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HomeMy Public PortalAbout4515 ELLIS LN_Building__ 'r ©s 76A638A ` CE,#803(REV.11/78) p p � APPLICATION FOR BUILDING PERMIT .3 f--,d,-i!' COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN ADDRESS a-�--Q BUILDING c ADDRESS _ .,? LOCALITY NEAREST CITY ZIP CROSS ST. NO.OF BLD S. ASSESSOR SIZE OF LOT-7 LTJ NOW ON LOT MAP BOOK PAGE PARCEL pp DISTRICT .GROUP TYPE FIRE JO SSED BY TRACT Z G� BLOCK LOT O a ' O CONST. ZONE OWNER NO STAIISTICALCLASS IFICAT ION C SEWER MAP „� pp ADDRESS -- -- �L�_ _ /� -_- _ _, __ CLASS NO. DWELL UNITS_ BK PG ; -7749 CITY ZIP ARCHITECT TEL. I/ [VALUATION $ ENGINEERNO. ADDRESS BLDG.SETBACK FROM TEL FRONT PROP.LINE OF. F (STREET) CONTRACTOR 1 NO. �I HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING . LIC. FRONT PROP.LINE HIGHWAY WIDTH ADDRESS 1i NO� + LIC. L �j CITY CLAS BLDG.SETBACK FROM CONSTRUCTION LENDER _ SIDE PROP.LINE OF (STREET( NAME AND BRANCH HIGHWAY + YARD = TOTAL SETBACK FROM TYPE EXISTING ADDRESS CITY SIDE PROP.LINE HIGHWAY WIDTH , V SO.FT. NO.OF NO.OF' CHECK +_ = SIZEI!58-7-1 STORIES' 4— FAMILIES ONE- 0 USE ZONE MAP ��,�� DESCRIPTION OF WORK - NEW � NO. ri.sLSPECIAL W �j � ! 1� / ADD ❑ CONDITIONS 9 ALTER ❑ BY' j 2 FINAL REPAIR 1:1 -H( - ``I�- 13 USE OF `` /� " EXISTING BLD(,a y Y✓�� DEMOL ❑ P� �' � O 2 0 0 (( APPLICANT i TEL PRINT) NO NO. �' �� fu)U BY(SIGNATURE) {r I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE / ry 0 � V THAT THE ABOVE IS CORRECT AND AGREE,TO COMPLY WITH ALL ORDINANCES r Iil AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE V - WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF,THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM-. %L✓/j //�� '�z _ PENSATION INSURANCE.' - .. C� � J %-A d SIGNATURE OF n c o PERMITTEE ADDRESS1� � g Z ° { 0,�/+ CaJ l>Tl�l+.-1L TEL. /Y 'IBJ CITY - NO.. 1 � 0 ; P.C. Fee$ 3 o Permit Feer > �Cfi4� Issuance Fee W d' Total Fee?19,, 1;1 `-a CE#803(REV.1 1/78) (/ APPLPIL ATPON FOR BUILLe,®PNIG PERMPT !llSSS COUNTY OF LOS ANGELES BUILDING AND SAFETY 0*.Ih , FOR APPLICANT TO FILL IN ADDRESS BUILDING ADDRESSeg ,e LOCALITY roc c NEAREST CITY ZIP !71 CROSS ST. d?'�iV NO.OF BLDG ASSESSOR. SIZE OF LOT• of NOW ON LOT ® MAP BOOK PAGE PARC DISTRICT 'GROUP TYPE FIRE R E SEDBY � TRACT BLOCK LOT N �� 7 CONST- ZONE yA� Q TEL. ,A+• ,�J,0O �3 OWNER. C 17•'6 -,Q NO. STATISTICAL CLASSIFICATION �! SEWER MAP ADDRESS DWELL.UNITSpp ,. CLASS NO. 1/��BK !J'7PG_ CITY _ ZIP n_ ARCHITECT OR TEL [ VALUATION ENGINEER • NO. ADDRESS BLDG.SETBACK FROM TEL !r FRONT PROP.LINE OF (STREET) CONTRALTO ND. _ TOTAL SETBACK FROM TYPE OF EXISTING . LIC. HIGHWAY + YARD - FRONT PROP.LINE HIGHWAY WIDTH ADDRESS �� NO AQ / CITY LIC.CLAO + C `S Q CONSTRUCTION LENDER BLDG.SETBACK FROM SIDE PROP.LINE OF (STREET) NAME AND BRANCH HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING ADDRESS CITY SIDE PROP.LINE HIGHWAY WIDTH, d SO.FT ..��1J NO OF NO.OF CHECK + of _ SIZE G�T9 Z STORIES FAMILIES ONE USE ZONE MAP n �' :® DESCRIPTION OF WORK NEW NO. o� 4 SPECIAL ADD ❑ CONDITIONS w ALTER ❑ FINAL j BY REPAIR ❑ DATE USE OF DEMOL ❑ EXISTING BLD / - Z APPLICANT TEL, 2 z 5,O 3,2 A IPRINTI NO97 a.L3 a o # o o o o 2 3 BY(SIGNATURE( ' y 2 0 0,4 O O 1 HEREBY ACKNOWLEDGE HAT 1'HAVE READ THIS APPLICATION AND STATE ' THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES _ Rp AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE ~�a^ S ,o C C 4'U Q 0'.x WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF V THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM- Z PENSATION INSURANCE." g Oa 2 9-8.1 SIGNATURE OF - :25 0 3 A PERMITTEE ADDRESS !��!l l' Iz # 0 0.0 0 0 1 TEL. 2 ' clrY — 1 N . 2 a 2 97 2 2 5 0 J -.,- 97225',x,.,- 2 P.C. Fee$ ,a O Permit Fee > 9 7 2.2 Jr 04.29-81 0,6)-i)� � Issuance Fee W Total Fe Y7 CE#803(REV.11/78) COUNTY OF LOS.ANGELES BUILDING ARID SAFETY /j�� 3 BUILDING FOR APPLICANT TO FILL IN ADDRESS BUILDING ADDRES4,,4tELOCALITY ' NEAREST CITYZIP (/ CROSS ST. Q61J q NO.OF BLD ASSESSOR SIZE OF LOT �/ NOW ON LOT MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIREWOED BY TRACT "� ,F BLOCK 1 LTEL �y� `0 i� CONST ZONE OWNER s.. NO J 3 mob' STATISTICAL CLASSIFICATION SEWER MAP ADDRESS CLASS NCId6p-DWEl-l-.LJNlTS====Jr/,6BK/3PG ZIP ARCHITECT OR t TEL VALUATION $ f Com? ENGINEER NO. ADDRESS BLDG.SETBACK FROM TELFRONT PROP.LINE OF (STREET) CONTRACTOR NO. HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING LIC. i FRONT PROP,LINE TYPE WAY WIDTH' ADDRESS LIC. ,+ - �(f CITY CLAS BLDG.SETBACK FROM CONSTRUCTION LENDER SIDE PROP.LINE OF (STREET) NAME AND BRANCH HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING t. ADDRESS CITY SIDE PROP.LINE HIGHWAY WIDTH. 0 SO.FT. NO OF r IN OF CHECK + _ SIZE - ' STORIES 1 FAMILIES ONE 0 USE ZONE MAP <<� DESCRIPTION OF WORK .NEW SPEUAL ADD ❑ le / CONDITIONS ALTER ❑ FINAL / �.� p/ BY / Z REPAIR DATE USE OF ❑ EXISTING BLDG�d y DEMOL. g APPLICANT ..e+ , TEL (' O 0 (PRINTJ��, ,. q NO-19j 7`Ll .� a 5.0 2 4A BY(SIGNATURE) '' S, ti, ? �3, d Q # i o 1 (HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE C 2o;1 2 O O THAT THE ABOVE IS CORRECT AND HAVE TO COMPLY WITH,ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE ( r a VVV 1 O O U WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF V O,o.' THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING.TO WORKMEN'S COM Z ' PENSATION INSURANCE.' 0429~-81 SIGNATURE OF PERMITTEE ADDRESS Q- z TEL E7 pf` CITY A Q D " J P.C. Fee$ 3 Permit Fee a Issuance Fee W IL Total Fee � WORKERSCOMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self n r_(0101O� IDI U�L D�MG P E R nn insure, or,o certificate of Workers'Compenstion Insurance, or L/�LI /l�1 LI�e1 LJ LI\1LIllLI .certified co y thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND S14F TY Cj bo. % �l3y An. Co. At. RkEfelcA Policy No. Company ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS ® Certified copy is.filed with`the county, building inspec- BUILDING ' tion department. ADDRESS •'y50`l-1 EL(-%S �AK)E. LOCALITY tt R. I�c fl!Z ll° Irt" NEAREST Date I' I�_�1. Applicant V r CITY - j GM��t y ZIP CROSS ST. :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 S USE ZONE MAP, of r7 hundred dollars,($100)or less.) TRACT 3 7 ( BLOCK LOT NO. NO: l ( TEL. SPECIAL C I certify that in the performance of the work for which this OWNER %T. H r 11EDk%Ce Co NO. Z 7'1-917-1 CONDITIONS O DISTRICT GROUP TYPE FIRE PRO ESSED BY' O permit Is,issued, I,shall hot employ any person in any manner / '� ADDRESS. X00 S. 5�4� CsAB�Fh C 81 UD CONST. ZONE so as to.become'subject to the Workers'Compensation Laws. r�. a r/ Q O CITY .SJ41�I lsRBRIl L ZIP II 17Ib a A IF —Date - Applicant. _._ T STATISTICAL CLASSIFICATION APT. CONDO. (� ARCHITECT OR-, - TEL - -. NOTICE TO APPLICANT: If, after making this Certificate of - �` —` ENGINEER NO. Exemption, you should 'become subject to the'.Workers' CLASS NO. DWELL. UNITS N Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP with comply. with such provisions or this permit shall be /� deemed revoked. ,. NEDQICh TEL. -nm l VALIDATION CONTRACTOR NO.ZFS'I 7 i I BK. PG, LICENSED CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 90C 5A O I&A BR I I.- NO,1_ qb'I m VALUATION (commencing with Section 7000)of Division 3 of the Business and ����I -L LIC. Q �' O�O Prdfessi'ons Code, and my license is in full force and effect. CITY 54A) CLASS LJ $ ` SQ. FT. INC. OF JNO. OF CHECK License Number. �O qLI-7 Lic.Class r SIZE (opo STORIES/ FAMILIErS� ONE H - Contractor' r . '`Te1I>P-1 e-IC Date J'- 1 1 -�1 DESCRIPTION OF,WORK GAP,0115N WAC L, NEW a $ ❑ d ,3 - ADD ❑ I am exempt from the licensing requirements as I m a l licensed architect or a registered.professional engineer ALTER ❑ FINAL �, � acting- in my professional capacity (Section 7051, ❑ DATE REPAIR Business and Professions Code).. USE OF FINAL- EXISTING BLDG. DEMOL EJLic.or Reg. No. Date APPLICANT TEL. By 2 3 7-8 / A\ OWNER--BUILDER DECLARATION (PRINT) NO. I hereby affirm that I am exempt from the Contractor's License #'O o:° o 2 3 Law for the following reason (Section 7031.5, Business and ADDRESS Professions Code): PRESENT 2 0 °93,60 ❑ $UILDING I, as owner of the•property, or my employees with 'ADDRESS '0 °'0 9 '6'0 c=i wages as their sole compensation,will do the work and the structure'is not intended or offered for sale-(Section LOCALITY O +�, 9-8 7044,'Business and Professions Code). MOVING, TEL. ❑ I, as owner of the-property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS z 3 7 a 8 A tion 7044,.Business and Professions Code). REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY. PROP. LINE WIDTH # 0 0 0'0-0 I hereby affirm that there is a construction lending agency for FRONT the performance'of the work for which this permit is issued P.L. 2 0 1 21 O 0 (Sec. 3097,Civ. C.). .. SIDE Lender's Nome P L o o 1 2'4;0 0 5) Lender's Address P.C. Fee$ , PermitFee 5 1 certify that I have read this application and state that theIssuance Fee above information is correct. I agree to comply with all County Investigation Fee. 0 ordinances and State laws relating to building construction, Total Fee w and hereby authorize representatives of this County to enter. < upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE ^ - Signature of Applicant or Agent Dote _ is 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 1212030086 PHONE: (626) 285-0488 EXT: ILEGAL ID: NO. OF CONST I BUILDING ADDRESS: I ITR: 37582 UN: 13 - -1 SQ. FT STORIES TYPE - ( 4515 ELLIS IN 1 2 3 I I (STRUCTURE: 1150 V-B I TEMP CA 917804249 1 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: LOWER AZUSA 1 18592-001-059 I - THOMAS PAGE: 597 GRID: A5 LOCALITY: TEMPLE CITY CAI I I I I (TENANT: (EXIST BLDG USE: DETAC USE ZONE: R-3. (ISSUED ON: PROCESSED BY: 1 (EXIST OCC GRP: 112/03/12 SR 1 I I I I 10WNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: IFINAL DATE FINAL BY: CODE: IFARBER, ROB (626) 462-8168 1 3,500 I _ 14503 ELLIS IN - 1 I I�` - ITEMPLE CITY CA 91780 - FEES PAID IDESCRIYTION OF WORK I I I IFLAT ROOF OVER DETACHED GARAGE TEAR OFF AND REROOF 1 I IFEE DESCRIPTION: - QUANTITY: UOM: AMOUNT: ( I (APPLICANT: TEL. NO: I I I ICHANG, BRYAN (562) 307-6532- IAA BLDG PERMIT ISSUANCE 27.80 I 119042 SAN JOSE AVE IAB STATE GREEN BLDG FEE 3500.00 VAL 1.00 ISPECIAL CONDITIONS: I ROWLAND HEIGHTS CA IAC STRONG MOTION RESID 3500.00 VAL 0.50 I I ID2 PERMIT W/O EN-HC 3500.00 VAL 115.80 I I TOTAL FEES 145.10 I CONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE I IGOLDEN WEST ROOFING SERVICES INC (562) 307-6532- 1 119042 SAN JOSE AVE LIC. NO 1 ILOCAT-ION AND SETBACKS I I IROWLAND HEIGHTS CA 91748 933907 1 I 1 ISOILS ENGINEER APPROVAL I 1ARCHITECT OR ENGINEER: TEL. NO: IFOUNDATION/TRENCH FORMS I I LIC. NO: 1 ISLAB/UNDER FLOOR I I I I I - I I I I I IRAISED FLOOR FRAMING I I 1I MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( JUNDERFLOOR INSULATION I I144H269 3 001 I -1-1 I - .-I IFLOORISHEATHING I I I INO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: ( I 0 NO 21 I IROOF SHEATHING I SCHOOL WITHIN HAZARDOUS ISHEAR PANELS (AIR QUALITY: 1000 FEET MATERIALS I - I NO NO NO I IFRAME INSPECTION I I I IFIRE SPRINKLER HANGERS I I I INSULATION/WEATHER STRIPI I I I I I (INTERIOR LATH/DRYWALL I I I 1 I (EXTERIOR LATH I I I I I I I I I IRATED� FLOOR/CELL ASSEM. I (RATED)WALL ASSEMBLIES I I I I I IRATED'. 9HAFTS/OPENINGS I I I I I I I I IT-BAR CEILINGS I I I I I* ADDITIONAL DATA ON FILE ILOT DRAINAGE I I I I I I I I I ' REPORT ID: DPR261 ROUTE TO: BS0508' I I I I 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 1212030087 PHONE: (626) 285-0488 EXT: ILEGAL ID: NO. OF CONST I BUILDING ADDRESS: 1 ITR: 37582 UN: 13 I SQ. FT STORIES TYPE - 1 4515 ELLIS LN 4 5 6 I I (STRUCTURE: 1150 V-B I TEMP CA 917804249 (ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: LOWER AZUSA 1 18592-001-059 THOMAS PAGE: 597 GRID: A5 LOCALITY: TEMPLE CITY CAI (TENANT: - (EXIST BLDG USE: DETAC USE ZONE: R-3 (ISSUED ON: PROCESSED BY: 1 '(EXIST OCC GRP: 112/03/12 SR 1 (OWNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: IFINAL DATE FINAL BY: CODE: 1 IFARBER, ROB (626) 462-8168- 1 - 3,500 I I 14503 ELLIS LN 1 Ili I ITEMPLE CITY CA 91780 FEES PAID IDESCRIP ION OF WORK li1 I - IFLAT ROOF OVER DETACHED GARAGE TEAR OFF AND REROOF I I ;FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 (APPLICANT: TEL. NO: I - I I ICHANG, BRYAN (562) 307-6532- IAA BLDG PERMIT ISSUANCE 27.80 1 1 119042 SAN JOSE AVE IAB STATE GREEN BLDG FEE 3500.00 VAL 1.00 (SPECIAL CONDITIONS: IROWLAND HEIGHTS CA 1AC STRONG MOTION RESID 3500.00 VAL 0.50 1 1D2 PERMIT W/O EN-HC 3500.00 VAL 115.80 1 TOTAL FEES 145.10 (CONTRACTOR: TEL. NO: j (APPROVALS - DATE INSPECTOR SIGNATURE IGOLDEN WEST ROOFING SERVICES INC (562) 307-6532- 1 _ 119042 SAN JOSE AVE LIC. NO ILOCATION AND SETBACKS" IROWLAND HEIGHTS CA 91748 933907 1 I I I ISOILS ENGINEER APPROVAL 1 I 1ARCHITECT OR ENGINEER: TEL. NO: 1 (FOUNDATION/TRENCH FORMS I 1 i I LIC. NO: 1 - , (SLAB/UNDER FLOOR 1 I 1 - (RAISED FLOOR FRAMING I I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP; ( (UNDERFLOOR INSULATION I II 1144H269 3 0 - I �.I IFLOOR SHEATHING I I INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS:, ( I -- 0 NO 21 (ROOF SHEATHING SCHOOL WITHIN HAZARDOUS ! I (SHEAR PANELS I \ I (AIR QUALITY: 1000 FEET MATERIALS : I I I I NO NO NO IFRAMR,INSPECTION I I (FIRE SPRINKLER HANGERS I I I 1 1 (INSULATION/WEATHER STRIP( 1 (INTERIOR LATH/DRYWALL I I I 1EXTERIOR LATH I I I I IRATED FLOOR/CEIL ASSEM. I I I I I IRATED WALL ASSEMBLIES I I I I I (RATED SHAFTS/OPENINGS I I I 1 1 IT-BAR CEILINGS I I 1* ADDITIONAL DATA ON FILE I I I I I i ILOT DRAINAGE I I I IREPORT ID: DPR261 ROUTE TO: BS0508 I I I