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HomeMy Public PortalAbout5517 ENCINITA AVE_Building__ 76A638A CE N803 2-63 APPLICATION FOR BUILDING PERMLT `- COUNTY OF LOS ANGELES BUILbING A DEPARTMENT OF COUNTY ENGINEER ADDRESS Sf BUILDING AND SAFETY DIVISION LOCALITY / JOHN A. LAMBIE. COUNTY ENGINEER NEAREST WILLIAM A. JENSEN. SUPT OF BUILDING CROSS ST. DISTRICT NO. GROUP TYPE SED BY FOR APPLICANT TO FILL IN J` CONST. BUILDING L - ` STATISTICAL CLASSIFICATION S WER MAP ADDRESS �J BK P CLASS. NO. DWELL. UNITSy ' LOT NO. BLOCK WATER CERTIFICATE: NOT REQUIRED I�/I, RECEIVED ❑ J G c LJ^Il TRACT 2 / Q MAP HIGHWAY N SLOGS. NO. . _ (CIRCLE) STATE MAJOR SECOND. ,CAL SIZE OF LOT -70 X / N W N LOT USE ZONE SPECIAL USE OF CONDITIONS EXISTING ByffiG. 4 L TEL. OWNER NO. BUIL ING EXIST. YARD HWSTRE T N `- SETBACK WIDTH ADDRESS �OO FRONT A/ ARCHITECT R TEL. P. L. I �C�f - ENGINEER. NO. SIDE I a P. L. ADDRESS TEL. Q CONTRACT .0 ADDRESS _ ~ I V DESCRIPTION OF WORK t a . . Z EW j ADD ALTER REPAIR DEMOLISH NO. OF NO. OF SIZE STORIES FAMILIES _ USE OF STRUCTURE IS - ._ SIGNATURE OF APPLICANT VALUATION $ APPROVALS DATE INSPECTOR'S SIGNATURE � FOUNDATION: LOCATION ' FEE $ FEE $ FORMS, MATERIALS FRAME: FIRE STOPS. ziI HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS tG AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING -GAS VENT. DUCTS BUILDING COzz IFY THAT IN DOING THE WORK r�- AUTHORIZED EMPLOY ANY PERSON IN VIOLA= LATH. INT. �r t TION OF THEE STATE OF CALIFORNIA RELAT- ^� ING TO WORKsUFANCE. LATH. EXT. rl SIGNATURE HOUSE NUMBER COR PERMITTEE RECT AND POSTED ADDRESS FINAL Y - JOHN F. LEWIS. PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION cK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH LAUD 4 5 5 4 JAN 1'7 2 3 D 5.7 5 A I 76A638A CE#803 2-63-APPLICATION FOR BU ILDIN G PER IT _ COUNTY OF LOS ANGELES ; ` ADDRESS DEPARTMENT OF COUNTY ENGINEER BUILDING AND .SAFETY DIVISION- LOCAL T JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. 'DISTRICT NCY TYPE ROC FyD BY FOR APPLICANT TO FILL IN CONST. BUILDING ,��' STATISTICAL CLASSIFICATION % W M� ADDRESS I CLASS. NO._t—DWELL, UNITS LOT NO. BLOCK WATER NOT REQUIRED RECEIVED ❑ CERTIFICATE: TRACT (� MAP HIGHWAY STATE MAJOR SECOND. L AL NO, OF BL S. NO. (CIRCLE.), SIZE OF LOT NOW ON L T USE ZONE SPECIAL USE OF �) CONDITION EXISTING B G.�, .� p�� ✓ i VEL. 5 OWNER NO. UILDI NG YARD HWY STREET NAME EXIST. SETBACK WIDTH ADDRESS FRONT ARCHITECT O TEL. P. L. ENGINEER NO_ ©� P. L. ADDRESS O TEL. V CONTRACTOR ' + ADDRESStl J O DESCRIPTION OF WORK' �� 9—� , W � a NE ADD ALTER REPAIR DEMOLISH NO. OF NO..OFL�9 SIZE ( STORIES .FAMILIE r �� r �• USE OF STRUCTU RE /' �* S NATURE - 0 /'ik'',s'5 .� A* t APPLICANT 6'�r a' VALUATION $ a 3�.,,,,,. r •• �a APPROVALS .,, DATE tINSPTOR'S SIGNATURE P.C. PMT. FOUNDATION: LOCAYLON FEE $ - FEE,$ .FORMS, MATERIALS FRAME:'FIRE STOPS. F FF ' I HEREBY ACKNOWLEDGE HAT I HAVE READ'THIS APPLICATION BRACING. BOLTS ,-&!s „i}' 41. "f 9;A AND STATE THAT THE AB E S CORRECT AND AGREE TO COMPLY '' " s 5 Af.A FURNACE: LOCATION. z n h�', �•k>�-0.ay:` -P �' WITH ALL COUNTY OR IN AN ES AND STATE LAWS REGULATING GAS VENT, DUCTS. BUILDING CONSTRUCTI N. I CERTIFY THAT- IN DOING THE WORK' ` 'AUTHORIZED HEREBY WIL NOT MPLOY'ANY PERSON IN VIOLA- TION OF THE LABOR CO - OF T STATE OF LIFORNIA RE LAT- �LAfiF1,"INT. LATH. EXT. _ING TO WORKMEN'S PENSATI INSURANCE SIGNATOR F HOUSE NUMBER COR- ? .' PERMITTEE ERECT AND POSTED I Yf ADDRESS FINAL ' JOHN F. LEWIS. RII CIPAL STRU TURAL EN INFER PLAN CHECK VALIDATION. cK. M.o. cgsH PERMIT VALIDATION CK. M.O. cgsH L_�4j�o1 1 .7, .5.ti OCT' 9 2 3 D 2 6.'7 J5 22841 NOV 6 1 D 53.50' Sys✓� ' 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 1305170022 PHONE: (626) 285-0488 EXT: LEGAL ID: 1 NO. OF CONST I BUILDING ADDRESS: I ITR: 9751 LT: 2 UN: .003 I SQ. FT STORIES TYPE I 5517 ENCINITA AV I I ISTRUCTURE: 2000 V-B 1 TEMP CA 917802308 I (ASSESSOR INFORMATION NUMBER: I 1 NEAREST CROSS STREET: I 15387-020-038 i THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY CAI (TENANT: IEXIST BLDG USE: RESID USE ZONE: R-1 (ISSUED ON: PROCESSED BY: (EXIST OCC GRP: 105/3.7/13 SR 1OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: (FINAL DATE FINAL BY: CODE: INAGLE KEVIN T;JUDY A - 1 1 6,060 1 15517 ENCINITA AV _I (TEMP 917802308 FEES PAID I SC.IPTIO OF WORK I I IREROOF HOUSE AND ATTACHED IRAGE WITH GAF LIFETIME TIMERLINEI I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: INATURUAL SHADOW SINGLES - ASPHALT. REPLACE 6 SIX WINDOWS (APPLICANT: TEL. NO: I (AND ONE SLIDING DOOR. SAME AS OWNER - IAA BLDG PERMIT ISSUANCE 27.80 J_ IAB STATE GREEN BLDG FEE 6060.00 VAL 1.00 (SPECIAL CONDITIONS: IAC STRONG MOTION RESID 6060.00 VAL 0.60 1 ID2 PERMIT W/O EN-HC 6060.00 VAL 166.20 TOTAL FEES 195.60 (CONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE ISAME AS OWNER - 1 I I LIC. NO I ILOCA'PION AND SETBACKS I 1 ISOILS ENGINEER APPROVAL 1 1ARCHITECT OR ENGINEER: TEL. NO: IFOUNDATION/TRENCH FORMS I I I LIC. NO: I (SLAB/UNDER FLOOR 1 I I I I (RAISED FLOOR FRAMING I I 1 11 IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: ( (UNDERFLOOR INSULATION I I 3 031 1 I I I I I (FLOOR SHEATHING I I 1 INO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: 1 l I I - I NC 21 I IROCF SHEATHING I SCHOOL WITHIN HAZARDOUS 1 (SHEAR PANELS 1 I 1AIR QUALITY: 1000 FEET MATERIALS I I I NO NO NO 1 _ IF'RAME INSPECTION 1 I IFIRF. SPRINKLER HANGERS I I I I I (INSULATION/WEATHER STRIPI I I I I (INTERIOR LATH/DRYWALL I I I I I IEXTERIOR LATH I i IRATED FLOOR/CEIL ASSEM. I I IRATED WALL ASSEMBLIES 1 1 1 I IRATED SHAFTS/OPENINGS I 1 I IT-BAR CEILINGS I ILOT DRAINAGE I (REPORT ID: DPR261 ROUTE TO: BS0508 I I I I WORKERS'COMPENSATION DECLARATION 'hdieby� to insure, orairm afcertif certificate of Workers' Compensat on that I have a certificate of coent Insuran elf APPLICATION FOR BUILDING PERMIT or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company • ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING � c ADDRESS ,) .7 l ❑ Certified copy is filed with the county building inspec- BUILDING ,/� tion department. ADDRESS ,(f� j51- /rig �] 11 Date Applicant CITY �'M I �6 0 ZIP / 70 v LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' G NO. OF'BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT Q I NOW ON LOT CROSS ST. (This section need not be completed if the permit is for one ASSESSOR hundred dollars ($100)or less.) TRACT 75I BLOCK LOT NOS./ GoL MAP BOOK PAGE PARCEL OWNER r v�lV 141U a��A y NO. dna -7pS USE E MAP I certify that in the performance of the work for which this N NO. — permit is issued, I shall not employ any person in any manner SPECIALi so as to b co e[�ss bject to the Workers'Compenns1ation S. ADDRESS581? /o yr CONDITIONS U 1 si���J OI�JO CITY (� ` / ZIP Date Applicant ARCHITECT OR TEL. NOTICE TO APPLICANT: If, after making this C of cote of ENGINEER NO DISTRICT GROUP TYPE FIRE PROCESSED BY Exemption, you should become subject to th orkers' CONST ZONE U Compensation provisions of the Labor Code, you must forth- ADDRESS40 with comply with such provisions or this permit shall be Ila �� gg rf TEL. STATISTICAL CLASSIFICATION APT. CONDO. N deemed revoked. CONTRACTORDw•1 e� NO. LICENSED CONTRACTORS DECLARATION CLASS NO. DWELL. UNITS LIC. ' I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. (commencing with Section 7000)of Division 3 of the Business and LIC. SEWER MAP Professions Code, and my license is in full force and effect. CITY CLASS BK PG VALIDATION SQ. FT. NO.OF NO. OF CHECK License Number Lic.Class SIZE STORIES FAMILIES ONE VALUATION DESCRIP N OF WORK 60C Will, NEW Com^ Contractor d Date � l J S ADO ® $ �J d ❑ I am exempt under Sec. ALTER B.BP.C. for this reason REPAIR ❑ $ Date: USE OF DEMO' ❑ EXISTING BLDG. Signature APP PR,NNT NO FINAL" OWNER-BUILDER DECLARATION I DATE I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS FI Professions Code): PRESENT ❑ BUILDING 1, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS r' tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK 7 CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH #f�2 O 6 r,:6.A 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 9 4 P.L.Lender's Name ,�oo P.C. Fee$ Permit Fee LDMA Ref. # Lender's Address ��!�'')) 3 I certify that I have read this application and state that the o y pp' Issuance Fee O _- V LDMA P/C# o above information is correct. I agree to comply with all CountyInvestigation Fee 0 ordinances and State laws relating to building construction, Total Fee (/ LDMA Perm. # 6 and hereby authorize representatives of this County to enter m Zthne above-mentioned pr rty for inspectio put ses. ' m SEE REVERSE FOR EXPLANATORY LANGUAGE n Signature of Applica r0 Agent Date