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Home My Public Portal About5006 BALDWIN AVE_Building__ WORKERS' COMPENSATION DECLARATION herPb�.'11 offirm`,hat I have a certificate of consent to self nsure, or a certificate of Workers' Compensation Insurance, APPLICATION F O R S NUi L L ?-I N G PERMIT �a certified copy thereof (Sec. 3800, Lab. C.) fOUNTY OF LOS ANGELES BUILDING AND SAFETY olicy No. Company Certified co is hereby furnished. FOR APPLICANT TO FILL IN BUILDING �Oa6 ��`� V� PY Y ADDRESS o Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS SDD6 p Date Applicant CITY ZIP p LOCALITY NO. OF BLDGS. NEAREST r, s ,All CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT 6 S NOW ON LOT :2 CROSS ST. 9,44-vor-1 �/ kI—A 91 �J COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK �j50�7 PAGEd� PARCE(, 0/,3hundred dollars ($100) or less.) TEL. USE ZONE MAP OWNER N �I O NO. �-1-11891-9 NO. I certify that in the performance of the work•for which this permit is issued, I shall not employ any person in any manner ADDRESS_; _00,6 ,�j�L �/�.�/� (�, K7-/ SPECIAL CL CONDITIONS so as to become subject to The Workers' Compensation Laws. O CITY IleLf-- ZIP '?/-790 U Date Applicant ARCHITECT OR TEL. W NOTICE TO APPLICANT: If, after makingthis Certificate of ENGINEER NO. DISTRICT GROUP TYPE FIRE PROCESSED BY CONST. ZONE � Exemption, you should become subject to the Workers' p tU Compensation provisions of the Labor Code, you must forth- ADDRESS ' /�O j. �2 -+r-�� with comply with such provisions or this permit shall be �fn_ a, ISEL. STATISTICAL CLASSIFICATION APT. CONDO. N deemed revoked. CONTRACTOR -e5f-_ t7/ Z LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. a� DWELL. UNITS — I hereby 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 BK PG VALIDATION SQ. FT. NO. OF NO. OF CHECK License Number Lic. Class SIZE STORIES FAMILIES ONE VALUATION Contractor Date DESCRIPTION OF WOR W ❑ $ R a ADD' ❑1 am exempt under Sec. I :xo ALTER 1:1IN Poo. BAP.C. for this reason r )s" //C✓ O S� REPAIR ❑ $ Date: USE OF _ EXISTING BLDG. _ DEMOL ❑ Signature APPLICANT � ^^ TEL. g OWNER-BUILDER DECLARATION (PRINT) �t� .6 NO �� g DATE FINAL .1 hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESSf��b )/�� FINAL Prof cions Code): PRESENT By I, as owner of the property, or m employees with BUILDING P P Y, YADDRESS 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. I CONTRACTOR❑ NO.1, 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 HWY PROP. 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. , Lender's Name 9 LDMA Ref. # t_.,.�`A "GE ;... P.C. Fee$ Permit Fee �d7,J'� �Lender's Address1 certif that I have read this a lication and state that the Issuance Fee LDMA P/C# 8 above information is correct. I agree to comply with oll.County Investigatiorn Fee / O -J. .�% �D / ' d ordinances and State laws relating to building construction, Total Fee . LDMA Perm. # ;*53 s y,rr nab a and hereby authorize representatives of'this County to enterWA upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Awl`cant or t Date v -J COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0608300016 PHONE (626) 285 0488 EXT LEGAL ID NO OF CONST NEW BUILDING ADDRESS ON FILE SQ FT STORIES TYPE OCCUP GROUP 5006 BALDWIN AV (STRUCTURE 0 1 VN R3 I TEMP CA 917804010 (ASSESSOR INFORMATION NUMBER GARAGE 796 1 VN U1 NEAREST CROSS STREET 18585 008 013 OTHER THOMAS PAGE 597 GRID B4 LOCALITY TEMPLE CITY Cl ITENANT JEXTST BLDG USE USE ZONE JISSUED ON PROCESSED BY EXPIRES ON EXIST OCC GRP 103/28/08 SR 09/24/08 I I I (OWNER TEL NO IBLDGS NOW ON LOT VALUATION IFINAL DATE FIN BY CODE ILU VINH P (626) 322 4475 1 45 000 I/j� I 15006 BALDWIN AV -j2i� ITEMP 917804010 FEES PAID I SCRIPTION OF WORK DEMO (E) 2 CAR GARAGE/WORKSHOP (DETACHED) REBUILD NEW 2 CAR 1 IFEE DESCRIPTION QUANTITY UOM AMOUNT lGARAGE W/ATTACHED WORKSHOP & RESTROOM WITH TOILET SINK AREA APPLICANT TEL NO I 1 ICHAN (626) 318 9839 ID1 PLANCHECK W/O EN HC 45000 00 VAL 622 58 1 19101 HERMOSA DR ID9 PC EXTENSION FEE 155 65 DOL 155 65 ISPECIAL CONDITIONS (TEMPLE CITY CA 91780 IAA BLDG PERMIT ISSUANCE 27 75 1 1 IAC STRONG MOTION RESID 45000 00 VAL 4 50 I 1 1 ID2 PERMIT W/O EN HC 45000 00 VAL 732 45 1 (CONTRACTOR TEL NO I TOTAL FEES 1, 1 542 93 1APPROVALS DATE INSPECTOR SIGNATURE IVINH P LU (626) 443 9642 1 1 15006 BALDWIN AVENUE LIC NO (LOCA-ION AND SETBACKS 1 1 ITEMPLE CITY CA 91780 NONE 1 I 1 I I (SOILS ENGINEER APPROVAL 1 I (ARCHITECT OR ENGINEER TEL NO I (FOUNDATION/TRENCH FORMS I I 1LiI LIC NO 1 15LAB/UNDER FLOORI I I I I I 1 IRAISED FLOOR FRAMING I I 1 I I IMAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP (UNDERFLOOR INSULATION I I 3 Oil 11ST 'EVEL FLOOR SHEATH 1 I IND OF FAMILIES DWELLING UNITS APT/GOND STAT CLASS 1 I 1 I I 1 NO 21 1 12ND LEVEL FLOOR SHEATH 1 I I I SCHOOL WITHIN HAZARDOUS 1 IROOF SHEATHING I (AIR QUALITY 1000 FEET MATERIALS I 1 1 I 1 NO NO NO I IFIRF DEPT FRAME INSPECT( I (REQUIRED TOTAL SETBACK FROM EXIST 1 1BLDC DEPT FRAME INSPECT ISET BACK YARD HWY PROP LINE WIDTH � I Y (FRONT PL- I I I I 1 1 15HEAR PANELS SIDE PL I I 1INSULATION/WEATHER STRIP 1 1 I 1 ANTERIOR LATH/DRYWALL -31 I 1 1 EXTERIOR LATH I I ILOT DRAINAGE I I I I I (SMOKE DETECTION DEVICES I 1 I I IFIRF DEPARTMENT APPROVALI I 1. ADDITIONAL DATA ON FILE I (REPORT ID DPR261 ROUTE TO BS0508 I 1 I I L I I J c COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD/ALT/REP BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0204020044 PHONE (626) 285 0488 EXT LEGAL OF BUILDING ADDRESS ON FILE SQ FT STORIES TYPE OCCUP GROUP 5006 BALDWIN AV STRUCTURE 590 1 VN R3 TEMP CA 917804010 ASSESSOR INFORMATION NR GARAGE NEAREST CROSS STREET LA ROSA 8585 008 013 OTHER 82 1 VNU1 THOMAS PAGE 597 GRID B4 LOCALITY TEMPLE CITY TENANTS G USE USE ZONE IISL ON CES -EXPIRES ON EXIST OCC GRP 05/14/02 JK 11/10/02 OWNER TEL NO BLDGS NOW ON LOT V UAT ON FINAL ATE FINAL BY CODE VINH P LU PHUONG T HUYNH (626) 443 9642 47 000 11537 CHERRYLEE DR 2 Z EL MONTE 91732 FEES PAID ECRI ON OF WORK AD FAMILY RM, DEN & PORCH, NEW ROOFING NEW WIND S-- FEE DESCRIPTION QUANTITY UOM AMOUNT REMDEL MASTER BATH, APPLICANT L E ` HIEN NGUYEN (626) 614 8165 B1 PLANCHECK W/ENERGY 47000 00 VAL 709 24 5219 ACACIA ST AA BLDG PERMIT ISSUANCE 27 75 SPECIAL CONDITIONS SAN GABRIEL 91776 AC STRONG MOTION RESID 47000 00 VAL 4 70 82 PERMIT W/ENERGY (1 47000 00 VAL 834 41 _ TOTAL FEES 1 576 10 CONTRACTOR TEL NO �� APPROVALS DATE INSPECTOR SIGNATURE EG BUILDER (626) 614 8165 ` 5219 ACACIA ST LIC NO Ur� 0 AN SETBACKS SAN GABRIEL CA 91776 NONE r r a, >� f , Sl ILS ENGINEER APPROVAL ARCHITECT 0 ENGINEER TEL �� _ � T-0kl�l DICT r _ _ LIC 110 -- -- - , -� r, 1 i Si AB/UNDER FLOOR FUSED FLOOR FRAMING O� MAP No SEWER MAP BOOK PAGE FIRE ZONE CMP , DMERFLOOR INSULATION 3 01 ` IST LEVEL F OOR SH ATH 0 OF FAMILIES DWELLING UNITS AP17COND STAT NO 21 'SND LEVEL FLOOR SHEATH SCHOOL WITHINHAZARDOUS �� i ROOF SHEATHING o AIR QUALITY 1000 FEET MATERIALS �\ �� 1 !� �' NO NO NO �� / FIRE DEPT FRAME INSPECT REQUIRED TOTAL CK E f- �� ! z LDS DEPT FRAME INSPECT SET BACK YARD HWY PROP LINE WIDTA FRONT PL PL = SHEAR PANELSSIDE INSULATION/WEATHER STRIP OZ NTFRIOR LATH/DRYWALL EX CR I OR LATH L L ILOT DRAINAGE ISMOKE DETECT 0 C S FIRE DEPARTMENT APPROVAL REPORT ID DPR261 ROUTE TO BS0508 i