HomeMy Public PortalAbout9123 EMPEROR AVE_Building__ •� COUNTY OF LOS ANGELES TEMPLE CITY # 0506 l BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS , ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 9908120016
PHONE: (626) 285-0488 EXT:
LEGAL I ADDRESS:
TR: 11990 LT: 6 SQ. FT STORIES TYPE 9123 EMPEROR AV
STRUCTURE: 0 VN SGAB CA 917752018
ASSESSORFOR NEAREST CROSS STREET: ROSEMEAD _f "3
5382-012-027 THOMAS PAGE: 596 GRID: H1 LOCALITY: TEMPLE CITY
TENANT: EXIST LDUSE: RESID USE ZONE: - p 0 : 0 D XP
EXIST OCC GRP: 08/12/99, • 'UT 02/08/ � -
OWNER: TEL. NO- BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY DE:
CHAN;RODNEY (626) 445-3239- 1 7,000 ,/ •�
9123 EMPEROR AV 6
SGAB 917752018 FEES PAID 6NEWIFFMN
REMODELING OF KITCHEN AND BATHR
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:
APPLICANT: .
SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75
AC STRONG MOTION RESID 7000.00 VAL 0.70 SPECIAL CONDITIONS:
D2 PERMIT 14/0 EN JE! �7000.00 VAL 166.20
,OGE L.ET,OT L®EES 194.65
CONTRACTOR: TEL. NO: �� ��/� APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER
LIC. NO LOCATION AND SETBACKS
SOILS ENGINEER APPROVAL
ARCHITECTENGINEER: 0
LIC. NO. 1111111 SLAB/UNDER R
� G
- r
MA NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: U DERFLOOR INSULATION
153H265 3 Oil F DD �n�L C V V 0�K 3 FLOOR SHEATHING
OF F LING 1
NO 21 ROOF SHEATHING
SCHOOL WITHIN HAZARDOUS 0 SHEAR PANELS
AIR QUALITY: 1000 FEET MATERIALS 0 E
NO NO NO El ® ®� FRAME INSPECTION
REQUIRED OTA E IST �✓�� n -wI0 FIRE SPRINKLER HANGERS
SET PYARD: HWY: PROP LINE: WIDTH-
FRONT
IDTH
FRONTTL �C g+�'rvice lba INSULATION/WEATHER STRIP
SIDE PL-
ILATH/DRYWALL
EXTERIOR LATH
RATED FLOOR/CFLOOR/CEIL ASSEM.
RATED WALL ASSEMBLIES
RATED SA TS
T-BAR CEILINGS
LOT DRAINAGE
REPORT ID DPR261 ROUTE TO: BS0508
t
if -
D13S-3 25M SETS 6-46 _ �- �J \•
DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT -
COUNTY OF LOS ANGELES L ® I
WM. J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
DISTRICT NO. /PLAANCK. NO. PERMIT NO.
BUILDING , /j_� _ d r f @ �^ CD 4'41 c
ADDRESS ..7
LOCALITY a Jrf o/Y elhu 1,7a
/'_a /i ar`h 8 REC ED BY 1yDATE OF AP,PrL., DATE ISSUED
NEAREST 'IF
CROSS ST.—
BUILD
T. K
l /� /' BUILDING
OWNER `4 r ll n rn C 1.7 t r a '��/,('m L/0 ADDRESS / }
ADDRESS /9 7F 4 a S / (11� LOCALITYMAIL i y «
NEAREST
CITY /LI�'I�✓/� C./ / G NO'rECR099 HT
(
[[ FIRE NO OF �,�,TYPE '/ i GROUP
ARCHITECT OR TEL. ZONE I_
PLANS I/
ENGINEER NO 1
BLDG / ORD. NO
ADDRESS SETBACK LINE /
/� r TEL APPROVED
CONTRACTOR _Il', G u NOL �[/ 8 /�. r BY /�J DATE
USEADDRESS
t' 1!1 �1Aj Ate c, Ili^ ZONE�i�/ BY DATE DATE
LEGAL I
DESCRIPTION I LOT NO I BLOCK —�� CORRECTIONS
TRACT — mil/,� /9- GAry �t/o NO OF BLDS. -7- ro.�a roc Fr c y` y Y7
SIZE OF LOT �� NOW ON LOST 1°
USE OF NO OFNO OF
EXISTING BLDG i FAMI (�,y� I LI ROOMS
DESCRIPTION OF WORK
NEW ALTERATION I ADDITION O
A
REPAIR MOVING DEMOLISH p
size NO or U b ROOMS STORIES D
r
WALL ROOF o Q
COVERING S (J(�� COVERING na/ S
USE OF NEW
BUILDING /Y(� l �e n c_e/
cP. F
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS ,
APPLICATION AND STATE THAT THE ABOVE 19 CORRECT FOUNDATION, LOCATION, NBOR DATE
AND AGREE TO,COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS Z1 2?
AND STATE LAWS REGULATING BUILDING CONSTRUCTION FRAME: FIRE STOPS,
SIGNATURE OF o/,/ BRACING, BOLTS �'��!9+�`-'�'1 �"�/✓ l c��
OWNER �j(/- %'� 1�9 60 LATH, INT.:
AUTHORIZED AOT- 0G) -'. I LATH, EXT:
$ r \
P. C.Ig PLABT,ER, INT.
6 odd VA FEE PLASTER, EXT.
VALUATION111 0-10
0 / U v—_ FEE 1(5? FINAL
L ,
DEPARTMENT OF BUILDING AND SAFETY � APPLICATION FOR PERK&
COUNTY OF LOS ANGELES ® �®
s WM. J. FOX,-CHIEF ENGINEERI LD® ®�
"'FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
DISTRICT NO. PLAN CK NO P.LRMIT NO
BUILDNG
ADD EISS //•� �/ ��ea "✓�� 1�� r(.1�
LOCALITY (� �eo RE IVED BY DATE OF APPL DATE ISSUED
NEAREST
CROBS ST. ,,/_/,�
OWNER // J�L _..�41 A_ B EIB9 .� L r
MAIL ®� yn P 19_0 LOCALITY y !'
ADDRESS Q�
NEAREST
CITY 4.//DYs �.� B'�e - ,Pv ` i,ll NO. CROSS ST
TE � � ~
FIRE ',JNO OF TYPE GROU�
ARCHITECTOR TEL. ZONE PLANS ^_ \
ENGINEER
BLDG v / / D O
ADD RE89 SETBACK LINE y
APPROVED
TEL. BY DATE
CONTRACTOR NO
USE APPROVED
ADDRESS ZONE 091 BY DATE -
LEGAL ` CORRECTIONS
DESCRIPTION LOT NO.
TRACT/7) P.Q c V✓ f lO
/ O OF BLDGB. _
SIZE OF LOT �^ ` I NOW ON LOT
US OF Ay, NO OF NO OF per`
EXISTIN LDCs FAeeIl1ED I ROOM9Jn�
DESCRIPTION OF WORK
NEW ALTERATION ADDITION �-�' S/ _ !•,7/�'�C�%s
aP.�t�GKw r O
REPAIR MOVING DEMOLISH+ ° A
SI FT A NO OF
SIZE..�� (✓ ROOMS ( STOR�I�ESWAL ��� g
ROOF
COV R R I COVERING //('�4'.c4��s',�
v
USE OF NEW t
BUILDING to
v �
a-®"d ol .
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS; APPROVALS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION INSPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS
AND STATE LAWS REGULATING BUILDING CONSTRU TION„
p FRAME: FIRE STOPS, -
SIGNATURE OF BRACING,BOLTS
PERMITTE
LATH, INT.: i
AUTHORIZED AOT
LATH,EXT.:
DBS-3 SOM SETS 7-47 $ _ P C t PLASTER,INT. -
FEE PLASTER,EXT.
VALUATION
FEE �.:' FINAL
\ I CS
WORKERS' COMPENSATION DECLARATION
hereby affirm that I have a certificate of consent toself APPLICATION FOR BUILDING PERMIT
insure, or a certificate of Workers'Compenstion Insurance,'or
a certified copy thereof (Sec 3800, Lab C )
COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No 5501 company' State Comnensat,' BUILDING
F-1Certifiedcopy is hereby furnished 1 n s , Fund FOR APPLICANT TO FILL IN ADDRESS
�I
Certified copy is filed with the county building inspec- BUILDING
LTJ tion department ADDRESS 91 23 Ee.ror LOCALITY
1 NEAREST
Date -,-,-80 Applicant E{�y�a r d L . Ra nil f)1 C CITY ZIP CROSS ST �
CERTIFICATE OF EXEMPTION FROM WORKERS' V,NO OF BLDGS ASSESSOR
COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL
This section need not be completed if the ermit is for one USE ZONE EMAP fhundred dollars ($100)or less ) p TRACT BLOCK LOT NO kTEL �O OI certify that in the performance of the work for which this OWNER , NO 00� NS
peimit is issued, I shall not employ'any person in any manner
TRI T GROUP TYPE FIRE PROC ED BY V"
so as to become subject to-the Workers'Compensation Lows ADDRESS 912 3 Em e r o r S t. �a�E �3 CONST / Z`O�NE 0
�t " CITY �„t ZIP 1 /V/ I-
Date Applicant 1 C STATISTICAL CLASSIFICATION APT CONDO W
NOTI TO APPLI ANT If, after makmg this,Certificate o ARCHITECT OR TEL CL
ENGINEER NO CLASS NO DWELL UNITS
Exemptiori, you should become subject to the Workers' Vi
Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER P' ?
with comply with tsuch provisions or this permit shall be _
deemed revoked CONTRACTO T L ^BK PG, � 4 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 San .G a b r i el) CLASS --C-39 $ 2095 . 0 0
NO OF CHECK
License Number 186.086 Lic Class C-.39 o/1 SIZE SORIIEES FAMILIES ONE _
Contractor [toward L .Rand este CO. 11-13 -t8�! DESCRIPTION OF WORK - NEW ❑ $
_ ❑am exempt from the licensing requirements as I am a and a r a e 1 t h 12X18 ADD
licensed architect or a registered professional engineer ALTER ❑ DATEFINA �^
acting in my professional capacity (Section 7051, REPAIR ® DATE r�Le Ile(
Business and Professions Code) USE OF
i EXISTING BLDG
Lic or Reg No DEMOL ❑ FINAL
NAL
_Date APPLICANT' TEL Y
(PRINT 'oward L . Randol C" 288-4040
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License ADDRESS 2 9 �" a 1 1 e B 1 San Gab>>'m e
Law for the following reasoy (Section 7031 5, Business'and
Professions Code) - PRESENT
BUILDING
I, as owner of the property, ormy employees with ADDRESS
wages as their sole co' ensahon,will do the work and
the structure is not intended or offered for sale(Section LOCALITY
7044, Business and Professions Code) MOVING TEL -3 1 0, 1 A
I as owner of the property, am exclusively contracting CONTRACTOR NO
with licensed contractors to construct,the project (Sec- ADDRESS �y # 0 0 o e o 1
hon 7044, Business and-,Professions Code)
s` e , REQUIRED LARHWY TOTAL SETBACK FROM EXIST _2 F0 0 (�3� 00'
CONSTRUCTION LENDING AGENCY SET BACKPROP LINE WIDTH � s ,
I hereby affirm that there is a construction lending agency for FRONT �7 _
the performance of the work for which this permit is issued P L Q C) 1 ,0 0'0' 0-0 v
(Sec 3097, Civ C ) SIDE
PL 11424'-8,0
Lender's Name
Lender s Address PC Fee$ Permit Fee
$36. 00
w I certify that I have read this application and state that the Issuance Fee 7 .00
above information is correct I agree to comply with all County Investigation Fee
0 ordinances and State laws relating to building construction, Total Fee $43 . 00
4andher thorize representati s of this County to enterae lone 'p;o y for inspection purposesF / SEE REVERSE FOR EXPLANATORY LANGUAGE
gnature of pplica or Agent /// Datetteell��---- �f