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HomeMy Public PortalAbout5405 ENCINITA AVE_Building__ APPLICATION FOR BUILDING PERMIT FOR 'APPLICANT TO FILL IN (Print or type only) BUILDING COUNTY OF LOS ANGELES ADDRESS DEPARTMENT OF COUNTY ENGINEER CITY ' P_cAZIP -- BUIL-DING AND SAFETY DIVISION NO OF BLOGS BUILDING B SIZE OF LOT NOW ON LOT ADDRESS ` TRACT BLOCK LOT NO LOCALIT TEL NEAREST OWNER NO CROSS ST ASSESSOR ADDRESS �j� MAP BOOK PAGE PARCEL �� �' DISTRICT GROUP TYPE FIRE PR ESSED BY CITY t7v ✓ T ZO ZIP '�� CONSr. NE ARCHITECT OR TEL '00 Z ENGINEER NO STATISTICAL CLASSIFICATION SEWER M P ADDRESS ��— ` CLASS NO�/_DWELL UNITS / K!57PG p y NOP O CONTRACTOR TEL USE ZONE NO ADDRESS NO211 - SPECIAL LIC CONDITIONS CITY +e'. CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑ CONSTRUCTION LENDER NAME AND BRANCH D BLIR FROM y. FR NT PROP LINE OF (STREET) ADDRESS CITY SQ FT NO OF NO OF CHECK HI HWAY } YARD TT OTAL SETBACK FROM HIGHWAY TPE OF EWIDT IHG V FRONT PROP LINE � SIZE STORIES FAMILIES ONE O + DE CRIPT10N OF WORK _ NEW ❑ LLI ADD 1:11BLDG ACK FROM (STREET) SIDE PROP ALTER HIGHWAY + YARD s: _ TOTAL SETBAC OM IGHWAY WIDTH TYPE OF EXISTING vim — REPAIR❑ SIDE PROP LINE USE OF t = EXISTING BLDG 3, DEMOL ❑ APPLICANT TEL ! f CORNER CUTOFF YES ❑ NO C](PRINT) b BY (SIGNATURE) IN OPEN SPACE _ YES ❑ NO ❑ Q IN COASTAL ZONE YES ❑ NO ❑ VALUATION$ CATEGORICAL EXEMPTION YES❑ NO ❑ I HEREBY ACKNOWLEDGE T AT I HAVE READ THIS APPLICATION ENVIRONMENTAL AND STATE THAT THE ABOVE-IS CORRECT AND AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE) WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON- ST,RUCTION I CERTIFY TMAT IN-DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE) HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE - LABOR CODE OFTME STATE OF CALIFORNIA IN RELATING TO t ' WORKMEN'S COMPENSATION INSURANCE SIGNATURE OF _ PERMITTEE ADDRESS FINAL /q/� BY TEL DATE CITY NOPMT 11'IKh ( IIL( h P l ABLL- 10 FEE $ FEE n 1 HARVEY T BRANDT, COUNTY ENGINEER - Ij_ 7 PLAN CHECK VALIDATION CK M O CASH PERMIT V ATAON CK M o CASH 76A638A CE#803 12/72 _ I- jr- '3 3 7"�?'S JULO 1 D 1 .7 75A838A CE#8035 W APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER F DDRESS BURDING AND SAFETY DIWSION LOCALITY r JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A JENSEN SUPT OF BUILDING CROSS ST DISTRICTNO GROUP TYPE OCESSED Y FOR APPLICANT TO FILL IN , 0 CONST ,BUILDING STATISTICAL CLASSIFICATION EWER MAP 5405 Encinitas K G ADDRESS CLASS NO DWELL UNITS `—' LOT NO BLOCK WATER NOT REQUIRED RECEIVED CERTIFICATE TRACT ' MAP HIGHWAY STATE MAJOR SECOND LOCAL NO OF BLDGS NO (CIRCLE) SIZE OF LOT NOW ON LOT USE ZONE SPECIAL USE OF CONDITIONS EXISTINGBLDG OWNER Mrs. L. B. Crawfoi'1 BUILDING EXIST SETBACK ^YARD HWY STREET N ME WIDTH ADDRESS Same FRONT ARCHITECT OR TEL P L ENGINEER NO SIDE 1 Q ADDRESS ' V CONTRACTOR Virgin Roof Co#40 AT705 INSPEC ON RECORD, 0 ADDRESS 600 S. San Gabriel Blvd. v u W CL DESCRIPTION OF WORK S.G'* I I NEW ADD ALTER REPAIR DEMOLISH SQ FT NO OF NO OF IZE STORIES FAMILIES USE OF' STRUCTURE Re-roof house & garage c SIGNATURE OF APPLICANT VALUATION$633,•00 , APPROVALS DATE 'INSPECTOR S SIGNATURE PC PMT .00 FOUNDATION LOCATION FEE $ FEE _FOUNDATION MATERIALS FRAME FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION, WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED,H EREB I WILL H PLOY ANY PERSON IN V OLA LATH INT TION OF THE LABO CODE OSTATE OF CALIFORNIA R LAT , ING TO WORKMEN S PENIN ANCE LATH,EXT / /9 SIGNATURE OF HOUSE NUMBER COR- PERMITTEE OR- ! PERM ITTE RECT AND POSTED �✓ IJ 1IADDRESS 00 • GabrielBlvd • FINAL an rie ' CLYDE N DIRLAM;PRINCIPAL TRURAL ENGINEER PLAN CHECS V cK w o CASH PEBMT VALIDATION cK m o CASH J L o0271-0,1 11fi26 1 0 5.00 WORKERS' COMPENSATION DECLARATION APPLICATION FO"�ILDING PERMIT '1 hereby affirm that I have a certificate of consent to self insure, or a certificate of Workers'Compenstion Insurance, ora certified copy,thereof (Sec 3800, Lab C ) COUNTY OF LOS ANGELES 'BUILDING AND SAFETY Policy No - Company Certified co is hereby furnished BUILDING � G copy v FOR APPLICANT TO FILL IN ADDRESS ElCertified copy is filed with the county building inspec- BUILDING .s 9 tion department ADDRESS ww 1 / LOCALITY Z Date Applicant— CERTIFICATE I #A PL C I ZIP o CROSS ST CERTIFICATE OF EXEMPTION FROM WORKERS' I �rJ J n NO OF BLDGS ASSESSOR ' - COMPENSATION INSURANCE SIZE OF LOT .I Jl D NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for oneUSE ZONE MAP hundred dollars ($100)or less ) TRACT L BLOCK LOT NO NO 'Z—V - TEL SPECIAL d. I certify that in the performance of the work for which this OWNER S L' NO CONDITIONS O permit is issued, I shall not employ any person in any manner f► " DISTRICT GROUP TYPE FIRE P D BY V so as to become subject to the Workers Compensation Laws ADDRESS 54,4_ L ) TAr A V6 /" _✓/ � CONST � -ZONE, Date ApplicanT CITY /v•/� �— G ) _ry ZIP STATISTICAL CLASSIFICATION APT CONDO V NOTICE TO APPLICANT If, after making this Certificate of ARCHITECT OR TELLU Exemption, you should become subject to the Workers' ENGINEER NO CLASS NO DWELL UNITS N Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER r - with comply with,such provisions or this permit shall be �TEL1�L deemed revoked CONTRACTOR NO [./nK 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 $ SO FT OF NO OF ++ CHECK License Number Lic Class SIZE STORIES FAMILIES Y ONE ' $ Contractor Date DESCRIPTION OF WORK NEW am exempt from the licensing requirements as I am a ADD licensed architect or a registered professional engineer ALTER FINAL acting m my professional capacity (Section 7051, (�� REPAIR DATE /( Z Business and Professions Code) USE OF EXISTING BLDG -' DEMOL FINAL Y Lic or Reg No Date APPLICANT — TEL b OWNER-BUILDER DECLARATION PRINT) NO 2 I hereby affirm that I am exempt from the Contractor's License _ d'1 �,5 A --Law for the following reason (Section 7031 5, Business and 1 ADDRESS Jf V # 0 0 0 0,e 1 P f ssions Code) PRESENT I, as owner of the property, or my employees with BUILDINGADDRESS 2 0 0 2 2.�Q , wages as their sole compensation,will do the work and the structure is not intended or-offered for sale (Section LOCALITY - '0,0 0 2 2 0 0 F' 7044, Business and Professions Code) MOVING TEL T 1 , CONTRACTOR NO I, as owner of the property, am exclusively contracting � -0'6'09-81 with licensed contractors to construct the project (Sec- ADDRESS- tion 7044, Business and Professions Code) REQUIREDBACK 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 --• v PL Lender s Name Lender s Address P C Fee$ Permit Fee I w I certify that I have read this application and state that the f Issuance Fee / above information is correct I agree to comply with all County Investigation Fee ordinances and'State laws relating to building construction, 7 Total Fee o and hereby authorize representatives of this County to enter C = aupon the above-mentioned property for inspection purposes a / SEE REVERSE FOR EXPLANATORY LANGUAGE l ' a L —�gnature f Applicant or Agent ©s_ D01e , 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 0506020058 PHONE (626) 285-0488 EXT LEGAL ID NO OF CONST BUILDING ADDRESS TR 7796 UN 002 SQ FT STORIES TYPE 5405 ENCINITA AV STRUCTURE VN TEMP CA 917803117 ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET OLIVE 5388-001-040 THOMAS PAGE 596 GRID J4 LOCALITY TEMPLE CITY, C TENANT EXIST BLDG USE RESID USE ZONE R-1 ISSUED ON PROCESSED BY EXPIRES ON EXIST OCC GRP 06/0/05 JK 05/28/06 OWNER TEL NO BLDGS NOW ON LOT VALUATION FINAL DATE FINAL BY CODE DIEP, SHARON (626) 321-6119- 5,000 5405 ENCINITA AVi _ TEMP 917803117 FEES PAID DESCRIPTION OF WORK REPLACE 12 WINDOWS (SAME SIZE) AND STUCCO PORCH PART FEE DESCRIPTION QUANTITY UOM AMOUNT OF FRONT TO FIREPLACE APPLICANT TEL NO SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27 75 AC STRONG MOTION RESID 5000 00 VAL 0 50 SPECIAL CONDITIONS D2 PERMIT W/O EN-HC 5000 00 VAL 132 60 FR INV WORK W/O PERMIT 257 00 DOL 257 00 TOTAL FEES 417 85 CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - LIC NO LOCATION AND SETBACKS SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER TEL NO FOUNDATION/TRENCH FORMS LIC NO SLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP UNDERFLOOR INSULATION XX 3 01 FLOOR SHEATHING NO OF FAMILIES DWELLING UNITS APT/COND STAT CLASS NO 21 ROOF SHEATHING SCHOOL WITHIN HAZARDOUS SHEAR PANELS AIR QUALITY 1000 FEET MATERIALS NO NO NO FRAME INSPECTION REQUIRED TOTAL SETBACK FROM EXIST I FIRE SPRINKLER HANGERS SET BACK YARD HWY PROP LINE WIDTH FRONT PL- INSULATION/WEATHER STRIP SIDE PL- INTERIOR LATH/DRYWALL EXTERIOR LATH RATED FLOOR CEIL ASSEM RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS LOT DRAINAGE REPORT ID DPR261 ROUTE TO BS0508