Loading...
HomeMy Public PortalAbout10945 DAINES DR_Building__ APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN (Print or type only). auaowG COUNTY OF LOS ANGELES ADDRESS DEPARTMENT OF COUNTY ENGINEER CITY fiP ZIP BUILDING AND SAFET ISION 'NO.OF BLDGS, BUILDING Q SIZE OF LOT NOW ON LOT ADDRESS TRAC C LOT NO. LOCALITY y TEL. NEAREST OWNER Gl TEL. �S ^ CROSS ST. ASSESSOR -ADDRESS �Qzy 14is MAPBOOK PAGE PARCEL -CITYDISTRICT GROUP TYPE FIRE PROC ED B ZIP 500o CONST- ZONE/ ARCHITECT OR TEL. _ ENGINEER NO. STATISTICAL CLASSIFICATION SEWERM ADDRESS //� CLASS NO.0�DWELL.UNITS / BK. /jOPG CONTRACTOR C(// N L. 6 USE ZONE MAP7,-) LIC. - nn NO. �- ADDRESS NO. IY' I 0 SPECIAL LIC VVVVV```"''' �'L/�' CONDITIONS CITY ✓ ( �' CLASS ROAD DEPARTMENT APPROVAL REO= YES ❑ NO ❑ CONSTRUCTION LENDER NAME AND BRANCH /V/ BLDG.SETBACK FROM 2656 FRONT PROP.LINE OF (STREET) ADDRESS CITY TOTAL SETBACK FROM TYPE OF EXISTING SO.FT. NO.OF NO.OF CHECK HIGHWAY } YARD = FRONT PROP.LINE HIGHWAY WIDTH SIZE'-- STORIES FAMILIES ONE DESCRIPTION OF WORK g NEW + b O BLDG.SETBACK FROM ax kc ADD ❑ SIDE PROP.LINE OF - (STREET) O ALTER ❑ TOTAL SETBACK FROM TYPE OF I EXISTING w PAIR ❑ HIGHWAY }. YARD = SIDE PROP.LINE HIGHWAY WIDTH H USE OF - a/{��7 _ Z EXISTING BLDG. 7 / MOL ❑ + APPLICANY F NOL i, CORNER CUTOFF YES NO ❑ ' 'T V' - IN OPEN SPACE YES NO BY(SIGNATURE( IN COASTAL PERMIT ZONE YES ❑ NO VALUATION � � �� O ��0 - I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION.1 CERTIFY THAT IN DOING THE _ WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODEOF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM_ PENSATION INSURAtNC4E. --+s]� ' SIGNATURE OF IV nw 6�7 ��f� Tf�j/LdjfZ v/(" PERMITTEE VVV«�--L6LLL�CCCJ11 /_ll// ADDRESS FINAL 'r1V'J�� DA CITY- N- .. 61 MAKE CHECKS PAYABLE TO FEE C. f7,$ ! cP FET $ �G.b700 HARVEY T.BRANDT,COUNTY ENGINEER i PLAN CHECK VALIDATION cN. M.o, usH /vim PERMIT VALID (CIN- M.O. CASH X 0 1 n.•:pP 13 2 3 U 1 2 �#.2 0 B' S Li/ 854 iAy 1223 u 3. 6.00 _ 85j�RMay 12 1 U 26700A ®f 76A638ACE#8033-75 6) WORKERS' COMPENSATION DECLARATION /�L L�I� /,a p� - - - .tom p F� L� p I�F� /�or a m that I have r certificate of consent to self /(�� Icylf��p /p���®IIOII FOR BLIP DO II AllG PI}hy'fgpLlPT insure, ora"cerhficote of Workers' Compensation Insurance, !/"111 Il V'!/-V U V FOR LJ LS II CI 11 LS IIOYC/Il or a certified copy thereof-(Ser 3800, Lob-C.) .COUNTY OF LOS ANGELES, - BUILDING AND SAFETY Policy NEICompany s -` ❑ ''Certified copy is hereby fdrnished. ,. - FOR)APPLICANT:TO FILL 1N ADDRESS p v ElBUILDING Certified copy is filed with the county building inspec- ADDRESS d,.'L rS'`. �,/'7T�� `B s - ''• - - • - - - - tion department. - - CITY L P/�Yf 'n� 'ZIP9 LOCALITY • Date '" Applicant - - `" NO OF BLDG$, CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT 4. X u NOW ON LOT NEAREST _ CROSS 51. C. -{OMPENSATION INSURANCE - ASSESSOR (This section need not be completed if the permit is for one - TRACT ) - BLOCK -' LOT NO ' - MAP BOOK PAGE PARCEL hundred dollars ($100) or less.) `- OWNER (�. NEL O.-) 7:5� / USUZONE MAP .. _ NO. I certify that in the performance of the!work for which this //( C� [ n SPECIAL permit is issued, I'shall not employ any person in y manner ADDRESSM /.z) J fj/Tl —W — CONDITIONS ` a so as t bet me ub ec to the W k r ' Com aLan Lows _ - O P CITY Lo /'/ /p C [ K ZIP 7 - ' ` U D Ilton ARCHITECT OR TEL. `� / - PP - .DISTRICT GROUP_ TYPE FIRE _ PROCESSED BY NOTICE TOA PLICA T: If,. after making this Certificate of ENGINEER NO.... -/ / CONST. ZONE Exemption, you should become subject to the.Workers' - `` 1// U Compensation provisions of the Labor Code, you must forth- ADDRESS -J P3 V _ 2 with comply with•such provisions or this permit shall be TELSTATISTICAL CLASSIFICATION APT, CONDO. N deemed revoked. - CONTRACTOR, NO. Z LICENSED CONTRACTORS DECLARATION - LIC. - CLASS NC.- DWELL. UNITS_ _ hereby affirm that I am licensed under provisions of Chapter ADDRESS NO. ,A ( LIC SEWER MAP commencing with Section 7000)of Division 3 of the Business -and Professions Code,and my license is in full force,and effect. CITY CLASS BK PG VALIDATION - SQ. FT. 3� NO. OF - NO. OF CHECK License Number-- 'Lic.'Class SIZE J STORIES FAMILIES ONE _ . - '- � - — VALUATION Contractor - Date DESCRIPTION RK •P ON OF WORK 5 (Sllf (aI NEW ElI� ElES¢ am exempt under Sec. /+ O `� -ADD ❑ $ ©v ' y�/J ALTER 1-1 - - D B.BP.C. for this reason ' ��' r ' REPAIR ❑ $ Dale: - USE-OF - ' EXISTING BLDG. S K DEMOL ❑ $gnat rej ,-� APPLICANT ) !/ TEL. "")� r/G - - - - _ - - OWNER-BUILDER DECLARATION (PRINT) �p C/ p NO� FINAL . -/ (/ - //,, DATE I hereby affirm that I am exempt from the Contractor's License y. ADDRESS �V l• /./X77 h U /�, Law for the following reason (Section 7031.5, Business and FINAL Professions Code): PRESENT By Imo- BUILDING w r AN IJ I, as owner of the property, or my employees with ADDRESS 'A - wages as their sole compensation,will do the work and - " - -- A .- the structure is not intended or offered for sale(Section LOCALITYr D \. .5.0! >� 2e 7044, Business and Professions Code.) MOVING - .. TEL. _ El 1, NO. ��. i ITEMS iv I, as owner of the property, am exclusively contracting � - with licensed contractors to construct the project (Sec- ADDRESS- 1 tion 7044, Business and Professions Code.) .. - �`g - T11,TAL 59 . 25 REQUIRED, TOTAL SETBACK FROM- EXIST.. CONSTRUCTION LENDING AGENCY SET BACK ' YARD HWY PROP. LINE CHECK 59 yc 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. - -C._ CHANGE .GO (Sec. 3097, Civ. C.). -1 q - SIDE ' PL, Lender's Name. 'E/V T'✓✓ ` FId0O7G0C12/85, 'O LOMA Ref. # n ( �� - P.C. Fee $ Permit Fee - S Ah �n Lender's Address �q D ,}24'4 L 0 U CD'' ,a a I certify that.I have read this application and state that the Issuance Fee LDMA'PiC k 8 above information is correct. I agree to comply with all County Investigation Fee • {{---� - `. ordinances and State laws relating to building construction, Total Fee .� V l LDMA.Perm. N and hereby authorize represents ryes of this County to enter o up the abo�entjoned rty for inspectio pur ses. a. _ _SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent WORKERS'.COMPENSATION DECLAaATION I hereby affirm that I have a certificate of consent to self - O D �Ip�Ip� I^� Ilp�grgry pg pI ��ry�p���r PERMT insure, or a certificate,of.Workers' Compensation Insurance, ������� �OII V �OIIU V V -LSD�11 V�J- Lr !�LrwUf7 L1�� - o(a certi$ed copy thereof (Seo: 3800,:Lab. C.) c, - COUNTY OF LOS ANGELES BUILDING AND,SAFETY Policy No. Company" BUILDING _ ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN - ADDRESS zQ ' ❑. Certified copy is filedwith the muntybuilding inspec- 'BUILDING• _ -- - - �• - tion department. - ADDRESS %i m16 5 Date :Applicant CITY' f/ ZIP VYa LOCALITY NO.OF LOT NEAREST- C -f ' CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT. NOW ON LOT L CROSS ST. J/ COMPENSATION INSURANCE ASSESSOR •�' O (This section need not 6e completed if the permit is For one - TRACT - BLOCK LOi NO- . MAP BOOK S? PAGE Q�O PARCEL 038 hundred dollars ($100) or less.) 7EL. . - OWNER'' 1/N L NO. - - - USE ZONE OP _ .. -I certify _that in the:performance of the work for which this ,N,// D SPECIAL P is Issued- Shall not employ any person in any manner - ADDRESS /VE-5xl J / CONDITIONS so as to become subject to the Workers.Camps, tion Lo vs. p - _ Date"�"�"r���'q CI7Y G C. ZIP _ s Applicant, ARCHITECT OR _ iEt. - 01 NOTICE TO APPLICANT: If, after.making this Certificate of .ENGINEER - NO - . r DISTRICT - GROUP TYPE. FIRE PROCESSED BY Exemption, I CONST. ZONE J p you,should become. subject to the, Workers' � �n _ U Compensation provisions of the Labor Code,.you must Forth- ADDRESS _ .:J/Q� 3 cu N with comply with such provisions or thispermit.shall be � TEL. - STATISTICAL CLASSIFICATION - - APT. CONDO. Z deemed revoked. � � � CONTRACTOR NO. _ � ' LICENSED CONTRACTORS DECLARATION. : UC. .CUSS NO.__.2:z_ DWELL. UNITS I hereby affirm than am licensed under provisions of Chapteri) ADDRESS NO. LIC SEWER MAP (commencing with Section 7000)of Division 3 o the Business CITY - - CLASS 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' ' -' VALUATION r ^ DESCRIPTION OF WORK NEW ❑ Contractor ate $ - D - - - D ADD ❑1 am exempt under Sec _ _.ALTER ' $.BP.C_ for this reason REPAIR ❑ $ Date: t USE OF _ ... y..- EXISTING BLDG. DEMOL ❑ Signature r ' APPLICANT - ' - TEL. FINAL - OWNER-BUILDER DECLARATION (PRIM NO. , (< d DATE I hereby affirm that I am exeni from the Contractor's License - - TPM G�C/T t Law for the following reason (Section 7031.5, Business and ADDRESS D �S FINAL Professions Code): . .- - PRESENT- - - - - ,-'By - - - ❑ J, as owner of theproperty, or m em Io'employees with BUILDING - 7.7-1017 J. Y P Y ADDRESS - - _ _ wages as their sole compensation,vwill do.the workand i LOCALI7V 4 - the structure is not intended or offered for sale(Section _ > ❑ 7044, Business and Professions Code.) - MOVING --- 'r. - - TEL. -- - - D - - - - i 1, as owner of the property,�am exclusively contracting CONTRACTOR.- 'NO. with l icensed•contractors to construct the project (Sec- All ADDRESS tion 7044, Business and Professions Code.) N•#��• .,e L _F._ REQUIRED TOTAL SETBACK FROM EXIST. -' ' - L t tf'-' CONSTRUCTION LENDING AGENCY - SET BACK YARD Hwv PROP. LINE WIDTH " - hereby affirm that there is a construction lending agency for FRONT"• I i 1;iii e - m _ the performance of.the work for which this permit is issued P.L. - (Sec. 3097, Civ. C.). SIDE Lender's Name. �/' 6 LDMA Ref.N m Lender's Address P.C. Fee 8 0•. 7 Permit Fee I certify fk6t I have read this application and state that the Issuance Fee - of LDMA•P/C psit i[; 8 above information is correct. I agree to comply with all County Investigation Fee / qq ordinances and.State laws relating to building construction, - - Total Fee OHO'.• LDMA Perm. p a and hereby authori:<e representatives of this County to enter m Zn above-me f oned property for inspection purposes. - - o �- �— ' - SEEREVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date - tr WORKERS' COMPENSATION DECLARATION t affirm that I have a certificate of consent to self D D TI��Ip� FOR, fps �rryl��[/(�� �r�f gyp}I��y��p7�p/�7� ins or a certificate of Workers' Compensation Insurance, ���������OII V Il O0Y1' -�V��D�"OV�J" ll;'IS II�lI1V O�� - or a tifieedreopy thereof (Sec. 3800, Lab. //!!//ppCCjj77LL// �T ✓.oto i\`COUNT,Y OF LOS ANGELES BUILDING AND SAFETY- Policy .L Company FOR APPLICANT TO;FILL;INN\ BUILDING n� / ❑ Certified Copy is hereby Furnished - ADDRESS Certified copy is filed with the county building inspec- ' BUILDING - • tion department. ADDRESS DateApplicant �fT � �N/ CITY' f 'j ZIP LOCALITY O. OF _ NEAREST LOT - CERTIFICATE OF fXEMPTION`FROM WORKERS' SIZE OF LOT NOW ON LOT � CROSS Si. -COMPENSATION INSORANCE _ - • _ ASSESSOR (This'section need not be completed if the permit is for one TRACT BL K LOT NO. _ MAP BOOK . - .PAGE PARCEL hundred dollars ($100) or less.). - TEL, - _ OWNER f �' NO. µms— USE ZONE MAP : I certify,that in the performance of or for which this �y�(�T NO. permit is issued, I SPECIAL > shall not any person in any;manner - ADDRESS r ' `` I CONDITIONS so as to become sub' o the Workers' Compensation Laws. _ 0 CITY' ZIP - - Date Applicant ARCHITECT OR TEL. Dc NOTICE TO APPLICANT: If, after making this Certificate of •- ENGINEER NO DISTRICT GROUP TYPE FIRE P CESSED BY CONS ZONE O Exemption, you should ,became subject to the Workers' Compensation provisions of the Labor Code,•you must forth- ADDRESS - -/� -361 - a with comply with such provisions or this permit shall be t Y TEL. STATISTICAL CLASSIFICATION APT. CONDO.. L0 deemed revoked. CONTRACTOR - NO.,:,"' Z LICENSED CONTRACTORS DECLARATION, 01 LIC. CLASS NO. DWELL. UNITS— d hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS "r/ NO. (commencing with Section 7000)of Division 3 of the Business LIC. SEWER MAP and Professions Code,and my license is in full force and effect CITY n� CLASS BK PG VALIDATION � SQ. FT. STORIES OF FA OF `CHECK ' License Number TY LLia Class SIZE ' STORIES FAMILIES l ONE ,,'//fr ,,T ft - ' ., VALUATION Con}ro<tor�, r i/e,yaG Date DESCRIPTION OF WORK �.,/!�/J L /�/,�/� NEW ❑ S. /)•'•='� _- � (/ D' ❑I am exempt under Sec. _ X•_ _ G ALTER ❑ B:BP.C. for this reason U7)4 ��(/ "I' — .REPAIR $ ... - Date: F r• EXISTING BLDG. /t DEMOL ❑ Signature - APPLICANT_ I TNOEL. (PRINTj ' . --FINAL {�-9l - •t OWNER-BUILDER DECLARATION - . . DATE I hereby affirm that I.am exempt from the Contractor's License - Law for the following reason (Section 7031.5, Business and ADDRESS Professions Code): PRESENT - - By N"," BUILDING ., C A I, as owner of the property,�myemployees with ADDRESS A{:.T.r wa esus their so le cam of- willdotheworkand the iru s is not' nd'a or offered for sale(Section LOCALITY - 3307 --- - 124.x. 7044, Busm nd Professions Code.) MOVING TEL D,r 1 ITEMS CONTRACTOR NO. _ ❑ I, as er of the property, am exclusively.contracting 1 i pp licensed contractors to construct the project (Sec- - ADDRESS 1 TOTAL- --'i24— �i� - ion 7044, Business and Professions Code.) 41'{E(`I; 124.00 REQUIRED TOTAL SETBACK FROM 'EXIST:" 88 CONSTRUCTIONLENDING AGENCY . SETBACK YARD HWY PROP. LINE 'WIDTH I hereby affirm that there is a construction lending agency for FRONT _ __ -- CHANGE .011 the performance of the work for which this permit is issued (Sec. 3097;Civ. C.). SIDE --- -- P.L.' OOQ�-0001 Leede' Name 6/30/89 LDMA Ref. a 4276 1 AM 8. 0 1" P.G. Fee$ ' Permit Fee D . 3 Lender's Address - I certify that I have read this application and state that the -� - Issuance Fee LDMA P/C q 8 above information is correct. I agree to comply with all County Irnestigat_ion Fee I _ _ ordinances and State laws relatind 6building construction, Total Fee LDMA Perm.q a and hereby authorize representatives of this Countyto enter - upon the -ave-men ' d pr.perty for inspection purposes. - - I r' a G19�S SEE REVERSE FOR EXPLANA70RY LANGUAGE /- Signatur Applicant or Agent - Date - 1lI 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 0511290052 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: BK: 67 PG: 49 PC: 1 SO. FT STORIES TYPE 10945 DAINES DR STRUCTURE: 2000 VN TEMP CA 917802921 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 8573-020-038 THOMAS PAGE: 597 GRID: D3 LOCALITY: TEMPLE CITY, C TENANT: EXIST BLDG USE: REBID USE ZONE: R-1 ISSUED ON: PROCESSED BY: EXPIRES ON: E%IST OCC GRP: 11/29/05 JK 11/24/06 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FIN�`I DATE NAL BY: CODE: HERNANDEZ LOUIE N;CONCEPCION A (626) 579-0706- 12,000 //�7/J 6 /(_ 10945 DAINES DR ✓! 11J '(9 TEMP 917802921 FEES PAID DESCRIPTION OF WOR TEAR OFF AND REROOF WITH 50 YR COMPOSITION SHINGLES HOUSE FEE DESCRIPTION: QUANTITY: DOM: AMOUNT: AND GARAGE APPLICANT: TEL. NO: SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RESID 12000.00 VAL 1.20 SPECIAL CONDITIONS: D2 PERMIT W/O EN-HC 12000.00 VAL 250.20 FR INV WORK W/O PERMIT 257.00 DOL 257.00 TOTAL FEES 536.15 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - LIC. NO LOCATION AND SETBACKS SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS LIC. NO: SLAB UNDER FLOOR RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION ISOH277 3 01 FLOOR SHEATHING NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I NO 21 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- INSULATION/WEATHER STRIP SIDE PL- INTERIOR LATH DRYWALL EXTERIOR LATH RATED FLOOR/CEIL ASSEM. RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTS TO: BSO508