HomeMy Public PortalAbout5627 ENCINITA AVE_Building__ Pp' APPLICATION FOR
BUILDING PERMIT
FOR APPLICANT TO FILL IN ADDRESS r2' IVCIN/ ,
BUILDING n 1�
ADDRESS l 7 LOCALITY rt
/7 NEA
CITY + (�s� ZIP � CRO55RESSTi. C/lil •
NO.OF BUDGE. ASSESSOR
SIZE OF LOT NOW ON LOT / MAP BOOK PAGE PARCEL
DISTRICT GROUP TYPE . FIRE PROCESSED BY
TRACTC iC BLOCK A �LTEONO. 6�T� �� � CONST., i ZO E -0[,),
OWNER . 'F V
_ STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS ,;( KL/ / p\ V CLASS NO. DWELL.UNITS BY/
CITY . C ' ` ZIP . ' // 7O O ' USE ZONE NAP
2-0 -
ARCHITECTOR TEL. ^ `' /�/J SP1-
ENGINEER FI` NO. ol1 7- r� '�! CONDITIS IAL ONS
ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO❑ -
TEL BLDG
CONTRACTOR L*' f - o. NO �a C7 FRONT ROP.LI FROM
LIC. FRONT PROP.LINE OF - ISTREEiI
'ADDRESS - NO. HIGHWAY + -_ YARD- TOTALSETBACK FROM TYPE OF EXISTING
LIC. FRONT PROP.LINE HIGHWAY WIDTH
CITY CLASS
CONSTRUCTION LENDER +
NAME AND BRANCH. O BLDG.SETBACK FROM - - - - - - - Ou
ADDRESS CITY SIDE PROP,LINE OF ISTREETI
O
SO.'FT NO.OF NO.OF CHECK HIGHWAY }- YARD TOTAL SETBACK FROM TYPE OF EXISTING w
SIZE STORIES FAMILIES ONE SIDE PROP.LINE . HIGHWAY WIDTH. o.
. - ❑ +Y `R Z
DESCRIPTION OF WORK NEW
E - ADD CORNERCUTOFF ,.YES ❑ NO ❑
ALTER ❑ IN OPEN SPACE YES ❑ NO ❑
T REPAIR ❑
USE OF DEMOL ❑ INCOASTAL PERMIT ZONE YES ❑ NO [3,
EXISTINGBLDG. P
APPLICANTec., Y3/78 /�/ e P,/�dS �SCe �� o "C 7
IPRINT7. /// C (S a
BY ISIGNATUREI 'I( l�J`w� �G
I HEREBY ACKNOWLEDGE THAT I HAVE READ:THIS APPLICATION AND STATE
THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES
AND LAWS REGULATING BUILDING CONSTRUCTION,I CERTIFY THAT IN DOING THE •i-�Ls-r+_�� /04/ �/.\ / f''-�'�f -
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN SCOM _ ♦ �(//�/,J�y/_�')•/�T
PENSATION INSURANCE.
ol
SIGNATURE OF FINAL •/�JL1'�V BY,
PERMITTEE DATE _
ADDRESS
TELT �L ( P.C. Fee•$ / Permit Fee �•• �
CITY NO. v .
''•, tIssuance Fee.
VALUATION Totob Fee
PLAN CHECK VALIDATION ' CK. ' into- cnsH' '_ -PERMIT VALIDATION CK. M.O. sH'
7 8 '0 DEC ,2Q 1 u 1 U 5.0 0 e�
®f 96A6388 CE(8QjBLR 1/9fj
n nnUla l G/'Y _ •-
`/ 2 3 D 1 1 7.0 0 'szls c2;' „6—,.
DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES [ F� A L ® �
WM. J. FOX, CHIEF ENGINEER F63� @�
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
DISTRICT NO. PLAN CK.NO. PERMIT NO.
ADDRESS 213 South Encinita Ave. ��
LOCALITY Temple City RECEIVED BY pDATE OF APPL gDATEIBSUED
"cans BeTT. Live OakeUILDING
OWNER
Fred Claus & Rose Marie ScYmi' DDREBB
AMAIL
DDRESS 2712 Glenview Ave 'L°°^LIT.'
NEAREST
ITY LOS Angeles NEEU. CROSS ST.
FIRENO.OF I TYPE' ORO -
ARCNDTECTOR self TEL �
ZONE PLANS
ENGINEER NO.
BLDG. ORD.NO.
ADDRESS same , SETBACK LINE
APPROVED
CONTRACTOR self Np BY r DATE
_ USE X� //��Ipp- ROVED
ADDRE99se ZONE �r•4BY DATE
LEGALCORRECTIONS
DESCRIPTION I LOT NO. 15 BLOCK
TRACT Sunny View 77 c-,' yc -1-
SIZE
91ZE OF LOT 97:E 11 x 3551 NOOVW FON LDOT9 3
USE OF �e ing NO.OF NO.OF ��
EXISTING BLDG. FAMILIE,l I ROOMS 4 1Z�1`-c. O 4✓ /[��<ia F�.
DESCRIPTION OF WORK
NEW ALTERATION ADDITION
O
REPAIR x MOVING DEMOLISH
NO. OF ,J. Z
SIZE ROOMS -1 STORIES F �A J .'�� ��✓ D
WALL Roar
J] L _ r
COVERING WOO a I C,VVEERDN[Tsphalt
BUILDINGUSE OF NEW 'dwellin♦g�
V./_v'✓r�_�L�i/mil t_� /
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS
APPLICATION AND STATE THAT THE ABOVE IB CORRECT FOUNDATION: LOCATION INSPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
�� /,��IW� ` , FRAME: FGRE BOLTS SIGNATURE OF /V/9`//r/J fff-bP��-.(((YYYfvvv�,,,J BRACING,HOLT9
OWNER LATH,INT.:
AUTHORIZED AST. LATH,EXT.. "
Das-a 25M s[Ts o-av $ P L. G PLASTER. INT.
� r6c FEE PLASTER.EXT.
y �.
VALUATION FEE 4 FINAL
DIVISION OF BUILDING AND SAFETY rt�{ A
Department
of County Engineer 1Q'� L� �]
wm. J COUNTY DFqox,of
Angeles
d APPLICATTION�--
FOR APPLICANT TO FILL IN BUILDINZ , .T /O/�/'Gfi✓/�(.L.
BUILDING77 -
/ V LOCALITY / C'
ADDRESS
II NEAREST
LOCALITY CROSS ST. YJ
DISTRICT NO. PUN CX.OR REG. No. PERMIT NO.
`. NEAREST T'' 2?47/
CROSS ST.
2�VONER FF``��//�� n,. ya RECEIVED BY DATE OF APPL. DAT [SSU D
ADAILDRESB✓�+� a ✓✓v �// 3O
USE ZONE t O. OF TYPE GROUP FIRE ZONE
CITY NO LJ;-
,/J/ .I NI 7 LAN9
ARCHITECTOR TE Y9}`N'//. ZONING _ _- RATED
ENGINEER NO APPROVED By-
BU'LD IN
ADDRESS �� SETBACK LINE:
TEAPPROVED , ' DATE
TEL
CONTRACTOR TE Q By,
HOUSE NUMBERING
ADDRESS A
LEGAL MAP NUMBE NO. ASSIGNED BY
DESCRIPTION �{ LOT NO. BLOCK
D
110 L'®3_� � CORRECTIONS INSPECTOR
TRACT110
NO. 6F
SIZE OF LOT#T —OA/�3 I NOW ON LOT BLDG$
USE OF NO. OF
EXISTING BLDG. FAMILIES I I O
DESCRIPTION OF WORK
z
r
ALTERATION ADDITION I D
r
DEMOLITION
//J NO. OF
/A O ROOMS STORIES
ALLJC�VCG O ROOF p /, _I _
ING COVERING n aC/1
STRUCTURE
� APPROVALS
INSP CCTTq 'S SIGNATURE DATE
FOUNDATION: LOCATION Y..FORMS. MATERIALS -90 FREBY ACKNOWLEDGE THAT I HAVE READ THIS AP FRAME: FIRE STOPS,
ION AND STATE,THAT THE INFORMATION GIVEN IS BRACING, BOLTSCT.REE TO COMPLY WITH ALL COUNTY ORDINANCESFURNACE: LOCATION,ATE LAWS REGULATING BUILDING CONSTRUCTION. GAS VENT, DUCTS /
SIGNATURE OF
r LATH, INT.
PERMITTE
zXr�ADDRESS / ue LATH. EXT. /
/
C PLASTER, INT. A ill
AUTHORIZED AGT.
_ s� PLASTER, EXT. I'/) ✓/�/ J
O v FEE $/� 4"0 HOUSE NUMBER COR-
�v �� RECT AND POSTED p w J
b
NI
VALu Io1G�i= FEE FINAL
76A69BA Des 9 Z-E9 &-V
/�) I/l v
..r.�„ V/ORKERS' COMPENSATION DECLARATION
".1 hereb;, affirm that I have o certificate of consent to self O 117 (/�,�. M gyp} tFY� O M�(/��., O �r�}I��y/��YLL
:Awe, or a certificate of Workers' Compensation Insurance, (/'"�I P P LS�V'����O N B _O R B U O L D O U' G PO E R 07
or a certified copy thereof (Sec. 3800,'Lob. C:)
11. COUNTY OF LOS ANGELES BUILDING-AND SAFETY
Policy,No: Company . . I - I
- BUILDING q
❑
Certified copy ii '•ereby furnished:, - FOR'APPLICANT TO FILL IN ADDRESS
Certified copy is filed�w tithe county building inspec BUDDING - - --
Y T
Loo depa.tment ADDRESS i C-1 /f
n _dm /� ./ lA_
yC A 1 �G' / Jc f LOCALITY
Date� :^ c pplicant 1'+ ITL.Y .ZCC CITY �`:��f ZIP�� t ( /
CERT ICATE OF EXEMPTION FROM WORKERS'- - ' - NO. OF BLDGS. -- - NEAREST .. J
COMPENSATION INSURANCE •. SIZE OF LOT NOW ON LOT CROSS,ST.
(This section need not betcortipleted if the'permit is for one - - - -- - - ... ASSESSOR
hundred dollars ($100)or less.) TRACT BLOCK LOT NO. - MAP BOOK PAGE PARCEL
I /J },� >`}� TEL. ir/ 7i'., f USE ONE MAP _.
OWNER'. 4Ui -G � C Com-_• NOi- \ L-'
I certify that in the performance of the work for which this _ NO. T
permit is issued, I'sholl'not employ any person in anymoriner it I— _ SPECIAL - - - - -- - •- •- d
sd`as to'beca me subject to-the Workers'Compeosotion'Laws. ADDRESS, eQr j /r' �1dC" / - 1 CONDITIONS r V
,•r t - CITY t:�(//p/-moi �i'T ZIP�i '�L -
Date �• Applicant ''''. .
NOTICE'TO APPLICANT �If, after nr this Certificate of ARCHITECT OR TEL. DISTRICT GROUP TYPE- - FIRE P C SED.BY - O
Exemption you should become subject to 4hee Workers - ENGINEER NO. CONSfT.: ZONE lJ
Compensation provisions of.the Lobon Code you- ADDRESS,must forth- Sr.(/(Y '3 V/ 3 _ S
with comply wilh„such•provisions or:,this.permit shall be _ - N
deemed revoked.; -: t C 4•Y T. IEL �I♦J STATISTICAL CLASSIFICATION APT. ONDO.- Z
CONTRACTOR �: UL.. `J /•�!TA/�NO. c_ ,X f _
LICENSED CONTRACTORS DECLARATION L - - LIC' CLASS NO.' 1 DWELL.UNITS—
hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS U /-5R .+:i NO.
(commencing with Section 9000)of Division 3 of the Business and LIC / SEWER MAP
Professions Code, and my license is in full force and effect CITY /L CLA55 y -/• - -' - - VALIDATION-
`r. :Ilk
y _ SQ._FT. - _ NO. OF _ NO. OF _ CHECK_' BK. PG. r
License Number tic Class'- SIZE STORIES FAMILIES ONE
y/f I ye /; ,/ *'s'� Date -,M/ '� DESCRIPTION OF WORKNEW-
ADD
_ VALUATION
Contracto,s��lL�'LLL�fLLL _ NEW_ ❑ ` F71
I /r ADD ® $ f L/ D • •.}... c
I am exempt under Sec -- t..•C 4T ALTER.
.0 . ;e
i. r
B.BP.C. for this reason _ REPAIR ❑ f'' '- -
.. USE OF �%/ ❑
EXISTING BLDG. �(.(.• ? /A1 Y DEMOL _ _ -
`I APPLICANT•- - �� L W +r �/7 '
-Signature' PRINT 'IL'<.AG �3/t� �-/LADS. TEL.j L /T/ ` FINAL �42'a_4•A '
OWNER-BUILDER-DECLARATION - _ _ _ ..DATE - -
I hereby affirm that I am:exempt.from.the Contractor's.License - �'/ r /'' ,r• ' #'• e e • • �~
• Law for the following 'reason (Section 7031.5, Business and ADDRESS. i6c� �% C� �� - l FINA '� }•i'_' t
'Professions Code): - - - '" -- ' - "" PRESENT - -BY ' - _I
BUILDING 7 �'
- f"�
El 1, as 7 `5
owner of the property, or my employees with ADDRESS _ _ r
wages as thei?sole compensation,will
'do the work and -' - - -• 7 1.7 S 6�
the structure is notintended or offered for sole(Section LOCALITY • ' t
--7044;-Business and Professions Code).' - ^•" / MOVING - -TEL.- D - - - '- "0 3. 1 4 8`y.,
I, as owner of the property, am exclusively contracting CONTRACTOR NO. e_
with licensed contractors to construct The project (Sec-
tion 7044, Business and Professions Code). ADDRESS -
. REOU
IR ED ,TOTAL SETBACK
-- 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
P.L.
Lender's Name - WMA Ref. p
Lenders-Address-
enders Address - _-_ t• ,
`-� P:C.-Fee S' Permit Fee -
- .. '
i
I certify that.[ have read.this application and state,that the -__ - - IssuanceFee SV LDMP.P/C q �. i. '' • - '
a above information is correct. I agree to comply with all County Investigation -71 fee
�j
ordinances and State laws relating to building construction, _ Total Fee v •LDMA Perm. N
and hereby authrep
orize resentatives of this County-to enter
the above-ale ti ned property for inspection purposes. -
r
_7�Jid /ZilJ�//(�r� % �G�? SEE REVERSE FOR EXPLANATORY LANGUAGE - M
Signal u a of Applicant or Agent - /ki
to
COUNTY OF LOS ANGELES TEMPLE CITY - q 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0508290080
PHONE: (626) 285-0488 EXT:
LEGAL ID: NO. OF CONST BUILDING ADDRESS:
ON FILE SQ. FT STORIES TYPE 5627 ENCINITA AV
STRUCTURE: 2238 VN TEMP CA 917802416
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: -
5387-019-03D THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY, C
TENANT: EXIST BLDG USE: REBID USE ZONE: R-1 ISSUED ON: PROCESSED BY: EXPIRES ON:
EXIST OCC GRP: OB/29/05 JK 08/24/06
OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FIN E FINAL BY: CODE:
QUM, KENNY - 6,500 ��-
5627 ENCINITA AV
TEMP 917602416 FEES PAID DESCRIPTION OF WORK
TEAR OFF COMPOSITION TO WOOD 15 NFELT 30 YEAR TIMBERLINE
FEE DESCRIPTION: QUANTITY: HOP: AMOUNT: CHARCOAL COMPOSITION ROOF
APPLICANT: TEL. NO:
WATKINS (949) 361-9555- AA BLDG PERMIT ISSUANCE 27.75
421 AVENIDA VAQUERO AC STRONG MOTION REBID 6500.00 VAL 0.65 SPECIAL CONDITIONS:
SAN CLEMENTE 92672 D2 PERMIT W/0 EN-HC 6500.00 VAL 166.20
TOTAL FEES 194.60
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
AERO-THERM CONSTRUCTION, INC. (949) 361-9555-
421 AVENIDA VAQUERO LIC. NO LOCATION AND SETBACKS
SAN CLEMENTE, CA 92672 393321C39 '�•
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
147H265 3 01
FLOOR SHEATHING
NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS:
NO 21 ROOF 1. SHEATHING
SCHOOL WITHIN HAZARDOUS SHEAR PANELS t
AIR QUALITY: 1000 FEET MATERIALS
NO NO NO FRAME INSPECTION
REQUIRED TOTAL SETBACK FROM E%IST 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 70: BS0508