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HomeMy Public PortalAbout9038 EMPEROR AVE_Building__ 76AGSBA DBS-2 aha APPLICATION FOR BUILDING PERMIT 1 DMSION OF BUILDING AND SAFETY ADDRESS ✓`O Deportment of County Engineer County of Los Angeles LOCALITY `- NGINEER NEAREST CASSATT O OGRI F NU NTY SUP•EOF BUILDING CROSS ST DISTRICT NO. GROUP ,HYPE SEWER MA BK PG FOR ApPPLICANT TO FILL IN CONST ADDREMAP STATE BUILDSS 7��EJ �� ��fJp�/'O/' o4yg NUM ER _ HWY YES NO LOT NO /O BLOCK USE ZONE SPECIAL TRACT 2.5'0 .5 L O JR— CONDITIONS ANO OF SIZE OF LOT /OX 14-/J I NOW ON LOTS BUILDING YARD HWY STREETINAME EXIST. SETBACK WIDTH USE OF EXISTING BLDG R6-5;25i(IGG GAS FPOL T ( p L /_'� OWNER CLA/f'E.UCE �. f�i¢�2>rEiQ SIDE r W p P L MAI L ADDRESS yQ3Q �r �/YfP /Q O TRACT DWELL. 1 UNIT _ y�T 5 INDUSTRIAL CITY SA'�/ �y.�-BieICL NO,47 ZS DWELL 1 UNIT 6 PUBLIC BLDG ARCHITECT OR TEL 2 DUPLEX I UNIT ADDN , A 7 T ETC. L ENGINEER NO 3 APT UNITS 8 MIBCEL. ADDRESS ef kz 4 COMMERCIAL TEL CONTRACTOR NO INSPECTION RECORD ADDRESS LqN .j DESCRIPtION OF WORK ADD ALTER REPAIR_ DEMOLISH_ SO FT ry•�''// NO OF �. NO OF spiv SIZE STORIES /i FAMILIES USE O SP/A� J �0 1kc ^ TRUCTURE UC- (/�C 7J X11 �cNGD /�.4Tia — cower T� �� 14 Almll r&,c-aF c.,4B SF. Res, �igR/96�.• I=XPGI��h' 7'a /`��R SIGNATURE OF `f • ,,/ APPLICAN�jT APPROVALS ADDRESS 7D%✓ C+. c� SPO, DATE INSPECTOR SSIGNAT11RE r ib ©O FOUNDATION LOCATION /f /' d P.E C $ FORMS, MATERIALS FE �� Z (){7 �� (/ FRAME FIRE STOPS. /,� �.-y� r�-���+. .�•-�� , 4 $ q 0 BRACING, BOLTSX'Y (�{,(�� VALUATION FEE i�/•/� �' FURNACE LOCATION, "--, 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS GAS VENT,DUCTS APPLICATION AND STATE THAT THE ABOVE IS CORRECT o AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH. INT. I[., AND STATE LAWS REGULATING BUILDING CONSTRUC- TION. LATH, EXT. SIGNATURE OFHOUSE NUMBER COR- PERMITTEE RECT AND ADDRESS FINAL WM.J. FOX.COUNTY ENGINEER VALIDATION C. N. DIRL.AM.CHIEF BLDG. INSPECTOR L,jC0 3 1 3 7 EYR APR 1 1 2.00 - to f �- COUNTY OF LOS ANGELES APPLICATION FOR r DEPARTMENT`OF COUNTY ENGINEER -:13IJILDING PERMIT ) BUILDING AND SAFETY yDIIVVIISION BUILDING /�?�/"�+� �gl� FOR APPLICANT TO FILL IN ADDRESS r1'j r BUILDING ADDRESS G' LOCALITY �{�/ L•�j .�(/ / CITY ZIP NEAREST A CROSS f ST /� O OF BLDGS -ASSESSOR SIZE OF LOT x NOW ON LOT MAP BOOK ' PAGE PARCEL / ' DISTRICT IGROUPITYPE __ FIRE PROCESSED BY TRACT ( C BLOCK �^ LOT NO O eo� CONST ZO E _ TEL 5 ✓_ 3%_ OWNER NO STATISTICAL CLASSIFICATION - _ SEWER MAP ADDRESS _ CZ4 CLASS NO DWELL UNITS BK PG J USE ZONE MAP 0`03 CITY ZIP NO GiC/ ARCHITECT OR �^ TEL �/ SPECIAL ENGINEER NO CONDITIONS ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑ CONTRACTOR TEL BLDG SETBACK FROM NO FRONTPROP LINEOF (STREET) LIC ADDRESS NO HIGHWAY }/% 'ARD - TOTAL SETBACK FROM EXISTING DH I TIG CITY LIC �{/ FRONT PROP e LINE HIGHWAY CLASS _ CONSTRUCTION d1lSNDER } a NAME AND BRANCH _ BLDG SETBACK FROM O ADDRESS CITY SIDEPROP LINEOF (STREET) ti SQ FT 13 NO NO OF NO OF CHECK HIGHWAY } YARD _ TOTAL SETBACK FROM TYPE OF EXISTING � SIZE NW STORIES FAMILIES ONE SIDE PROP LINE HIGHWAY WIDTH W DESCRIPTION OF WORK NEW 11 } G. N ADD CORNER CUTOFF YES ❑ NO ❑ Z ALTER ❑ - ' t / REPAIR❑ IN OPEN SPACE YES ❑ NO ❑ USE OF IN COASTAL PERMIT ZONE YES ❑ NO ❑ EXISTING BLDG f/'- (��j�,� A,�}DEMOL ❑ AP PRI NT)IL NT Lp G 414"OLiSA BY (SIGNATURE) r ,� A - - - I HEREBY ACKNOWLEDGE THAT I HAYk IWAD THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- , STRUCTIONI CERTIFY THAT IN- DOING THE 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 COMP OF �INSUNC SIGNATURE OF FINAL .�1� BY PERMITTE�E'` DATE ` ADDRESS / Q CITY NE PC Fee$ Permit Fee / Issuance Fee `� VALUATION / -11-710 Total Fee PLAN CHECK VALIDATION, CK M o CASH _ PERMIT VALIDATION CK M o CASH 2_2-7r-_ SAY 12 1 ® 2 8:5 0 ,65-8 76AS38A CE*803B 12/75 - 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 1302010013 PHONE (626) 285-0488 EXT , (LEGAL ID I NO OF CONST BUILDING ADDRESS ITR 12504 LT 10 J SQ- FT STORIES TYPE 9038 EMPEROR AV I ISTRUCTURE 2400 V-B I SGAB CA 917752040 ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET 15382-019-005 I THOMAS PAGE 596 GRID H1 LOCALITY TEMPLE CITY CAI ITENANT (EXIST BLDG USE RESID USE ZONE R-1 (ISSUED ON PROCESSED BY I (EXIST OCC GRP J02/01/13 SR OWNER TEL NO IBLDGS NOW ON LOT VALUATION IFINAL D 5FNIALY CODE JBING, BING XU (626) 644-9152- 1 2,40019038 EMPEROR AV 1 - ISGAB 917752040 I FEES PAID IDESCRIPT N OF ORKIIREPLACE NINE (9) WINDOWSME SIZE CHANGEOUT, RETROFIT I I IFEE DESCRIPTION QUANTITY DOM AMOUNT I J (APPLICANT TEL NO I I I IMAA, CHIN FOO (626) 226-6550- IAA BLDG PERMIT ISSUANCE 27 80 I I 112731 RAMONOA BL 206 JAB STATE GREEN BLDG FEE 2400 00 VAL 1 00 ISPECIAL CONDITIONS I JIRWINDALE CA 91706 JAC STRONG MOTION RESID 2400 00 VAL 0 50 I I I ID2 PERMIT W/O EN-HC 2400 00 VAL 99 00 I _J TOTAL FEES 128 30 I ICONTRACTOR TEL NO I - (APPROVALS DATE INSPECTOR SIGNATURE JIRWINDALE WINDOWS CO (626) 226-6550- I I 112731 RAMONA BLVD #206 w LIC NO I ILOCATION AND SETBACKS I IIRWINDALE, CA 91706 846482 C17 ISOILS ENGINEER APPROVAL 1 1 JARCHITECT OR ENGINEER TEL NO I IFOUNDATION/TRENCH FORMS I I I LIC NO I ISLAB/UNDER FLOOR I I I I IRAISED FLOOR FRAMING IMAP NO SEWER MAP BOOK PAGE FIRE ZONE CMF I JUNDLRFLOOR INSULATION I I I 1153H265 3 001 I 1 1 _I IFLOOR SHEATHING INO OF FAMILIES DWELLING UNITS APT/GOND STAT CLASS I I I I ' 1 0 NO 21 1 IROOF SHEATHING I SCHOOL WITHIN HAZARDOUS I ISHEAR PANELS I (AIR QUALITY 1000 FEET MATERIALS I I I NO NO NO IFRANE INSPECTION I I IFIRE SPRINKLER HANGERS I I I (INSULATION/WEATHER STRIPI I I JINTERIOR LATH/DRYWALL I I I I 1EXTERIOR LATH I I I - IRATED FLOOR/CEIL ASSEM I I IRATED WALL ASSEMBLIES I I IRATED SHAFTS/OPENINGS I I I IT-BAR CEILINGS I I I I ILOT DRAINAGE I I I IREPORT ID DPR261 ROUTE TO BS0508 I 1 I I I I I I I I WORKERS'COMPENSATION DECLARATION � hereby affirm that I have a certificate of,ons^t.to sets ; p�I CAT I O N FOR BUILDING PERMIT insure, or a certificate of Workers' Compensation Insurance, or a certMed copy thereof (Sec 3800, lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company Certified copy is hereby furnishedILDING I FOR APPLICANT TO FILL IN ADDRESS Certified copy is filed with the county building inspec- BUILDING tion department ADDRESS O LOCALITY S ` NEAREST , Date Applicant CITY ►'� ZIP CROSS STVM CERTIFICATE OF EXEMPTION FROM WORKERS' NO OF BLDGS ASSESSOR COMPENSATION INSURANCE I SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one j USE ZONE MAP I TRACT BLOCK LOT NO' NO hundred dollars ($100)or less ) c" �< 1 TEL n SPECIAL } I certify that in the performance of the work for which this l OWNER� { NO gQ CONDITIONS a IF DISTRICT GROUP TYPE FIRE PROCESSED BY • ,O permit is issued, I shall not employ any person in any manner ADDRESS CONST ZOE U so as to become subject to the Workers'Compensation Laws f" Date Applicant reN 10 1..2r ,_ Q n CITY ZIP STATISTICAL CLASSIFICATION PT ]CONDO, O TICE TO APPLICANT If, after making this Certificate of ARCHITECT OR TEL ENGINEER NO CLASS NO DWELL UNITS Exemption, you should become subject to the Workers' f a Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP Z with comply with such provisions or this permit shall be t TEL deemed revoked CONTRACTOR NO BK/V VALIDATION LICENSED CONTRACTORS DECLARATION LIC I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO VALUATION (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 Qdo ` _ SQ F NO OF"' NO OF CHECK License Number Lic Class SI STORIES FAMILIES ONE Contractor Date DESCRIPTION OF WORK NEW ❑ S I am exempt under Sec _ ADD L ALTER _ FINAL E —I �3 B&P C for this reason REPAIR [E] DATE a Date USE OF DEMOL 0 -FINAL EXISTING BLDG - By Signature APPLICANT TEL OWNER-BUILDER DECLARATION PRINT NO I hereby affirm that I am exempt from the Contractor's Licensepoll- Law for the following reason (Section 7031 5, Business and f ADDRESS 4 Professions Code) PRESENT r1 2 1. 1 A BUILDING j, as owner of the property, or my employees with ADDRESS Wo 0 0 0 0 1 wages 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 TEL 2 o 1 7 V7 5 ❑ '' C NTRACTOR NO _ s �W j, as owner of the property, am exclusively contracting `o o r 1;7 5-0 with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code) 0 5, 1 9—, 8 3 REQUIRED TOTAL SETBACK FROM EXIST CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP LINE WIDTH 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 m - PL o Lender's Name L'ender's Address PC Fee$ Permit Fee I certify that I have read this application and state that the Issuance Fee above information is correct I agree to comply with all County Investigation Fee ` ordinances and State laws relating to building construction, Total Fee / S >� and hereby authorize representatives of this County to enter _upon t above-menti ed property for inspection purposes � SEE REVERSE FOR EXPLANATORY LANGUAGE qgr�a'tu_re of A p,cant or Agent Date Os APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES " BUILDING AND SAFETY "WC_7-K.ER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS I hereby affirm that I have a certificate of consent to self Insure BUILDING ADDRESS O C�-� e"e or a certificate of Workers Compensation Incur�,-ce,00r ace stied 9,6 ? LCA copy thereof (Sep 38 b C) fM�i2 CITY I�z c P i ZIP p 7�Q 7 LOCALITY Policy No Comp SIZE OF LOT NO OF BLDGS NOW ON LOT ❑� Certified copy Is hereby furnished NEAREST CROSS ST 09 rtlfled copy is filed with the county building Inspection TRACT BLOCK LOT NO ��d e L« to Ad department —7 I� USE ZONE MAP NO Date , '/ Applicant I&IhVVLI of n 1?/J,& ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS �!L� CERTIFICATE OF EXEMPTION FROM WORKERS' OWNE TEL NO (j/ COMPENSATION INSURANCE WITHIN 1000 FT OF SCHOOLS YES No (This section need not be completed If the permit Is for one hundred AD REQSS t 6'kDISTRICT GROUP TYP CONST FIRE ZONE PROCESSED BY dollars ($100)or less) I certify that In the performance of the work for which this permit CITY ) f ZIP , Q �p Y P_3 ` is Issued, I shall not employ any person In any manner s0 as t0 ARCHITECT OR ENGINEER TEL NO Q �iJ( rA.,-W, become subject to the Workers Compensation Laws STATISTICALCLASS ICATION APT CONDO Date Applicant ADDRESS CLASS No C— DWELL UNITS NOTICE TO APPLICANT If, after making this Certificate of REOUIRED TOTAL SETBACK FROM EXIST Exemption, you should become Subject t0 the Workers CONTRACTOR TEL NO p SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith LC V 2 yL� (3O FRONT comply with such provisions or this permit shall be deemed revoked ADDRESS LIC NO PL LICENSED CONTRACTORS DECLARATION 6 SIDE CITY LIC CLASS P L I hereby affirm that I am licensed underprovisions Of Chapter 9 P e --t A SEWER MAP >_ (commencing with Section 7000)of Division 3 of the Business and SO FT SIZE NO OF STORIES NO OF FAMILIES d Professions Code,and my 7 license Is In full force and effect NEW BK . PG v License Number LIC Class DESCRIPTION OF WORK ADD ❑ Q VALUATON ® )q,/ U O ContractorALTER ❑ IT w ❑ 1 am exempt under Sec !u REPAIR [I $ °' z BBPC for this reason DEMOL ❑ LDMA P/C# Date USE OF EXISTING BLDG URM ❑ Signature APPLICANT(PRINT) TEL NO LDMA Perm# t C1.1,as owner of the property, or my employees with wages as �- > Z r- their sole compensation, will do the work and the structureO Is ADDRESS not Intended or offered for sale (Section 7044 Business and O tc!Q FINAL DATE Q Professions Code) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL ❑ 1, as owner of the property, am exclusive) contract) OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE P P Y. Y ng with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE'S FINAL BY licensed contractors to construct the project (Section 7044, 1'. r, -;; 35 Business and Professions Code) VES El NO -'I 17yL � � �, -1 WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKUST FOR GUIDELINES I hereby affirm that there Is a construction lending agency for YES❑ No❑ / 131 t�il3 °_I a the performance of the work for which this permit is Issued(Sec 3097,Civ C I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING N ) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE /� Q � �� S� TITLE 2 CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS Z Lenders Name 7_S_ p l v v[ MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD o Lenders Address��� (,TPB,i � OWNER OR AGENT cL o I certify that I have read this application and state under penalty o PC FEE PERMIT FEE of perjury that the above information is correct I agree to comply a $ with all county ordinances and State laws relating to building construction, and hereby authorize representatives of this County II SUANCE FEE a toenterupon the above-mentioned property for Inspection purposes INVESTIGATION FEE TOTAL FEE - /• 1` s'cw//ue a noyaaa w Apes,-` D. rJ SEE REVERSE FOR EXPLANATORY LANGUAGE