HomeMy Public PortalAbout10558 DAINES DR_Building__ r ��F1�y��)� 11F1,1 71111' �(��.
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APPLICATION LOCALITY
NEAREST R
DIVISION OF BUILDING AND SAFETY i CROss9T. / _S� 'Y/ 10
Department of Los A eles I1eC[ DISTRICT NO. RECEIPT NO. 1 PERMIT� N
O.
County of Los Angeles {� 7
WIA. J. FOX, COUNTY ENGINEER GROUP DATE RECEIVED DATEISSUED
CASSATT D. GRIFFIN, 5uwi OF BUILDING " .rl7 __S
V
FOR APPLICANT TO FILL IN TYPE CONST. RECEIVED BY OY ISSUED
BY ..�
OWNER S �J,Y (STATE YES,
ES, r
MAP
MAIL / NUMBER Iq
ADDRESS O O HWY
/ jG. USE ZONE SPECIAL
CITY No.
O 4.y2 j dj�-e�n1 CONDITIONS
ARCHITECTOR TEL.
_ ENGINEER NO.
i BUILDING YARD HWY STREET NAME EXIST.
SETBACK WIDTH
ADDRESS
( FRONT
CONTRACTOR Y w e Q// Na1' 033i P.L. JS(/ /Ir 4-1 _
r SIDE _
ADDRESS 7�SD JG A y a>.r Cl>T AAAzm � P. L
DATE CORRECTIONS INSPECTOR
BUILDING
ADDRESS / LS r•, jv hp
/{
LOT NO. — LJ &/: r VBLOCK
7GTRACT / Rea.„
NO. OF SLOGS.
SIZE OF LOT S- I NOW ON LOT
USE OF j
EXISTING BLDD. •2' OVi
DESCRIPTION OF WOR$ O
M
0
NEW ADD(/ ALTER REPAIR DEMOLISH Z
Sq. FT. ` NO. OF _._ NO.OF D
SIZE &X7 BTORIE9 -/ FAMILIES - - -- -
USE / STRUCTURnE
GIle,f Ife. 07,1 rc
/-)(I
-4 C4ILyI
/1 X 23 eat, L,
I
NO.OF
EMPLOYEES �4 C
THEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP,
PLICATION AND STATE THAT THE INFORMATION GIVEN IS APPROVALS INSPECTOR'S SIGNATURE DATE
CORRECT.
IAGREE TO COMPL WITH ALL COUNTY OppDINANCEB ! FOU p NDATION: LOCATION
ANO STATE LAWS R".. ATIND BUILDING CON 9TRI.ICT N. FORMS, MATERIALS F/F f I7` I
' FRAME: FIRE STOPS, F
SIGNATURE OF BRACING,BOLTS
PERMITTEE FURNACE: LOCATION,
O GASVENT,DUCTS
ADDRESS
S LATH, INT.
AUTHORIZED AOT.
LATH, EXT.
$ P.,
S HOUSE NUMBER COR-
(STV FEE' RECT AND PORTED
VALUATION U FINAL ��3G
76AG38A DBS 3 12-53
/} ADDRESS
APPLICATION _LocALlry 2 , 1 .
DIVISION OF BUILDING AND SAFETY GROSS T
NEARE BT.
Department of County Engineer DISTRICT NO. - RECEIPTNO.- PERMIT NO.
County of Los Angeles
WM. J. FOX, COUNTY ENGINEER 'DATC R[CEIVED DA IBB CD
CABBATT D. GRIFFIN. H8P•T Dv BDILOINR ' �^ J7 3 A
FOR APPLICANT TO FILL IN TYPE DONBT. nv Y 1
♦ OWNER r MAP' . . /
MAIL _ _ ZO
ADDRESS O $HSE YFIt� O
8 �A 6 NUMB[R
�� A USE ON[[[ SPECIAL
CITY
TEL CONDITIONS
i l�
ARCHITECT O TEL. '
ENOINEER NO.
_� Sr toy�� ^Q�Q , SETBA NB YARD HWY STREET NAME EXIST.
�
ADDRESS '•/ SETBACK WIDTH
TL FRONT
EL.
P. E V
CONTRACTOR NO.
P.
—
P.L
ADDRESS
BU ILDINn w DATE CORRECTIONS INSPECTOR
ADDRESS +/ r
LOT NO. //I.7Z ' BLOCK— ' O�
TRACT
_ NO. OF SLOGEL
SIZE OF LOT' �� NOW ON LOT
USEy
IBTIN G
DESCRIPTION OF WORK /"' X60
NEW ADD ALTER REPAIR D[NOLIBN �s
SO. FT. NO. OF NO.Or �yr
SIZE STORIES rAMILI[B•/- ,
USE OF STRUCTURE w O 0
r J,
NO.DF
M OY '
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP-
PLICATION AND STATE THAT THE INFORMATION GIVEN IB APPROVALS INBPECTORIS SIGNATURE DATE
CORRECT.
1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION: LOCATION
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FORMS.MATERIALS
/J FRAME: FIRE STOPS,
SIGNATURE OF /I ' BRACING,BOLTS
PERMITTER 1. FURNACE: LOCATION,
L� A , GAS VENT,DUCTS
ADDRESSJ
i.A 424 LATH,
INT.
-AUTHORIZED AS �(�
/��� LATH. EXT.
$ AO r 0.0P• C' S �YZ SHOUSE NUMBER CUR-
FEE RECT AND POSTED
VALUATION `V Jt
FEE BSO FINAL
76A638A 0883 4-54
F
�" WC+'> ER�COMP�NSATION DECLARATION �
t I h 7Rrm"^ot I have a yerrifi<ote,of consent to self //p�� 1�y�� O ((/� //p�� M [FOR
�r��( �Ipg1���/��-s ��,}a RO Fp�R//f��
' ihsur ra <C'ificate of Workers' Compensation Insurance, A PLOCA �OO4V U OU�I LJ�����UV\/ �IS II�l00 U�� _
fl
or-a ce�ifiedcopy thereof (Sec. 3800, Lab. C.) -
' 7b3'6-RV Company idTs �'nL.3D COUNTY OF LOS ANGELES BUILDING AND SAFE Y
PaJi<y No' P Y�r�' - -
v l;ertified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING /, �( /y�
I'm, ADDRESS V��(J e
O ,Certified copy is filed with the county building inspec- BUILDING �^ -^^��
tion depbrrmenl. ADDRESS I SJo
,
�Oata Applicant CITY (� ZIP LOCALITY
CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. NEAREST
COMPENSATION INSURANCE SIZE OF LOT Q NOW ON LOT =CROSS ST. .
(This section need not be completed if the permit is for one TRACT ' BLOCK LOT NO. ASSESSOR
hundred dollars ($100)or less.) MAP BOOK PAGE, PARCEL
TEL
USE Z NE MAP
I certify that in the performance of the work for which this OWNER V No
NO.
permit is issued, I shall not employ any person in any manner / SPECIAL
so as to become subject to the Workers'Compensation Laws. 'ADDRESS CONDITIONS O
CITY ZIP O
Date Applicant _--
ARCHITECT OR TEL. 1
NOTICE TO APPLICANT: If, of
making this Certificate of DISTRICT GRpUP TYPE FIRE PRO D BY O
Exemption, you should become subject to .the Workers' - ENGINEER ^_ NO. (o- -• 9 /1 CONST.,. Z U
Compensation provisions of the Labor Code, you must forth- ADDRESS .p � S ,J. K fV/ W
with comply with such provisions or this permit shall be D-•
deemed revoked. TEL STATISTICAL CLAS$JFI TION APT. CONDO. cn
CONTRACTOR A3-T6&S GDO 1 NO O Z
LICENSED CONTRACTORS DECLARATION A LIC, CLASS NO. DWELL. UNITS_
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS O Q.'ILLS l9/y�NO. Z6 '� SEWER MAP
(commencing with Section 7000)of Division 3 of the Business ono LIC.
Professions Code, and my licenseisin full force and effect. CITU O O(ZO 14 CLASS EX. r VALIDATION
• s3-2.C7'4- �� SIIZZEFT•. S STORIIEES FAMIOLIES CHECK
--
license Num6or Lic.Class -
tj! _ VALUATION ,-�l
Contractor - �'��C� ��^'�'<60te DESCRIPTION OF WORK I "' NEW ❑, $ ewe'
I am exempt under Sec.
LYTO {U L L ADD ❑ ewe'
D
AIiER ❑
8.8P.C. for thl s 1 _ �y"' REPAIR ClS
D e: USE EXISTTIF k ING BLDG. DEMOL ❑ # �.8 6 2 4.�1
Signak e ` / - ' APPLICANT iEl. FINA
PRINT RA1 s_TT' O. "-9• 1 4.3.63
O E ER EC RATION DATE e e
I hereby fflrm at s exempt from the Contractors License I
Law for the fo lo, g reason (Section 7031.5, Business and ADDRESS Ad,C� •A' .�&VC-5 ,( Z ']--a'�
Profess ons Code . PREADDRESS
I, as owner of the property, or my employees with nd ADDRESS
waste ct their sole compensation,will f o the work and D -
the structure IB 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-
RL
DDREsS
tion 7044, Business and Professions Code). ` I
CONSTRUCTION LENDING AGENCY SETTUIREBACK YARD HWY .TOTA pROP.LCNErKum WIDTH P " �• ,t
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.I.
Lender's Name
2 7LDMA,Ref. R
m P.C. fee$ Permit Fee
Lender's Address - , w\ h• t '^^'.k
1 certify that 1 have read This application and state that the Issuance Fee l/ry (/ LDMA P/C R �" " `- � \ ,J ., •
9 above' formation is correct. 1 agree to comply with all County Investigation Fee '7 / ^>� )moi\1`
q or on and'State Iyy+s bring to building construction, Total tea 3 rv'J LDMA'Perm. R . -�•. T L'�. `
R d re authors 6 d sentotives of this County to enter I
n t above- a ed pro t .inspection purposes.
/-7�� SEE REVERSE FOR EXPLANATORY LANGUAGE
I at re of Applicant ar Agent Date -
WORKERS COMPENSATION DECLARATION'
_ I hereby affirm that I'liave�a certificate ofconsent to self �PP. UC�Tpp. RBURDINV PpM
of
Tinsure or d certificate Workers Compensation Insurance,
,or a cerfifiedmpy thereof,(Sec.3800j lab. C.) _ COUNTY OF LOS ANGELES - BUILDING AND•SAFETY
Policy No Company
❑ Certified',mpy.is NBUILDING,
2. hereby furnished.. '' FOR APPLICANT TO FILL IN - ADDRESS
❑ Certified copyis filed with the county.building inspec- BUILDING . 1 OG.S �. • (y� a /� - - - .- ,
ficin department., ^ ADDRESS
((,� r ,J�J ��.1Nv^L�J„ ��•' ,
._ 1. •1;.. .. .. CITY LM l.M1.. �L ZIBP 1 LOCALITY
.+ Date - Applicant NO. OF LDGS. • NEAREST ,L� _
CERTIFICATE OF EXEMPTION FROM WORKERS' " - SIZE OF LOT I L" -I tpV - NOW ON LOT. y ' - CROSS ST.
COMPENSATION INSURANCE - //� ^ �JIP;�� 2 ASSESSOR
(This section Tneed not b-e completed if.the permit is for one - TRACT (p �J BLOCK LOT NO: Mgp'BOOK -1 PAGE ' '`�• PARCEL'
hundred-dollars ($100) or less.), , ✓C ��y' TEL.
,; . , �1 OWNER �- ajgp NO: _ US 'ZONES, OP t
.",1 certify'that in the performance ofthework for which this - `A� - ISPEIAL _ _
permit is issued,I sli not employ any'peFson in any manner ADDRESS - L - - - CONDITIONS a
so as to.become-subject ro_the Workers' Compensation.Laws. _ :Q
• CITU ' ._ .-
Date Applicant ' -` �;' ARCHITECT OR _ TEL -
'NOTICE TO APPLICANT: If; after Makin this Certificate of ENGINEER _ --. NO. DISTRICT GROUP TYPE FIRE OCESSED BY
g' Ir,DI 7r(' 2 TYPE ���/ ^ ZONE' (/.J��� O
Exemption, yo ;should become subject toy the Workers' ADDRESS - � /D(J �-�/ ^ . '• - �� {V a
Compensation-provisions of the Labor Code, ou.must forth-
with comply
orthwith-.comply with .such,provisions-or this permit,shall be TEL N
STATISTICAL CLASSIFICATION APT. CONDO
deemed,revoked. CONTRACTOR NO. - -.. .., . Z
LICENSED.CONTRACTORS DECLARATION • - NC. CLASS NO.�DWEU. UNITS
.1 hereby affirm that I'am licensed under provisions.of Chapter 9 ADDRESS NO. -LIC. SEWERMAP
(commencing with Section 7000)of Division 3 of the Business -•r ...
and Professions_Code,and my,license is in.full force an0effect. CITY 'vim - CLASS -BK' --'- L -' 3 VALIDATION
50: FT. ry c NO. OF NO. OF - I CHECK _ 'I
License.Nu tuber Lia Class SIZE I LOJ ORIS FAMILIES `L ONE:: 'L' T
INC" ICH)iVALUATIO .T .�L [ �f
Contro<tor Date DESCRIPTION OF WORK L�Dn�/�2 NEW -q❑ry $8
j , V -`5`�'t� 43
DESCRIPTION
❑1 am exempt under Sec. aW011.eL P�1`D GAJ I•PC�e "ADD' "I/y rp TOTAL'T:_L�1 I'TE/�. _ -- -
ALTER FLJ, .D 1�11tL Y 2 'J.
B.BP.C. for this.reoson - - ((''LL.4I��((��yy �'f
- S-�'' FL-��IZ' .. - - REPAIR ❑ $ .. L�nGI•Es
vDate- .. USE OF L�/'�' rte,.C _ _ dd?.nL,�i
EXISTING BLDG.W�+�f - DEMOL ❑ CHANGE 'n�l
.,Signature- APPLICANT- ` pt ytsti ���/(, FINAL
- - ffllttUU`�IVVGG '• t-t- -
OWNER-BUILDER DECLARATION (PRINT) -ILS J r.Mr,v�310: . -i
1 hereby affirm that I am exempt from the Contractors License. _ - T �y DATE - 8
Law for the following reason (Section 7031.5, Business and ADDRESS�n5 "PP, T..C• 11 U(� FINAL '�v �i Z9�/L+8If�1'9
Profe sions Code)`. - PRESENT By - _ J9'IT 1 Fll 111 Vl
r, BUILDING "�� �� _
as owner of the property .or my employees with ADDRESS IO �
wages as their sole compensation will do the work and
the structure isnot intended or offered for sale(Section LOCALITY D'
7044 Business'and
Professions Code.) MOVING -. .TEL._ �(f
v I, as Owner of the property,.am exclusively'contracting CONTRACTOR NO.
with licensed contractors to construct the project (Seo- ADDRESS - 1 f !'
tidn'7044, Business and Professions Code.) -
REQUIREDTOTAL 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 worB,foowhich this permit is'issued 'P.
,(Sec..3097,.Civ..C.). - SIDE .. . -
Lender's Name,'- -
mPermit Fee 'CDMA Refr'N .
{
Lender's Address P.C..Fee$- 1 - '
certify that I have read this application and'state that the Issuonce Fee - LDMA PTC& '` -
8 above information is correct. I agree to comply with all County Investigation Fee
ordinances and $t a laws relating to bu ding construction, Total Fee LDMA Perm. N ,
and eby outho representatives of this County to:enter _
"upp' t e e tproperty for inspecti-n qp pos s. -
SEE REVERSE FOR EXPLANATORY LANGUAGE
.SignatvrA of Applicant or Agent Dat
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 0311210022
PHONE: (626) 285-0488 EXT:
LEGAL ID: NO. OF CONST NEW BUILD NG ADDRESS:
TR: 7690 LT: 16 UN: .002 SQ. FT STORIES TYPE OCCUP GROUP 10558 DAINES DR
STRUCTURE: 1365 2 VN R3 TEMP CA 917802812
ASS SSOR INFORMATION NUMBER: GARAGE: NEAREST CROSS STREET: PAL MAL
8586-029-024 OTHER: THOMAS-PAGE: 597 GRID: C3 LOCALITY: TEMPLE CITY
TENANT: EXIST BLDG USE: USE ZONE: ISSUED N: PROCESSED BY: EXPIRES ON:
EXIST OCC GRP: 03/12/04 VG03/07/05
OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATES PIR`EY: CODE:
SHELBURNE CHARLES F;BROWN GEORGIA E (626) 448-8545- 113,000
10558 DAINES DR
TEMP 917802812 FEES PAID DESCRIPTIO F WORK
ADD 2ND FLR (2BR&1 3/4BATH);EXPAND 1ST FLR:DINING RM,KITCHEN
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: LIVING RM & BEDRM; TTL WHEN DONE:4BR/2 3/4BATH
APPLICANT: TEL. N0:
SAME AS OWNER - B1 PLANCHECK W/ENERGY 108000.00 VAL 1,254.40
AN BLDG PERMIT ISSUANCE 27.75 SPECIAL CONDITIONS:
AC STRONG MOTION RESID 113000.00 VAL 11.30
B1'PLANCHECK W/ENERGY 113000.00 VAL 30.85
B2 PERMIT W/ENERGY 113000:00 VAL 1,512.06
CONTRACTOR: TEL. NO: j'.� I TOTAL'FEES' 2,836'.36 APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER - CC�i.` .,J '
LIC. NO - LOCATION AND SETBACKS
SOILS ENGfUEER APPROVAL
ARCHITECT OR ENGINEER: TEL. N0: FOUNDATION/TRENCH FORMS
U -
LIC. NO: SLABlUNDER FLOOR
RAISED FLOOR FRAMING
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZON : CMP: UNDERFLOOR INSULATION
3 01
ST LEVEL FLOOR SHEATH
NO. OF FAMILIES: DWELLING UNITS: APT COND: SAT CLASS:
NO 21 2ND LEVEL FLOOR SHEATH
SCHOOL WITHIN HAZARDOUS ROOF SHEATHING_
AIR QUALITY: 1000 FEET MATERIALS -�
NO NO NO FIRE DEPT. FRAME INSPECT
REQUIRED TOTAL SETBACK FROM EXIST BLDG DEPT. FRAME INSPECT
SET BACK YARD: HWY: PROP LINE: WIDTH:
FRONT PL- SHEAR PANELS
SIDE PL-
J INSULATION/WEAT ER STRIP /
INTERIOR LATH/DRYWALL
EXTERIOR LATH
LOT DRAINAGE J`
SMOKE DETECTION DEVICES
FIRE DEPARTMENT APPROVAL
REPORT ID: DPR261 ROUTE TO: BS0508
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS NEW RESIDENTIAL
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0203290037
PHONE: (626) 285-0488 EXT:
LEGAL ID: NO. OF CONST NEW BUILDING ADDRESS:
TR: 7690 LT: 16 UN: .002 SQ. FT STORIES TYPE OCCUP GROUP 10558 DAINES DR
STRUCTURE: 565 1 VN R3 TEMP CA 917802812
ASSESSOR INFORMATION NUMBER: GARAGE: NEAREST CROSS STREET: PAL MAL
8586-029-024 OTHER: THOMAS PAGE: 597 GRID: C3 LOCALITY: TEMPLE CITY
TENANT: USE 0 : R- ISS ON: PROCESSED BY: EXPIRES ON:
09/10/02 JK 03/09/03 -
OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE:
SHELBURNE CHARLES F;BROWN GEORGIA E (626) 448-8545- 42,000
10558 DAINES DR 'I
TEMP 917802812 FEES PAID DESCR PION OF OR
GUESTHOUSE - 565 S.F.
FEE DESCRIPTION: QUANTITY: UCM: AMOUNT:
APPLICANT: TEL. NO:
SAME AS OWNER - B1 PLANCHECK W/ENERGY 42000.00 VAL 648.22
AA BLDG PERMIT ISSUANCE 27.75 SPECIAL CONDITIONS:
AC STRONG MOTION^RESID - 42000.00 VAL 4.20 NO KITCHEN; COVENANT RECORDED
B2 PERMIT-W/ENERGYc - 42000:00 VAL 762.63
TOTAL,,FEES .. 1,442.80
CONTRACTOR: TEL. NO: ",�]- - APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER - �
LIC. NO LOCATION AND-SETBACKS
SOILS ENGINEER APPROVAL
i l
ARCHITECT OR ENGINEER: TEL. NO: FOUNDAT I 0 NL FORMS
17797-
LIC.
flyLIC. NO: SLAB/UNDER FLOOR '
RAISED FLOORFRAMING
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP.: UNDERFLOOR INSULATION
147H273 N 17 3 01. .
1ST LEVEL FL 0 H
NO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: - -
NO 12 ND LEVEL FLOOR SHEATH
i
SCHOOL WITHIN HAZARDOUS . _ OOF—SHEATHING
AIR QUALITY: 1000 FEET MATERIALS
NO NO NO - FIRE DEPT. FRAME INSPECT
REQUIRED TOTAL SETBACK FROM EX[ -G BLDG DEP FRAME INSPEC
SET BACK YARD: HWY: PROP LINE: WIDTH: '' /
FRONT PL- - SHEAR PANELS
SIDE PL- j /" n QST —1
INSULATION/WEATHER STRIP -
INTERIOR LATH/DRYWALL
EXTERIOR LATH
LOT DRAINAGE
SMOKE DETECTION DEVICES
FIRE DEPARTMENT APPROVAL
REPORT ID: DPR261 ROUTE TO: BS0508