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Home My Public Portal About5114 DOREEN AVE_Building__ 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 9905170031 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: BK: 254 PG: 39 PC: 1 SQ. FT STORIES TYPE 5114 DOREEN AV STRUCTURE: 0 VN TEMP CA 917803438 ASSESSOR INFORMATION NUMBER: - NEAREST CROSS STREET: FREER 8585-022-044 THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: RESID USE ZONE: R-1 ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 05/17/99 UT 11/13/99 OWNER: TEL. NO: SLOGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE: WU SHIM YUAN;FRANCES Y (626) 452-0572- 1 5,000 5- 11-11 - I-I/Z(_n n � 5114 DOREEN AV 1 7 TEMP 917803438 FEES AI ESCRI TEXISTING RITT RECOVER EXISTING ROOF WITH LIGHT aIGHT PIONEER TITLE FEE DESCRIPTION: QUANTITY: UDM: AMOUNT: APPLICANT: EL. N0: C BQ —�J Q- SAME AS OWNER - AABLDG PERMIT ISSUANCE 27.75 T V AC STRONG MOTION RESID 5000.00 VAL 0.50 SPECIAL CONDITIONS: D2 PERMIT W/O EN-HC��5000.00 VAL 132.60 P�GELESTOTcAOFEEs 160.e5 CONTRACTOR: TEL. NO: �O�j U�ry APPROVALS DATE INSPECTOR SIGNATURE SAME AER LIC. NO LOCATION AND SETBACKS , SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. V0-: / FOITNDATIO TR NC FO MS LIC. N0,1� 1111111 SLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:; n n /� p /� �-+ UNDERFLOOR INSULATION 147X273 3 IOC:D.� OO II �II 9O�IKC \1 g� SEA H O. 0FAMILIES: DWELLING UN S: AP /CON-: -.- A S:- 'L� Vl/ J Ll\l\ C'll NO 21 h S SOg R FSH EATHIN C�. SCHOOL WITHIN AZA DO S \I1 42 07{ All AIR QUALITY: 1000 FEET MATERIALS HEA AN S zl NO NO NO A O 0 �'ymXp1D� FRAME INSPECTION REQUIRED OTA SETBACK XIST L• (� " ,� IR S I L NGRS SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- C Service That NSULATION/WEATHER STRIP SIDE PL- /j� rINTERIOR LATH/DRYWALL EXTERIOR LATH RATED F OO C LAS M. RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508 WORKERS' COMPENSATION DECLARATION hereby affirm that I have certificate of consent to =elf _ QPPLO Q�pON . FOO R [�Mpd�p� G PEf�MT 1110111 insure, or a certificate of Workers' Compensation Insurance, or a terrified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. 'Company - L BUILDING / �yy L ❑ • Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS- ❑ Certified copy is filed with the county building inspec- BUDDING ,�/ AVE—,� - - - - tion department. ADDRESS / �y /� f /�/ yc. Q/y ,,,r / t/ Date Applicant CITY V1 LC`/' ✓iT ZIP d l/ LOCAUTV jl]�(_, '� C(T- CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT v X -6 NO. OF BLDG CROSS NEARESST. NOW ON LOT COMPENSATION INSURANCE' ''77�� ASSESSOR (` _ •7 ` (This section need not be completed if the permit is for one TRACT/l BLOCK dJ LOT NO. MAP BOOK J PAGE a PARCEL hundred dollars ($100) or less.) OWNER G��' fr�� (/V TEL' �L USE ZONE- MAP •��. N ✓� NO. ' . certify that in the performance of the work for which this �(�/� //..�s - permit is issued, I shall not employ any person in any manner ADDRESS c /7� C- K- I SPECIAL - CONDITIONS O so as to become subject to the Workers'Compensation Laws. CITY ��' C� `�� - ZIP � G v U Date Applicant ARCHITECT O TEL 'DISTRICT GROUP TYPE ENGINEER NO. FIRE PROCESSED BY Q W " ' NOTICE TO APPLICANT: If, after making this Certificate of CONST. ZONE U Exemption, you should..become subject to the Workers' ,5`, y CompensatioProvisions of the Labor Code, you musttforth- DRESS �/ off •`_3 V With comply with such provisions or thispermit shall be _ TEL, STATISTICAL CLASSIFICATION APT. CONDO.. Z deemed revoked. - CONTRACTOR NO. LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. Z DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9-_ ADDRESS NO, SEWER MAP (commencing with Section 7000)of Division 3 of the Business • LIC' , and Professions Code,and my license is in full farce and effect. CITY CLASS BK. O. VALIDATION - SO. FT. NO. OF NO. OF CHECK License Number Lic. Class I SIZE ��0 STORIES FAMILIES ONE -. - - / �• VALUATION - Contractor Date DESCRIPTION OF WORK ./—Gp' J NEW O $ . [jI am exempt under Sec. WAC—Iftrl ADD D• - ALTER ❑ B.&P.C. for this reason REPAIR ❑ $ Date: USE OF EXISTING BLDG, J.J DEMOL APPLICANT �7— �y TEL. /� (''- Signature (PRINT) �( Gi�'G �� NO.�J -al FINAI l� G�' OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License ADDRESS CJ� CCN - - - FINAL v c Law The following reason (Section 7031.5, Business and ADD ssians Code): . . . - PRESENT ��JJ I,r� By err P P Y• ormy em ADDRESS G ��y✓�P I, as owner of the property, ' s BUILDING S//`r Pto Yeewith wages as their sale compensation,will do theworkand LOCALITY /Lf �� C�77. D - d�•U7 the structure is not intended or offered for sale(Section 7044, Business and Professions Code.) - MOVING TEL: - - - - - - ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. 1 HEN; EN With licensed contractors to construct the project (Sec- - {II,dL SQ - 00 tion 7044, Business and Professions Code.) ADDRESS REQUIRED TOTALSETBACK FROM'^ EXIST. ' -' - C_.H[{-;K ' CONSTRUCTION LENDING AGENCY SET BACK YARD Hwv PROP. LINE WIDTH '-'°�Iil I hereby affirm that there is a construction lending agency for FRONT - - i' ANC the performance'of'the work for which this permit is issued P.L. - Xlj (Sec. 3097, Civ. C.). SIDE ' P.L. - - - Lender's Name (ll It`1l:_I—F110 7/ 7/5'1 - _ L)MA R.I. P.C. Fee$ Permit Fee Lender's Address qq a I certify that I have read this application and state that the Issuance Fee �l LDv%A P/C# 0 above information is correct. I agree to comply with all County Investigation Fee - � - ordinances and State laws relating to building construction, Total Fee LDMA Perm. # a and hereby authorize representatives of this County to enter _ upon t bove-p Ientioned property fo inspection purposes. - a ppp �7q / SEE REVERSE FOR EXPLANATORY LANGUAGE ^ '' Signature of1lApplicant or Agent pate l WORKERS COMPFN%ATION DECLARATION = I hereby affirm that I have a certificate of consent to self //(]�� O O �(/� //p�� I��rylp�_FOR I�•�( �I��Ip��[/��. D app�I�y�g/�� juure, or o certificate of Workers' Compensation Insurance;' /aPPHC�Q��OO V_ OR LJU��D�'MG PLS0011 CV or d certified copy thereof(Sec. 3800, Lab. C.) - COUNTY OF LOS'ANGELES'. BUILDING AND SAFETY Policy No. Company r Certified'copy is hereby.furnished. . 'IN - '- BUILDING El FOR APPLICANT TO FILLS n ' ADDRESS ' 14 V ❑ Certified co is filed with the count building' inspec-' BUILDING PY Y P 'ADDRESS /4 j�QiQZic/ 17 vfi tion department. 'j Date Applicant CITY /�/ GE CiA/ ZIP' `/ LOCALITY PP _ NO, OF BLDGS. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT. - CRO55 ST. COMPENSATION INSURANCE n ASSESSOR (This section need.not be completed if the permit is for one TRACT 2 U BLOCK L LOT NO. MAP BOOK PAGE PARCEL hundred dollars ($100) or less.) STy r� / /(15 TEL ND(' p)s' Ad USE ZONE MAP 'F ' OWNER f L`� UV _ _ NO. ' .1 certify that in the performance of the work for which'this �l p �j /� Pemploy Y P Y 7TO S�' (fr 'ELS /v�� f SPECIAL > permit is issued, I shall not any person in an manner ADDRESS _ d so as to become subject to the Workers' Co CONDITIONS I pensation Laws. ��/ '/ �/ ^p /-- � /� CITY1C L oN &11'e) �) lt ZIP / . DateAppli 1 w ARCHITECT OR //�� // TEL. p lr� X NOTICE TO APPLICANT: If, a ter makin this Certificate of ENGINEER F✓� vv� N .O IP/� �Z DISTRICT OUP TYPE FIRE PROCESSED BV 9 CONST. V ZONE O Exemption, you should become subject to the Workers' ADDRE55 "0 v d Compensation provisions of the Labor Code, you must forth- with comply with such provisions or this permit shall be // // TELA' p y STATISTICAL CLASSIFTCgTION APT. .CONDO. deemed revoked CONTRACTOR �� /lnJLl NQ /f>S��2/.� �1 / z _ LICENSED CONTRACTORS DECLARATION i/C / LIC CLASS NO.r�/-I/—DWELL. UNITS_ I hereby affirm that I am licensed under provisions of Chopter 9 ADDRE55 'YO �' yA� ��o ALNO. LIC. SEWER MAP (commencing with Section 7000)of Division 3 of the Business �n ✓ 73 ' and Professions Code,and my license is in full force and effect. CITY/Vr �ieN �re�� CV`s BK. pG. O - VALIDATION SO. FT /q NO. OF NO. OF CHECK -- License Number Lia. Class' SIZE /V�V STORIES 2 FAMILIES ONE 7 . UON] NEW ❑ VALU PON 3307 .. -.. .• 'S•95.�5 Contractor _ Date DESCRIPTION OF WORK `- Sir D -. �y� A�.I /lt/,) - ADD I ITEMS ❑1 am exempt under Sec ❑ TOTAL r ALTER /.�,ypy,./, S� 35 B.BP.C. for this reason REPAIR ❑ $ WL//oO • Date: � USE OF //,, > - . � C�� 495.Q.� EXISTING BLD��G..�CZVPi?-1V4,7TEL./p- .Q DEEMOL ❑ _ . CHANE, .UD Signature � APPLICANT (PRINT) 7Tzrve /Ju- NOL O �0 J I--C7 FINAL OWNER-BUILDER DECLARATION � DATE. / 1 hereby affirm that I am exempt from the Contractor's License gDDRE55�� S. �A� � AVG ' inn_nnn 0 Law for the following reason (Section 7031.5, Business and FINAL ,?r J&^ t ,Gcrw.r-0001 flu/ 9/v9 Professions Code): _ _ PRESENT - - - By-� ��GG BUILDING �SOIU I Pf ppL 11.2'11 ❑ I, as owner of the property; or my employees with ADDRESS wages as their sole compensation,will.do the work and , the structure is not intended or offered for sale(Section LOCALITY D \t.t + 7044, Business and Professions Code.) MOVING TEL. HA T ❑ I, as owner of the property, CONTRACTOR NO. „07 1,am exclusively contracting r ��• �., +1 7 with licensed contractors to construct the project (Sec- ADDRESS { Ijci? tion 7044, Business and Professions Code.) REQUIRED TOTAL SETBACK FROM EXIST.. - - CONSTRUCTION LENDING AGENCY 'SET BACK YARD HW PROP.PROP. LINE WIDTH � � TOTAL 1 1 e 47 1 hereby affirm that there is a construction lending agency for FRONT - -i the performance of the work for which this permit is issued P.I. - - Ci tCK 11.42 (Sea. 3097, Civ. C.). SIDE f.J n —' r. ,a> t . P.L. - 1_J ,., .. = rn':.I =t :t� , NAND Lender's Nameq P.C. Fee$ r�� Permit Fee Lender's Address 110010—i 11 flj 1 • 8/ L:f'TQ a I certify that I have read this application and state that the17E Issuance Fee '''�--� v LD P �, -, above information is correct. I agree to comply with all County Investigation_Fee _ c' _Ar • S_ 6 ordinances and State laws relating to building construction, Total Fee / LD Perm. q mand hereby authorize representatives of this County to enter s Is upon// ave- ntioned property for spectlon purpo es. �� 3 1 ) �12�OrJfOIO . 1 T (/ SEE REVERSE FOR EXPIANATORV IANGUA6E _ 11 n S9�T,�i µ �7 SII NI �/� Signoture�t Applicant or Agent Date f+t '=' O '1 •_q