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HomeMy Public PortalAbout5420 BALDWIN AVE_Building__ A ROAD DEPT PEPMfT IS REQUIRE[) FOR AId f MATtRi L S,O^r,:ze U� ti jRK f DONE IN THE ROALL RIGHT OF WAY 76A08A CE#8036IM APPLICATION FOR BUILDING PERMIT _ 1 COUNTY OF LOS ANGELES- BUILDING A wr DEPARTMENT OF COUNTY ENGINEER ADDRESS 0 L !J i r BUILMNG AND SAFETY DMSION LOCALITY G �' JOHN A LAMBIE COUNTY ENGINEER NEAREST t c CASSATT D GRIFFIN SUP T OF BUILDING CROSS ST L 1,0 tams DISTRICT O G UP TYPE PROCESSED B FOR APPLICANT TO FILL IN CONST BUILDING CQ[STATISTICAL CL,I►S FICATION + SEWER A , ADDRESS67 Q L LV f/(J BK PG CLASS NO DWELL UNITS LOT NO BLOCK MAP STATE i 6,7 dam. NUMBER �© HWY YES ACT E ZONE SPECIAL f i D I NO OF BLDGS CONDITIONS IJt, SIZE OF LOT NOW ON LOT OO �� USE OF EXISTING BLDG BUILDING EXIST SETBACK YARD HWY STREET NAME WIDTH OWNER ► FRONT ESS OT MAIL �i O D LY 4 SIDE ADDRESS P L CITY e- �7' IE L- ARCHITECT OR TEL INSPECTION RECORD ENGINEER NO ADDRESS CONTRACTOR L/(r'Q G'd.�!/ �LdNO _ ADDRESS.i '12eSl rsd L,$I& / DESCRIPTION OF WORK r NEW ADD ALTER REPAIR DEMOLISH SQ FT NO OF NO OF + SIZE C STORIES `FAMILIES USE UO STCTURE E4UG A'r"E i¢R,r��PP r 7 SIGNATURE OF u APPLICANT ' q� APPROVALS DATE INSPECTOR SSIGNATURE ADDRESS I �� D N/ 1 �-+ FOUNDATION LOCATION / L! ap FORMS MATERIALS VALUATION $ FRAME FIRE STOPS BRACING BOLTS FURNACE LOCATION FEE $ FEE I GAS VENT DUCTS r I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP a PLICATION AND STATE THAT THE ABOVE IS CORRECT AND LATH INT AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS �RF(��ULA`TI,NGBUILDING CONSTRUCTION LATH EXT SIGNATURE OF T� y/�.yq�t�t.p,{ft� HOUSE NUMBER COR y� PERMITTEE Lf sY+"�/��j RECT AND POSTED ADDRESS ..a R aft Y '� FINAL w CK M o CASH CLYDE N DIRLAM PRINCIPAL STR CTURAEAS.� PLAN CHECK VALIDATION PERMIT VALIDATION L x 9834 - nPR25 1A 200 �F y 4 s f A ROAD DCPT I'E�VIT i3 FOR ANY &�r TER�Hlr 1Jr ;� t VVOPK 76AQ79A CH M9�l9 C0 APPLICATION NF�0F�o� .dl PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DMSION LOCALITY JOHN A LAMBIE COUNTY ENGINEER NEAREST ST ' CASSATT D GRIFFIN SUP T OF BUILDING CROSS DISTRICT NO GROUPTYpE ^P ESSED BY ' FOR APPLICANT TO FILL IN I CONT BUILDING STATISTICAL CLASSIFICATION S WER MAP ADDRESS" &;tv A3.44,0W/1V i '+� BK PG CLASS NO—'.—DWELL UNITS '' LOT NO 6) aZoZ B' CK NUMBER MAP S�.{TVATE YES NO ZONE TRACT � USE SPECIAL NO OF BLOGS / J CONDITIONS ' SIZE OF LOT �� O1- I NOW ON LOT / -/ USE OF �1 / EXISTING BLDG .A--s/Q6/V BUILDINGEXIST SETBACK YARD HWY STREET NAME WIDTH OWNER L- r A'L✓.�.2 SQ' FRONT MAIL P L ADDRESS .I: 6 p SIDEEL s P L CITY C,7' IN T690 INSPECTION RECORD ARCHITECT OR f TEL ENGINEER NO ADDRESS TEL CONTRACTOR NO ADDRESS DESCRIPTION OF WORK y NEW ADD$' ALTER REPAIR DEMOLISH SQ FT / NO OF NO OF SIZE S, STORIES FAMILIES USE OF STRUCTURE o oT// f,E',QLIAC& SIGNATURE OF _ APPLICANT - 3 APPROVALS DATE INSPECTOR S SIGNATURE ADDRESS [�8 /3 �� FOUNDATION LOCATION �A FORMS MATERIALS �Fyt fj(��,�{�.....,r,e� VALUATION $ �© ( ` FRAME FIRE STOPS BRACING BOLTS PC I PMT �} I FURNACE LOCATION FEE S FEE $ 1J GAS VENT DUCTS r 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP LATH INTylt�.�.;�1...�.�a�� PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION LATH EXT SIGNATURE OF HOUSE NUMBER COR 0 PERMITTEE- RECT AND POSTED ADDRESS FINAL ?� CLYDE N DIRLAM PRINCIPAL STRUCTURAL EN E PLAN CHECK VALIDATION CK M o CASH PERMIT VALIDATION CK M o CASH F 4 l AC 1 2 9 6 ciAr 5 6 C 0 1 A _r< s®� c � r WORKERS' COMPENSATION DECLARATION insure,hereby certif carte of Worke srlCompensat on eInsuran ificate of consnt to e, APPLICATION FOR BUILDING PERMIT or a certified elk coeeY thereof (Sec. 3800,°lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified co is hereby furnished. FOR APPLICANT TO FILL IN BUILDING PY'. Y ADDRESS i C Certified copy is filed with the county buildin inspec- BUILDING Y tion department. ADDRESS oV CITY (� ZIP t LOCALITY Dat ^� Applicant NO. OF BLDGS. CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT 'Zi NEAREST CROSS ST. COMPENSATION INSURANCE ASSESSOR � (This section need not be completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK �`) PAGE 02,__ PARCEL4 hundred dollars ($100) or less.) TEL. OWNER/q//59F16 . NO. •STY'-df8ak USE ZONE 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 ADDRESS Za SPECIAL Q_ CONDITIONS so as to become subject to The Workers' Compensation Laws. .` O CITY , ZIP V Date Applicant ARCHITECT OR TEL. 0 NOTICE TO APPLICANT: If, after makin this Certificate of ENGINEER NO. DISTRICT GROUP TYPE FIRE PROCESSED BY O g•. CONST. ZONE � Exemption, you should become subject to the Workers' y 2 U .Compensation provisions of the Labor Code, you must forth- ADDRESS QO —J V a with comply with such provisions or this permit shall beTEL. s STATISTICAL CLASSIFICATION APT. CONDO. N. deemed revoked. CONTRACTOR NO. S.33o Z LICENSED CONTRACTORS DECLARATION LIC. ��/ CLASS NO. o�/ DWELL..UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. ' _ p (commencing with Section 7000)of Division 3 of the Business LIC. SEWER MAP and Professions Code,and m license is in full force and effect. 14 a v� CLASS C��� y CITY BK. PG.,V/ VALIDATION SQ. FT. NO. OF NO: OF CHECK License Number Lic. Class<_�1�` ' SIZE STORIES FAMILIES ONE / � �� `� VALUATION �Q Contractor Date- — `�c/ DESCRIPTION OF WORK NEW ❑ C�17r)1) ADD ❑ $ /•(/(f(�r ► ❑I am exempt under Sec. ' ALTER B.&P.C. for this reason REPAIR $ Dater USE OF. EXISTING BLDG. Lilt L a DEMOL F-1 Signature APPLICANT ti TEL. q g OWNER-BUILDER DECLARATION (PRINT) 4, 6 Ip NO. � � Q FINAL DATE I hereby affirm that I am exempt from the Contractor's License ��11►► ` Law for the following reason (Section 7031.5, Business and ADDRESS V FINAL Professions Code): PRESENT By BUILDING ❑ I, as owner of the property, or my employees with ADDRESS /%'!/Z/�lt�.• I"t'•L s Fr 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 Y��/ � � , tip r p _ •-x�- Tion 7044, Business and Professions Code.) REQUIRED TOTAL SETBACK FROM EXIST. ;;�,� ..• CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH ir,�� .;`,• >;a;,o ,; 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. LDMA Ref. # i'+.j? i I–i' i P.C. Fee$ Permit Fee G Lender's Address ► ^. - 0 1 certify that 1 have read this application and state that the Issuance Fee LDMA P/C# above information is correct. I agree to comply with all County Investigation Fee S ordinances and State laws relating To building construction, I Total Fee LDMA Perm. # a and hereb uthorize represe tatiyes of this County to enter upon 1 v -m o ed o ty for inspection purposes. — SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of A plic nt or gent Date a WORKERS COMPENSATION DECLARATION hereby affirm that I have a certificate of consent to self � APPLICATION FOR BUILDING P E RM I T insure or a'certificate of Workers Compensation Insurance or a certified copy thereof (Sec 3800 Lab C ) P �A EN)0 T COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No 3 o any ) l BUILDING Y Certified copy is hereby furnished FOR APPLICANT TO FILL IN ADDRESS V Certified copy is filed with the county building inspec BUILDING 5420 Baldwin Ave. tion department ADDRESS LOCALITY r Date Applicant CITY Temple City ZIP 917 8 0 NEARES T E -CROSS IFICATE OF EXEMPTI FROM W R RSNO OF BLDGS ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK s PAGE PARCEL (This section need not be completed if the permit rs/or one _ USE ZONE MAP �D hundred dollars ($100)or less ) TRACT BLOCK LOT NO NO TEL ( SPECIAL r >_ OWNERAlfred Ritcher No 599-0183 CONDITIONS a. I certify that in the performance of the work for which this ; permit is issued I shall not employ any person in any manner DISTRICT GROUP I TYPE FIRE PR ESSED BY 0 so as to become subject to the Workers Compensation Laws t ADDRESS As above CONST ZONE r— U Date Applicant { CITY ZIP ASTATISTICAL CLASSIFICATION APT CONDO a NOTICE TO APPLICANT If after making this Certificate of ARCHITECT OR TEL c Exemption you should become subject to the Workers ENGINEER NO CLASS NO ' DWELL'UNITS d Compensation provisions of the Labor Code you must forth ADDRESS SEWER MAP with icomply with such provisions or this permit shale be { _ deemed revoked y CONTRACTOBT L Shipley RNO 792-2437 BK S PG J� VALIDATION r 1 LICENSED CONTRACTORS DECLARATION 4 LIC e I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 265 N V inedo NO 309178 VALUATION (commencing with Section 7000)of Division 3 of the Business and Pasadena, 91107 LIC C 3 9 Professions Code and my license is in full force and effect CITY CLASS $1 , 600 , �/ C~ SIZE FT STORIIEF NO ES FAMILLIIES CHECK License Number 30 O Lic Class , Contractor Dote DESCRIPTION OF WORK Remove remain— NEW ❑ $ F-1 I am exempt under Se ing top roof , nail on l 2 D ❑ ALTER ❑ FINAL m ` B 8P C for this reason ' ' REPAIR ® DATE r Date EXISTING BLDG House DEMOL E] BNALr L, Signature APPLICANT J L SHIPLEY RFG TEL 792-2437 ' OWNER BUILDER DECLARATION ) PRINT NO , /O� y� I hereby affirm that I am exempt from the Contractor s License 2 65 N V1ned0, Pasadena, 9110 Law for the following reason (Section 7031 5 Business and ADDRESS f i Professions Code) PRESENT ❑ BUILDING 8 8 7 8 I as owner of the property o my employees with ADDRESS $ o ialpp wages as their sole compensation will do the work and r z r0 v°t ry = the structure is not intended or offered for sale Section kADDR 1 0 7044 Business and Professions Code) TEL I as owner of the property am exclusively contracting CONTRACTOR NO f with licensed contractors to construct the project (Sec ` Tion 7044 Business and Professions Code) 1ED TOTAL SETBACK FROM EXIST CONSTRUCTION LENDING AGENCY CK YARD HWY PROP LIN WIDTH I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued(Sec 3097 Civ C ) tmLender s Name $ Permit Fee 39 38 Lender s Address I certify that I have read this application and state that the Issuance Fee 10 50 above information is correct 11 agree to comply with all County Investigation Fee y ordinances and State laws relating to building construction t Total Fee 49 88 d and hereauthorize representatives of this County to enter upon th a entrone property for inspection purposes P SEE REVERSE FOR EXPLANATORY LANGUAGE a Signature of plicant or gent Date r ®t (t 1. 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 0409150025 PHONE (626) 285 0488 EXT BUILDINGLEGAL ID NO OF CONST NEW ADDRESS ON FILE SQ FT STORIES TYPE OCCUP GROUP 5420 BALDWIN AV STRUCTURE 817 1 VN R3 TEMP CA 917802624 Sn%'?W INFORMATION NUM85R GARAGE NEAREST CROSS STREET OLIVE 8586 023 019 OTHER 214 1 VN U1 THOMAS PAGE 597 GRID B4 LOCALITY TEMPLE CITY, C TENANT EXIST BLDG USE USE ZONE ISSUED0 EXIST OCC GRP 02/15/05 JK 02/10/06 OWNER TEL NO BLDGS NOW ON LOT VALUATION FINAL DATE FINAL BY CODE CHU JACK (626) 673 5562 71,760 //' �- 5425 BALDWIN AV /f" TEMP 917802624 FEES PAID DESCRIPTION OF 817 SF AND ENCLOSED ADD 3 BEDROOMS 1 KITCHEN, 1 BATHROOM, FEE DESCRIPTION QUANTITY UOM AMOUNT PATIO 214 SF APPLICANT TEL NU- SAME AS OWNER - 61 PLANCHECK W/ENERGY 71760 00 VAL 952 44 AA BLDG PERMIT ISSUANCE 27 75 SPECIAL CONDITIONS AC STRONG MOTION RESID 71760 00 VAL 7 18 B2 PERMIT W/ENERGY 71760 00 VAL 1,120 52 TOTAL FEES 2,107 89 CONTRACTOR TEL APPROVALS DATE SP C SAME AS OWNER LIC NO LOCAlION AND SETBACKS SOILS ENGINEER APPROVK-L ARCHITECTRFORMS LIC NO SLAB/UNDER FLOOR SE MAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP UNDE qFLOOR INSULATION 3 03 � �-T _ TgT-L R SHEATH DWELLINGNO OF FAMILIES S 0 S NO 21 2ND LEVEL FLOOR SHEATH SCHOOL T G AIR QUALITY 1000 FEET MATERIALS NO NO NO FIRE DEPT FRAM N REQUIRED TOTAL S C r, � BLDG DEPT FRAME I CT C2- SET BACK YARD HWY PROP LINE WIDTH FRONT PL SHEAAREL SIDE PL y� S ER S TWM _�/ 4 INTERIOR ATH/DRYWALL (J► LOT DRAINAGE SMOKEDETECTION TY-RET DEPARTMENT APFOW REPORT ID DPR261 ROUTE TO BS0508