HomeMy Public PortalAbout10636 DANBURY ST_Building__ 76A638A GE/9O3 11_57 APPLICATION FOR BUILDING PERM IT
COUNTY OF LOS ANGELES BUILDING '
DEPARTMENT OF COUNTY ENGINEER °DDRESS
BUILDING AND SAFETY DIVISION LOCALITY /
JOHN A. LAMBIE,COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN, SUPT OF BOILGING CROSSST. < "'
DISTRICT NO. GROUP rYPE. - SEWER..MAP
FOR APPLCANTITO FILL IN BK P
CONST.
BUILDING _ -
ADDRESS _ G' STATISTICAL CLASSIFICATION
k .
CLASS.NO. DWELL.UNITS "
LOT NO. _P C A rel BLOCK MAP STATE
NUMBER HWY. YES O
TRACT • USEZONE SPECIAL
SIZE OF LOT 5200 sq ft I ON NO. LOGS. O CONDITIONS,
NOW ON LOT / q
USEOF Ju O -
4,VA Ira,
EXISTING BLDG. BUILDING EXIST.�.
YARD HW Y STREET NAME
Mr.n�y—( � We SSe1S SETBACK WIDTH
OWNER FRONT
MAIL P.L.
ADDRESS SIDE /O./
TEL. P.L. -
CITY NO INSPECTION RECOi
ARCH ITECT OR TEL. -
ENGINEER NO.
ADDRESS LL..,, // (�
CONTRACTOR Selected Homes No%D 029
ADDRESS 16322 Ari•ow Hwy, Irwindal
DESCRIPTION OF WORK �' /' /
pI NEW X.ADD ALTER REPAIR DEMOLISH ^' - - -
I•
SIZE 106$ STORIES 1 FAMILIES 1 -
Ir USE OF STRUCTURE I)welling and -
attached x 22 arage
SIGNATURE OF fes, APPROVALS
APPLICANT .� LI ,.Ial
ADDRESS 1 2I�� ArrowS Hwy,. i:ndDATE INSPEC R'S SIGNATURE
FOUNDATION: LOCATION
A FORMS.MATERIALS 'I a,-o 3P •-1.,
P.G E U FRAME: FIRE STOPS. �
f D FEE BRACING,BOLTS / . SL r
VALUATION E.5& _— FURNACE: LOCATION.
_ FEE GAS VENT,DUCTS
I HEREBY AOKNOWLEDGE THAT I HAVE READ THIS AP- LATH,INT.
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND ,
AGREE TO COMPLY H ALL COUNTY ORDINAN 5 AND w .4
STATE LAWS R ��•• TING- BUILDINP ST CTIO LATH,EXT. - -
SIGNATUREO V HRECT AND POSTE
OUSE NUMBER % W S9
PERMITTE
ADDRESS 1 22 Arrow Hwy, indal FINAL N
CLYDE N. DIRLA M. PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION uL M.O. c H PERMIT VALIDATION cN. .
",,,o6 8,3 7T 11119 2 3 A 113 ,0 0 , 2 . . 'er.
LAC0 7 1' 3 1 M DEC 2 1 V 3 6.0/
76AG38A CEu8038-63APPLICATION FOR BUILDING PE MIT ,_;
COUNTY OF LOS ANGELES BUILDING O
DEPARTMENT OF COUNTY ENGINEER ADDft ESS
BUILDING AND SAFETY DIVISION LOCAL(
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST.
DISTRICT N GROUP TYPE P C ED BY
FOR APPLICANT TO FILL IN s Q CONST. 0 Ylz
BUILDING fO/ 5 STATISTICAL CLA (CATION SEWER MAP
ADDRESS/ /7J
CLASS. NO. DWELL. UNITS__'_]
LOT NO E BLOCK WATER
CERTIFICATE: NOT REQUIRED ❑ RECEIVED ❑
TRACT MAP HIGHWAY
NO. OF BLDGS./ NO. _0 0 (O8CLE1 STATE MAJOR SECOND. LOCAL
SIZE OF LO NOW ON LOT USE ZONE PECIAL
USE OF CONDITIONS
EX ISTIN
TE 1
OWNER // I!pl/ '/ N C/ BUI DING EXIST.
StIBACYARD HWY STREET NAME
ADDRESS/0" /J rJ FRONT
K WIDTH
ARCHITECT OR TEL -F. L. O,2
ENGINEER NO. SIDE
P. L.
A RESS r
A a
0
ON !/ u
ADDRESS O
DESCRI OF WORK
� W
a
NEW ADD C LTE REPAIR DEMOLISH Z
SQ. FT. NO. OF NO. OF
SIZE STORIES FAMILIE
USE OF
STRU TU
7 '
SIGNATURE OF
APPLICANT
VALUATION $ ��
APPROVALS DATE INSPECTOR'S SIGNATURE
SAT FOUNDATION: LOCATION
FEE $ L' FEES FORMS. MATERIALS
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS rr
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION.
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS
BUILDING CONSTRUCTIONj ERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY NO EMPLOY ANY PERSON IN VIOLA- LATH. INT.
TION OF THE LA CODF TE OF CALIFORNIA RELAT
ING TO WORKM 'S CO O 5 FAd
LATH. EXT.
SIGNATUR OF HOUSE NUMBER COR-
PERM ITTE RECT AND POSTED I
ADDRESS L
JOHN F. LEWIS, PRINCIPAL ST URAL ENGINEER
PLAN CHECK VALIDATION CK. M.D. LASH PERMIT VALIDATION DK. M.D. DASH
.9 8 5 8-� JUL 31 D 9.00 e
'1 A
WORKERS'COMPENSATION DECLARATION
_ L hereb of irrn that I have a certificate of consent to self A D O 1p' �/(� //p�� M �F}} fpr;L�pf �pf 1p1 'fp�1p� D / 11SI
insu-e or a certificate of Workers' Compensation Insurance, ff—u P P LS��, WAa_CT 5 O 11'V' -Il O R ✓V�t=om D 5 st V'O PLS UNIT V 11��or
certified copy.thereof (Sec. 3800, Lab. C.) i .,
COLINTY.OF LOS ANGELES BUILDING AND SAFETY " a
Policy No.- Company
❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN • ADDRESS
Certified copy is filed.with the county building inspec- BUI DING Lf
Q qq((��
tiondepartment. - ADDRESS . 6Vf� LOCALITY
NEAREST
Date Applicant CITY CTY
ZIP '1 O CROSSST.
CERTIFICATE OF EXEMPTION FROM WORKERS' NO. 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 USE ZZZpppNE, MAP
hundred dollars ($100)or less.) TRACT - BLOCK LOT NO. / NO. - -
_ nn
TEL (� SPECIAL " - y-
I certify that in the performance of the work for,which this OWNER ) T` Q L NO. / I CONDITIONS d.
-.permit is issued, I shall not employ any person in any manner - - -1pp pp 1 DISTRICT GF.UP TYPE FIRE PROC ED BY 0
ADDRESS 14f>O CONST. / ZONE V
so as to-,be ome s ject to the Workers'Compensation Laws. p i 0.
s Date ApplicantFAYLIKif'CJ CITY 7 L/� G I 1 ZIP STATISTICAL CLASSTI TION.. APT. CON .
ARCHITECT OR TEL.
NOTICE TO APPLICANT: if, after m king this Certificate of - '- `- " CLASS NO. DWELL. UNITS_
ENGINEER NO. I/ W
Exemption, you should become subject to the Workers' a,
Compensation provisions of the.Labor Code, you must forth- SEWER MAP
with comply with such provisions or this permit sholl be ADDRESS Z
'deemed revoked. . TEL' _ BK. PG, :' VALIDATION '
CONTRACTOR 1.0 NO
LICENSED CONTRACTORS DECLARATION ' ' �s uC.
1 hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS /)'/f *Vi NO. YU2VALUATION
(commencing with Section 7000)of Division 3 of the Business and .,A UC
Professions Code, and my license is in.full forceand effect. CITY 1y 1Q7J )/I� �Y�- D)� CLASS l—�� $
• �. C (� SQ. FT SNO,TO IE NO. OF CHECK D
License
Number— (,�� q/�bin Lic.Class SIZE STORIES r�F�A1MO ONE
Contractors s `y^ii-// 1 M V Date - / V NEW ❑ $ - -
DESCRIPTION OF WORK ,.
❑ am exempt Lnder Sea U y-0 - ADD ,❑
�,�7 ALTER ❑ FINA
B.BP.C. for this reason G /.'_ REPAIR ❑ DATE
Date: USE OF ❑ - FIN -
EXISTING BLDG'. DEMOL B
Signature APPLPRINT) J1,L LRl l�o T - 7 5 3 8 A
OWNER-BUILDER DECLARATION - - -
I hereby affirm that I am exempt from the Contractor's License •� ��,�• /L C �/� �#
-Law for the following reason (Section 7031.5, Business and. -.. ADDRESS 17A/ n
Professions Code): PRESENT - I ° ° 4 G50
.❑ - .. BUILDING - _ 4 G 5 0 5
I, osowner of the property, m my employees with ADDRESS •°
wages as their sole compensation,will do the work and
the structure is notintended or offered for sale(Section LOCALITY _ .0'7 .L%)„8 7. '
7044, Business and Professions Code). MOVING - TEL. -
E. I, as owner of the property, am exclusively contracting• CONTRACTOR NO. - - _• -
with licensed contractors to construct the project (Sec- - ADDRESS -
'tion-7044;Business and Professions Code). '
REQUIRED - TOTAL SETBACK FROM EXIST. a '
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH
hereby affirm that there is a construction lending agency for .FRONT
the'performance of the work for which this permit Is issued PL.
(Sec. 3097, Civ. C.). SIDE
P.I.
Lender's Name - ��/� _
W. 1W
Lender's Address P.C. Fee$ Permit Fee L(JV
certif that I have read this application and state that the D.,J
y pp an ce Fee
above information is correct. I agree to comply with all County Investigation Fee _ �/l
ordinances and State laws relating to building construction, Total Fee L/ -
d ZSign=W11Z.ntt
re esentatives f t is County to enter o.o d prop r ' spection//77urpos s.
' SEE REVERSE FOR EXPLANATORY LANGUAGEor A6,nF JrDate -
®s
a. COUNTY OF LQ^. AKGcLES TEMPLE CITY # 0508 BUiii5 i.s i_
DEPARTMENT OF PL0S 7O WORKS 470' LAS TUNAS RESL;;'- "x\;16::
BUILDING AND SAF[TY / i.,....: DEVELOPMENT TEMPLE CITY CA 91780 SL -3 0410^4:'.018
PHONE: (626) 285-0488 EXT:
TL-fir lii: �— —� N�— i..^F�? NEW BUILDING ADDRESS: --T
ON FILE SQ. FT STORIES TYPE OCCUP G.". - 10636 DANBURY `T
_ STRUCTUs=: 491 1 VN R3 'EtdP C9 917802823
P�SEFS'CR it:FCRMAIE_—' ;
ION NUMBER: GARF.GE: NEAREST CROSS STR : °! CTNE -i
8 Oit +.1 O - THOMAS PAGE: 597 1:3 LOCALITY iE+ -, ;,r -I
TEMEXIST�6?. 'St cLL JSE: -'JSE ZONE: 2 = ON: PROC°S EXPIRES ON:
EX:ST - GRP; I.i I /04 10/10/05 --
OWbeR' _ ---- TEL. RO: Bv.;_a, tr.a. ON ,.Oi: --� V.ALUATION. eft :-.= TE F,�..- 3To CODE:
C,CP,L:_A, WAn;E (626) 579-1005- 40,660
10636 DANBURY ST _ _
TEMP 91?802%123 - _— F=S PATE (�.. XIP 10k Of WORK
TEN ,,,Cr LIVING ROOM, KITCHEN A:D ADO FAMILY ROOM 4=.''
F'P DESCRIPTIO:-1: 7 Y: UOM: AMOUNT: '.DDITJOU
AA"PI.I;:A!iT: __ TEL. N0: i _
SAME AS OUNC-R - Cst PLANCHECK W/ENERGY ,,..,,-,,., VAL 636.0
liA BLDG PERMIT ISSUANCE 27.7> �;AL CG3DITIOWS:
IAC STROUG MOTION RESID `:A! 4.Lr
a ' F!/ENERGY _ ,.ca,i.".'i, .JAL 748.2
__. . -.._._. 1,416. ._
—_ - . .::VA. .....= iNSPEC'i OR
LIC. NO I wti..ry AND SETBACKS
E@;iNEEFi APPROVP.L _I__— _i
i I
..__- OP t.GIi.E ;,./,r JC1 FCn%' r..L/ •
:NI C - -- —— _. ---
,.JL.,t i
3:
_ EVE[ F :OR SHEATH
NG.:]F FA.M 11.1 ESo �SiELLING SN[ -SL .4pT;' OND; STAT CLASS:
NO 21
SCHOOL W1Tfl HAZARD0U5 ---
AIF, NIM ITY: 1000 FEET MATERIALS
NC — ND k0 ( ;FI,.� DEPT. FRAME INSPE"Ti---�—
SET BACK YARD: HWY: PROP LINE: WIDTH:
;SH
1-
-_ .-- -4--I
. _ /
REQUi NEC+ IOTA!.�SEIfiP.�C.K FROM EXIST Nt,.n PANELS v —
i¢TrT-nvPT. FRAME INSPECT
FRO
-N.5Ll TION/WE CHER STRIFI +
N.5 � I
IINTEd TOR LATH/DRYWALL -
EXT ERIOR LATH --_-�'--
--- -_--,
SLOT DRAINAGE
;Emu'E DETECTION DEVICES !--
I
if?RE DEPARTMENT APPROVALi ---__
REPORT ID: DPR261 ROUTE TO: BS0508 `