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Home My Public Portal About4905 ENCINITA AVE_Building__ 1 ' APPLICATION FOR BUILDING PERMIT, COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARAT ONFOR APPLICANT TO FILL IN BUILDIN DRE ^DR A V C I hereby aff that I have a certificate of consent self Insure, BUILDIN -/ J` or a certlflcate Workers Compensation Insur e,or a certified copy thereof (Sec 00, Lab C) OI �! /��! ZIP AW D C� Com- LOCALITY Policy No Co ny r SIZE OF LOT NO OF BLDGS OW ON LOT ❑ Certified copy is hereby ed NEARESTCRO SST .O �� Certified copy is filed th ounty Spection TRACT BLOCK LOT NO CG department I I USE ZONE MAP NO Dat Applicant ASS�$Sa BOOK PAGDE� PARCEL /J/ !l�J.. r� SPECIAL CONDITIONS CERTIFICATE OF IONMPTION FROM WORKERS' W,,0,A)A LU6 r r TEL NO U�ry�1� CO SATION INSURANCE �—/►R �G�� G 4 7Y� (p WITHIN 1000 FT OF SCHOOLS YES NO (This section nee of be completed If the permit is for one red DRESS ��. �� p dollars ($100) or less) AlrC/ DISTRICT GROUP TYPE CONST FIRE ZONE PROCESSED BY I certify that in the performance of the wo or w ch this permit 0 l oelae-a/J ZIP QO _ e is'Issued, I shall not employ any perso any anner,so as to ARCHITECT Qggg EN •-, TEL NO ,J 3 become subject to the Workers Co Uo aws / M?rh� � J(,� f- �"G STATISTICAL CLASSIFICATION APT CONDO Date _ Applicant ADDRESSAi / CLASS NO DWELL UNITS er mhisCertificat NOTICE TO APPLICANT If, a e of C— REQUIRED TOTAL SETBACK FROM EXIST Exemption, you Should become subject to the WorkersT�� TEL NO SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith 4/ 6WP FRONT comply with such provisions or this permit shall be deemed revoked ADDRESSF UC/ry PL LICENSED CONTRACTORS DECLARATION SIDE CITY - LI � P L I I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ� SJZE9r NO OF STORIES NO OF FAMILIES NEW ❑ BK PG Professions Code,and my licen s in full force a fect Z-V 7 a DESCRIPTION OF WORK ADD ❑ VALUATION License Number 2 nn Lic Clas `�l� �. $ 0 & Q�(f�L�Date �(� ALTER U Contractor • REPAIR E] 0 ❑ 1 am exempt under Sec B&PC for this reason DEMOL ❑ W LDMA P/C# Date USE F X`TIp1G.BLDG URM ❑ IL SignatureAPPLIC-AN 1 T TEL N / LDMA Perm# '� Z ❑ I, as owner of the property, or my employees with wages as � •f 7 �� " z ACCT.s their sole compensation, will do the work and the structureis RES .I �1 O not Intended or offered for sale (Section 7044, Business and �� L�fQ�� C `�D lr/ FINAL DATE Q 3307 50.50 Professions Code) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE s J El I, as owner Of the property, am exclusively contracting 44 AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDES FINAL BY +• licensed contractors to construct the project (Section 7044 � _ �`�T a El and Professions Code) YES . NOX .a WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING 3307 {yt p'}rl OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH r Lfa !l CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKUST FOR, GUIDELINES ,i ITEMS I hereby affirm that there Is a construction lending agency for YES❑ Not- the o N the performance of the work for which this permit Is issued(Sec IHAVE READ T HAZAR MAT ON GUIDE AND THE SCAQMDPERMITTNG TOTAL �.,�i ® T0 3097,CIV C) �f CHECK L ST I UND REQUIREMEN DER THE LOS ANGELES COUNTY CODE h u ��/r�r TITLE 2 DHAP TIONS 2 20 100 THRO H 2 20 140 CONCERNING HAZARDOUS iL I�Jn 1,� . 0 3 Lender's Name MATERIALS AND FOR OBTAINING A PER IT FROM THE SCAQMD 4 " o Lender's Address CHANGE .0[1 OWN O o I certify that I have read t ' application and state under penalty - O of perjury that thea inf mation i ct I agree to Comply PC FEE 0 PERMIT FEE /- o with all county dura tate laws�,e g to budding O� yam 1 a 01300-0001 1 5,, 14/03 Q COr1StrUCtlO uthorize representatives o this County ISSUANCE FEE // _ oo ID to enter ve- Honed property for inspect n purposes (O 7�� ] A�( :513 < IINVESTIGATION FEE TOTAL FEE /• - - - �J � i nodKem«rpem ove SEE REVERSE FOR EXPLANATORY LANGUAGE ' 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 0709110007 PHONE (626) 285-0488 EXT LEGAL ID NO OF CONST BUILDING ADDRESS ON FILE SQ FT STORIES TYPE 4905 ENCINITA AV 1 STRUCTURE 1200 VN I TEMP CA 917803706 1 ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET SERENO 1 15388-013-014 THOMAS PAGE 596 GRID J5 LOCALITY TEMPLE-CITY, CI TENANT JEXIST BLDG USE RESID USE ZONE M-1 JISSUED ON PROCESSED BY EXPIRES ON EXIST OCC GRP 109/11/07 SR 03/09/08 1 OWNER TEL NO IBLDGS NOW ON LOT VALUATION (FINAL DATE FI CODE 1 ILI, JUCK MAN (626) 286-8605- 1 3,000 1 1 14905 ENCINITA AV 1 1 1TEMP 917803706 1 FEES PAID 1 ARIPTION OF WORK 1 1TEAR OFF AND REROOF WITH COMPOSITION SHINGLES IFEE DESCRIPTION QUANTITY UOM AMOUNT 1 1 APPLICANT TEL NO I ' 1 1 (SAME AS OWNER - JAA BLDG PERMIT ISSUANCE 27 75 1 1 1 JAC STRONG MOTION RESID 3000 00 VAL 0 50 1SPECIAL CONDITIONS 1 ID2 PERMIT W/O EN-HC 3000, 00 VAL 99 00 1 1 TOTAL FEES 127 25 ICONTRACTOR TEL NO (APPROVALS DATE INSPECTOR SIGNATURE 1 ISAME AS OWNER I1 I LIC NO ILOCATION AND SETBACKS 1 1 1 1 1 ISOILS ENGINEER APPROVAL 1 (ARCHITECT OR ENGINEER TEL NO 1 _ IFOUNDATION/TRENCH FORMS I I I LIC NO 1 1SLAB/UNDER FLOOR 1 1 1 I (RAISED FLOOR FRAMING 1 1 IMAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP 1 (UNDERFLOOR INSULATION I 1 1 1144H265 3 011 1 I1 1 1 1 1FLOOR SHEATHING 1 1 1NO OF FAMILIES DWELLING UNITS APT/GOND STAT CLASS 1 I 1 NO 21 IROOF SHEATHING �( / SCHOOL WITHIN HAZARDOUS 1 ISHEAR PANELS / (AIR QUALITY 1000 FEET MATERIALS 1 NO NO NO (FRAME INSPECTION 1 IREQUIRED TOTAL SETBACK FROM EXIST I 1FIRE SPRINKLER HANGERS 1 ISET BACK YARD HWY PROP LINE WIDTH 1 I I I IFRONT PL- 1 (INSULATION/WEATHER STRIPI 1 1 1 SIDE PL- I 1 1-1 11NTERIOR LATH/DRYWALL 1 1 I IEXTERIOR LATH 1 1 I IRATED FLOOR/CEIL ASSEM 1 1 I 1 1RATED WALL ASSEMBLIES 1 1 1 1RATED SHAFTS/OPENINGS ( 1 I I I I I I 1 1T-BAR CEILINGS 1LOT DRAINAGE 1 1 IREPORT ID DPR261 ROUTE TO BS0508 1 1 COUNTY OF LOS ANGELES TEMPLE CITY y • # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0006270043 PHONE (626) 285-0488 EXT- LEGAL ID. NO OF CONST BUILDING ADDRESS ON FILE SQ. FT STORIES TYPE 4905 ENCINITA AV STRUCTURE 0 VN TEMP CA 917803706 ASSESSOR FO TION NUMBER NEAREST CROSS STREET: LOWER AZUSA 5388-013-014 THOMAS PAGE: 596 GRID J5 LOCALITY TEMPLE CITY TENANT: EX ST BL USE: RES USE ZONE. M ISSUED ON PROCESSED BY: EXPIRES N: EXIST OCC GRP 06/27/00 UT '1/o0 OWNER: TEL NO. BLDGS NOW ON LOT VALUATION: FINAL DATE FINAL CODE WANG, BOB (626) 962-0416- 1 700 �� 4905 ENCINITA AV TEMP 917803706 FEES PAID MSCRIPTION OF WORK REROOF OVER 2 LAYERS OF EXISTI FEE DESCRIPTION QUANTITY UOM AMOUNT APPLICANT TEL NO SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RESID 700 00 VAL 0.50 SPECIAL CONDITIONS- D2 PERMIT W/O,EN;HC 700 00 VAL 43.65 GELES T�Oa®L 'FEES 71 90 CONTRACTOR: TEL. NO � Q961�� APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC NO LOCAlION AND SETBACKS SOILS ENGINEER APPROVAL ARCHITECT R ENGINEER TEL // —NG 0 RENCH FORMS LIC Ne 1111111 SLAB/UNDER FLOOR RAISLD FLOOR FRAMING MAP NO SEWER MAP BOOK PAGE: FIRE ZONE dCMP: (1 n C � �pq 0(�\(1�/ UNDERFLOOR INSULATION 144H265 3 D1 'ISI I ;UKC�\ FLOOR SHEATHING 0. OF FAMILIES DWELLING S: APT/COND: STAT CLASS - -NO 21,E ROOF SHEATHING SCHOOL N HAZARDOUS \\\\\\�\ Ly ? { 5FU: PANELS AIR QUALITY 1000 FEET MATERIALS \ 7 ❑ �451, NO NO NO FRAME INSPECTION REQUIRED TOTAL SETBAER-FF5F EXIST Qq2 _�4®dam RE SPRINKLER HANGERS SET FRONTBACKYARD: HWY PROP LINE WIDTH. 4aZ6�, r�-'� v INSU'LATION/WEATHER STRIP SIDE PL- INT 210R LATH/DRYWALL t EXTERIOR LATH RTD FLOOR C IL ASSEM RATED WALL ASSEMBLIES RAT50 SHAFTS/OPENINGS T-BAR CEILINGS LOT DRAINAGE REPORT ID• DPR261 ROUTE TO BS0508 \