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Home My Public Portal About5301 DEGAS AVE_Building__ " -,'TEMPLE CITY +•A••••••�•• APPLICATION FOR BUILDING PERMIT IJ COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS 5301 BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST. FOR APPLICANT TO FILL IN DISTRICTT Nh GR Q npE D SS�Y S• CONST. ADDRESS �✓� Q ( �' DHCJ!{f �V`p STATISTICAL CLAS IFICATION SEWER MAP CLASS. NO. O DWELL.UNITS SK PG LOT NO. BLOCK WATER NOT REQUIRED ❑" RECEIVED CERTIFICATELi -2 o TRACT 72- MAP HIGHWAY STATE MAJOR SECON LOCAL SIZE OF LOT ,5"I /� i.� INOW ON LOTS /I b USO O E SPECIALLEI USE OF i CONDITIONS EXISTING BLDG. . g OWNER ef- V NO. ILDI ypRD HWY STREET NAME EXIST. 'FJ/' ?2^ L'' / �5 rT N4,s �}- SETBACK WIDTH ADDRESS XX kO� LL.. L N FRONT ARCHITECTOR TEL. P. L. ENGINEER NO. SIDE P.L. ADDRESS INi�SPEC}T�.,IOrN 1r�RECORD CONTRACTOR R &Ge/- � V ADDRESS 2l - '245; .4 O. C D,ESCRIPTION OF WORE � I-'•.-i.c �,cf�,.�.'.;.f-�, �fF iK.t.'1.^ -�;r r a NEW ADD ALTER REPAIR DEMOLISH 'Al SO.FT. p NO.OF NO.OF / ? IZE O STORIES FAMILIES USE OF STR C URE SIGNATURE OF APPLICANT q VALUATION owAPPROVALS �}DATE�J INSPECTOR'S SIGNATURE F E $ - FEE $ ` POFORMS!MATERIALS FRAME: FIRESTOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS ANO STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GASVENT DUCTS S I I /`+r• / .p BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK I p ` AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH, INT. \ l 1 TION OF THE LABOR CODE OF THE STAT OF C�(�LIFORNIA RELAT- 'A ING TO WORKMEN'S CO 10 IL INS IRA1 E. W IY✓} `�,c,/,///Y r LATH,EXT. �W SIGNATURE OF HOUSE NUMBER COR- PERMITTEE �/64RECT AND POSTED ADDRESS - -S C(HRS FINAL Ilit/ _ CLYDE N. DIRLAM, PRINCIPAL ST AL ENGINEER PLAN CHECK VALIDATION cK M.D. CASH PERM VALIDATION cK M.D. CARR LA,0 1 '7 7 � SEP P 72 3 D 2 1 .0 0 '1 L.' 375 6 -�-' I, r1r 1D 4 5 .0 0 l3 �r/ COUNTY OF LOS AAGFLES TEMPLE CITY ii 0503 BUILDING Pt RmIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR ' BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0408180042 -PHONE: (626) 285-0480 'XT: LEGAL ID: N0: OF CONST BJILDING ADDRESS: - TR: 26522 LT: 13 SQ. FT STORIES TYPE 5301 DEGAS AV _ STRUCTURE: 372 N: TEF1P CA 917803324 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: GREEN 8585-003-027 THOMAS PAGE: 597 GRID: S4 LOCALITY: TEMPLE T FWAT: EXIST BLDG US : RESID USE20-- NIRA'— ISSOED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 08/'9.104 - JK 08/14/05 OWNER: TEL. NO: BLDGS. NOW um LOT: VALUATION: F_IN:' L'. T FINAL BY: CODE: —j TSAI HAU WEN;PATTY :626) 574-7101- 1,000 220 WALNUT AVE - - `+ ARCD 910772041 FEES PAID DESCRIPTION OF WORK -� ENCLOSED EXISTING STORAGE ROOM AND SEALED WINDOWS j FEE DESCRIPTION: QUANTITY: LOM: AMOUNT: APPLICANT: 'f El.. NO: - YANG (626) 672-5098- AA DI PC PERMIT ISSUANCE 27.75 9138 OLEMA ST AC STRONG MOTION RESID 1000.00 VA! - 0.50 T'raIALDCONDITiOHS: - TEMPLE S:TY 91730TO7AL 148.35 AX BUILDING REVIEW FEE 54.70 - - D2 PERMIT W/O EN-HC ;000.00 VAI 65.40 _ " :EES _ CONIRACTUR: 7'c l.. !:0: - - A,?? -VAL.i- DATE - iKSPECTOR SIG..... d KEVIN YANG (626; 672-5098- _ L'gT__� _ 9138 OLFMA STREET LIC. NO DOIUN AND SEIGACKS TEMPLE CITY, CA 91780 NONE ' Ipi,S TNf.i NEER APPROVALL AkCNITBC? OR ENG!iE'cR: -_—_��--- :'n• i` LIC. NO: l.A:?/U,ynER LOON IS' MAP MOo PAG-E—: F1 kE ZDh E: CMP•• 'U;tDERFLOrJ"n IaSULATION XX3 03 ;FLOOR S:IEA-,,ING _ • __.____ 90. 0F F—kM]LI E$: DNELLING UNITS: i�AijCONO: STkiLLASS: _ �e0 21 GC.7` SilaT111 NG __.. _I SCHOOL WITHINHAZARDOUS S4� R PAN Lam— AIR QUALITY: 1000 FEET MATERIALS NO NO NO iFrtr;�E iFiSPECTION — REQUIRED TOTAL SgTSACK FkOM EXIST � 14 SP2!NKLER HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PI- INSOLVION/WEATHER STRIP SIDE PL- - iATErl0k LATH/DRYWALL X1 ERIQR LATH --- — RATDLOOR/CEIL A—SSTM... --- RATED WALL ASSEMBLIES ' RATED SHAF S/OP— E�yGS I-BAR CEILINGS LO?DRP.I NAGE REPORT ID; DPR261 ROUTE TO: BS0508 WORKERS'COMPENSATION DECLARATION - "•' .. . +" }-. :,i_, . . - - __ . .. - - _.- `I hereby affirm that I have a certificate of consent to self ��n ��ON FO� OO n n�n D��n.�. ��(�/�� 1� I insure, or a certificate of Workers' Compensation Insurance, �rL uCI v LL N ERAUT u or a cltifi d top thereof ec'3800,'Lab C.) err $=Z -��$' COUNTY OF LOS ANGELES -,BUILDING.AND SAFETY I Policy.IN Company r �Yl`OAI T ___ .. ._ _ _ O: Certified copy is hereby furnished..:. - FOR APPLICANT TO FILL INBUILDING S 2�j/ - ADDRESS J alit s. Certified copy is filed with the county bailding'i'nspec- - BUILDING .q. - 'tion department. ADDRESS 'i T �- Date /Z- Applicant• �Etf�r .C`d)lii7 • CITY C zIP LOCALITY -%: CERTIFICATE OF EXEMPTION FROM WORKERS"' --"- - - - - -NO.OFBLDGS.�-_. - - NEAREST. ' COMPENSATION INSURANCE.. SIZE OF.LOT NOW ON LOT. CROSS ST. _ (Thissection need.not be completed ifahe'permit is,for one - - - -- • -- ASSESSOR' - '-+• - hundred dollars ($100)or Less.) TRACT BLOCK LOT NO. MAP BOOK PAGE• PARCEL a Y TEL /,r�( ) ( USE ZONE MAP. OWNER �` i— , /" NO.--/T n`124 1-certify that in the performance of the work for which this ) NO. } permit is issued, I shall not employ any person m any manner �) P' I SPECIAL - — - d ADDRESS- I)r<i L,'vr -- - -- /•'� CONDITIONS _ - 0 s% . to become suble<i to the Workers'Compenshtiob laws. - /1 t V CITY - X- 0 I F'1" -ZIP . C7 _ t - . .. Dote ` Applicant'• - "• ARCHITECT OR TEL - - 0 NOTICE TO APPLICANT: If, after making this Certificate of - I DISTRICT GROUP TYPE '_ FIRE _ P OCESSED BY H ENGINEER NO. / CONST. ZONE V Exemption, you should become subject to -the. Workers' W Compensation provisions of the Labor Code; you.must forth- ADDRESS - v ' 1`�/ -. - -� - 1 with comply with such,provisions or this permit shall be deemed (evoked. TEL. - STATISTICAL CLASSIFICATION APT. NDO. Z CONTRACTOR ( NO. S _ LICENSED CONTRACTORS DECLARATION .+ .. ._ _ _ LIC. _ CLASS NO.-'C�- DWELL:,UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS G^' ,�/ �s NO. 6 G� SEWER MAP (commencing with Section 7000)of Division 3 of the Business and _ �/- . .. _ LIC.- Professions Code„and my license is in full force and effect. CITY /. CLASS '� BK- PG. - - - -VALIDATION - ��6 Sq. FT. NO.OF NO. OF CHECK License Number ✓ l Lia Class'' /� SIZE / J STORIES FAMILIES Y ONE Contractor/_) r= �Z-Y Date ' T7%/ S'� -- DESCRIPTION OF WORK �� r ADD O 'VALUATION 3ow"'I I am exempt under Sec. - - - - - ❑ - ALTER 3 6 6 5'A' &&P.C. for this reason REPAIR ❑ $ - `"Dater USE OF DEMOL ❑ # e e • e • 1 ' EXISTING BLDG. - - -.. Slgriatare - APPLICANT {� - - - TEL. FINAL- PRINT NO: 0j �,16 ( s o 5 9,2 5 _DATE OWNER-BUILDER DECLARATION _ ,I ( _ - -. .. -I hereby offirm,that I am exempt from the Contractors License - 7-� � ' Law for the following'reason (Section 7031 5, Business and ADDRESS C) / 'F�14� `'/ I �-.: FIN • s e a,5^9.2 5 x ` -Professions Code): PRESENT - - - -- s BY” "-t•` 1 �• -c ' J F-1 _ BUILDING I - _ _. . ,) 2 6 T 8,5, I, as owner of the property, or my employees with ADDRESS _ t 'wbbe-s 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- -' - -FEL- - ❑ - CONTRACTOR N . "I;as owner of the property, am exclusively contractingO with licensed contractors to construct the project (Sec- ADDRESS -� - tion 7044, Business.and Professions Code). rc CONSTRUCTION LENDING AGENCY' -" -- EBD TOTAETACKFRO REQUIRED !ARD HWVPROWIDTH - ' 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 I '- Lender's Name LDMA Ref. % ( 1 m - . LhFee$ Permil Fee ... _- P.0. - _ Le_nder's Address w - I certify.that ave read this application-arid state-that the Issuance Fee Q zJ D -TDMA P/C% aabove information is correct. I agree to comply with all County Investigation Fee A ordinances and State laws relating to building construction, Total Fee-- S/ .�L -S LDMA Perm. % - - - - • and by authorize representati es of this County to enter - m on th above-me tion prop y for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE - -SignaNre o A Ic nt orAgen L- - - Date - - - - - -- - - - - - --- - • 4 - - -'\ _ .._ _ OO �