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HomeMy Public PortalAbout5430 ENCINITA AVE_Building__ i COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL. 0508 9805040008 PHONE: (818) 285-0488 EXT: GAL N0. OF CONST— BUI MNG ADDRESS: TR: 45965 LT- 1 UN: 6 SQ. FT STORIES TYPE 5829 ENCINITA AV STRUCTURE: 0 VN TEMP CA 917802458 �5 SESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 5387-017-050 THOMAS PAGE: 596 GRIDl,J3 LOCALITY:!-TEMPLE CITY TENANT: ST BLDG USE: RESID USE ONE: R-2 ISSUED ON: PROCESSED BY: EXPIRE ON:. EXIST OCC-GRP: - 05/04/98 UT 05/04/99 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE ' FINAL BY:: CODE: CHANG HUI C•SYLVIA T - 1 1,000 ,��L� 5829 ENCINITA.AV V M� TEMP 917802458 FEES PAID DESCRIPTION LlF WORK REMOVE EXISTING TILES AND APPLY NEW FELT TO-500 SO. FT. OF FEE DESCRIPTION: QUANTITY: UOM: AMOUNT' EXISTING .HOUSE ROOF-HOUSING REHABILITATION APPLICANT: L. NO: MC CURDY'S CONSTRUCTION (626) 963-0425- AA BLDG PERMIT ISSUANCE 27-75 1123 E. ARROW HGHWAY AC STRONG MOTION RESID ,1000.00 VAL 0-50 SPECIAL CONDITIONS: GLENDORA, CA D2 PERMIT W/O EN-HC 1000.00 VAL 65.25 GELTOTAL-FEES93.50 CONTRACTOR: TEL. NO: �S - ?L.Nt. ti.'„ _„ APPROVALS DATE INSPECTOR SIGNATURE MCCURDY'S CONSTRUCTION (818,) 963-0425- 1123 E. ARROW HWY. LIC. NO LOCATION AND SETBACKS GLENDORA, CA 91740 57814 SOILS ENGINEER APPROVAL - ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS LIC. NO:� SLAB/UNDER FLOOR 711171 RAISEDFLOOR FANG MSOH265 SEWER MAP BOOK: PAGE: IRE ZONE: CMPO.' t l n n QO C MY O�� UNDERFLOOR INSULATION L vLF OOR SHEATHING NO. OFFAMILIES: W LL NG UNITS: APT/CONDI STAT CLASS: YES 21 �: �{-, ROOF SHEATHING SCHOOL WITHIN HAZARDOUS SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS zl? �y NO NO NO FRAME. INSPECTION REQUIRED 0 L SETBACK ROM EXIST 46�, VtlC`� FIRE SPRINKLER HANGERS SET BACK YARD: HWY:. PROP LINE: WIDTH: FRONT PL- `SCrVIC6 Tha INSULATION/WEATHER STRIP SIDE PL- INTERIOR LA H/DRYWALL EXTERIOR LATH RATED FLOOR/CEILS - RATED WALL ASSEMBLIES RATED SHAFTS/OPENING T-BAR CEILING LOT DRAINAGE • REPORT ID: DPR261 ROUTE TO: BS0508 WORKERS• COMPENSATION DECLARATION [„ I insure, oo certificate I have r cert Come of consent to self APPUC ./ �p0o N FOR B�p��pN� PERMH IILJII insure, or a certificate of Workers' Compensation Insurance, or'a certified copy thereof (Sec. 3800, Lab. C.) ' COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy 0. Company 4414 TAlik-C ", _�`r` ❑ Certified copy rs hereby furnished. FOR APPLICANT TO FILL IN BUILDING G rvNPIT t�� E] Certified copy is filed with the county building inspec. BUILDING tion department. . ADDRESSV 1 }.t. •E'er. FV E� N �L Date .i 1 Applicant �c i✓.M'�sln OL� CITY VF" N ZIP O LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' I t ONO. OF BUDGE. NEAREST COMPENSATION INSURANCE SIZE OF LOT I Z.Z2o0 NOW ON LOT CROSS ST. u (This section need not be completed if the permit is for one ASSESSOR ,(.- ` hundred dollars ($100)or less.) TRACT Z ��oe°� BL K LOT ffNO.' MAP BOOK `l �� PAGE © � PARCEL U OWNER Iy N`4713 Y ' USE Z E-- �•/Is Z,6�' I certify that in the performance of the work for which this '/r� _ V A _ � permit is issued, I shall not employ any person in any manner '-`T �C�.}I �� SPECIAL {� so as to become subject to the Workers'Compensation Laws. ADDRESS /� ^ i (-� CONDITIONS 0 CITY ftT tT Dal CA ZIP Date Applicant NOTICE TO APPLICANT:tlf, after makin this Certificate of ARCHITECT O `` 11 /�� TEL DISTRICT GROUP TYPE RE4APT. COJN . BY 0 g ENGINEER r T NO -yam H J Exemption, you should become subject to the Workers' ( r..� L�-�� `,.�/ R CON,S/T• ONEW Compensation provisions of.the Labor Code, you must forth- ADDRESS boa vF ✓Fc• • Jll.i I 1 / a with comply with such provisions or.this .permit shall be t STATISTICAL OLASSIF ION ;,_F �� N 'a deemed revoked. CONTRACTOR , NO. CLASS NO. DWELL UNITS Z r) LICENSED CONTRACTORS DECLARATION UC. 'I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. SEWER MAP �w Y 3 Q 4 (commencing with Section 7000)of Division 3 of the Business and DO Professions Code, and my license is in full force and effect. CITY CLASS I BK.L PG. ,�����•`�'^-""' pp SO.t T. 6 NO:OF NO. OF CHECK— License Number 5TH 4r1 } Lic.Class U SIZ I I STORIES Z FAMILIES ONE ( 'e 4 0 6 9 8 �� Defd VALUATION O�1 9 8 Controctor'��c111 G Ok7=af.� TA I/P� . DESCRI TI OF wW�7kK NEW / /l -, '�1 a e ,^';! . Dale ADD $ v ❑ I am exempt under Sec. --1J ylvu .,❑ D ACC Ta,'�,0.4 88 ALTER ��f�:s �s[ 1 B.BP.C. for this reason REPAIR C] $ .� 3307 -"T--rye L4.a1 - Date: USE OF DEMOL Q 1 ITEMS EXISTING BLDG.' �'1 L y y Signature APPLICANT TA TEL. �p FINAL.__ ___. TOTAL .t 24 a 11 OWNER-BUILDER DECLARATION PRINT �J/opTr�, N (�,,D DATECHE,( ,24.11 I hereby affirm that I am exempt from the Contractor's License ADDRESS �D E.I• ✓(� . FINAL Law for the following reason (Section 7031.5, Business and MI Professions Code): FREbkN1 By -% "" CHMIGE" n ❑ BUILDING I, as owner of the property, or my employees with ADDRESS t.L' wages as their sole compensation, will do the work and D ,tt �t Tom' 1 f OIWY-V�1 8�1�89 the structure is not intended or offered for sale(Section LOCALITY y 7044, Business and Professions Cade). MOVING TEL.. g - �(�p A►� _r' ❑ - CONTRACTOR NO. a�~' '�. 542 1 N 1II-40 I, as owner of the properly, am exclusively contracting. -� �: 1'' with licensed contractors to construct the project (Sec- - tion 704ADDRESS4, Business and Professions Code). �. REQUIRED YARD HWV TOTAPROP. LIN , v` j • �.. N S \ kCT.: CONSTRUCTION construction G'AGENCY SET BACK PROP. LINE WIDTH ,�\ +, „1 « f I hereby affirm that there is a construction lending agency for FRONT y \{' `� u� `,�7 767.00 the performance of the work for which this permit is issued . . P.1. � s Es� (Sec. 3097, Civ. C.). . SIDE 1 r. t` • r� 1 ITEM I, Lender's Name - - L :TOTAL I 7.15 a 00 7� --LDMA Ref. N t.. Lf f v P.C. Fee E (. Permit Fee D CHECK MOO Lender's Address CHEC\ (JJ O I certify that I have read this application and state that the «/ Issuance Fee �O- -v LDMA P/C A CE .00 above information is correct. I agree to comply with all County Invesligalion Fea 1l,,/� q ordinances and State lows relating to building construction, Total Fee -�_ V`••� LDMA Perm. N and hereby authorize representatives of this County to enter �srs p� upon the abov_Qm.nt,. ed property for inspection purposes. VV0D0001 8�1/Vl s--Q/Y--•� - ki I18EEE REVERSE FOR EXPLANATORY LANGUAGE 5430 1 AM 11 y40 Sign re of Af1jlican,or Agent. Dote'