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HomeMy Public PortalAbout5311 ARDEN DR_Building__ 76A638A CE*803 8-63 APPLICATION FOR BUILDING PERMIT LJ COUNTY OF LOS ANGELES BUILDING�3 // 6� DEPARTMENT OF COUNTY ENGINEER ADDRESS !� BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST - '9 WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. i DIS .GT NO. GRRR�O.(,1; TYPEr RO ESSED BY FOR APPLICANT TO FILL IN L^O .11/�. coN`STa;I,�Fm e BUILDING '� I /��' �/ STATISTICAL CLASSIFICATION SECWER MAP ADDRESS p •� it / -� BK PG CLASS. NO. DWELL. UNITS LOT NO. BLOCK WATER NOT REQUIRED ❑ RECEIVED ❑ CERTIFICATE:MAP �l TRACT NO !/ (iC RCLE) ST E MAJOR SECON OCA IGHWAY NO.OF BLDTS. SIZE OF LOT NOW ON LOT USE ZONE SPECIAL USE OF CONDITIONS EXISTING BLDG. TEL �6- OWNER - d� OWNER '� /T �/4' �(j NO OC7 BUILDING EXIST. 5�y /J SETBACK YARD..' HWY STREET NAME WIDTH ADDRESS �i M FRONT X?/� ARCHITECT OR TEL. P. L. Q Vv ENGINEER NO. SIDE -I"'� 'n^^• n-••'�:' r'I.� P. L. ADDRESS J' TEL. CURB,GUTTER, DRIVEWAY APPROACH, —CIL OEO CONTRACTOR 'y Q , ( V "i ADDRESS ,F/4 eAcl I T9@x�Frermits for curb, gutter, <_ides, and driveway approach O DESCRIPTION OF WORK ��TLLtt1o, Road Wept., AlFaden W ra15i$e iordT. i '.. H NEW ADD LTER' REPAIR DEMOLISH @ len'thy delay. Survey & Des* •.vcr!:''ia'-ec time and is not sta I! Z SQ. FT. NO.OF NO. OF ' SIZE STORIES / FAMILIES 1 Q is�ued. Apply for parkway tree permit at L . USE OF STRUCTURE /`t•//��, 4) zw i1. 6-3 i ` SIGNATURE OF r APPLICANT VALUATION $ E�" L �A APPROVALS DATE INSP MGNATURE 2 FOUNDATION: LOCATION _ FEE $ FEE $ �J -� FORMS. MATERIALS `" i 3 FRAME: FIRE STOPS. ``j� I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. 7 WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS ' DUCT$ �je 40 BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK p ,,n. AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA. TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT. LATH. INT. ���+"• �,.e' ,ft��,p.•-" ING TO WORKMEN'S COM NSATION IN LATH. EXT. SIGNATURE OF HOUSE NUMBER COR- 4 PERMITTEE r S�ACE, RECT AND POSTED m ADDRESS-3ICA FINAL 24-� JOHN F. LEWIS, PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIO CK. M.O. CASH LA'u'o048T SEP 7 1 D 33:0 l 76A638A CE#8035-61 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES ADD EISS 5311 Arden Dr.# DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION LOCALITY Temple ,, Cit JOHN A. LAMBIE, COUNTY ENGINEER NEAREST j WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST. DISTRICT N OU TYPE P`R S BY FOR APPLICANT TO FILL IN �';(% G-�,Q CONSr. BUILDING STATISTICAL CLASSIFICATION - SEWER MAP ADDRESS 53 11 Arden Dr.s K CLASS. NO: DWELL. UNITS -[ LOT NO. 3 BLOCK WATER NOT REQUIRED RECEIVED ^i CERTIFICATE: 9 TRACT "`' MAP /^/ HIGHWAv NO.OF BLDGS. NO. . {" (CIRCLE) STATE MAJOR SECOND, L CAL SIZE OF LOT I NOW ON LOT USE ZONE SPECIAL USEOF house ELM g4rege CONDITIONS EXISTING BLDG. p�d/gN��R 3�i TEL. ii NO. BUIL NGJJy-L —I-umnom+ I s ~.L SETBACK YARD HWY STREET NAME WIDTH ADDRESS FRONT ARCHITECT OR TEL. P. L. I f ENGINEER NO. SIDE d STANDIkRD PIANP. L. O ADnSS � OD s, m } TEL. M�L INSPECTION RECORD CON_T4RACTO NO AD RE S re a C ne V • ' o a s V W DESCRIPTION OF WORK H NEW X ADD ALTER REPAIR DEMOLISH SONO.OF NO.OF �IZE. FT. 830 STORIES FAMILIES USE OF y STRUCTURE Private s Wim. ool SIGNATURE OF APPLICANT VALUATION SU000106 APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. I FOUNDATION: LOCATION FEE $ C/ FEE $ /' G"�' FORMS, MATERIALS 2 FRAME: FIRE STOP::, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: L TIQN, �y, ,`.✓'.'" WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GA$VENT T 'P BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOI THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY A P N IN VIOLA. LATH, INT. - TION OF THE LABOR CODE THE STATE O C ORNIA RLAT- ING TO WORKMEN'S M SATI N y/ LATH, EXT. SIGNATURE O OUSE LIMBER COR- A 6DRI��EE ®s one • O RECT AND POSTED P 6`9D EE// O FINAL CLYDE N. DIRLAM, PRINCIPAL ST URAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK.� M.O. CASH CE SCWB(Rt ri 11-/78) APPLICATION R BUILD"G ERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN BUILDING / ADDRESS FR�E 5311 Arden LOCALITY NEAREm le Cit Ca. CPO''ST p y) ZIP 91780 CROSS SL C,�+ O O.OF BLDGS. ASSESSOR. SIZE OF LOT 71.84 X 16 OW ON LOT MAP BOOK PAGE I PA_RCZL ' DISTRICT GROUP TYPE FIRE rISSED BY ` BLOCK LOT NO. 3 TRACT 11699 CON OWNER Mr. & Mrs. John TsuboZ 444-9055 d'Or 11 Arden STATISTICAL CLASSI�CATION EWER ADDRESS 53 OAC/ CLASSNO. DWELL.UNITS BK 'G CITY Temple City, Ca. ZIP 91780 ARCHITECT OR TEL, VALUATIONr ENGINEER NO. %� C�7rO+ ADDRESS BLDG.SETBACK FROM TEL FRONT PROP.LINE OF' (STREET) CONTRACTOR Charles E. Boggs N4.446-0841 TOTAL SETBACK FROM TYPE OF EXISTING LIC HIGHWAY + YARD = FRONT PROP.LINE HIGHWAY WIDTH ADDRESS 61 E. Foothill B1vd.No.312552 LIC. + O " CITY Arcadia, Ca. gloo6 CLASS B CONSTRUCTION LENDER BLDG.SETBACK FROM NAME AND BRANCH SIDE PROP.LINE OF (STREET) �i HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING ADDRESSCITY SIDE PROP.LINE HIGHWAY WIDTH, u �� SQ.FT. F NO.OF CHECK + _ SIZE O l I FAMILIES l ONE as �U iIE MA NOP W DESCRIPTION OF WORK Bedroom & Bath. NEW ❑ / SPECIAL addition ADD © CONDITIONS y r� LTER ❑ FINAL A/ BY / Z l O ' ❑ DATE �/9 ._ it REPAIR EPAIR USE OF ❑ EXISTING BLDG. Residence 2 APPLICANT TEL •�•� �/ 0 / PRINT( Charles E. Boggs. No.4_46-0841 a BY(SIGNATURE IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ND STATE Y THAT THE'ABOVE•IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES W AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE S WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF u THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM Z ' PENSATION INSURANCE.' g 9 5 9.0 A (� d SIGNATURE OF Y # 0 0 0.0 0 1 PERMITTEE ADDRESS l E. Foothill Blvd. Z 2 o 3 3 8.5 0 'CITY Arcadia, Ca. No. 8 446-o841 a - ° 3 3 8 5 0 6 0 0 27- G P.C. Fee$ Permit Fee /� > f Issuance Fee . ' m W �{ 6 Total Fee ✓ ! A APPLICATION ECR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS or a certificate of Workers' Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.CC..) , CITY I ZIP LOCALITY Policy Na)Mg-SS=1- -ompany Certified copy is hereby furnished. SIZE OF LOIF U NO.OF BLDGS.NOW ON LOT CROSS ROSS ST. _ ❑ Certified copy is filed with the county build in inspection TRACT BLOCK LOT NO. department. USE ZONE MAP NO. ASSESSOR MAP BOOK PAGE PARCEL Date Applicant --- SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER o TEL NO. NO COMPENSATION INSURANCE _l�7-�{"�(7Z WITHIN 1000 FT OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred ADDRESS DISTRICT GROUP TYPE CONST, FIRE ZONE PROCESSED BY dollars($100) or less.) CITY ZIP I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as t0 ARCHITECT OR ENGINEER TEL NO. J� become subject to the Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT.' If, after making this Certificate Of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject t0 ' the Workers' COFACTOR TEL NO. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith '3"3— FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. P L (Otl$� i� SIDE LICENSED CONTRACTORS DECLARATION Y LIC,CLASS P L I hereby affirm that I am licensed underprovisions of Chapter 9 G 3 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SO.FT.SIZE NO.OF/�TORIES NO.OF FAMILIES Professions Code,and my license is in full force and effect. 3O$ I ( NEW BK PG a License Number Lic. Class DESCRIPTION DESCRIPTION OF WORK ADD ❑ VALUATION , Q ContractorDate ii? -T—a-1 Qp- ALTER El $ EO� X LaL El am exempt under Sec. REPAIR El $ F- BAP.C.for this reason DEMOL ❑ LDMA P/C# W Date:. USMF EXISTI GAJ BLDG. URM ❑ a Signature APPLICANT(PRINT) TEL NO. LDMA Perm# Z El 1, as owner of the property, or my employees with wages as Lx2m(10-", �� 'i- Z ACCT.T' their sole compensation, will do the work and the structure is ADDRESS If \ 0 3303 175.65 not intended or offered for sale (Section 7044, Business and �2 Ll U FINAL DATE r Q Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL `/'J�(�J 1 ��Ei ITEMS OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE ElAMOUNTS SPECTI ON THE HAZARDOUS MATERIALS INFORMATION GUIDE?I, as owner of the property, am exclusively contracting with Q FINALBY � 175 - 65 licensed contractors to construct the project (Section 7044, YES 11 NO TOTAL Business and Professions Code.) CHECK 175.65 WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH NV CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES. CHANGE o00 I hereby affirm that there is a construction lending agency for YES N11K (►(�(� (�(� t7 t► o N the performance of the work for which this permit Is Issued(Sec. 1HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING 0000-0001 3/30/95 3097, Civ.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, N TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS d Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. 1[j�I 1 AM 9.00 o Lender's Address O OWNER OR AGENT o I certify that I have read this application and state under penalty O of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE - with all county ordinances and State laws relating to building m construction, and hereby authorize representatives of this County ISSUANCE FEE ato enter upon t e arc e-mentioned property for inspection purposes. , INVESTIGATION FEE TOTAL FEE / 1 1. b Sipnature AppW'.a�n of r Awnl Mte SEE REVERSE FOR EXPLANATORY LANGUAGE