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HomeMy Public PortalAbout9117 EMPEROR AVE_Building__ CE#gO:,WREV.6/78) V .!l/ / 126 r G t APPLICATION FOR. BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN ADDRESS ADIDRESS 'FM 1� Q LOCALITY 7/`4 � NEAREST CITY ZIP CROSS ST. NO.OF BLDGS. ASSESSOR SIZE OF LOT NOW ON LOT . MAP BOOK PAGE PARCEL t''P6 NT (iF L, DISTRICT GROUP TYPE FIRE OCESSE TRACT BLOCK LOT NO. . CO ,yp TEL. Jv ��5/C�/ OWNER �G�C �. NO.dg '� .3 ! STATISTICAL CLASSIFICATION SEWER MAP ADDRESS ►r I CLASSNO. - DWELL.UNITS BK PG CITY ZIP ARCHITECT OR t TEL. VALUATION $ENGINEER } c U S NO. -IMI I ADDRESS / yS Y - jC BLDG.SETBACK FROM TEL. FRONT PROP.LINE OF (STREET) CONTRACTOR S l-f- NO. TOTAL SETBACK FROM TYPE OF EXISTING C. HIGHWAY + YARD . = FRONT PROP.LINE HIGHWAY WIDTH ADDRESS Iq O 7 CITY S `/9 CLASS `= BLDG.SETBACK FROM CONSTRUCTION LENDER NAME AND BRANCH SIDE PROP.LINE OF (STREET( HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING ADDRESS CITY SIDE PROP.LINE HIGHWAY WIDTH O SO.FT. NO.OF NO.OF CHECK + = V SIZE STORIES FAMILIES ONE /7i 0 / ✓ Permit Fee 7 7 DESCRIPTION OF WORK � L GV� NEW ❑ P.C. Fee$ !/! lvl� ADD 77�✓'(: At64 Issuance Fee inin ALTER ❑ Z (� T REPAIR ❑ Total Feed USE OF DEMOL ❑ TIIOV f,� -j l�'� EXISTING BLDG. / a Z APPLICANT /Q d 3 O ZV C, O (PRINT) Q �L N 5 t Q r 7.01..9A BY(SIGNATURE) Q YHEREBY ACK OWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE Pt o c c o 2 1 THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES W AND LAWS REGULATG BUILDING CONSTRUCTION.I CERTIFY THAT I ,DOING THE = L o ° 1 5, 1 2 WORK AUTHORIZED EREBY WILL NOT EMPLOY ANY PERSONJN VIOLATION OF V THE LABOR CODE OF THE TATE OF CALIF RNIC R IN O 'MEN'S COM z PENSATION INSURA CE g IC. u C I F i d J SIGNATURE O . 0.02--79 PERMITTEE �N ADDRESS — J ` r Z O 1'E A ���•777 TEL. 2 '}? o u c- a o l CITY Q UONE MAP J N C� / SPECIAL > o CONDITIONS 09 FINAL BY 31 DATE fD 3Ce� Z� ©S 7eA6;38A .9. CE#393(REV.6/78) APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN BUILDING ADDRESS BUILDING' I \mak Z LOCALITY ''s� GI 11JJ�� ADDRESS NEAREST CITY �� Cj. '- ZIP CROSS ST. QA n A E NO.OF BLDGS. ASSESSOR SIZE OF LOT ! . NOW ON LOT MAP BOOK PAGE I PARCEL DISTRICT GROUP TYPE FIRE SSED B TRACT/ V BLOCK LOT NOS . 6 CONST. ZONE TEL 0 Q _ OWNER �- �]�.J NO. STATISTICAL CLASSIFICATION SEWER MAP ADDRESS nn ��'121�� CLASS NO. DWELL.UNITS BK PG CITY J l�\ �1ZIP _ ARCHITECT OR TEL. VALUATION ENGINEER NO. � ?l� 9 �C�UrdC� ADDRESS BLDG.SETBACK FROM TEL. r41� FRONT PROP.LINE OF (STREET) CONTRACTO " ( (. �T �w HIGHWAY + YARD _ TOTAL SETBACK FROM TYPE OF EXISTING (�/ �Y� LIC J� FRONT PROP.LINE HIGHWAY WIDTH ADDRESS le NO. OC I LIC. + CITYTRogc—, CLASS BLDG.SETBACK FROM CONSTRUCTION LENDER SIDE PROP.LINE OF (STREET) NAME AND BRANCH HIGHWAY + -YARD = TOTAL SETBACK FROM TYPE OF EXISTING � ADDRESS CITY SIDE PROP.LINE HIGHWAY WIDTH SO.FT. NO.OF NO.OF CHECK + = M SIZE STORIES FAMILIES ONE DESCRIPTION OF WORK NEW ❑ P.C. Fee$." Permit Fee N9 ADD ❑ Issuance Fee' 00, ALTER g REPAIR ❑ Total Fee , o USEOF (7E-�`bLM DEMOL ElEXISTING BLDG.K-r+ l�, 1 TT ZO APPLICANT T (PRINT BY(SIGNATURE) VeL—Q n P, > IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION A STATE Y THAT THE ABOVE 15 CORRECT AND GREE TO'COMPLY WITH ALL RDI NCES' tVu AND LAWS REGULATING B G STRUCTION.I CE T AT DOI G THE V WORK AUTHORIZED HERE LL N T EMPLOY ANY ERS IN IOLATI NOF THE LABOR CODE OF THE TATE ALI RNIA IN AT NGT O MEN'S OM Z p PENSATION INSURANCE. z g ,6,1 54 A CL. # 0,0;0 o(o SIGNATURE OF : PERMITTEE ADDRESS E Ol trf✓I17 � 2- 1 0600 C �o,0 1 Q Q CITY USE ZONE MAP Q R 1 `5'-7 9 > SPECIAL CONDITIONS FINAL BY � DATE 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 1202270079 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS:9117 EMPEROR AV ITR: 11990 LT: 6 BL: .001 SQ. FT STORIES TYPE I _(STRUCTURE: 850 V-B 1 1 I SGAB CA 917752018 1 ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: OAK 15382-012-026 I THOMAS PAGE: 596 GRID: Hl LOCALITY: TEMPLE CITY, Cl (TENANT: (EXIST BLDG USE: RESID USE ZONE: R-1 I1 (ISSUED ON: PROCESSED BY: 1 1 (EXIST OCC GRP: 102/27/12 SR 1 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: IFIN_AL_aATE FI///IIAT,,BY: CODE: IHSU (626) 449-3227- 2,400 1 3� j I Z 19117 EMPEROR AV I L ISGAB 917752018 I FEES PAID IDESCRIPTION OF WORK I IBACK SIDE OF HOUSE ONLY (850 SQ.FT.) OLD ROOF INSTALL 20 YR I _(FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ICOMP SHINGLE TO MATCH EXISTING 1 (APPLICANT: TEL. NO: I I (ALFRED LAU (626) 622-8108- IAA BLDG PERMIT ISSUANCE 27.80 I I IAB STATE GREEN BLDG FEE 2400.00 VAL 1.00 ISPECIAL CONDITIONS: 1 IAC STRONG MOTION RESID 2400.00 VAL 0.50 1 ID2 PERMIT W/O EN-HC 2400.00 VAL 99.00 - - IFR INV WORK W/O PERMIT 257.00 DOL 257.00 1 s [alis\� 1CONTRACTOR: TEL. NO: I TOTAL FEES 385.30 (APPROVALS' f ()DATE INSPECTOR SIGNATURE 1 IGOLDEN KEY INC. (626) 285-9016- 1 1 14533 SHIRLEY AVE LIC. NO ILOCATION AND SETBACKS I I IEL MONTE, CA 91731 775115C39 1 1 S0ILS ENGINEER APPROVAL (ARCHITECT OR ENGINEER: TEL. NO: 1 (FOUNDATION/TRENCH FORMS _ LIC. NO: I SLAB/UNDER FLOOR 1 1 I I I I 1 IRAISED FLOOR FRAMING I I I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMy I (UNDERFLOOR INSULATION I I 1153H265 3 OOI 11 I 1 I -1 (FLOOR SHEATHING I I INO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: 1 I 1 I I 0 NO , 21 1 IROCF SHEATHING 1 SCHOOL WITHIN HAZARDOUS I (SHEAR PANELS (AIR QUALITY: 1000 FEET MATERIALS 1 1 NO NO NO [ 1FRP.ME INSPECTION 1 I I I 1 (FIRE SPRINKLER HANGERS I 1 I I I INSULATION/WEATHER STRIPI I I INTERIOR LATH/DRYWALL I I I 1 IEXTERIOR LATH 1 I [RATED FLOOR/CEIL ASSEM. 1 I 1 I iRATED WALL ASSEMBLIES I 1 I 1RATED SHAFTS/OPENINGS I I f i I I IT-BAR CEILINGS I I I 1 11 1 ILOT'DRAINAGE I I 1 I I I (REPORT ID: DPR261 ROUTE TO: BSO508 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 1202270080 PHONE: (626) 285-0488 EXT: LEGAL ID: 1 NO. OF CONST BUILDING ADDRESS: 1 ITR: 11990 LT: 6 BL: .001 1 SQ. FT STORIES TYPE 1 9117 EMPEROR AV I ISTRUCTURE: 250 V-B 1 SGAB CA 917752018 1 (ASSESSOR INFORMATION NUMBER: I 1 NEAREST CROSS STREET: OAK 1 15382-012-026 I 1 THOMAS PAGE: 596 GRID: H1 LOCALITY: TEMPLE CITY, Cl I I I I (TENANT: JEXIST BLDG USE: STORA {•.� USE ZONE: R-1 JISSUED ON: PROCESSED BY: 1 I JEXIST OCC GRP: 102/27/12 SR I TOWNER: TEL. NO: iBLDGS. NOW ON LOT: VALUATION: iF�y„ \\DATE F` Y: CODE: HSU (626) 449-3227- J 800 �/1�L/j11•-y� 19117 EMPEROR AV ISGAB 917752018 1 FEES PAID IDESCR PTION OF WORK 1 I I (STORAGE ROOM NEXT TO DETACHED GARAGE INSTALL TORCH DOWN BITUI I _IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: JMEN (250 SQ.FT.) 1 (APPLICANT: TEL. NO: I I I (ALFRED LAU (626) 622-8108- IAA BLDG PERMIT ISSUANCE 27.80 J I 1 JAB STATE GREEN BLDG FEE 800.00 VAL 1.00 ISPECIAL CONDITIONS: I JAC STRONG MOTION RESID 800.00 VAL 0.50 I I I ID2 PERMIT W/O EN-HC 800.00 VAL 65.40 I I 1 _1 TOTAL FEES 94.70 �(/�� (CONTRACTOR: TEL. NO: I APFPO'VA13S ATE INSPECTOR SIGNATURE (GOLDEN KEY INC. (626) 285-9016- 1 I 14533 SHIRLEY AVE LIC. NO 1 (LOCATION AND SETBACKS I I I JEL MONTE, CA 91731 77511SC39 I I I I I I ISOILS ENGINEER APPROVAL I I I JARCHITECT OR ENGINEER: TEL. NO: 1 (FOUNDATION/TRENCH FORMS I I I J LIC. NO: I ISLAB/UNDER FLOOR I I I I I- 11 1 _ I (RAISED FLOOR FRAMING I I I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMF: 1 'c� " r : JUNDERFLOOR INSULATION I I I I153H265 3 001 1 11 I I _1 (FLOOR SHEATHING I I I INC. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I I I I 1 0 NO 21 1 1ROCJF SHEATHING ,I_�I 1 SCHOOL WITHIN HAZARDOUS (SHEAR PANELS I I JAIR QUALITY: 1000 FEET MATERIALS 1 I I I 1 NO NO NO 1 (FRAME INSPECTION I I I I I I I I I I IFIRE SPRINKLER HANGERS I I I I I I I I I JINSULATION/WEATHER STRIPI I I I I I I I I I I JINTERIOR LATH/DRYWALL I I I I I I I I I I I 1EXTERIOR LATH 1 I I I_ I I I i (RATED FLOOR/CEIL ASSEM. 1 1 I I (RATED WALL ASSEMBLIES I I I I I I J IRATED SHAFTS/OPENINGS I I I I I I I IT-BAR CEILINGS I I I I I I h, s ILOT DRAINAGE I I I (REPORT ID: DPR261 ROUTE TO: ES0508 t y APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES. BUILDING AND SAFETY WORKER'&COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING DDRES I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS 1' or a certificate of Workers'Compensation Insurance,or a certified �f copy thereof(Sec.3800,Lab.C.) CITY��N 6-46r'e. ZIP /� �.� / ��. Policy No. / �A. LOC ���z� Company SIZE OF LOT r NO.OF BLDGS.NOW ON LOT O c,{ t NEA EST CROSS ST. O I ❑ Certified copy is hereby furnished. 1 [ v ST P ❑ Certified copy is filed with the county building inspection TRACT IBLOCK LOT NO. department. / 22 Date Applicant ASSESSOR MAP BOOK PAGE I2 PARCELa`.� USE ZONE MAP NO. / /�J �'3,f 2 /_ / SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TE .NO. LI COMPENSATION INSURANCE ee 5aH V " 2 WITHIN 1000 FT.OF SCHOOL? YES No ADDRESS Ave—This section need not be completed if the permit is for one hundred `� 1 Piro r � 1 ' DISTRICT GROUP TYPE CONST.'. FIRE ZONE PROCESSED BY dollars($100)or less.) I certify that in the performance of the work for which this permit CITY c�li•H Grb rte ZIP q ? ?5 is issued, I shall not employ any person in any manner so as to ARCHITECT OR ENGINEER TEL.NO. become subject to the Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO.-C>21 DWELL UNITS NOTICE TO APPLICANT. If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the ,Workers' CONTRACTOR TEL.NO. SETBACK YARD HWY PROPLINE WIDTH Compensation provisions of the Labor Code, you must forthwith FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL LICENSED CONTRACTORS DECLARATION CITY LIC.CLASS PIDE I`;r,4.T a c I hereby affirm that I am licensed under provisions of Chapter 9 SQ.FT.SIZE NO.OF STORES NO.OF FAMILIES SEWER MAP _, 1:4. (commencing with Section 7000)of Division 3 of the Business and p Professions Code,and my license is in full force and effect. 1 1 1 NEW ❑ BK PG i CD DESCRI TI OF WORK License Number Lic.Class . ADD VALUATION -•• a �++ Contractor Date ALTER ❑ � �' _I' i•I e ti ❑ I am exempt under Sec. REPAIR 11J OD O 0-v B.&P.C.for this reason �[I"r�I ���� DEMOL El / 3 z USE OF EXISTING BLDG. LOMA P/C# -_1 Al Date: 'e URM ❑ Signature APPLICANT(PRINT EL.NO. t..l LDMA Penn# I, as owner of the property, or my employees with wages as p% : f. L their sole compensation,will do the work and the structure is ADDRESS not intended or offered for sale (Section 7044, Business and FINAL DATE ^/ 1((� G Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL —per 1/ _� jl OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN I J "'`I'�(i—S i [•1 '"}?•'I'j•','•'f ❑ 1, as owner of the property, am exclusively contracting With THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL 13 > }p f A4'.I::r licensed contractors to construct the project.(Section 7044, 'y 4.3 s7 _ H ),s?_ __ YES❑ NO❑ l/ Business and Professions Code.) WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTHD/�� CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST ✓ (/ G/ FOR GUIDELINES. hereby affirm that there is a construction lending agency for VES❑ No❑ dT ��%�� the performance of the work for which this permit is issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD O 3097,CIV.C.). PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES lO COUNTY CODE,TITLE2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING ��- / o Lenders Name HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. Lenders Address .Q OWNER OR AOENT o I certify that I have read this application and state that the above PERMIT FEE FEE P.C. q v,/� e �] information is correct. I agree to comply with all county Cs/�f ordinances and State laws relating to building construction,and O eJ a. hereby authorize representatives of this County to enter upon04— V ISSUANCE FEE the above-mentioned roperty for' ction purposes. 1 / INVESTIGATION FEE TOTAL FEE ` n (� 7.a Appikent a Apert pate SEE REVERSE FOR EXPLANATORY LANGUAGE