The URL can be used to link to this page

Home My Public Portal About5830 ENCINITA AVE_Building__ TEMPLE CITY 76A639A CE ;803 3-52 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES gUILDIN DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION LocnuT, [ C JOHN A. LAMBIE. COUNTY ENGINEER NEAREST WILLIAM A. JENSEN, SUPT OF VIL.ING CROSS ST. _111 4ci 11 11 DIST T O. GROUP TYPE MESSED BY FOR APPLICANT Ty FILL IN j DONST-Z �[i24 BUILDING STATISTICAL CLASSIFICATION EWER MAP' AO DRESS CLASS. NO. DWELL. UNITS BK PG LOT NO. •-�.. BLOCK WATER NOT REQUIRED RECEIVED // CERTIFICATE: TRACT (1+ [G MAP J HIGHW41 STATE MAJOR SECON , LOCA NO. OF BLDGS. NO., j (CIRCLE) SIZE OF LOT 10 NOW ON LOT USE ZONE: SPECIAL USE OF op2- CONDITIONS EXISTING SLOG. OWNER _ - NO. BUILDING YARD HWV STR ET NAM EXIST. SETBACK TH ADDRESS () lFi�-�-• FRONT ARCHITECT OR TEL. - I P. L. ENGINEER NO. { SIDE ADDRESS O TEL. I e[{� A V CONTRACATOR NO. DDRES$ ✓•'�� a 1 /, �- ,• �' G. O . DESCRIPTION OF WORK NEW AdD ALTER NOREPAIR DEMOLISH ,�•/ f FT. / �/•f' y -- I Z SIZE STORIES FAMILIES USE OF STRUCTURE 30 — Sim• .� -, 2-+ • i "'NATURE OF APPLIOANT VALUATIONS '� ` APPROVALS Q OA/E INSPEcio 's SIGN P.C. PMT. / �Y SFO FORMS( MATERIALS N' R V FEE S- EMITS n �_ ,FRAME: FIRE STOPS. 1 HEREBY FCHNOW LEDGE THAT 1 HAVE READ TM IS 4PPLICATION ' BRACING,FIR BOLTS AND STATE THAT THE ABOVE IS CORRECT ANO AGREE TO COMPLY FURNACE: LOCATION. WITH ALL'COUNTY S 'ORDINANCEAND STATE LAWS REGULATING ''GAS VENT. DUCTS BUILDING,CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK' / I AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- T. (LATH. IN TION OF'THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- t ING TO WORKMEN'S COMPENSATION INSURANCE. LATH: EXT. SIGNATURE OF ) J 'HOUSE NUMBER COR-_ { �� PERMITTEE RECT AND POSTED noDREss FINAL �Q �o r'• - '✓� JOHN F. LEWIS. PAIN C i PAL'STRUCTURAL EN PLAN CHECK VALIDATION , CK. M.OI BASH _ PERMIT VALIDATION CK. M.G. EABH (;°{ 06.2 8 7tL'IR 6 1 D 6.00- 2 7GA89SACE*8G9-7.e6APPLICATION FOR BUILDING PERMIT. BLRLDING AND SAFETY DIVISION BUILDING ^fO �L 1 ADDRESS V Department of County Engineer r County of LOS Angeles - LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER - NEAREST_ CASSATT D.GRIFFIN. SUPT OF BUILDING' CROSS ST. DISTRISCT N_O. -OUP I TAPE I SEWBER MAPF FOR APPLICANT TO FILL IN T �I CONST. BUILDING O / �,V/r Q � STATISTICAL C SIFICATION ADDRESS/�/ I� �y /7 ^ LOT NO /11,,50 OF / / y BLOCK MAPCLASS. NO. /1DWELL. UNITS / / NUMBER OO SHWYE YES O 27 TRACT /J�(1 I USEZONE SPECIAL SIZE OF FL:OT !/D � /� NO. OF BLDGS, q 2— CONDITIONS NOW ON LOT -S/ K? _ USE OF L/O ^w� rr D c'T /r ,� EXISTING BLDG. / !7/V�71G BUILDING EXIST. YARD HWY STREET NAME / y t� SETBACK WIDTH OWNER /�/��.Y/O / [/ r.(/Ae�� r,yrr FPROINTAl L a AD RE�55]Q 7L916 j nnd/�lrelwz) /Jye- p SIDE d - 'f0 CITY Pe:).« m eq NOI.AY./r2l�/ P.L INSPECTION RECORD ARCHITECT OR TEL. ENGINEER NO. ,R. ADDRESS ^'`, TEL. CONTRACTOR !)yy i$4?11e�..- NO. ADDRESS DESCRIPTION OF WORK NEW ADD ALTERREPAI SQ. FT. NO. OF NO SIZE STORIE FA IES _ - US OF STRUCTURE T Q dv g �8�9�e ,�yDplloP� APPROVALS SIGNATURE OF i IS J` APPLICANT r/ DATE INSPE OR SSIGNATIIRE ADDRESS FOUNDATION: LOCATION vi a- Y Y FORMS. MATERIALS S FRAME: FIRE STOPS. Aid P .�.v .J O FEE BRACING. BOLTS VC dI VALUATION , FURNACE: LOCATION, FEE Q GAS VENT. DUCTS �A 1 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH. INT. PLICATION AND STATE THAT THE ABOVE IS CORRECT AND - -- AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND 1/ 'n LATH STATE LAWS REGu1,AT NG 6UIL fNG CONSTRUCTION. . EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTEE / RECT AND POSTED �A ADDRESS Q6 l'.. � - FINAL JOHN A. LAMBIE;.COUNTY ENGINEER, CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATIONM.o. CASH 1 .l`1Lo 16 -1-0.00- ,10 ce wt,�� WORKERS' COMPENSATION DECLARATION hereby affirm that I have a certificate of consent to self -OR BM R M N G P E RMOT insure, or a certificate of Workers' Compensation Insurance, ' or a certified copy thereof (Sec 3800; Lab. C.) - M {' Jl COUNTY OF L 5AN0ELE5: -, 'BUILDING AND SAFETY ) Policy No:(c3,90 73.1 Company' S7c,-y' r l/•�✓ ® BUILDING Certified copy is Hereby furnished. � � �•, FOR APPLICANT TO FILL IN � ADDRE55 BUD NG/ El Certified copy is filed with the county building inspec- - ADDILRE550 /+. IG1 AS% a8" tion department. 7 dY ` 61 - 1 lfOcs�S• �of"I�cz cliy-� l.tT - ZIP- _. LOCALITY ! Date Applicant rl NO. OF BLDGS. NEAREST ' CERTIFICATE OF EXEMPTION FROM WORKERS" : SIZE OF LOT NOW ON LOT CROSS ST. - COMPENSATION INSURANCE _ _ -OCK ASSESSOR (This section need not•be completed if the permit is for one TRA7 BLLOT NO. MAP BOOK PAGE PARCEL . hun dred'dollais ($100) or less.) s' ' ' + � �^ TEL USE ZONE MAP OWNER' \N, \ �-te NO.:5 TZ;- S' S, NO. ' I certifythat in the:perfarmance of the work for which this - - - -- permit is issued; I shall not employ any person in any manner - ADDRESS dg 3c, 'rd c� SPECIAL CONDITIONS 11 so as to become subject to the Workers' Compensation Laws. r� 1 0 (� OSJY O�. K pn ZIP ce Date a4 Applicant�r 3 O t'"t - ARCHITECT OR TEL DISTRICT 'GROUP TYPE FIRE PROCESSED By O NOTICE TO APPLICANT:. If, after.making this Certificate of — ENGINEER- - — NO. CQVST - ZONE .F Exemption, you -should become subject to the Workers' _ _ O� •- ��F ,C L• a Compensation provisions of the Labor Code, you must forth-- ADDRESS _ with comply. with such provisions or, this permit shall bea TEL STATISTICAL CLASSIFICATION _ APT. C DO... Z. deemed revoked. r - - CONTRACTOR JS ro s- 0"4NO. aS- H LICENSED CONTRACTORS DECLARATIONn IC. CLASS NO.�DWELL. UNITS— . I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 'O 1 u ,/1 }yc) �n NO: 3.56 O (commencing with Section 7000)of Division 3 of the Business LIG. ry SEWER MAP and Professions Code,and my license is in full farce and effect. CITY r0 I 0. CLASS' r—-3 BK PG VALIDATION 1 p �q SQ. FT NO. OF NO. OF CHECK - License Nu mn^ber r013�4/(� // Lic. Class L SIZE �$ STORIES FAMILIES .� ONE ' Contioclorl.fb�r4a,D 2aTn^+'kDate Z 9 L. DESCRIPTION OF WORK NEW ❑ _ N _ VALUATIO ADD Q D ❑ am exempt under Sec. Rp co Qqz qcc- _ - /1 ALTER-- B.BP.C. for th' r son `�f s V&_-; x.,35, S t (242' REPAIR ❑ $ . Date: USE-OF [ - - _ EXISTING BLDG. I- W r:k, 1 /J DEMOL ❑ Si nature L'�' APPLICANT t TEL. - a, - g WNER-BUILDER DECLARATION (PRINT) s'1' i. S OOil a, NO. fq FINAL I.hereby affirm that)am exempt from the Contractor's License - DATE ADDREss scl W t o-T-L., 11 1V /{;'Nlc,J+:r *Law for the following reason,(Section 7031.5,Business'and" Professions Code): PRESENT By ACCT.a ❑ - i 'I, as owner of the property, or my employees with BUILDING ADDRESS I 3303 U - 195.75 - wages as their'sole compensation,will do the work and - - - the structure is not intended or offered for sale(SectionLOCALITY D, 1 ITEMS '' 7044, Business and Professions Code.) - MOVING - - - TEL. - - -E El1, as owner of the property, am'exclusively contracting CONTRACTOR NO. TOTAL 195 75, with licensed contractors to construct-the project.(Sec- tion ADDRESS CHECK .,19,5.75 - ' - c tion 7044, Business and Professions Code.) - REQUIRED TOTAL SETBACK FROM 'EXIST. ' CONSTRUCTION LENDING AGENCY, SETBACK YARD H'A'Y PROP. LINE' ' WIDTH -NANt •1�� 1 hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is.issued P.I.' , (Sec. 3097, Civ. C.). SIDE P.L. 0000 0001 7/24/96 Lender's Name - q '7C t-. m - P.C. Fee$ Permit Fee :2 7. 'LDMA Ref.N 7bu'7 1 I-� 4"-r+=' Lender's Address _ D a I certify that 1,have•read this applicdtion and state that the - Issuance Fee LDMA P/C A 8 above information.is correct. Iagree to comply with all County Investigation Fee - .. R ordinanc a State laws relating to building construction, Total Fee LDMA Perm. N a and he by a thorize r presentatives of this County to enter upon a ve me d property for inspectio purposes. - - �`—'\ SEE REVERSE FOR EXPLANATORY LANGUAGE _ . . Signature o Applican ar Agent Date -