HomeMy Public PortalAbout5936 ENCINITA AVE_Building__ c
ce/en3 ;oa
= - APPLICATION FOR. BUILDING PERMIT `
COUNTY OF LOS ANGELES BUILDING AND SAFETY
BUILDING '
FOR APPLICANT TO FILL IN ADDRESS `7
BUILDING
ADDRESS r /�%' Q e LOCALITY
NEAREST
CITY ZZG . ZIP 'CROSS ST.
}- NO.OF BLDGS. - ASSESSOR
SIZE OF LOT J. C NOW ON LOT on e. MAPBOOK PAGE RRMA
_�" - n DISTRICT GROUP 'TYPE FIRE BY.
TRAC S -{/ J BLOCK LTEO'(A - ,� O31 COIy'STj 1j
OWNER Z Q NO. / �I
STATISTICAL CLASSIFICATION "*E //��
ADDRESS ;'o'.-' .a CLASS NO,—Al DWELL.UNITS •` 8li '�' P5'
CITY (., r ZIP V
ARCHITECT OR EL. VALUATION $ a O �
ENGINEER NO.
ADDRESS' BLDG.SETBACK FROM
//J�
TEL: FRONT PROP.LINE OF ISTREETI
CONTRACTOR (0 NO.. _ HIGHWAY, + YARD = TOTAL SETBACK FROM TYPE OF EXISTING
. — - - TIC. FRONT,PROP.LINE HIGHWAY WIDTH
ADDRESS NO.. - \
.. LIC. •• + _
CITY CLASS BLDG.SETBACK FROM
CONSTRUCTION LENDER - ' SIDE PROP.LINE OF ISTREET)
NAME AND BRANCH
HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING
ADDRESS (OI C.. TRCIi,V C'� L. SIDE PROP.LINE HIGHWAY WIDTH O
50,FT._ NO.Of NO.OF CHECK + _ - V
SIZE NO
FAMILIES ONE b
DESCRIPTION OF WORK NEW ❑ P.C. Fee$ Permit Fee 8
ADD ❑❑ " Issuance Fee /
ALTER
REPAIR El - —]Total"fee
USE TINGDEMOL :❑ //CA p•�.../��,,,� //��, 1
EXISTIBLDG. `0
APPLICANT TEL O \U • // i
IPRINTI NO.
BY ISIGNATUREI,
HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE y ,
THAT THE ABOVE IS CORRECT.AND AGREE TO COMPLY WITH ALL ORDINANCES m
AND LAWS REGULATING BUILDING CONSTRUCTION,I CERTIFY THAT IN DOING THE O�
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF
THELABOR CODEOFTHESTATEOF CALIFORNIA IN RELATING TO WORKMEN'SCOMl �+
PENSATTON INSURANCE. // f : �2 5 116 4 A
SIGNATURE OF \S
PERMITTEE
PERMITTEE n y/ U
ADDRESS 4z Z 2 - 1960"
-
O
TEL.
CITY NO.' G
USE ZONE NADP Q
3 SPECIAL
CONDITIONS
FINAL By i
DATE
.
City of Temple Cit n
AP*LICATION FOR BUILDING PERMIT
FOR APPLICANT TO FILL IN (Pdnr or type only) '
- COUNTY OF LOS ANGELES .
ADDRESS5§36 No Encinita DEPARTMENT OF COUNTY ENGINEER
CITYj ty ZIP 91786 BUILDING AND SAFETY DIVISION
/210 NO.OF SLOGS. BUILDING
SIZE '-
L T/� NOW ON LO ADDRESS
TRACT4v/ BLOCK L T O Q LOCALITY
t� TEL. p11���/C' NEAREST
.OWNER Hrs. POIa nUP1C NO. 286-V41 J CROSS ST.
,ASSESSOR _
ADDRESS 6 No. EnCimta MAP BOOK PAGE" PARCEL
CITY Temple City, Cal if 21P 91780 DISTRICT GROUP TYPE FIRE ESSED BY
L pp -T CONST[//^ ZON
ARCHITECT OR 'TEL. S ' 0G0 -1_ 3 `
ENGINEER NO. _./
STATISTICALCLASSIFICATION S WER A14 -
ADDRESS - CLASS NOC,?�DWELL,UNITS
_ TE -USE ZONE MAP
CONTRACTOR l ONO �� NO.
C.
ADDRESS 12 O Maren O. AVeNLO. 253163. SPECIAL
LIC. CON OI TIONS
CITY CLASS O P
ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑
CONSTRUCTION LENDER
NAME AND BRANCH BLDG,SETBACK FROM -
FRONT PROPLINE OF (STREET) ,
ADDRESS CITY _ TOTAL SETBACK FROM TYPE OF EXISTING
SO. FT. NO. OF NO. OF CHECK HIGHWAY } YARD - FRONT PROP, LINE HIGHWAY WIDTH
SIZE STORIES FAMILIES
DESCRIPTION OF WORK
2 Section of NEW , ❑ ' } O
�/)�� BLOC.SETBAC KFROM U
-Tile II VM roofing & reset ADD SIDE PROP.LINEOF EETI
LTERp HIGHWAY } YARD _ TOT SETBACK FROM TypE.OF (STING V
Tile. dLhCJ HIGHWgY OTH W
REPAIR SIDE PROP. LINE
USE OF } _ N
EXISTING BLDG. DEMOL ❑
Z
APPLICANT TEL CORNER CUTOFF YES ❑ NO ❑
(PRINT) NO.
BY (SIGNATURE)
IN OPEN SPACE YES ❑ NO ❑
_..
nnnn TT IN COASTAL'PERMIT ZONE YES C] NO ClVALUATIONpCJ 33 V
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON- `
ST RUC TION. 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY WILL NOT EMPLOY AMY PERSON IN VIOLATION OF THE
LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO
WORKMEN'S COMPENSATION Ian kl",E. k
SIGNATURE 1 KK
PERMITTEE
ADDRESS -Z SO• Marengo ve ,a
FINAL ' BY
CITY Alylambra, Cal-if. TEL
L24Z-l9[U DATE �7
r / C F
,141 KE CHECKS /'A YA BLE 7"0. FEE'S I/ FEE 9 OO.
HARVEY T. BRANDT. COUNTY ENGINEER
PLAN CHECK VALIDATION CH. MD. CASH PERMIT VALIDATION cK. CASH
' 5,8 5izav 1U 1'' U . y.0 U AL 9t
76A638A CC*003 5/74
I
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNA4� " ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9708140008
PHONE: (818) 285-0488 EXT:
LEGAL D: CONST BUILDING, ADDRESS:
TR: 6561 LT: 380 SQ. FT STORIES TYPE 5936 ENCINITA AV
STRUCTURE: 0 VN TEMP CA 917801931
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LAS TUNAS DR.
8587-001-020 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, C
TENANT: EXIST BLDG S SD USE ZON : R- ISSUED N: PROCESSED B : EXPIRES .
EXIST OCC GRP: 09/08/97 UT 09/08/98 .
OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY:n CODE:
DESSOFFY, VALERIE (626) 287-5001- 9,000 /9,
5936 ENCINITA AV l!• _! 0 / '"••�u""11 r/
TEMP 917801931 FEES PAID DacRUTION OF WOR
INTERIOR NON-STRUCTURAL KITCHEN 8 BATHROOM REMODEL
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:
APPLICANT: E 0:
SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75
AC STRONG MOTION RESID 9000.00 VAL 0.90 SPECIAL CONDITIONS:
AX BUILDING REVIEW.FEE 54.70
B2 PERMIT W/ENERGY, LE,Q9000-00 VAL 220.94
t� –TOTAL FEES�� 304.29
EL
CONTRACTOR: T . N0: ((!! 1lll APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER
LIC. NO LOCATION AND SETBACKS
SOILS NGINEER APPROVAL
ARCHITECT OR ENGINEER EL. 0: I - �,� FO NDAT)ON OR S
MORENO AND CO. (818) 441-8815- "
1954 PRIMROSE AVE LIC. NO: '� '1 -f _�I SLAB/UNDER FLOOR
PASADENA CA 91030 NONE
WA-TS—ED FLOC
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: f ERFLOOR INSULATION
150-265 3 01
FLOOR SHEATHING
UND
0. OF FAMILIES: DWELLING NTS: T/CO D: STAT CLASS:
NO 21 ROOF SHEATHING
S
\ 4,�
SCHOOL WITHIN H ARGOLIS QHS SHEAR PANELS
AIR QUALITY: 1000 FEET .. MATERIALS �i7 V �' �_�
NO NO NO j T ' - ��� FRAMEINSPECTION
e J��
FROM EXIST REQUIRED TOTAL ACK (aQ /
TIWE SPR NKLER HANGERS
SET BACK YARD: HWY: PROP LINE: WIDTH:
FRONT PL- INSULATION/WEATHER STRIP
✓ -���• °
INTERIOR LA H RY AL
EXTERIOR LATH Z
1
RATED-FLOOR/CEIL ASSEM.
RATED WALL ASSEMBLIES
RATEDH /OE I 5
T-B R CEILINGS
LOT DRAINAGE
REPORT ID: DPR261 ROUTE TO: BS0508
/ WORKERS' COMPENSATION DECLARATION
I sure, o affirm that have a certificate of consent to self t QPPL1CQ1rMN FOR BURONG PE 1DI�SIIFl00 11
insure, or a certificate of Workers"Compenstion Insurance, or ,
a certified co tl}ereo�Sec. 3800, La C.) s
���r���J 77QQ� C —/ L COUNTY OF LOS AN BUILDING.AND SAFETY
•Policy No. Cd'mp�ny � �!� w
BUILDING
Certified copy is hereby furnished. FOR APPLICANT TO FILL IN — ADDRESS & i - h Bo•v
Certified copy is filed with.the county building inspec- BUILDING ! _
tion dep ar56
tm enc. ADDRESS C LOCALITY G i
q /�J NEAREST p p
Date;,—�N Applicant\% /1/ J/ CrtV / IP CROSS ST. .•EiJ l/H�•G
CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. ASSESSOR
COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL
(This section need not be completed if the permit is for oneUSE ZONE6"5 MAP
hundred dollars ($100)or less.) TRACT BLOCK LOT NO. NO. - y
T TEL. SPECIAL d
I certify that in the performance of the work for which this OWNER / - —' TN CONDITIONS Q
' DISTRICT GROUP TYPE FIRE PROCESSED BY {.1
permit is issued, shall not employ any person in any manner - p� CONST. ZONE
so onto become subject to the Workers'Compensation Laws. ADDRESS / '03 '— 119
0
�yr / 0
Date��Appliccm CITY ZIP STATISTICAL CLASSIFI ATION APT. CONDO. V
NOTICE TO APPLICANT: If, after making 'this Certificate of ARCHITECT OR' /' 7 . _ Ly
Exemption, you should became subject to the Workers' ENGINEER •Cr /�•q N CLASS.NO. DWELL. UNITS_ N
:Compenscition provisions of the Labor Code, you must forth- ADDRESS ER P Z
with comply with such provisions or this permit shall be
,deemed revoked. - CONTRACTOR NL. • BK. PG, /—� VALIDATION
LICENSED CONTRACTORS DECLARATION �/� / 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. CITY c' CLASS CEJ
/r/ SO. FT. TORIFAMILIES NO IEES IONE
GGK.
License Ndmber J Lic Class SIZE ) `,
Jr, �-G/ /"// NEW 'Q� $
Contractor -Date ' DESCRIPTION OF WORK ADD
an
am exempt from the licensing requirements as I am a /�—
licensed architect or a registered professional engineer // r7 ALTER -❑ FINAL %� ).��%�• .�3`9'1 S A' n
acting in my professional capacity (Section 7051, V L REPAIR '/ o (�. '
Business and Professions Code). USE OF ❑ AFINAL / - #:-f..e-e 2 1
EXISTING BLDG. DEMOL ❑ By
✓ r.--`�
c.or Reg.No. Date APPLICANT TEL���./y// -
Li2t—;o 8:5 4 4
OWNER-BUILDER DECLARATION (PRINT N['l./-/V
I hereby affirm that I am exempt from the Contractor's Licensey� l I O •e.a'e 8 a 4 4 j
gDDRE55
Low for the following'reason (Section 7031.5, Business and t '
Professions Code): PRESENT Q 5,0 7'.-8 2
aI, as owner of the property, or my employees with ADIDRESS T
wages as their sole compensation,will do the work and
the structure is not intended or offered for sole (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-
. tion 7044, Business and Professions Code). ADDRESS - ,�.� 9 1,4 A
REQUIRED. TOTAL SETBACK FROM EXIST.
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH \ # e'• e e • 1
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. �, ?f• 1 42 0'0
(Sec. 3097, Civ..C.). .-_ SIDE '
P-L. •:142005
Lender's Name �'l l 2 '
$ P.C. Fee b -• Permit Fee / % �� �0 r5.0 7—8 2
Lender's Address �O _ -
5 1 certify that I ha read this application and state that the Issuance Fee
above informal io is co ect. agree to comply with all County Investigation Fee'
m ordinances Sta laws relating to building construction, Total Fee
and her y aulhori a representatives of this County to enter
a n above- enti property for inspection purposes.
y^ry
SEE REVERSE FOR EXPLANATORY LANGUAGE
^ Signwre of A plicant or Agent Dote
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 9704170018
PHONE: (818) 285-0488 EXT:
LEGALI : - NO. OF CONSTIN ADDRESS:
TR: 6561 LT:380 SQ. FT STORIES TYPE 5936 ENCINITA AV
STRUCTURE: 2000 V TEMP CA 917801931
ASSESSOR INFORMATION N NEAREST CROSS STREET: LAS TUNAS
8587-001-020 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY
EN EXIST BLDG USE: RESID USEZONE: R-2 ISSUED PROCESSED B PIR S 0
EXIST OCC GRP: 04/17/97 TC 04/17/98
OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL-DATE FINAL BY: CODE:
DESSOFFY, VALERIE (818) 287-5001- 1 1,500 9�- '
5936 ENCINITA AV 7
TEMP 917801931 FE PAID DES 0 WOR
RECOVER OVER EXISTING WITH 25 YR. GAF DIMENSIONAL ASPHALT
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: SHINGLE
APPLICANT:
SIERRA PACIFIC ROOFING (909) 982-6611- AA BLDG PERMIT ISSUANCE 27.75
ACSTRONGMOTION RESID 1500.00 VAL 0.50 SPECIAL CONDITIONS:
D2 PERMIT W/O EN-HC" ' 1'1500.00 VAL 82.20
; �._,�: ,TOTAL!FEES. 110.45
�v/ice
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
SIERRA PACIFIC ROOFING (909) 982-6611-
400 25TH ST. LIC. NO LOCATION� ` D SETBACKS
UPLAND, CA. 91784 627233 C39
SOILS ENGINEER APPROVAL
ARC C 0 E _ -
�� �-f' ��`�, a 0 N TIO /TR CH S
LIC. NO: I� Imo, {,. SLAB/UNDER FLOOR
1. AAIED FLOOR MSG
AP O: SEWER MAP BOOK: AGE: FIR ZONE: CMP: �� "; UNDERFLOOR INSULATION
150H265 3 01
LOOK SH ING
0. OF F DWELLING UNITS: A CO : STAT CLASSL
NO 21 ROOF SHEATHING
SCHOOL INHA SH PANELS .
AIR QUALITY: 1000 FEET MATERIALS
NO NO NO _ FRAM- INSPECTION
REQUIRED TOTAL SETBACK OM XIS ((� \_ ._ I SPRINKLER ANG RS
SETBACK YARD: HWY; PROP LINE: WIDTH:
FRONT �/Po �� 1 INSULATION/WEATHER STRIP
SIDE PL- �% ll
INTRIOR LATH/DRYWALL
EXTERIOR LATH
RATEDFLOG /CE
RATED WALL ASSEMBLIES
RATED SHAFTS/OPENING
T-BAR CEILINGS
OT DRAINAGE
REPORT ID: DPR261 ROUTE TO: BS0508