HomeMy Public PortalAbout5719 ENCINITA AVE_Building__ DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR 'PERMIT
COUNTY OF LOS ANGELES n ® n O p
WM. J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
BUILDING yn (� I DISTRICT NO. PLAN CK.NO. PER/MIIT NO.
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ADDRESS �G/6y/ .7. �L `' • /����D "//X•.�✓
LOCALITY /IJRar.�+�. (-.vL/`�"i RECEIVED BY DATE OF APPL. (CD/ALTE/IB9U[D
NEAREST v -27 j
CROSS ST.
OWNER i'e. /Ltl/D✓"�'W�`MAILyA� - ADDRESS /,y / S Cn/JifiL!/'s)f��w./ V4�_Y
ADDRESS �` /Qyq IJ✓�P�v1J/�Gty LOCALITY
NEAREST
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CITY �-Ia //� '�✓'�� NO. L` CROSS ST.FIRE
ARCHITECT OR TEL ZONE PLANS Z TYPE GROUP�J'�
ENGINEER NO. L.
BLDG. qq � ORD.NO:
ADDRESS SETBACK LINE
Aft ( APPROVED
CONTRACTOR [ /ly/t ,,ILf1/ � L/ ' BY IS..r..._- DATE
^ USE G. �� APPROVED
ADDRESS / 3 0 , ZONE BY DATE
LEGAL �,� CORRECTIONS
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LEGAL
LOTNO.r�II�i�Ol1gtpCK��`/�
TRACT iQa..(✓�✓•(+�iV✓/Y1•/NitJ�e�J �i1d-SGA -. �� /� (� O .f!/! ccs i/- � J l/�[��.+}
SIZE OF LOT"16 /� 1 N d NOW ON LOTg/YLd�✓r"�
USE OF NO.DF NO.OF
EXISTING BLDG. FAHI LIefi I ROOMS
DESCRIPTION OF WORKi
NEW ALTERATION ADDITION -
A
REPAIR G / MOVING ` DEMOLISH81,
/ O
s ZE - 0 tl ROOMS .I STORIES /
D
WALL n I ROOF r
COVERING
COVERING A� COVEf .
USE OF NEW
BUILDING
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a-
D D" `
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION: LOCATION INSPECTOR DATE
FORMS,MATERIALS
AND STATE LAWS R GULATING BUILDING CONSTRUCTION. �G4
F
RAME: FIRE STOPS, Q r/
SIGNATURE OF y /�//J GRACING, BOLTS /, �a- �
PERMITTEE LATH, INT.:
c AUTHORIZED AST LATH,EXT,:
Das-3 soM s"s 1-48 $ P C ® PLASTER,INT.
7
�']QO9 FEE f/l'J PLASTER,EXT.
LVALUATIDN= / • n C 'o
>FEE ® /�( FINAL „� lyiV/17 �
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APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
BUILDING
FOR APPLICANT TO FILL IN - ADDRESS CT IQ Iq. EE S-• TC,
BUILDING
ADDRESS 57I _ ST. LOCALITY L G M pI G
NEAREST
CITY ' C.ItU ZIP CROSS ST. L.AsTuNAS
L F NO.OF BLDGS. ASSESSOR t'^) `7 D PAGE d 1 PARCEL Q I
SIZEOF LOT Y NOW ON LOT MAP BOOK V J
DISTRICT GROUP TYPE FIRE PROCESSED BY,
TRACT BLOCK. LOT NO. _ p' 5-Oa CONST , ZONE
OWNER Bit I+(A III NO.7.45-S73D 3
STATISTICAL CLASSSIIFIC'ATION SEWER
MAP
ADDRESS G • E It CLASS IN DWELL.UNITS L BK 1 PG
CITY i-E U ZIP q 1
ARCHITECTOR TEL VALUATION $ /�/b C`
ENGINEER NO / VV
ADDRESS BLDG.SETBACK FROM
TEL FRONT PROP.LINE OF (STREET)
CONTRACTOR 'NO: HIGHWAY .+ YARD = TOTAL SETBACK FROM TYPE OF EXISTING
_ LIC. - FRONT PROP.LINE HIGHWAY WIDTH
ADDRESS NO _
LIC. +
CITY 'CLASS BLDG.SETBACK FROM
CONSTRUCTION LENDER SIDE PROP.LINE OF ISTREETI
NAME AND BRANCH
HIGHWAY + YARD TOTALSETBACK TYPE EXISTING
ADDRESS 'CITY SIDE PROP.LINE.
HIGHWAY WIDTH 0
50.FL 1L 1 NO.OF NO.OF CHECK + _ U
SIZE H 7 IS
TORIES FAMILIES I ONE l ITZI
O
DESCRIPTION OF WORK NEW ❑ P.C. Fee$ Permit Fee / O
L ADD ®❑ Issuance Fee
ALTER f _
REPAIR ❑ Total Fee /
USE OF pEMOt ❑
EXISTING BLDG.' r�11>i _
APPLICANT TEL O
(PRINT)13 L NO. 7-iQ
D
BY ISIGNATUREI j
HEREBY ACKNOWLEDGE THAI I HAVE•READ THIS APPLICATION AND STATE Y
THAI THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES W
AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE V
WORK AUTHORIZED HEREBY'I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF -
THE LABOR CODE OFTHE STATE OFCALIFORNIA INRELATING TOWORKMEN'S COM z 7t p
PENSATION INSURANCE, 5 1 OA
6 q '
qe0 OO O'O,'�
SIGNATURE OF '
PERMITTEE 2 0 1 6 Q,O Q
ADDRESS •:Esl,
CK1. TELNo. G 1-0 1 '6 0.0 0 ux
CITY Q
e ' 0725-'79
USE ZONE J�SPECIALS
Z '
CONDITIONS. f '
FINAL BY L` - • _ i
DATE
COMPENSATION DECLARATION
at I,have a'certificate of consent to self
ficateof Workers' Compensation Insurance, P P L O C1MM } R BU O LIO G P E RMOLI IL
or a cert ied copy thereof (Sec. 3800, Lab. C.) '
Policy No. -COUNTY OF LOS ANGELES BUILDING AND SAFETY
Company - CBUILDING
Certified,copy is.hereby furnished. � FOR APPLICANT TO FILL IN ADDRESS"
'F-1 Certified copy is filed with the'county building inspec- BUILDING - y� r
tion department. ADDRESS S`. l ` / /s✓ LOCALITY
/' NEAREST
Date ^Applicant CITY ZIPv CROSS ST.
CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLLOT ASSESSOR
COMPENSATION INSURANCE SIZE OF LOT Q X >O NOW ON LOT MAP BOOK PAGE PARCEL - (,1
(This section need not be completed if the permit is for.one / USE ZONE MAP q
hundred dollars-($100)or less.) _ TRACT BLOCK / LOT NO. NO. O�
.•�+ TEI: vi �f�.DO SPECIAL 0010 }
I certify that in the performance of the work for which.this OWNER CJ ( CONDITIONS 0
permit is issued, I shall not employ any person in any manner -� DISTR/ICT(/ GROUP TYPE FIRE P OCESSED BY 0
so as to be�APPLICto the Workers'Compe 1 n Laws. ADDRESS �i /� �}} 6f V Q Y..� CONST. ZONE W
CITY J / - ZIP; ���v t I` •J O
�\ IG !✓
Datepplicant STATISTICAL CLASSIFICATION - APT. C NDO. V
NOTICE If, after ma . g`this Certificate of ARCHITECT OR 1 7EL. - _.
ENGINEER NO. - CLASS NO. DWELL. UNITS_ W
'Exemption, you should become 'subject to the Workers' d
Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP V1
with comply with such provisions or this permit shall be Z
TEL
deemed revoked. - ' CONTRACTOR _ TEL _ BK PG, VALIDATION -
LICENSED CONTRACTORS DECLARATION V 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. 6TV CLASS $ OC)47 00 •. t -
SQ. FT. NO. OF NO. OF 'CHECK D' � 10 1,2 A
License Number Lic.Class SIZE STORIES FAMILIES ONE
NEW $ e e
Contractor Date DESCRIPTION OF WORK - i ,
�s ADD ❑
I am exempt under Sec e
ALTER. ❑ FINAL Af T8 0 0 . .
B.BP.C. for this reasonE]- DATE
REPAIR
Date: EXISTING
OF . ❑ 7 R 0 0 U.:
FIN
E%ISTING BLDG. - - --- DEMOL BY �.� /
Signature - - APPLICANT - TEL. - .� Q
OWNER-BUILDER DECLARATION PRINT U// .G� /l7Lg SIO _ -
I hereby affirm that I am exempt from the Contractor's License / .ADDRESS ow-
Professions
Law for the following reason (Section 7031.5, Business and.
Code): PRESENT '
❑ BUILDING. -
I, as owner of the property, or my employees with ADDRESSf
wages as their sole compensation,will do the work and
the structure'is not intended or offeredfor sale(Section LOCALITY -. ..
7044, Business and Professions Code). MOVING .TEL.
-F-1 1, as owner of the property, am exclusively contracting CONTRACTOR NO.
with licensed contractors to construct the project (Sec-
tion 7044, Business and Professions Code). ADDRESS
REQUIRED TOTAL SETBACK FROM EXIST.
' CONSTRUCTION LENDING AGENCY - SET BACK YARD HWY PROP. LINE WIDTH D
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 I
P.I.
m Lender's Name t '
$ Lender's Address P.C. Fee$ Permit Fee `�� -
- � '
I certifythat I have read this application and state that the [ten t
pp Issuance Fee / SO `' 1
above information is correct. I agree to comply with:all County Investigation Fee Q
g ordinances and State laws relating to buildt>�onstruction, Total FeeLod �,. I
u and hereby authorize representatives of this County to enter 1 v01 -`
m Ont eabove-mention d, roperty for inspection p '\ 1 \ '_)
n SEE REVERSE FOR EXPLANATORY LANGUAGE. -
tore of Applicant or Agent Date .®s
COUNTY OF LOS ANGELES TEMPLE CITYJ_, ,' BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS - 9071 LAS -TUNAS - RESIDENTIAL ADD/ALT/REP
BUILDING AND SAFETY L LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9703180052
PHONE: (818) 285-0488 EXT: _
LEG NO. OF CONST NEW B NGR •
ON FILE SQ. FT STORIES TYPE OCCUP GROUP 5719 ENCINITA AV
STRUCTURE: 772 1 V R3 - TEMP CA 917802418 -
ASSESSORORMA BER: GARAGE: NEAREST CROSS STREET:
5387-018-015 OTHER: 120 1 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY
. TEN EXIST BLDG USE: USE ZONE: ISSUED ON: PROCESSED PIR ON:
EXIST OCC GRP: 06/17/97 TC 06/17/98
OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATIO FINAL DATE FINAL BY: CODE:
CHAVEZ- JULIAN E;KATHLEEN K (818) 285-5799- 1 - 60,000
5719 ENCINITA AV - -
TEMP 917802418 FEES PAID DESCRIPTION OF WORK -
MASTER BATH, UTILITY ROOM WITH 1/2 BATH, EXTEND LIVING ROOM
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: WITH NEW FRONT ENTRANCE, EXTEND.MASTER BEDROOM, NEW BREAK-
APPLICANT: . N0:
SAME AS OWNER- - - B1 PLANCHECK W/ENERGY 60000.00 VAL 839.95 -
AA BLDG PERMIT ISSUANCE 27.75 SPE IAL CONDITIONS:
AC STRONG MOTION RESID60000.00 VAL 6.00
B2 PERMIT W/ENERGY���„60000:00 VAL 988.19 f
TOTAL FEES 1,861.89
CO RACTOR: T N0: �� �'(�� APP OVALS - DATE INSPECTOR SIGNATURE .
SAME AS OWNER ,
LIC. NO �i - 0 D SETBACK
SOILS ENGINEER APPROVAL
ARCHITECT ENGINEER: _ s - FO 10! 0 S -IlLi F7
LIC. NO: \/ / � 1 -- SLA /UND R FLOOR
_
Al
��
MAP O:.SEWER MAPBOOK: PAGE: FIRE ZONE: CMP: D 1 UNDERFLOOR INSULATION
3 01 �A �uL HLci � ( �
1ST LEVEL FLOOR SHEATH-
0. ES: ELL G /CO - ST AS : —K G A
NO 21 1� ND;LEVEL FLOOR HEATH
O i. �ii•.
!J
S I G
L
HAZARDOUS 1-_ v' SHEATHING AI
AIR QUALITY: 1000 FEET MATERIALS �� X 1 7
NO NO_� � NO � � -� :/ �, � FIRE DEPT. FRAML INSPECT
REQUIRED TOTAL SETBACK— ST BLDG FRA INSP
SET BACK . YARD: HWY: PROP LINE: WIDTH: i•
FRONT PL- �ifY, ��/�, SHEAR PANELS
SIDE PL; `LL:: Q!
INSULATION/WLAIMtK blKir
INTERIOR LATH/DRYWALL
EX ERIOH
LO DRAINAGE L! -
SMOKE DETECTION EVIC
FIR DEPARTMENT PPROVAL
* ADDITIONAL DATA ON FILE
REPORT ID: DPR261 ROUTE TO: BS0508
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 9710210047
PHONE: (818) 285-0488 EXT:
LEGAL ID: NO. OF CONST B L I D
ON FILE SQ. FT STORIES TYPE 5719 ENCINITA AV
STRUCTURE: 0 VN TEMP CA 917802418
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET:
5387-018-015 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY
TENANT: EXIST BLDG USE: RESID USE ZONE: R-I ISSUED 0PROCESSED Y: EXPIRES ON:
EXIST OCC GRP: 10/21/97 UT 10/21/98
OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE:
CHAVEZ JULIAN E;KATHLEEN K 626285799 - 1 2,800
5719 ENCINITA AV �J
TEMP 917802418 FEES PAID DESCRIPTION OF WORK
REMOVE AND RECOVER WITH GAF 30 YR. COMP. SHINGLE
FEE DESCRIPTION: QUANTITY: LION: AMOUNT:
APPLICANT: TEL. NO:
SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75
AC STRONG MOTION RESID 2800.00 VAL 0.50 SPECIAL CONDITIONS:
D2 PERMIT WEN-HC �r-VSOOO99.15
DIAL FEES
OVA� 1 .40
CONTRACTOR: TEL. N0: 1^Vq•' APPROVALS DATE-- INSPECTOR SIGNATURE
SAME AS OWNER
LIC. NO /J LOCATION AND SETBACKS
SOILS ENGINEER APPROVAL'
ARCHITECT OR ENGINEER: TEL. NO: ® FOUNDATION/TRENCH FORMS
LIC. NO: SLAB/UNDER FLOOR
illi
RAISED FLOOR FRAMING
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: �{ UNDERFLOOR INSULATION
147H265 3 . 01 PUBLIC W RKS
FLOORSHEATHING
NO. OF FAMILIES: DWELLING UNITS: AP OND: STAT CLAS :
NO 21 "' ��p r^ ROOF SHEATHING
SCHOOL WITHIN HAZARDOUS o � SHEAR PANELS
AIR QUALITY: 1000 FEET MATERIALS
NO NO NO / Q O FRAME INSPECTION
REQUIRED TOTAL SETBACF FROM EXIST FIRE SPRINKLER HANGERS
SET BACK YARD: HWY: PROP LINE: WIDTH:
FRONT PL- {{� INSULATION/WEATHER STRIP -
SIDE PL- e vyryv�1,i,Y1� \ e�
'L INTERIOR LATH/DRYWALL
EXTERIOR LATH
RATED L /CEIL ASSN—.
RATED WALL ASSEMBLIES
RATED SHA S/0 NI S
T-BAR CEILINGS
LOT DRAINAGE
REPORT ID: DPR261 ROUTE TO: OS0508