "SIDE
P.L.
Lender's,Name," - -_0a_ ti
LDMA Ref. # � 1r- t I � `o t
1! �i
Lender's Address P.C. Fee$ Permit Fee -'�-
o
I 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.
N ordinances and State laws relating to building construction, Total Fee DMA'Perm. #
a and h uthorize represe tatives of this,County to enter
u the - - entione operty for inspection purposes.
zz—
n SEE REVERSE FOR EXPLANATORY LANGUAGE
gnature of Applicant or Agent Date
..r
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 1006170047
PHONE: (626) 285-0488 EXT:
(LEGAL ID: I NO. OF CONST I BUILDING ADDRESS: I
ITR: 16957 LT: 6 1 SQ. FT STORIES TYPE 1 5516 BALDWIN AV 1
I (STRUCTURE: 1800 V-B 1 TEMP CA 917802627 1
ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: LIVE OAK
18586-022-006 I THOMAS PAGE: 597 GRID: 24 LOCALITY: TEMPLE CITY, Cl
(TENANT: IEXIST BLDG USE: RESID USE ZONE: R-1 (ISSUED ON: PROCESSED BY: - 1
EXIST OCC GRP: 106/17/10 SR
(OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: IFI.F&IT, E FIN BY: CODE: 1
INGUYEN, MAI N (626) 318-6497- 1 2,600 1 '� ��
15516 BALDWIN AV I
(TEMP 917802627 1 FEES PAID (DESCRIPTION OF WORK 1
I (TEAR OFF AND REROOF REPLAC THE DAMAGED LUMBERS AS NECESSARYI
I 1FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: IINSTALL ROLL #30 AND INSTALL SHINGLES 30 YEARS OF WARANTY I
(APPLICANT: TEL. NO: 1
1SAME AS OWNER - IAA BLDG PERMIT ISSUANCE 27.75 1 1
I IAB STATE GREEN BLDG FEE 2600.00 VAL 1.00 (SPECIAL CONDITIONS: 1
I 1AC STRONG MOTION RESID 2600.00 VAL 0.50 1 1
I ID2 PERMIT W/O EN-HC 2600.00 VAL 99.00 1 1
I I TOTAL FEES 128.25 1 1
(CONTRACTOR: TEL. NO: 1 (APPROVALS DATE INSPECTOR SIGNATURE 1
(SAME AS OWNER _ 1
LIC. NO 1 1LOCATION AND SETBACKS 'I I I
(SOILS ENGINEER APPROVAL I
ARCHITECT OR ENGINEER: TEL. NO: - i (FOUNDATION/TRENCH FORMS 1 1
LIC. NO: 1 (SLAB/UNDER FLOOR I I
I 1 IPAISED FLOOR FRAMING I I I
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: I (UNDERFLOOR INSULATION I
1147H269 3 001
I (FLOOR SHEATHING 1 1 I
INC. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS:_-I I. V I
NO 21 - I ROOF SHEATHING
I SCHOOL WITHIN HAZARDOUS 1SHEAR PANELS
(AIR QUALITY: 1000 FEET MATERIALS 1
INO NO NO 1 (FRAME INSPECTION I I I
1
i IFIRE SPRINKLER HANGERS I I
I I I I
(INSULATION/WEATHER STRIPI II
I
(INTERIOR LATH/DRYWALL I I
1 I 1EXTERIOR LATH I I
I I I
1 1RATED FLOOR/CEIL ASSEM. i 1
I1
1 I 1RATED WALL ASSEMBLIES I I I
1 I (RATED SHAFTS/OPENINGS I I I
I I I I
IT-BAR CEILINGS I
I I I I
1 11LOT DRAINAGE
1 I I I
1 (REPORT ID: DPR261 ROUTE TO: BS0508 I I I I
I I I I