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Home My Public Portal About10134 DAINES DR_Building__ 76A638q DBYyH 3-66 '` `' y�• APPLICATION FOR BUILDING PERMIT 1 DIVISION OF BUILDING AND SAFETY BUILDING "`j/�S D Deportment of`County Engineer ADDRESS County of Los Angeles LOCALITY .C- WM.J. FOX,COUNTY ENGINEER NEAREST .CASSATT D. GRIFFIN,SUPT OF BUILDING CROSS ST. A3 ;'NF DISTRICT NO. GROUP (TYPE S BER MAP a :6 FOR APPLICANT TO FILL IN CONST. BUILDING• bA 1 MAP STATE ADDREBB / NUMBER HWY YES NO - - LOT NO. BLOCK USE ZONE SPECIAL _ _ CONDITIONS TRACT t NO. OF BLDGS. • SIZE OF LOT / I NOW ON LOT SETBACKgU1LDING- YARD .HWY STREET NAME EXIST. WIDTH USE OF 'EX STING BLDG. FRONT O 5 A P. L. L7 SIDE OWNE P. L. ' MAILevZ O TRACT DWELL. I UNIT ADDRESS _ 5 -INDUSTRIAL` ' 1 DWELL. .7-UNIT - CITY- NO. 8 PUBLIC BLDG. 2 DUPLEX 1 UNIT ARCHITECT OR i/ � TEL. 7 ADDN.,ALT.. ETC. ENGINEER NO. 3 APT. UNITS _ ' 8 MISCEL. - ADDRESS 4 COMMERCIAL = TEL. INSPECTION RECORD' CONTRALTO n NO. , ADDRESS 42 ESCRIPTION OF WORK ��j�y 1.01 NEW�ADD ALTER REPAIR DEMOLISH REPAIR DEMOLISH A,6e'/— SQ. FT. NO.OF NOSQ• FT. NO.OF OF� y, v- i SIZE STORIES FAMILIES ,f�/' 'r,;�, -USE OF STRUCTU / `4�l ��/'WiS� lVC1✓ /' 1�i SIGNATURE OF - ' APPLICANT,p► - -APPROVALS ADDRESS g DATE INSPECTORS SIGNATURE DATION: LOCATION �j,/ �y O •P.C. !$ �3 FOUNFORMS, MATERIALS FEE FRAME: FIRE STOPS. VALUATION BRACING. BOLTS !� FEE' • V FURNACE: LOCATION, - I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS, GAS VENT, DUCTS fi APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREETOCOMPLY WITH,ALL COUNTY ORDINANCES .LATH. INT. AND STATE LAWS REGULATING BUILDING CONSTRUC- TION. LATH, EXT. SIGNATURE OF�. HOUSE NUMBER COR- - PERMITTEE RECT AND POSTED ADDRESS •� FINAL WM.J. FOX,COUNTY ENGINEER VALIDATION. C. N. DIRLAM. CHIEF BLDG. INSPECTOR 6 7 3 0 APR 2 1 6 .`� 3 +86 7 3 1? APR - 1 315.0 C . APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION _ FOR APPLICANT TO FILL IN BUILDING�ADDRESS f� BUILDING ADDRESS �.rh w%- J, I hereby affirm that I have a certificate of consent to self Insure, or a certificate of Workers' Compensation Insurance,or a certified Copy thereof(Sec 3800,Lab C) - �� /- ,J CITY ''�7�•f): I�ZIP �fJf--�1.1�'v�, • LOCA PTY Policy No Company r7a/e /'Ge ra( '" Apo ,,..,,,,lram� SIZE OF LOT 0 OF BLDGS NOW ON LOT �t'�ertifie copy Is hereby furnished NEAREST CROSS ST _ Certified copy Is filed with the county building Inspection TRACT BLOCK LOT NO department USE ZONE MAP NO Date _J.4 Applicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS r CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL NO COMPENSATION INSURANCE C WITHIN 1,000 FT of SCHOOL? YES No (This section need not be completed If the permit Is for one hundred ADDRESS ev? �LlB fJ�2 DISTRICT GROUP TYPE CONST FIRE ZONE PROCESSED BY dollars($100)or less) v CIT ZIP certify that In the performance of the work for which this permit � - ' Is Issued, I shall not employ any person In any manner so as to L �� / become subject to the Workers'Co tion Laws ARCHITECT OR ENGINEER TEL NO a� STATISTICAL CLASSIFICATION APT CONDO O - Date ate —Yy,AppllCant - ADDRESS CLASS NO � DWELL UNITS LJ NOTICE TO APPLICANT, If,, after making this, Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject t0 the Workers' CO RACTOR TEL NO SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith 2 G fd_ FRONT comply with such provisions or this permit shall be deemed revoked ADDRESS LIC NO '!�a P L ySr x SIDE LICENSED CONTRACTORS DECLARATION CITY LIC CLASS P L I hereby affirm that I am licensed underprovisions of Chapter 9 EWER MAP >_ (commencing with Section 7000)of Division 3 of the Business and S FT SIZE , NO OF STORIES NO OF FAMILIES..+ •• C1 Professions Code,and my license its In full force and effect NEW SK PG , U License Number Sys^ P'YJ LIC Class �� DESC PTION OF WORK ADD ❑ VALUATION Ck: Contractor Date n�/ l ALTER ❑ $ N ❑ 1 am exempt under Sec / REPAIR ❑ Z B&PC for this reason ,�� L 'Lo X74,6, DEMOL ❑ LDMA P/C# Date USE OF EXISTING BLDG I QI?0 -.)O URM ❑ Signature _ APPLICANT(PRINT) TEL NO LDMA Perm# _ ❑•I,as owner of the,property, or my employees with wages as Z ` their sole compensation, will do the work and the structure Is ADDRESS ` not Intended or offered for sale (Section 7044, Business and FINAL DATE / Q Professions Code Code) 1G i 1 i t _ WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL � `- ,� _ OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE _ _ ❑ 1, as owner of the property, am exclusively contracting- (Section with44, AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE' Q A 85 FINAL BY� > !!I(ti� "�� m �.a � licensed contractors to construct the project (Section 7044, Business and Professions Code) YES❑ No C1r'i - _ , yr WILL THE INTENDED USE OF THE BUIOUNG BY THE APPLICANT OR FUTURE BUILDING t- 1 =�`• --"••f' OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR I_ �� ! GUIDELINES I,hereby affirm that there Is a construction lending agency for YES❑ No❑ a the performance of the work for which this permit is Issued(Sec I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMDPERMITTING ' rn f Le - 3097,CIV C) CHECKLIST I UNDERSTAND MV REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE t�Ll(I!I—I)�IlJ I - _; J -{ TITLE 2 CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD - =j-7 d ��n {-�#"!• o Lender's Address k' O OWNER OR AGENT o I certify that I have read this application and state under penalty 4 of perjury that the above information Is correct I agree to comply PC FEE PERMIT FEE N with all county ordinances and State laws relating to building o� construction, and hereby authorize representatives of this County ISSUANCE FEEOD / to o,ent on the ab -mentioned roperty for inspection purposes Q m --��/ a INVESTIGATION FEE - TOTAL FEE ^ �e d Appl�nl to 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 91780 BL 0508 1108240057 PHONE (626) 285-0488 EXT LEGAL ID NO OF CONST BUILDING ADDRESS ITR: 22438 LT 16 SQ FT STORIES TYPE 1 10134 DAINES DR ISTRUCTURE: V-B TEMP CA 917802706 (ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET: NADINE 18586-027-025 1 THOMAS PAGE- 597 GRID B3 LOCALITY TEMPLE CITY, Cl TENANT JEXIST BLDG USE RESID USE ZONE R-1 1SSUED ON PROCESSED BY EXIST OCC GRP. 108/24/11 SR OWNER- TEL NO IBLDGS NOW ON LOT VALUATION IF IIDATE FINALAY CODE ILEU CARL,LI MIN - 220 I �I�rI 14865 N W 72 AVE r l XV IMIAMI FL 33166 FEES PAID IDE!3CRTPTIO'N OF WORK REPLACE (2) WINDOWS LIVING ROOM I IFEE DESCRIPTION QUANTITY UOM AMOUNT (APPLICANT TEL NO I IFLORES, NELSON (626) 448-8705- IAA BLDG PERMIT ISSUANCE 27 80 I I 110134 DAINES DR IAB STATE GREEN BLDG FEE 220 00 VAL 1 00 ISPECIAL CONDITIONS I ITEMPLE CITY CA 91780 IAC STRONG MOTION RESID 220 00 VAL 0 50 I I ID2 PERMIT W/O EN-HC 220 00 VAL 43 60 1 I IFR INV WORK W/O PERMIT 257 00 DOL 257 00 I I. CONTRACTOR TEL NO I TOTAL FEES 329 90 (APPROVALS DATE INSPECTOR SIGNATURE I IFLORES, NELSON (626) 448-8705- 1 110134 DAINES DRIVE LIC- NO I ILOCATION AND SETBACKS I 1 I ITEMPLE CITY, CA 91780 NONE I I I 1 ISOILS ENGINEER APPROVAL 1 1 1 (ARCHITECT OR ENGINEER TEL NO IFOC,.+DATION/TRENCH FORMS I I LIC NO I ISLAB/UNDER FLOOR I 1 RAISED FLOOR FRAMING 1 IMAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP (UNDERFLOOR INSULATION I 1147H273 3 001 1 1 I I IFLOOR SHEATHING INO OF FAMILIES DWELLING UNITS APT/GOND: STAT CLASS 1 I 0 NO 21 I IROOF SHEATHING SCHOOL WITHIN HAZARDOUS 1 ISHEAR PANELS 1AIR QUALITY 1000 FEET MATERIALS I I NO NO NO I IFRAME INSPECTION I IFIRE SPRINKLER HANGERS 1 INSULATION/WEATHER STRIP( r (INTERIOR LATH/DRYWALL 1 I IEXTERIOR LATH 1 I 1 IRATED FLOOR/CEIL ASSEM I 1 I IRATED WALL ASSEMBLIES 1 IRATED SHAFTS/OPENINGS I 1 - I I I IT-BAR CEILINGS 1 1 1 I 1 1,LOT DRAINAGE 1 1 I '• _ II I � I I IREPORT ID DPR261° ROUTE TO BS0508 I 1 I I t