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HomeMy Public PortalAbout6253 AVON AVE_Building__ l 4 Y 76A638A CE#803162 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DMSION LOCALITY r JOHN A LAMBIE COUNTY ENGINEER NEAREST WILLIAM A JENSEN SUP T OF BUILDING CROSS ST DISTRICT NO ROUP PE P SSED BY FOR APPLICANT TO FILL IN corlsT BUILDINGSTATISTICAL CLASSIFICATION SE ER MAP ADDRESS JR V CLASS NO DWELL UNITS / BK �GL LOT NO Q BLOCK WATER /� CERTIFICATE NOT REQUIRED ❑ RECEIVED TRACT 15 MAP ..2 HIGHWAY STATE MAJOR SECOND OCAL NO OF BLDGS �/ NO �j/C/ (CIRCLE) SIZE OF LOT 0- NOW ON LOT G..,., USE ZONE SPECIAL USE OF ^ CONDITIONS EXISTING BLDG TEL / OWNER �, NO xOvIcclso BUILDING EXIST I SETBACK YARD HWY STREET NAME WIDTH ADDRES36 A11,4 11 /Y/Gc� FRONT ARCHITECT OR TEL P L ENGINEER NO SIDE P L ADDRESS ! 12' TEL 11�26`�Ca 1 u CONTRACTOR 9A7 M G NO >i o A , mA GC ADDRESS C (- DESCRIPTION OF WORK W CL Vf NEW ADD ALTER REPAIR DEMOLISH Z SQ FT � NO OF NO OF / SIZE STORIES FAMILIES USE OF NN STRUCTURE l 192 e C7 SIGNATURE OF APPLICANT VALUATION $ O 1 APPROVALS DATE INSPgCTOR S SIGNATURE PMTPC .—y� FOUNDATION LOCATION FEE $ FEE $ �� (/ FORMS MATERIAL FRAME FIRE STOPS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY 1 NOT EM OY ANY PERSON IN VIOLA LATH INT TION OF THE LABOR DC F T STA E OF CALIFORNIA RELAT too ING TO WORKMEN S MPEN ATI N INS ANCE LATH EXT / SIGNATURE HOUSE NUMBER COR PERMITTEE RECT AND POSTED ADDRES FINAL 3� /� JOHN F LEWIS PRINCIPAL STR TURAL ENGINEER PLAN CHECK VALIDATION CK M O !A H _ PERMIT VALIDATION CK M D CASH 6 3`2 2tv0U 1 2 3 R 3 3 75d LAL0 7 0 1 1 NOd 15 1 A 6750- � APPLICATION FOR BUILDING PERMIT COUNTY OF LOS'ANGELES BUILDING AND SAFETY WORKER S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDS S _r I herebyaffirm that I have a certificate of consent to self Insure BUILDING ADDRESS /� �- / , 'Y � 9. or a certificate of Workers Compensation Insurance or a certified ©N copy thereof (Sec 3800 Lab C) CITY `_ ZIP _ S LOCALITY Policy NO 1 Company SIZE OF LOT NO OF BLDGS NOW ON LOT ❑ Certified copy is hereby furnished NEAREST CR SS ST SC ❑ Certified copy Is filed with the county building Inspection TRACT BLOCK LOT NO , ,department USE ZONE MAP NO Date Applicant t ASSESSOR MAP 800K PAGE c PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS OWNER [J�I TEL NO COMPENSATION INSURANCE G/�1 r — WITHIN 1000 FT OF SCHOOL? YES No (This section need not be completed If the permit Is for one hundred ADDRESS _ v" C DISTRICT GROUP TYPE CONST FIRE ZONE PROCE Y dollars ($100)or less) CITY ZIP �� O I certify,that in the performance of the work for which this permit � J` Is Issued I shall not employ any person In any manner so as to ARCHITECT OR ENGINEER TEL NO become subject to the Workers Compensation Laws STATISTICAL C AS IFICATION APT CQ14DO 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 to the Workers CONTRACTOR �� TEL NO SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code you must forthwith comply with such provisions or this permit shall be deemed revoked FRONT P P ADDRESS LIC NO PL LICENSED CONTRACTORS DECLARATION PILE CITY LIC CLASS PL I hereby affirm that I am licensed underprovisions of,Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ FT SI NO OF STORIES NO OF FAMILIES Professions,Code and my license Is in full force and effect 0 NEW ❑ BK PG CL VALUATION , 1 d DESCRIPTION OF WORK License Number Lic Class C LL.. 016F& � ADD �] _ Contractor Date ALTER 3 U El am exempt under Sec Y t F REPAIR $ B&PC for this reason 6) Sb1fV -S DEMOL ❑ LDMA P/C#r W Date USE OF EXISTING BLDG URM ❑ ii a_ Signa _ W APPLICANT(PRINT) TEL NO LDMA Perm# 1 r Z as owner of the property or my employees with wages as t ' - - Z fiL L I i } their sole compensation will do the work and the structure Is ADDRESS w _O not Intended or offered for sale (Section 7044 Business and FINAL DATE Professions Code) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL El I as owner of the property am exclusively contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE J I ITEM: AMOUNT9 SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE'S FINAL U licensed contractors to construct the project (Section 7044 YES NO❑ It TATA_ ��} ® O Business and Professions Code) WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH yy, { t HEL 11� TI CONSTRUCTION LENDING AGENCY CAST AIR QUAUTY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR GUIDE •Jm L C`,O K` �� © r u I hereby affirm that there Is a construction lending agency for _ VJ rfH��ti3E VES❑ NO❑ -... � I N the performance of the work for which this permit Is Issued(Sec p, I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING 3097 Civ C) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE TITLE 2 CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS LliJ1.l.!-I1l,l 1 Z J'1 J_ Lenders Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD o Lenders Address " ` 03F 1 AM y+;15 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 PC FEE PERMIT FEE with all county ordinances and State laws relating to building 97-1..5 CO construction and hereby authorize representatives of this County ISSUANCE FEE �// ��r to enter upon the abov menti ned property for Inspec Ion purposes ZJ,Gs i ��,� (0 11 � INVESTIGATION FEE TOTAL FEE Q ^�S�+ I Aodb+ We+ T f o+ z. SEE REVERSE FOR EXPLANATORY LANGUAGE 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 91760 BL 0508 1302270033 PHONE (626) 285 0488 EXT ILEGAL ID NO OF CONST BUILDING ADDRESS ITR 5903 LT 0 BL 001 I SQ FT STORIES TYPE 6253 AVON AV ISTRUCTURE 2700 V B SGAB CA 917752649 ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET 15386 006 032 THOMAS PAGE 596 GRID G2 LOCALITY TEMPLE CITY CAI TENANT IEXIST BLDG USE RESID USE ZONE R 1 (ISSUED ON PROCESSED BY IEXIST OCC GRP 102/27/13 SR (OWNER TEL NO IBLDGS NOW ON LOT VALUATION IF T FIN BY CODE 1 IALEXANDER GRANT ELOISE B TRS (626) 286 6059 1 7 000 1 16253 AVON AV ISGAB 917752649 FEES PAID ID9SCRIPTION OF WORK IRE ROOF REMOVE EXISTING SH NGLES INSTALL 30 YR DIMENSIONAL I IFEE DESCRIPTION QUANTITY UOM AMOUNT ISHINGLES I (APPLICANT TEL NO I I ISAME AS OWNER IAA BLDG PERMIT ISSUANCE 27 80 I IAB STATE GREEN BLDG FEE 7000 00 VAL 1 00 ISPECIAL CONDITIONS IAC STRONG MOTION RESID 7000 00 VAL 0 70 1 I ID2 PERMIT W/O EN hC 7000 00 VAL 166 20 1 I _I TOTAL FEES 195 70 ICONTRACTOR TEL NO I (APPROVALS DATE INSPECTOR SIGNATURE I ISAME AS OWNER I 1 I LIC NO I (LOCATION AND SETBACKS I I I ISOILS ENGINEER APPROVAL I I I 1 11 (ARCHITECT OR ENGINEER TEL NO IFOUNDATION/TRENCH FORMS I I I LIC NO I (SLAB/U DFR FLOOR I I I I- I I IRAI-ED FLOOR FRAMING I I IMAP NO SEWER MAP BOOK PAGE FIRE ZONE CNP I IUNDURFLOOR INSULATION I I _ I 1153H261 3 001 1 I I (FLOOR SHEATHING INO OF FAMILIES DWELLING UNITS APT/GOND STAT CLASS I I I I I 1 0 NO 21 I IROOF SHEATHING I SCHOOL WITHIN HAZARDOUS 1 ISHEXR PANELS �I�I (AIR QUALITY 1000 FEET MATERIALS I _ I I NO NO NO - IFRANE INSPECTION IFIRE SPRINKLER HANGERS I I 11NSULATION/WEATHER STRIPI I (INTERIOR LATH/DRYWALL " I IEXTERIOR LATH I I I IRATED FLOOR/CEIL ASSEM I I IRA-ED WALL ASSEMBLIES I I I IRATCD SHAFTS/OPENINGS IT B71-R CEILINGS I ILOT DRAINAGE I 1 1 (REPORT ID DPR261 ROUTE TO BS0508 I I I