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Home My Public Portal About5212 ARDEN DR_Building__ APPLICATION FOR BUILDING PERMIT �1 COUNTY OF LOS ANGELES BUILDING AND SAFETY ' WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS. i BUILDING ADDRESS I hereby affirm that I have a certificate of consent to self insure, 2 N or a certificate of Workers'Compensation Insurance,or a certified CITi� elzIP copy thereof(Sec.3800,Lab.C.) LOCALITY Policy No. Company SIZE OF LOT NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. -.3 LOT CROSS ST. _ ❑ Certified copy is filed with the county building inspection TRACT O /� BLOCK LOT NO. V department. ��a 7 T � USE ZONE MAP NO.OJ V 7— ASSESSOR MAP B¢00� GE PARCEL / Date Applicant OO r, ,_,,.� SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL.NO COMPENSATION INSURANCE �rIVI937 WITHIN 1000 FT.OF SCHOOL? Yes No X ADDRESS (This section need not be completed if the permit is for one hundredD� DISTRICT GROUP TYPE CONST.' FIRE,ZONE PROCESSED BY dollars($100)or less.) CITY / ZIP I certify that in the performance of the work for which this permit /deL O is issued, I shall not employ any person in any manner so as to ARCHITECT OR ENGINEER TEL.NO. become SU jec to the Workers'COmpensatio Caws. �/ �T 2 D STATISTICAL CLASSIFICATION APT CONDO Date Applicant i 6' p 1 ADDRESS CLASS NO.T DWELL UNITS NOTICE TO APPLICANT. If, after making this 16ertlficate Of /Q REQUIRED TOTAL SETBACK FROM EXIST Exemption, I CONTRACTOR TEL.NO. p you Should become subject t0 the Workers' SETBACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith c� L- comply with such provisions or this permit shall be deemed revoked. ADDRESg, LIC.NO. . FRONT PL SIDE LICENSED CONTRACTORS DECLARATION CITY LIC.CLASS PL p0. I hereby affirm that I am licensed under provisions of Chapter 9 SEWER MAP C� (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORES NO.OF FAMILIES CD Professions Code,and my license is in full force and effect. NEW [IBK PG , License Number Lic.Class DESCRIPTION OF WORK ADD ❑ VALUATION uvi L 7&U/ o . a Contractor Date p4 ALTER ❑ � _z �J I am exempt under Sec. I REPAIR ❑ $ B.BP.C.for this reason lokym" ",/J_,P0ER_ DEMOL LDMA P/C# USE OF EXISTING BLDG. URM ❑ Signature APPLICANT(PRINT) TELD7' LDMA Perm# ❑ I, as owner of the property, or my a ployees with wages as T ZO their sole compensation, will do the work and the structure is ADDRESSH not intended or offered for sale (Section 7044, Business and �'�8v.� �/!!l��'�fL FI Q ACCT.Professions Code.) 0110. WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL 6 il,:w• n 5 OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN ❑ 1, as owner of the property, am exclusively contracting with THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDES FINAL BY -C 7 i i licensed contractors to construct the project.(Section 7044, q� li! w f 9l VES❑ e.f5._.. Business and Professions Code.) No L• f T n WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING + 1 i�t fw� OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH _ _ _ CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST q{ { FOR GUIDELINES. l l-)T AL - r 3 1 hereby affirm that there is a construction lending agency for YES 9i;.I! the performance of the work for which this.permit is issued(Sec. ❑ No C 11 CIO I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD 3097,CIV.C.). PERMITTING CHECKLIST.1 UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES "".,!-MANGE e Cul To. COUNTY CODE•TITLE Z CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING Z21 Lender's Name HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. Lender's Address o. OWNER OR AGENT i j-; �e j f:;:jf 1 o 1 certify that I have read this application and state that the above pC.FEE PERMIT Fye' ' information is correct. I agree to comply with all county g'/D ,�y�y 6r ordinances and State laws relating to building construction,and (J !/ '' AM hereby authorize repre n atives of this County to enter upon ISSUANCE ,�17 the above- a ion pe ty for i section urposes INVESTIGATION FEE TOTAL FE •!1 CJ spawn w SEE REVERSE FOR EXPLANATORY LANGUAGE, DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT :` COUNTY OF LOS ANGELES I WM. J. FOX, -CHIEF ENGINEER. FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTRICT NO. PLAN CK.NO. PERMIT NO. BUILDING _ Rt ADDRESS . (---- °�`�y,)- � 7_ 1 y ^6' LOCALITY �G/f 1 ✓ RECEIVED BY DATE OF APPI. DATE ISSUED NEAREST CROSS ST. _ BUILDING / G• �lY OWNER (/_,4/-ATF 60- ..C7W' �.0 ADDRESS MAIL LOCALITY ADDRESS d -6 3' (-.. .4VD. N � r�1I�� / NEAREST CITY 1--rAgo/.f !T NO. YAC Y� CROSS ST. TYPE !C FIRE NO.OF TYPE - GROUP ARCHITECT OR / TEL.. ZONE PLANS ENGINEER NO. BLDG. / / ORD.N�7p ADDRESS SETBACK LINE Q (2-/ & / 1 APPROVED / TEL. CONTRACTOR BY DATE �.9ME S NO. USE APPROVED ADDRESS �O IIS ZONE BY DATE LEGAL DESCRIPTION LOT NO. BLOCK CORRECTIOtNS TRACT I..5[f'744 / "3, 77 (Ir Al" 7 ` NO.OF BLDOS. SIZE O 'F LOT '� ) �..�� I NOW ON LOT 0 USE OF NO.OF NO. Q OF EXISTING BLDG. O I FAMILIES I ROOMS DESCRIPTION OF WORK NEW ALTERATION ADDITION O REPAIR MOVING NO or / DEMOLISH p SIZE T. 9.S".S ROOMS a7 STORIES WALL ROOF COVERING STLIeCQ I COVERING C.OPyPB�JT/Bj�! USE OF NEW �,�, ✓ BUILDING /j✓`L/` -Dr-7-14-IT 'w z1o, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS - APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION INSPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION. L Y, f .y FRAME: FIRE STOPS, SIGNATURE OF BRACING,BOLTS PERMITTEE - °t LATH,INT.: AUTHORIZED AOT .� LATH,EXT.: 0 DBS-3 50M SETS :-48 $ / � , -77/��'j� P_C.S r ' PLASTER,INT. L(� = FEE J - , PLASTER,EXT. VALUATION /l FEE i FINAL LT 7'ti�+ / �---/' J/ s 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 0209260023 PHONE: (626) 285-0488 EXT: LEGAL ID: NO.'OF CONST BUILDING ADDRESS: TR: 15874 LT: 7 SQ. FT STORIES TYPE 5212 ARDEN DR STRUCTURE: VN TEMP CA 917803317 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: OLIVE 8585-019-007 THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: RESID USE ZONE: R-1 ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 09/26/02 JK 03/25/03 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE: DANFORTH ROBERT A (626) 286-6225- 1,000 /)n ,�n,� �, / 5212 ARDEN DR (b(/!'`6e 11ad TEMP 917803317 FEES PAID DESCRIPTION OF WORK T/0 ROCK ROOF ON HOUSE; INSTALL COMP ROOF FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. NO: SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RESID 1000.00 VAL 0.50 SPECIAL CONDITIONS: D2 PERMIT W/O EN-HC 1000.00 VAL 65.40 TOTAL FEES 93.65 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - L'IC. NO LOCATION AND S TBACKS 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 147H273 3 01 FLOOR SHEATHING NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: NO 21 ROOF SHEATHING SCHOOL WITHIN HAZARDOUS \,\ l SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS (VVV 1 NO NO NO FRAME INSPECTION REQUIRED TOTAL SETBACK FROM EXIST FIRE SPRINKLER HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- of INSULATION/WEATHER STRIP SIDE PL INTERIOR LATH/DRYWALL EXTERIOR LATH RATED FLOOR/CEIL ASSEM. RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: SS0508 WORKERS' COMPENSATION DECLARATION .ns e1'e, ora ,:ertif catte of Workers' Compensation on Insurancee of consent to , - APPLICATION FOR BUILDING PERMIT ora ,: rtifiec,copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS•ANGELES BUILDING AND SAFETY Policy No._! Company ❑ Certified co is hereby furnished. FOR APPLICANT TO FILL IN BUILDING/n �LG copy y ADDRESS d� 2 ❑ Certified copy is filed with the county building inspec- BUILDING f tion department. ADDRESS CITY ZIP LOCALITY , t Date Applicant NO. OF BLDGS. CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF COT NOW ON LOT NEAREST CROSS ST. COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one TRACT BLOCK I LOT NO. MAP BOOK PA PARCEL, hundred dollars ($100) or less.) TEL. OWNER i r�drr�>✓NO. S/Q9,�"9 USE ZONE MAP a 73 I certify that in the performance of the work for which this n NO. permit is issued, I shall not employ any person in any manner ADDRESS��i �. (fi�' / SPECIAL d //�� CONDITIONS O so as to become subject to the Workers' Compensation Laws. /'� /j - Lam, U CITY AJ V /�L• G ZIP 7 Date Applicant. ARCHITECT OR TEL. DISTRICT GROUP I TYPE FIRE PROCESSED BY 0 NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. CONST. ZONE F- Exemption, you should become subject to the Workers' .[�n�/ e � W Compensation provisions of the Labor Code, you must forth- ADDRESS �I l/oG CL with comply with such provisions or this permit-shall be TEL. STATISTICAL9ASSIFICATION APT. CONDO. N deemed revoked. CONTRACTOR NO. ICA Z LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS Thereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. (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. CITY CLASS 413K PG --VALIDATION SQ. FT. NO. OF NO. OF CHECK License Number Lic. Class SIZE STORIES FAMILIES ONE v�c� T�� c Contractor Date ION DESCRIPTION OF WORK NEW El am exempt under Sec. �tiL 1 CO d ADD ❑ a / G(0 ALTER ❑ B.&P.C. for this reason fiu C - REPAIR ❑ Date: USE OF oFj EXISTING BLD(j. DEMOL Signature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION (PRINT) NO. DATE I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS FINAL Prof ssions Code): PRESENT - By _ BUILDING I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and -- , t ---- - the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code.) MOVING TEL. 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.) REQUIRED- TOTAL SETBACK FROM EXIST, CONSTRUCTION LENDING AGENCY SET BACK YARD` HWYPROP. LINE 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. - (Sec. 3097, Civ. C.). SIDE P.L. _ border's Name . D y LDMA Ref. # P.C. Fee$ Permit Fee / - f tt•�- . Lender's Address I cartify that I have read this application and state that the Issuance Fee 13• LDMA P/C# above information is correct. I agree to comply with all County' _ Invesrigation Fee �/ — ` ordinances and St laws relating to building construction, Total Fee r�✓ J� Ol LDMA Perm. # and hereby out rize representatives of this County to enter upo the b ti ned pro rty for i pection purposes. Ak��, SEE REVERSE FOR EXPLANATORY LANGUAGE ✓Sig azure o Applican or Agent Sate/7f- 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 0508250042 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS_: TR: 15874 LT: 7 SQ. FT STORIES TYPE 5212 ARDEN DR STRUCTURE: 1400 VN TEMP CA 917803317 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: FREER 8585-019-007 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: 08/25/05 JK 08/20/06 OWNER: TEL. NO: BLDGS. NOW ON LOT: ,VALUATION: FINAL DAVE FINAL BY: CODE: DANFORTH ROBERT A (626) 221-2563- 4,200 `/ �fq v 5212 ARDEN DR /L �-L L TEMP 917803317 FEES PAID DESCRIPTION OF WORK TEAR OFF EXISTING ROOFING FRONT HO ONLY RE-ROOF WITH FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: CLASS A FIBERGLASS SHINGLES APPLICANT: TEL. NO: RANDOL ROOFING (626) 288-4040- AA BLDG PERMIT ISSUANCE 27.75 2304 TROY AVE AC STRONG MOTION RESID 4200.00 VAL 0.50 SPECIAL CONDITIONS: SO. EL MONTE 91733 D2 PERMIT W/O EN-HC 4200.00 VAL 132.60 TOTAL FEES 160.85 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE RANDOL ROOFING (626) 288-4040- 2304 TROY AVE LIC. NO LOCATION AND SETBACKS SO. EL MONTE, CA 91733 451937039 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 147H273 3 01 _ FLOOR SHEATHING NO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: NO 21 ROOFSHEATHING _ SCHOOL WITHIN HAZARDOUS SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS _ NO NO NO FRAME 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 EXTERIOR LATH RATED FLOOR/CEIL ASSEM. _ RATED WALL ASSEMBLIES RATED.SHAFTS/OPENINGS T-BAR CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508