HomeMy Public PortalAbout5127 DOREEN AVE_Building__ COUNTY OF LOS ANGELES TEMPLE CITY k 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 OL 0508 0207260044
PHONE: (626) 285-0488 EXT:
LEGAL ID: NO. OF CONST BUILDTNG ADDRESS:
TR: 11290 LT: 19 SQ. FT STORIES TYPE 5127 DOREEN AV
STRUCTURE: VN TEMP CA 917803439
ASSESSOR INFORMATION U BER: NEAREST CROSS STREET: FREER
8585-023-033 THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY
TENANT: S LDG USE: RESID USE ZONE: R-I ISSUED N: PROCESSED EXPIRES Ok.
EXIST OCC GRP: 07/26/02 JK 01/22/03
OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: "I ATE FINAL BY: CODE:
GUZMAN RICHARD (626) 442-2099- 4,000
5127 DOREEN AV ( 2
TEMP 917803439 FEES PAID I IIUN 0 ( K -
D -
V0 WINDOWS, STUCCO OVER EXISTING SIDING
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:
APPLICANT: TEL. 0:
SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75
AC STRONG MOTION RESID 4000.00 VAL 0.50 S P-E—C I-A-L-CON DI T ION S:
D2 PERMIT W/0 EN-HC� 4000.00 VAL 115.80
>`--""-- - TOTAL<F.EES 144.05
CONTRACTOR: TEL. N0: ��� '0�3L Cc
u�
SAME AS OWNER APPROVALS DATE INSPECTOR IGNATURE
CIL. NO �' �✓ LOCATION AND SETBACKS
SOILS ENGINEER APPROVAL
P/ 41
ARCHITECT OR ENGINEER: TEL.Nb: �, yi�
/ �\ \\. FOUNDATION/TRENCH FOR
N /
LIC. NOS- \ ,��, SLAB/UNDER FLOOR
RNIS_D FL R FRAM NG
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CI1P: .� UNDERFLOOR INSULATION
X 3 01.
�'.
N0. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: FL2HEA HINT
NO 21 / ROOF SHEATHING
SCHOOL WITHIN HAZARDOUS . t�� SHEA' PANELS
AIR QUALITY: 1000 FEET MATERIALS
NO NO NO �� �.1� FRAME INSPECTION
OU -TOTAL SETBACK FROM EXIST SPRINKLER HANGERS f _
SET BACK YARD: HWY: PROP LINE: WIDTH:
FRONT PL-
INSULATION/WEATHER STR P
SIDE PL- 71/IC-
INTERIOR LATH/DRYWALL
EXTERIOR LATH
R FL 0 /CEIL ASSEM.
RATED WALL ASSEMBLIES
RATED SHA /OP NINGS
T-BAR CEILINGS
OT DRAINAGE
REPORT ID: DPR261 ROUTE TO: BS0508
890413SF�VORKERS' COMPENSATION DECLARATION r� /,a /� p p FOR
^p p p �Ip�Ip�((/�� gyp}I��y��Tryy/L��
hereby affirm that I have r certificate ns tion Int to self /p� PIy�OIL /O\ 711O111UI IP®I�`P' I:•All 111111 DEII V V PIERM97
insure, or a certificate of Workers' Compensation Insurance, (rll Il V• //tel fill 11 D V 0 UYl LLLYYY///l�/11 LS
or a certified copy thereof (Sec. 3800, Lob. C.) - - COUNTY OF LOS ANGELES'" BUILDING AND SAFETY " -
Policy NVf1NM_J46Company' $6aV07Ing _
FOR APPLICANT TO FILL IN BUILDING
El Ceritfied copy is hereby.furnished. ADDRESS
� ' .Certified copy is filed with the county building inspec- BUILDING 5127 N. .Doreen Ave. '
tion department. � ADDRESS -
. - 61TYTemple -City. Zia - LOCALITY L
Date71T/QOApplicantVi rainRnnf. Cn-
NO. OF BLD NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT
CROSS 5T.
COMPENSATION 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.) TEL' USE ZONE�, MAP
11 OWNER ' Fran 'Gill Zman. NO.
I certify that in the performance of the work for which this _ _ SOMAL _ }
permit is issued, I'shall not employ any person in any manner ADDRESS jQ - CONDITIONS 0,
so as to become subject to the Workers'Compensation Laws. - • , 0
CITYQIP - -
Date - Applicant ARCHITECT OR TEL. - DISTRICT C, TYPE 7� ' FIRE CESSED BY
NOTICE TO APPLICANT: If, 'after making this Certificate of ENGINEER - NO: - (t r/ O� CONS RO
Exemption, you should become subject to the Workers' _ U 1VL 11\/ '-•—(Y/ wr
Compensation provisions of the Labor Code, you must forth- ADDRESS Il
with comply with such 'provisions or this permit shall beTEL. STATISTICAL CLASSI C TION APT. CONDO.
deemed revoked. CONTRACTORVlrgin ROOF Co. No. 287-0507 Z -
LICENSED,CONTRACTORS DECLARATION LIC. CLASS NO. DWELL UNITS
I hereby affirm that I am licensed under provisions.of Chopter9 ADDRESS POBOX J NO, 160650 SEWER MAP
-(commencing with Section 7000)of Division 3 of the Business LIC. ,
and Professions Code,and my license is in full force and effect. CITU CLASS BK VALIDATION
SO. FT. - NO. OF NO. OF CHECK
License Number - -
160650 C39 ' SIZE 1700 STORIES 1 - FAMILIES ONE
'
- Lic. Class VALUATION .,
Virgin Roof Co 6/30/91 DESCRIPTIONoFw6RK Tear. off 2 layers NEW ❑ 4000.00
_ Contractor Date $ - '
❑
of 'existing roof &-reroof hous' ADP" ❑ D am exempt under Sec. ❑ _
' attached garage Wl 855.. ALTER - -
B$P.C. for this reasonshngl:es REPAIR ❑ f - _
.Date: EXISTING BLDG. d ellin DEMOL ❑
APPLICANT TEL.
Signature (PRINT). NO. FINAL -
OWNER-BUILDER DECLARATION - .— - DATE. .._
• I hereby affirm that I am exempt from the'Contractor's License - 'ADDRESS PO' BOX J; `San Gabriel. CA 9177, 1 -
Law for the following reason,(Section 7031.5,'BusinessandFINAL' j T
Professions Code): PRESENT - - - --By ' V1 (' fel{ I .i -
BUILDING
❑ I, as owner of the property, Or my employees with ADDRESS - 11f� /�` ^I' 7 _-• pyt.r�� ,
wages as their,sole compensation,will do the work and LOCALITY _ - "'- D, WNft�Ql9 _
the structure is not intended or offered for sale(Section j IW� l� V4 rfi/f�CJD 1 ITEMS _
7044, MOVING - TEL. - -
Business and Professions Code:) '
❑ 1, as owner of the property, am exclusively contracting CONTRACTOR - NO. TOTAL 68 . 63
with licensed contractors to construct the project•.(Sec- ADDRESS - '- G F'
tion 7044, Business and Professions Code.) � '
REOUI RED - ygRD HWV• TOTAL SETBACK FROM "EXIST. _ - '- X00 s
CONSTRUCTION LENDING AGENCY _ SET BACK PROP. LINE WID H' GHAtE Vit,:
I hereby affirm that there is a construction lending agency for FRONT
the performance of the work for which this permitisissuedP.L.
(Sec. 3097, Civ. C.). SIDE IJuIJO—IJ�01 11/21/9
.. P.L. _
Lender's Name . . -" 6951 1 .F'M 3'07
P.C. Fee$ Permit Fee
58. 13 LDMA Ref. N
Lender's Address
O I"certify that I have read this application and state that the Issuance Feel O.50' LDMA P/C tl D -
8 _ above information is correct. I agree to comply with all County Investigation Fee
R ordinances and State laws relating to building construction, Total Fee• LDMA Perm. If
^ and her by authorize represe rive Qfi .County to enter _
upon Q6ove-mentioged pr p rt I r i ection purposes.
7 11/15/89 SEE REVERSE FOR EXPLANATORY LANGUAGE
�ignaN( of Applicant or Agent Date