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Home My Public Portal About4855 ARDSLEY DR_Building__ DIVISION OF BUILDING AND SAFETY 1 Department of County Engineer County of Los Angeles WM. J. FOX, COUNTY ENGINEER APPLICATION FOR APPLICANT TO FILL IN _ FOR OFFICE USE ONLY DISTRICT NO. PLAN CK.OR REC.No. PERMIT NO. BUILDING t� ADDRESS �.� / C' / L,74/ :J Q (O 'T' RECEIVED BY DATE OFAPPL. DATE ISSUED LOCALITY �. _ PjEARFCST (/ ROSS BT. 1 BUILDING �4 �g ADDRESS OWNER MAIL LOCALITY 1/ ADDRESS Ns:AREST / CROSS BT. CITY FIRE NO.OF �- TYKE! GROUP As ZONE --` PLANS ARCHITECT OR TEL/'" ENGINEER NO. BLDG. SETBACK LINEA ADDRESS USE/ / APPROVED L ZON ( BY DATE CONTRACTOR ND. HO/,FUSE NUMBERING ADDRESS MAP NUMBER d.� / `�' NO. ASSIGNED BY LEGAL CORRECTIONS DESCR1PTfON LOT NO.-AA BLDCK Z y TRACT �+ P NO. OF SLOGS G Qe bc/.OGG �o �� PLS C'} a51bEiD SIZE OF LOT / ,,P I A4 I NOW ON LOT USE OF •.'s N O.OF EXISTING BLDG. FAMILIES DESCRIPTION OF WORD / 13 3 �.a...:.• cr �4 r �.G-4f.-�.�1 NEW��LTERATION ADDITION /� �A REPAIR ey�� JI DEMOLITION 89. ZE [ O}(® ROOMS STORIES EXT.WALL - �RODF COVERING i COVERING USE OF STRUCTURE '/0 .tf ofii INSPECTION FOR APPROV S OCCUPANCY AS INSPECTO 'S SIGNATURE DATE FOUNDATION: LOCATION FARMS, MATERIALS „i,n,,a.. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS.AP- PLICATION AND STATE THAT THE INFORMATION GIVEN IS FRAME: FIRESTOPS, CORRECT. BRACING, BOLTS !L I ABREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION, AND STATE LAWS REGULATING BUILDING CONSTRUCTION. - GAS VENT,DUCTS SIGNATURE OF /1 LATH, INT. PERMITTEE � ��r_XXX �.C.�t ,,..CC�1�//14��'' ADDRESS LATH, EXT. . ► PLASTER, INT. AUTHORIZED AOT. O PLASTER, EXT, i a FEE HOUSE NUMBER COR- RECT OR- I / RECTAND POSTED VALUATION ( FEE 1p 6 O FINAL i / E 76AG36A DSS 3 1-52 %DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES B U I L I N G j WM. J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTRICT NO. PLAN CK.NO. PERMIT NO. BUILDING ADDRESS UZ LL 1 V �� - / v o ( q LOCALITY 1 M Q�� {yam p �p`at'o RECEIVED BY DATE OF AP'P,{L.J DATEI+SSIJED NEAREST Low crL A .%jsA 'RW P.� �• '-"� `/ Il 4!� � ' CR088 HT. 1 A Q �+ BUILDING / OWNER \\J�.J��-��f�4a(A�Q��•��a��G9, ADDRESS xf> ADDREBS 73 A „ �.{ L �� VC .MAIL LOCALITY NEAREST. i- q ,t^f P� ��`` TEL. e CROSS ST CITY �1"t 'f'om�$Qa0�1.- CvfYND. �• llg FIRE NO.OF TYPE(•�y� GROUP ARCHITECT OR / � EOL. * ZONE PLANS _LryG/-- �, ®LOG. f _ ORD.NO. ADDRESS I%t ve .,_ ��• �a SETBACK LINE APPROVED CONTRACTOR v Ile m \/��C LS NOL ` I S4�1 BY DATE SS (� USE �'�_� APPROVED ADDRESS SX+! vCv;Aat-o�_eHtic-• S;- CT. ZONE �•�p-{BY DATE LEGAL DESCRIPTION LOTNO. � I BLOCK �® /CORRECTIONS TRACT 1!4u //� �/ �1 /I 'NO.OF SLD-B.�rip l C o SIZE OF LOT G Y I I l/ 1 NOW ON LOT 'Uig USE OF NO.OFNO.OF EXISTING BLDG. I FAMILIES ROOMS DESCRIPTION OF WORK NEW ALTERATION ADDITION O A REPAIR MOVING DEMOLISH - FT. I ND'OFZ SIZE clI 7J ROOMS STORIES > WALL ROOF COVERING �L�"LT ( COVERING SgllKltrLt USEOFNGW 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE 19 CORRECT FOUNDATION: LOCATION INSPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS �s AND STATE LAWS REGULATIN BUILDIN ONSTRUCTION, `x /> f FRAME: FIRE STOPS, SIGNATURE OF BRACING,BOLTS 0 " J PERMITTEE "\ /C• //� 3 — %�� •• LATH,INT.: AUTHORIZED AG LATH,EXT.: l ' VBS-s SEIM SETS 7-47 $ P C D® PLASTER,INT. ap -FEE �y� PLASTER,EXT. VALUATION �� FEE $//J �U FINAL WORKERS'COMPENSATION DECLARATION insure, oraffirm a certif catte of Workers' Compensaf on I have a certificate of coent Insurance, A Ob I'AT I O N FOR BUILDING PERMIT or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy NoIV84-22515 _mpany Fremont Indemnity BUILDING ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS ® Certified copy is filed with the county building inspec- BUILDING tion deportment.- ADDRESS 4855 N. Ards]ey LOCALITY Pit 9. Date 1216184 pp V t rg i n Roo f CO. CITY Temple C 1 t NEAREST Applicanty ZIP CROSS ST. V",ffA CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one USEO E MAP hundred dollars-($100)or less.) TRACT BLOCK LOT NO. NO. TEL. SPECIAL I certify that in the performance of the work for which this OWNER Hector Carrera NO. CONDITIONS DISTRICT GROUP TYPE / FIRE PR CESSED BY O permit is issued, I shall not employ any person in any manner ADDRESS 4855 N. Ardsley CONST./ ZONE so as to become subject to the Workers'Compensation Laws. 5-109 '"/�9r� ,V/ U CITY Temple Cit . CA ZIP 5J 1 J O 9401� Date Applicant STATISTICAL CLASSIFI ATION APT. CO O. 0 NOTICE TO APPLICANT:. If, after making this Certificate of ARCHITECT OR TEL. Exemption, you should become subject to the Workers' ENGINEER NO. CLASS NO. DWELL. UNITS Compensation provisions of the.Labor.Code,.you must forth- ADDRESS SEWER MAP with comply with such provisions or this permit shall be deemed revoked. CONTRACTOR Virgin Roof Co. NQ28 -O 0 BK. PG, VALIDATION LICENSED CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS P.O. BOX J NO. 160650 VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC. Professions Code, and my license is in full force and effect. CITY San Gabriel CLASS C39 $ 1664.00 , C39 SQ. FT. NO. OF NO. OF CHECK License Number 160650 Lic.Class SIZE STORIES FAMILIES ONE }� Contractor 12]6]84 DESCRIPTION OF WORK Re-roof house & NEW ❑ $ ¢ V i r4 i n Roof Co.Date q $ x ❑ I am exempt under Sec. attached garage with Class A ADD E] I 9 ALTER ❑ FINAL B.&P.C. for this reason comp. shingles. 22 s s REPAIR ❑ DATE Date: USE OF FINA EXISTING BLDG. dwe 1 1 I n DEMOL ❑ By Signature APPLICANT TEL. OWNER-BUILDER DECLARATION (PRINT) V 1.r i n Roof CO. NO. 28]-050] I hereby affirm that I am exempt from the Contractor's License ADDRESS P.O. BOX J, San Gabriel , CA 91]] , Law for the following reason (Section 7031.5, Business and Professions Code): PRESENT ❑ BUILDING I; as owner of the property, or my employees with ADDRESS wages'as their sole compensation,will do the work and the structure is not intended or offered for sale(Section kADDRE 7044, Business and Professions Code). TEL. ❑ I, as owner of the property, am exclusively contracting CTOR NO. with licensed contractors to construct the project (Sec- tion 7044, Business and Professions Code). ED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY CK YARD HWY PROP. LINE WIDTH , I hereby affirm thaCthere is a construction lending agency for the performance of the work'for'which this permit is issued(Sec. 3097, Civ..C.).lender's Name Lender's Address $ Permit Fee 39.38 I certify that l have read this application and state that the Issuance Fee l O O above information is correct. I agree to comply with.all County Investigation Fee g ordinances and State laws relating to building construction, Total Fee 49.88 and hereby authorize representatives of this County to enter up n the above-mentioned pr pterty for inspection purposes. (/ SEE REVERSE FOR EXPLANATORY LANGUAGE ®s gnature of Applicant or Agent Date WORKERS' CG•MPENSA-MON DECLARATION hem1 ensure boroa certif carte of Workers' Compensation eInsuran of APPLICATION FOR• BUILDING PERMIT or a certified copy thereof (Sec. 3800, Lab. C.) ` t3 ,rV,.•-�� _ COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No73'MCompany !S 1.�0 ElCertified copy is'hereb•y furnished. FOR APPLICANT TO FILL IN ADDRESS .% Certified copy is filed with the county building inspec- -BUILDING Y tion department. 1N1 1 ]—�Il,�a,/ ADDRESS 1 ,�� C6 , IPL-moi �♦ Dat � 2 Applicant__16 6` `LC Y CITY' 1.9 ( ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKER SIZE OF LOT6 NO.+a NOW F, LOT r NEAREST �� CROSS ST. + Ci. LV Q. k, {P D/►�� COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one TRACT q7 BLOCK LOT NO. / hundred dollars ($100)or less.) MAP BOOK PAGE PARCEL� 3 OWNER t y��j( `�' �' T USE ZONE MAP I certify that in the performance of the I.work for which this � NO. permit is issued, I shall not employ any person in any manner ADDRESS 1�♦ j SPECIAL CL !!!��` so as to become subject to the Workers'Compensation Laws. CONDITIONS 0 CITY LC 1 ZIP Date Applicant ARCHITECT OR TEL. 0 NOTICE TO 'APPLICANT: If, after makingthis Certificate of ENGINEER NO DISTRICT �GROUP TYPE FIRE PROCESSED BY CONST. ZONE U Exemption, you should become subject to the Workers' / , / Compensation provisions of the Labor Code, you must forth- ADDRESS �i4 9 V _-:5� �iLG1L a with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. CONDO. N deemed revoked. CONTRACTOR NO.' Z LICENSED CONTRACTORS DECLARATION LIC. CLASS NO.�DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS ' ii NO. 3r5 �� i SEWER MAP (commencing with Section 7000)of.Division 3 of the Business LIC. CITY. �� CLASS and Professions Code,and my lice n a is in full force and effect. BK PG. ;--VALIDATION : r r. SQ. FT. NO. OF p NO. OF CHECK _ _ 6T. License Number Lic. Class SIZE STORIES ( FAMILIES ONE y VALUATION s, ``••''. '� 9 �� DESCRIPTION OF WORK I'T(o' NEW ❑ �� - Contractor Date $ _ 3 f.5 (_ ` {_ -,-.i,_,t,0 El am exempt under Sec. Z ADD ❑ ► ALTER -- ❑ t_t:i, t (i1,i,i B.&P.C. for this reason $ USE.OF REPAIR ❑ :;,p;Y( n FJ Date: EXISTING BLDG. e DEMOL ❑ APPLICANT_" TEL, Signature (PRINT) NO. ` FINAL 2 �q si';')(";�{':It w;4 a OWNER-BUILDER DECLARATION DATE ��3- 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 BUILDING El 1,I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and ^; 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 , i'•.!! .._, tion 7044, Business and Professions Code.) . t _ .=i REQUIRED TOTAL SETBACK FROM EXIST. -- _ CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I herebyaffirm that there is a construction lending agency for FRONT 9 9 Y the performance of the work for which this permit is issued P:L.' (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name. LDMA Ref. # �. :. >.. _,... P.C. Fee$ (J 0(/i Permit Fee Lender's Address 0 1 certify that I have read this application and state that the Issuance Fee LDMA P/C# 0 pol- above information is correct,8 I agree to comply with all County Investigation Fee o� 9 ordinances and State laws relating to building construction, Total Fee ~�J r 3 / LDMA Perm. # and hereby authorize representatives of this County to enter !=e-me hid foperty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature o pplicant or Ag - Date 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 0509230004 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: TR: 14647 LT: 29 SQ. FT STORIES TYPE 4855 ARDSLEY DR STRUCTURE: 265 VN TEMP CA 917803802 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: TEMPLE CITY 8590-017-023 THOMAS PAGE: 597 GRID: AS LOCALITY: TEMPLE CITY, C TENANT: EXIST BLDG USE: RESID USE ZONE: R-1 ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 09/23/05 JK 09/18/06 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FIN D TE FINAL BY: CODE: CARRERA HECTOR;YUPAPORN (626) 285-6007- 5,500 4855 ARDSLEY DR TEMP 917803802 FEES PAID PASCWIPTION OF WORK TEAR/OFF OLD ROOF, INSTALL OSB PLYWOOD, INSTALL CLASS A FEE DESCRIPTION:. QUANTITY: UOM: AMOUNT: COMPOSITION SHINGLES APPLICANT: TEL. NO: LAU (626) 285-9016- AA BLDG PERMIT ISSUANCE 27.75 4533 SHIRLEY AVE AC STRONG MOTION RESID 5500.00 VAL 0.55 SPECIAL CONDITIONS: EL MONTE, CA 91731 D2 PERMIT W/O EN-HC 5500.00 VAL 149.40 TOTAL FEES 177.70 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE GOLDEN KEY INC. (626) 285-9016- 4533 SHIRLEY AVE LIC. NO LOCATION AND SETBACKS EL MONTE, CA 91731 775115039 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 F FLOOR SHEATHING NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: NO 21 ROOF SHEATHING 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