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Home My Public Portal About6154 BURTON AVE_Building__ WORKERS'COMPENSATION DECLARATION I hereby affirm, that I havecertificate of consent to self APPLICATION FOR BUILDING PERMIT insure, or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec: 3800, Lab. C ) _ / Polity No. Company --' �� `�»'C/ COUNTY OF LOS ANGELES BUILDING AND SAFETY Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING ADDRESS •r� XJ Icy�I� Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS �'7 cr/v'•%/� 'f LOCALITY Ct/ ZIP Date✓ !/ Applica CITY ZIP CROSS ST.T. CERTIFICATE OF EXEMPTION FROM WORKERS' N . 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 USUZONE MAP hundred dollars ($100)or less.) TRACT BLOCK LOT NO. NO. jJ OWNER NO, CONDITIONS C.%6 TEL. SPECIAL Y 5//�'✓® (� �G d certify that in the performance of the work for which this f ,/ p L �I TRICT GROUP TYPE FIRE PROCESSED By O permit is issued, shall not employ any person in any moaner ADDRESS(/� T .f/•✓��7� I:P/e CONST. SE V so as to become subject to the Workers'Compensation Laws. K CITY (/(.f✓7>/ 6lI�%'J6 ZIP _ I Ir O Date Applicant STATISTICAL CLASSIFICATION APT. CONDO. V NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. Exemption, you should become subject to the Workers' ENGINEER NO. CLASS NC _/—DWELL. UNITS_ 6 Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP W with comply with such provisions or this permit shall be Z CONTRALTO deemed revoked. R2�/110/jq� N(i+ 6 forth- TEP7- BK. PG, -VALIDATION 44. LICENSED CONTRACTORS DECLARATION }, LIC. 'l p I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 7/10JE�f�d~/ � 'E� NEfw^�7%�� VALUATION (commencing with Section 7000)of Division 3 of the Business andLIC. P -'x�, Professions Code, and my license is in full force and effect. CITY 1540/11// �� CLASS/J $ ��VC),G.. 0 2 Q 3 A -� fW R SIZ FT.7 ♦/ NO.OF NO. Of CHECK #. License Numbe r- X77 Li<.Class K/ SIZE 7T STORIES FAMILIES ONE o o'0 0 2 3 n $ Coniractorr�'� Date DESCRIPTION OF WORK NEW ❑ 2'0 27 .285 I am exempt under Sec. ALTERC] x iYOsi C] FINAL � 27285=0 8 5 0 B.&P.C. for this reason L _p0✓n - r '�Date: USE OF REPAIR0308-T93❑ �,� �/ FINAL EXISTING BLDG. DEMOL 6 f ❑ o-•s.•�-r 5'gna Nre Sw�L APPLICANT / TEL. OWNER-BUILDER DECLARATION PRINT -C7 ' �`✓�`, N I hereby affirm that I am exempt from the Contractor's License ADDRESS �� J U/✓w L� G�� '" Law for the following reason (Section 7031.5, Business and / Professions Code): R NT QBUILDING I, as owner of the property, or my employees with ADDRESS �` 0 8 2 2 A 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. # o o e o o I, as owner of the property, am exclusively contracting CONTRACTOR NO. 2'1 331.50 with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). 1.5 x CONSTRUCTION LENDING AGENCY REQUIRED YARD HWY TOTAL SETBACK FROM EXIST ° - 3 3 0 v SET BACK PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT , 0 329- 83 the performance of the work for which this permit is issued gip.L. (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name Lender's Address P.C. Fee$ Permit Fee I I certify that I have read this application and state that the Issuance Fee Q. \ a above information is correct. I agree to comply with all County Investigation Fee p t g ordinances and State laws relating to building construction, Total Fee �,_J d and here authorize representatives o4 this County to enter uPon u b ve-mentio ed property for inspectioJr purpo�s (�. �� -p3 SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or AgentD6te ®s ' LL WORKERS'COMPENSATION DECLARATION ' hereby affirm that I havecertificate of consent to salt APPLICATION --FOR BUILDING PERMIT - •' insure, or a certificate of Workers' Compensation Insurance, ' or a certified copy thereof (Sec. 3800, Lab. C.) ' " ' - ` .. 'I _ .. . . COUNTY OF LOS ANGELES BUILDING AND SAFETY • Policy No. . Company BUILDING Certified copy is hereby furnished: FOR APPLICANT TO FILL IN ADDRESS OCertified copy is filed with the county building in"spec- BUILDING - �`' U n-7 tion department. ADDRESS I!, Z' le-7 Date Applicant ` - Cll',L /✓ffl�/l/n l /-L ZIP LOCALITY � CERTIFICATE OF EXEMPTION'FROM WORKERS'- NO. OF BLDGS. - - NEARES ' COMPENSATIONINSURANCE 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 LOT NO. MAP BOOK 4 PAGE PARCEL . TEL USE ZONE MAP ' ' I certify thar'.in the performance of the work for which this OWNER - NO. - NO >. permit is issued,�I shall'not employ any per in any manner SPECIAL- - - R so as to become subject to the Wor o ensotion L /) ADDRESS �S �� CONDITIONS V (i/�/ CITV I ZIP - - OC Date �� Apolican r' ARCHITECT OR TEL O NOTICE-TO APPLICANT: If, after making this Certif rate of DISTRICT GROUP- CONST, ZONE PROC ED,BY V Exemption, you should become subject to. the Workers' Will ENGINEER NO. W Compensation provisions of the Labor Code, you must forth- ADDRESS 'S with comply with such provisions or this permit shall be - - TSI. STATISTICAL CLASSIFICATION A ON O. Z deemed revoked CONTRACTD Q/!! �Gv NO �^�3 - LICENSED CONTRACTORS DECLARATION - / -LIC �[�y p CLASS NO. DWELL, UNITS_ I hereby affirm that I am licensed under provisions of Chapteri? -ADDRESS y1a' &;5-:V� `- NO."l /o _:rA (commencing with Section 700D)of Division 3 of the Business and - LIC SEWER MAP Professions Code, and my license is in full force and effect. CITY fie 5>/� CLA55 / BK VALIDATION �7 _ , SIZ FT. STONO. OF _ NO. OF CHECK ONE License Number �� ic.Class' SIZE STORIES FAMILIES ONE VALUATION _ { ContractorDate DESCRIPTION OF WORK ?o�GL - NEW - ❑ Q ' •` ❑ I am exempt under Sec. __ %�N( ��SCK/ ADD _ _ `// ALTER , B.BP.C. for this reason ,F'dd0 —cJA/�// 'J2 REPAIR ❑ $ . - DUSE OF Dote: DEMOL EXISTING BLDG. ❑ _ . . Signature APPLICANT TEL. DL - FINAL OWNER-BUILDER DECLARATION (PRINT) NO. DATE -- -.- ..thereby affirm that I.om exempt from the Contractor's License Low for the following reason (Section 7031.5, Business and ADDRESS FIN Professions Code):' - - PRESENT - -' - - -BY , ❑ BUILDING r I, as owner of the property, or my employees with ADDRESS / 4�g�. wages as their sole compensation,will do rhe work and t l� LJ ;24 2 7. 1 A the structure is not intended or offered for sale(Section LOCALITY ' I # o .... e e 7044, Business and Professions Code). MOVING -' - TEL. :.. - ` ( e o'6 a 6 3 El1, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS - - • - • o's . b b 3 v tion 7044, Business and Professions Code). EXIST. _ 0 3.21 -86. - - -"'CONSTRUCTION LENDING AGENCY SETOBAOC YARD HWY TOTAL FROP. LINE CK FR M -WIDTH 1 hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.I. - - - - - - (Sec. 3097, Civ. C). SIDE , P.I. Lender's Name CDMA Ref. # _ m Lender's Address - P.C. Fee$ Permit Fee -- - , - - - > I.certify that 1/�have read this application and stole that the _ Issuance Fee ` V •J LDMA P/C IF - - above information is correct. I agree to comply with all County Invesligatlon Fee �" $ _ordinances and State laws relating to building construction, Total Fee a - - - u and he y cath orize representatives of this County to enter r �� -CDMA Perm: R a the bove-mentione pr per/ry inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE - Signature of App cam or Agent COUNTY OF LOS ANGELES TEMPLE CITY 4 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1103170055 PHONE: (626) 285-0488 EXT: LEGAL ID: N0. OF CONST I BUILDING ADDRESS: I ITR: 29475 LT: 10 1 SQ. FT STORIES TYPE 6154 BURTON AV N STRDGTDRE: V-B SCAB CA 917752653 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 15386-007-071 1 I I THOMAS PAGE: 596 GRID: G2 LOCALITY: TEMPLE CITY, ClC TENANT: IEXIST BLDG USE: REBID USE ZONE: R-1 (ISSUED ON: PROCESSED BY: 1 I 1EXIST OCC GRP: 103/17/11 SR 1 IOWNER: TEL. NO: IRLDGS. NOW ON LOT: VALUATION: FIN��LL DATE FINAL BY: CODE: I 1WONG, PDI NCHINGAVE (626) 782-2550- 2,000 �� I G((1 6154 BURTON AVE. �[,�, Y 1� (SAN GABRIEL CA 91775 FEES PAID IDES RIPTION OF WORK I I 1SPLIT ONE 156 SQFT. (E) BATHROOM INTO TWO BATHROOMS, ONE I IEEE DESCRIPTION: QUANTITY: QOM: AMOUNT: BATHROOM WILL BE 58 SOFT AND THE OTHER WILL BE 98 SOFT (APPLICANT: TEL. NO: (SAME AS OWNER - IAA BLDG PERMIT ISSUANCE 27.80 1Al STATE GREEN BLDG FEE 2000.00 VAL 1.00 ISPECIAL CONDITIONS: IAC STRONG MOTION REBID 2000.00 VAL 0.50 IAX BUILDING REVIEW FEE 54.70 B2 PERMIT W/ENERGY 2000.00 VAL 90.50 1 CONTRACTOR: TEL. NO: TOTAL FEES 174.50 (APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - 1 LIC. NO 1 1LOCATION AND SETBACKS I I ISOILS ENGINEER APPROVAL (ARCHITECT OR ENGINEER: TEL. NO: FOC'DATION/TRENCH FORMS LIC. NO: 1 1SLAB/UNDER FLOOR 1IRAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: ( IUNDEFFLOOR INSULATION 1150H261 3 001 1 I (FLOOR SHEATHING INC. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: 1ROOF SHEATHING I1 NO 21 II I I I I I SCHOOL WITHIN HAZARDOUS ISHEAR PANELS (AIR QUALITY: 1000 FEET MATERIALS I I NO NO NO 1 FRAME INSPECTION 1 IFIRE SPRINKLER HANGERS I I I INSULATION/WEATHER STRIP( (INTERIOR LATH/DRYWALL I I 1 (EXTERIOR LATH (RATED FLOOR/CEIL ASSEM. I I 11 RATED WALL AsseMBLles I I I 1 (RATED SHAFTS/OPENINGS I I 1 I I I 1 IT-BAR CEILINGS ILOT DRAINAGE 1 IREPORT IU: DPR261 ROUTE T0: DS0508 I COUNTY OF LOS ANGELES TEMPLE CITY g 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9901 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1306100093 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: TR: 299 5 LT: 10 SQ. FT STORIES TYPE 6154 BURTON AV N 1 _ISTRUCTURE: V-B SGAB CA 917752653 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LONGDEN 5386-007-071 THOMAS PAGE: 596 GRID: G2 LOCALITY: TEMPLE CITY CA (TENANT (EXIST BLDG USE: RESID USE ZONE: R-1 (ISSUED ON: PROCESSED BY: III (EXIST OCC GRP: 106/10/13 SR OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: IF L SATE FINAL BY: CODE: 1WONG, VENA (626) 782-2550- 1 25,000 11 16154 BURTON AVE /-.f/K �I _ , \ 1TEMP 917801756 FEES PAID DE CRI PT ION OF WORK ( INTERIOR REMODELING THE KITCHEN, BATHROOM, A/C DUCTS, DRY IFEE DESCRIPTION: QUANTITY: UOM- AMOUNT: WALL, INSULATION, PLUMBING, PAINTING, LAMINATED FLOOR, I 1APPLICANT: TEL. NO: I IBATHROOM/KITCHEN FLOOR TILE 1 ITAN YEW K (626) 257-8900- IPA BLDG PERMIT ISSUANCE 27.80 1_ 16703 N GOLDEN WEST IAB STATE GREEN BLDG FEE 25000.00 VAL 1.00 1SPECIAL CONDITIONS: ARCADIA CA AC STRONG MOTION RESID 25000.00 VAL 2.50 I 1 IB2 PERMIT W/ENERGY 25000.00 VAL 515.50 1 11 TOTAL FEES 546.80 1 (CONTRACTOR: TEL. NO: - 1APPROVALS DATE INSPECTOR SIGNATURE POLYVISION LAND CORP (626) 257-590-- 1 16703 N GOLDEN WEST LIC. NO ILO CATION CA 91007 NONE GTTON AND SETBACKS SOILS ENGINEER APPROVAL (ARCHITECT OR ENGINEER: TEL. NO: FODCDAT ION/TRENCH FORMS Ii LIC. NO: (SLAB/UNDER FLOOR - RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: ( IUNDERFLOOR INSULATION 3 001 I IFLOOR SHEATHING N0. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: NO 21 1ROOF SHEATHING I I SCHOOL WITHIN HAZARDOUS SHEP.R PANELS (AIR QUALITY: 1000 FEET MATERIALS NO NO NO -I FRAME T-NSPECTION IFIRE SPRINKLER HANGERSyi 11NSUTATION/WEATHER STRI (INTERIOR LATH/DRYWALL .� EXTEF.IOR LATH 1_ II 1RATED FLOOR/GEIS ASSEM. 1 I I RATED WALL ASSEMBLIES I RATED SHAFTS/OPENINGS IT-BAR CEILINGS 1 1 1LOT DRAINAGE 1 1 IREPORT ID: DPR261 ROUTE T0: BS OS OB 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 BE 0508 1307080011 PHONE: (626) 285-0486 EXT: ILEGAL ID: N0, OF CONST BUILDING ADDRESS: T ITR: 29475 LT: 10 SQ. FT STORIES TYPE 6154 BURTON AV N ISTRUCTURE: V-B I SGAB CA 917752653 T ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LONGDEN 15386-007-071 THOMAS PAGE: 596 GRID: G2 LOCALITY: TEMPLE CITY CAI I I TENANT: IEXIST BLDG USE: RESID USE ZONE: R-1 TISSUED ON: PROCESSED BY: I IEXIST OCC GRP: 107/08/13 SR I TOWNER: TEL. NO: 1BLDG5. NOW ON LOT: VALUATION: IFI AL DATE FINAL B CODE: 1 WONG, VENA (626) 782-2550- 1 1,500 1 16154 BURTON AVE TEMP 917801756T T FEES PAID TDE CRI PTIO- OF WORK INTERIOR REMODEL OF CLOSETS IN TWO BEDROOMS & WIDEN OPEN IEEE DESCRIPTION: QUANTITY: UOM: AMOUNT: IBETWEEN LIVING ROOM, BREAKFAST NOOK AND REMOVE BATHROOM FROMI JAPPLICANT: TEL. NO: I GARAGE I TAN YEW K (626) 257-8900- IAA BLDG PERMIT ISSUANCE 27.80 1 16703 N GOLDEN WEST JAB STATE GREEN BLDG FEE 1500.00 VAL 1.00 ISPECIAL CONDITIONS: 1 JARCADIA CA JAC STRONG MOTION RESID 1500.00 VAL 0.50 B1 PLANCHECK W/ENERGY 1500.00 VAL 90.30 B2 PERMIT W/ENERGY 1500.00 VAL 90.40 (CONTRACTOR: TEL. NO: IFR INV WORK W/0 PERMIT 339.60 DOL 339.60 JAPPROVALS DATE INSPECTOR SIGNATURE IPOLWIS ION LAND CORP (626) 257-690)- TOTAL FEES 549.60 1 16703 N GOLDEN WEST LIC. NO LOCATION AND SETBACKS JARCADIA CA 91007 879756 1SOILS ENGINEER APPROVAL I 1 (ARCHITECT OR ENGINEER: TSL. NO: IFOWiDATION/TRENCH FORMS I I I LIC. NC: TSLAB/Wi DER FLOOR RAISED FLOOR FRAMING I I I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( (UNDERFLOOR INSULATION 3 001 1 1 IFLOOR SHEATHING IND. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: I NO 21 IROOF SHEATHING SCHOOL WITHIN HAZARDOUS ISHEAR PANELS JAIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME INSPECTION IFIRE SPRINKLER HANGERS T i INSULATION/WEATHER STRIP1( INTERIOR LATH/DRYWALL I � I IEXTERIOR LATH (RATED FLOOR/CEIL ASSEM. TRATED WALL ASSEMBLIES I I � RATED SHAFTS/OPENINGS I I I T-BAR CEILINGS I I I ILOT DRAINAGE I I I REPORT ID: DPR261 ROUTE TO: HS0508 3 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 0305080067 PHONE: (626) 285-0488 EXT: LEGAL D: NO. 0 G ADDRESS: TR: 29475 LT: 10 SQ. FT STORIES TYPE 6154 BURTON AV N STRUCTURE: VN SGAB CA 917752653 ASSESSOR INOR - NEAREST CROSS STREET: LONGDEN 5386-007-071 THOMAS PAGE: 596 GRID: G2 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG U 0 USE ZONE: R-1 ISSUED ON: PROCESSED BY: PIKES . EXIST OCC GRP: 05/08/03 JK 05/02/04 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE: PRAM; TRI (626) 641-9850- 4,800 FXPIR n 6154 BURTON AVENUE SAN GABRIEL FEES PAID DESCRIPTION 0 1/0 SHAKE ROOF OFF HOUSE & GARAGE; INSTALL 1/2"PLYWOOD $ FEE DESCRIPTION: QUANTITY: UOM: AMOUNT; 50YR PRESIDENTIAL SHINGLE APPLICANT: L. WILLIAM GOODMAN (909) 337-0933- AA BLDG PERMIT ISSUANCE 27.75 1391 CALGARY COURT AC STRONG MOTION RESID 4800.00 VAL 0.50 SPECIAL CONDITIONS: LAKE ARROWHEAD 92352 D2 PERMIT W/0 EN-HC 4800.00 VAL 132.60 TOTAL FEES 160.85 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE GOODMAN ROOFING CO. (909) 337-0933- 1391 CALGARY COURT LIC. NO LOCATION AND SETBACKS P.O. BOX 8 298965 C39 LAKE ARROWHEAD, CA 92352 SOILS ENGINEER APPROVAL ARCHITECT OR N EER: TEL. N0: FOUNDATION/TRENCH FOWRTS LIC, NO: SLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION 150H261 3 01 N0. OF FAMILIES: DWELLING UNITS: AP /CON S AT CLAS FLOOR SHEATHING NO 21 ROOF SHEATHING S SCHOOL WITH N HAA OU SHEAR PAN L AIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME INSPECTION REQUIRED TOTAL AC ROM XIST FIRE SPRINKLER HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- INSULATION/WEATH R STRIP SIDE PL- INTERIOR LATH/DRYWALL EXTERIOR LATH RATED FL SSEM. RATED WALL ASSEM LIES R T D HA / S T-BAR CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508