Loading...
HomeMy Public PortalAbout5319 BALDWIN AVE_Building__ APPLICA R BUILDING PERMIT FOR APPLICANT TO FILL IN (Print or type only) BUILID[NGCOUNTY OF LOS ANGELES ADDRESS 3/ / DEPARTMENT OF COUNTY ENGINEER CITY eV7 2 fp BUILDING AND SAFETY DIVISION NO.OF BLDGS. BUILDING SIZE OF LOTP0 NOW ON LOT ADDRESS - ` J TRACT �� BLOCK LOT NO. / LOCALITY .y- TEL. NEAREST OWNER �SCI7%/I i - NO. CROSS ST. r ASSESSOR ADDRESS � % [c) Id UJ MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE SSED BY CITY Q_ ZIP CONST. ZONE ARCHITECT OR TEL. ENGINEER NO. STATISTICAL CLASSIFICATION SEWER MAP ADDRESS f,,F CLASS NO. _DWELL,UNITS BK PG CONTRACTO O NOL QJ/�`� 4699 USE ZONE NADPf LIC. 0/ ADDRESS Q G L70N 1 ` NO '} �� SPECIAL LIC. y CONDITIONS CITY �� l,p ' CLASS �'�/ ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NOD CONSTRUCTION LENDER NAME AND BRANCH BL .SETBACK FROM F NT PROP.LINE OF (STREET) a ADDRESS CITY H GHWAY + YARD _ TOTAL SETBACK FROM TYPE OF EXISTING GC_'. SQ. FT. NO. OF NO. OF CHECK - FRONT PROP. LINE HIGHWAY WIDTH SIZE STORIES FAMILIES ONE DESCRIPTION OF WORK NEW ❑ C~.] BLDG.SETBACK FROM a /t 114 ADD ❑ SIDE PROP. LINE OF (STREET) tr. /C 9J ALTER ❑ Z W/' � `��j Q� � d HIGHWAY } YARD = TOTAL SETBACK F M TYPE OF EXISTING REPAIR[] SIDE PROP. LINE HIGHWAY WIDTH USE DEMOL [:1 + EXISTING BLDG. APPLICANT TEL CORNER CUTOFF YES ❑ NO El(PRINT) NO. BY (SIGNATURE) IN OPEN SPACE YES ❑ NO ❑ IN COASTAL ZONE YES ❑ NO Q ❑ VALUATION Y o ' CATEGORICAL EXEMPTION YES❑ NO ❑ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE) WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE) HEREBY I WILL NOT EMPLOY ANY PERSON IN VIO BION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELATING TO WORKMEN'S COMPENSATIONA 7 SIGNATURE OF PERMITTEE ADDRESS t .,Jdn (f p FINAL 41ef� 8.11 &3 CITY 6/1��=�� NOL / �'��/ DATE Q P.C. PMT, %lA KE CHECKS ID,I YA131-E 7 0: FEE FEE rHARVEY.T. BRANDT, COUNTY ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH V� 1 P, 2 4 7 )3- JUL 2'7 1 D 1 5.0 0 A 76A638A CE9803 12/72 WORKERS'COMPENSATION DECLARATION ur , y affirm that I have certificate of consent to self APPLICATION FOR BUILDING P E RM I T insure, or a certificate of Workers' Compensation Insurance, ora e-Rified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company ❑ Certified copy is hereby furnished. �3 FOR APPLICANT TO FILL IN BUILDING ADDRESS 3 f GSL Certified copy is filed with the county building inspec- BUILDING6 Tw 6VfjJY/ k/ tion department. ADDRESS a.t /► Date Applicant CITY ii'i�L ( ZIP LOCALITY r til/ CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. (This section need not be completed if the permit is for one ASSESSOR hundred dollars ($100)or less.) TRACT BLOCK j LOT NO. � t MAP BOOK PAGE PARCEL OWNER C t �j NUI-//� -" �� �J USE ON MAP I certify that in the performance of the work for which this NO. permit is issued, I shall not employ any person in any manner G Aw ® SPECIAL so as to become s b'ect to the Workers'Compensation Laws. ADDRESS } L�' �y� �1� CONDITIONS 0 �ri/?� `T�"-�'y LI/`/ CITY /SSL 10410 `"VC7 -0464 ZIP Date r Applicant LL' NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE P CESSED BY O Exemption, you should become subject to _the Workers' ENGINEER NO. CONST ZONE U Compensation provisions of the Labor Code, you must forth- ADDRESS �� with comply with such provisions or this permit shall be I CL' deemed revoked. TEL. STATISTICAL CLASSIFICATION I APT.TONDO. (n CONTRACTOR NO. LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. 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 and LIC. SEWER MAP 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 ISTORIES FAMILIES ONE ❑ VALUATION DESCRIPTION OF WORK NEW jl Contractor Date ADD $ U ❑ I am exempt under Sec. � `' � ,q ❑ ALTER ❑ B.&P.C. for this reason USE OF REPAIR $ # Date: EXISTING BLDG. DEMOL ❑ ;1 '$4 6 5 0 Signature APPLICANT TEL.(( 7 g OWNER-BUILDER DECLARATION PRINT DGC—iJ.� ��� NO. lQS/ DATEFINA/6 I herebyaffirm that I am exempt from the Contractor's License y t/ 0:0' .'o 4 5 p ADDRESS3/,,P.J%F7i�' 6s /r9.+>�. L �f/S7 l .O Law for the following reason (Section 703,1.5, Business and FINA ;I 2 9®$7 Prpfessions Code): PRESENT By Q BUILDING 1,I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK FROM CONSTRUCTION LENDING AGENCY SET BACK YARD HWY• PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). /, SIDE Lender's Name +� " 411 /✓ P.L. LDMA Ref. # Lender's Address Q�� /�fj/�L "� P.C. fee$ Permit Fee 3 � $ I certify that I have read this application and state that the Issuance Fee f S LDMA P/C# oabove information is correct. I agree to comply with all County Investigation Fee 0 ordinances and State laws relating t uilding construction, Total Fee LDMA Perm. # R and hereby outhoriz epresentativ o this County to enter upon thementned pert 6r inspec/tion,pur oses.' [ � SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date WORKERS' COMPENSATIO.Ni DECl4RATION 1eby'affirm,,that IhfxfcNsznt.to selfee l)r a certificateWrkers' Compensati$ri Insurance, ' APPLICATION FOR. BUILDING PERMIT o "tiified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS.FANGELES BUILDING AND SAFETY Pdlicy No._ Company BUILDING / H V- a 'Certified copy is hereby furn Elished. FOR APPLICANT TO FILL IN ADDRESS r^!�'i N LDVd//11 ❑ Certified copy is filed with the county building inspec- BUILDING �� ��� . � ; T �L G ADDRESS tion department. 7 Date Applicant CITY' I LG�r�- .L1/ ZIP,!-,,, 1 LOCALITY NO. OF BLDGS. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT ��� �� OW:ON LOT,. CROSS ST. COMPENSATION INSURANCE ASSESSOR (This section need not,be completed if'the permit is for one TRACT c5 BLOCK LOT NQ. �. MAP BOOK PAGE PARCEL hundred dollars ($100) or less.) y ` �?�/' L. q �f USE ZONE MAP a OWNER �N l.-T/� NO. 'I I certify that in the performance of the work for which this / 7; K i SPECIAL. d permit is issued, L -j/sholl not employ any person in any manner ADDRESS "L�U_Jj1A �i CONDITIONS O so as to become subject to the Workers' Compensation Laws. U CITY (::7,r7 ZIP Date Applicant ARCHITECT OR TEL. NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER i D NO., a Q 2 �I GROUP TYPE FIRE OCESSED BY g CONST. ZONE 0 Exemption, you should become subject, to the Workers' �Q-3 Compensation provisions of the Labor Code, you must forth- ADDRESS GV ��C 4U�' ' , v ��`J a with comply" with such provisions or this permit shall beSTATISTICAL C FI TI N APT. CONDO. N ' deemed revoked. , . ' � 7v Z LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. SEWER MAP (commencing with Section,7000)of Division 3 of the BuLICsiness CITY D �-� CLASS .r VALIDATION and Professions Code,and my license is in full force and.effect. BK. PG. SQ. FT NO. OF NO. OF 'CHECK License Number Lic. Class SIZE STORIES / `, FAMILIES ONE g n-�� VALUATION L f i IP d-it.X! a g Contractor Date DESCRIPTION OF"WORK AQO 54AI E NEW ❑ $ '� °mo i 5_a:.'7`i El am exempt under Sec. DifQ (55�1+► $Lb�G� CQ �. ADD , i F i EMS ALTER ❑ B.&P.C. for this reason A N GAUC/ �1K,V e�S �(01.(sf�+� REPAIR 1:1 $ �Q TOTAL 532 -95 Date: USE OF EXISTING BLDG.'Sl^G MIL WfVW DEMOL F-1 o CHECK ' c.;`f APPLICANT f- -T^ TEL. d Signature (PRINT)CLr�c� `� NO. a�$ INA nI�I OWNER-BUILDER DECLARATION © } I hereby affirm that I am exempt from the Contractor's License ADDRESS -772-S S.G+R AV-f,#3 K0%AAZ ,D Law for the folloyving'reason (Section 7031.5; Business andFINAL _ " Professions Code): PRESENT By li 0�•f00-000 1, 1/21.5}'.t`il BUILDING , El 1, as owner of the property, or my employees with ADDRESS 3147 } #11ei_E wages as their sole compensation,will do the work and LOCALITY the structure is not intended or offered for sale(Section • ��•.•-r s 41 7044, Business and Professions Code.) MOVING TEL. , ;�t.t•s ,� I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS Tr-r' tion 7044, Business and Professions Code.) �'s C REQUIRED TOTAL SETBACK FROM EXIST. . a CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH " y Ih1 zL 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' _ A I„ P.L. r` E',); iiliE}E E � • Lender's Name LDMA Ref. # P.C. Fee$ 53Permit Fee Lender's Address o I certify that I have read this application and state that the Issuance Fee _ .3. LDMA P/C# above information is correct. I agree to comply with all County Investigation Fee l- / s;:'1 i v 8 . ordinances and State laws relating to building construction, Total Fee 'Z p (01 1. LDMA Perm. # a and hereby authorize representatives of this County to enter upon t e above- entionederty for inspection purposes. a o •�' -�i_r'�. SEE REVERSE FOR EXPLANATORY LANGUAGE N511gnature of. pplicont or Agent Date - - COUNTY OF LOS ANGELES TEMPLE CITY - #.508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9609190017 PHONE: (818) 285-0488 EXT: LEGAL ID: NO. OF CONST, BUILDING ADDRESS: TR: 6755 LT: 13 SQ. FT STORIES TYPE 5319 BALDWIN AV STRUCTURE: 0 V TEMP CA 917803264 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: OLIVE 8589-005-009 THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: RESID ISSUE ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 09/19/96 TC 09/19/97 OWNER: TEL NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL.BY• CODE: WANG WEN CHUNN;SANDY S (818) 442-0977- 1 4,000 �( ` 5319 BALDWIN AV TEMP 917803264 FEES PAID DESCRIPTION OF WORK REMOVE/RECOVER 1/2"'CDX PLYWOOD WITH 20 YR. COMP. SHINGLE FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. NO: SAME AS OWNER AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RESID 4000.00 VAL 0.50 SPECIAL CONDITIONS: D2 PERMIT W/0 EN; 04000:00 VAL 116.10 - TOTAL E n t 144.35 CONTRACTOR: TEL. N0: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER ' IC. NO LOCATION AND SETBACKS SOIL..c ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL.. 0: t �.- ¢ FOUNDATION/TRENCH FORMS LIC. N0: ;r 1 -- ,Jill SLAB/UNDER FLOOR i RAISED FLOOR FRAMING MAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION 147H269 3 01 FLOOR, SHEATHING N0. OF AMILI S: DWELLING UNITS: APT/COND: STAT CLASS: NO 21 ��� ��� j / � J 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- ����TC1 `• INSULATION/WEATHER STRIP SIDE PL- INTERIOR LATH/DRYWALL EXTERIOR LATH RATED FLOOR/CEIL ASSEM. RATED WALL ASSEMBLIES. RATED SHAFTS/OPE INGS T-BAR CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508