HomeMy Public PortalAbout6214 ENCINITA AVE_Building__ 79A.S.A CE t...1 .10.eeAPPLIcATIO-N FOR BUILDING PERMIT �..
BUILDING AND SAFETY DIVISION BUILDING
Department of County Engineer ADDRESS
County of Los Angeles LOCALITY !
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST -
CASSATT D. GRIFFIN, SUPT OF BUILDING CROSS ST.
- '• ""• DISTRICT NO. .GROUP- TYPE I— SEWER MAP
FOR AMICANT.TO FILL IN coNST.X�.I
BUILDING ,�j STATISTICAL CLA SIFICATION
ADDRESS C,,P''O"��7y� - ��/yam _ -
��r/nI CLASS NO_-{J_DWELL. UNITS
LOT NO. 1�C 8'f' A�- '�i `L BLOCK MAP SMNTY YES- O
e-s / / I NUMBER ,yp--✓
TRACT 44 / to 13. / USE ZONE _ _SPECIAL ..
'4413
NO.OF BCONDITIONS
SIZE OF LOT NOW ON LOT
USE OF `�! G-
EXISTING BLDG. C c BUILDIILDI NGYARD HWY' STREET NAME ' EXIST.
p J Z _ SETBACK WIDTH
OWNER
FRONT t T
MAIL ' ^ I �p�J P. L.
ADDRESS �y ,/{II/ /7 - SIDE
T.tM A l �'G,T,d
CITY o INSPECTION RECORD '
ARCHITECT OR TEL,
ENGINEER NO. .,0,/ '/ p "
ADDRESS i.��7 ///�� AY/) C..• L I //�dC
CONTRACTOR eo P O
ADDRESS / Q
DESCRIPTION OF R$ e/fr�M/ 'FJTH'(�G 1M Xv_rr
/V G✓ N 3 dE fI�'
NEW DD ALTER REPAIR DEMOLISH ,/ s✓I/ r n
54. FT. �� NO. OF NO. OF / J) `J n 70 11.112 -�/17
SIZE STORIES FAMILIES
USE.OF STRUCTURE
• APPROVALS ICIF�UiFY� /AP'/t.,EIJ
SIGNATURE OF -
APPLICANT DATE INSPEQO/H•S SIGNATURE
ADDRESS - FOUNDATION:
FORMS. MATERIALS
ION
S. FRAME: FIRE STOPS..
��® FEE J BRACING. BOLTS
VALUATION 0 FURNACE: LOCATION. ,
FEE GAS VENT. DUCTS -
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH. INT. tl Zf1 V / /TO✓/D7�.Y/..Il�
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND 7
AGREE TO COMPLY I AL COUNTY*OROI �NCESTAID LATH..EXT.STATE LAWS R ING UI DINIO
SIGNATURE O HOUSE NUMBER COR-
PERMITTEE D RECT AND POSTED �jj(�/�
ADDRESS 6 FINAL "/ ' l5 7 & /( /
JOHN A.LAMBIE, COUNTY ENGINE CLYDE N..DIRLAM, PRINCIPAL STR URAL ENGINEER
PLAN CHECK VALIDATION M.O. CASH - PERMIT VALIDATION 'c K. M.O. CASH -
� .�00 5 9 JUL 24 1 6 5.5 0
JACO 0 6 3 11 —6� JUL 2 5 1. 11 .0.0 In
rs 76A638A
CE#803(REV.11/78)
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUILDING
ADDRESS
BUILDINGrY-
ADDRESS �"' / v0 LOCALITY
NEAREST
CITY ZIP CROSS ST. Q /
!✓ .OFBLRGS. ASSESSOR
SIZE OF LOT NOW NLOi MAPBOOK PAGE PARCEL
DISTRICT I GROUP TYPE FIRE PR ESSED By
TRACT BLOCK LOT NO. \ CONST./ ZONE ' 1
TEL.
OWNER E NOJIe
STATISTICAL CLASSIFICATION l SEWER MAP
ADDRESS / CLASS NO. DWELL.ON ITS . G BK/� PG
CITY r ZIP "
ENGI{NT ERECTORzei / / &TLO.• VALUATION $ -`/��j(770o
ADDRESS G BLDG.SETBACK FROM
v i
�� TEL F PONT P ROP.L I N E OF e: r d�� (STREET)
N/TRACTOR NO. HIGHWAY + YARD = TOTAL SETBACKFROM TYPEOF EXISTING .
C, FRONT PROP.LINE HIGHWAYI WIDTH
ADDRESS . LIO. -, + .2U =
CITY
EONSTRR CLASS -
CTION LENDER BLDG.SETBACK FROM
NAME AND BRANCH SIDE PROP.LINE OF ISTREETI
HIGHWAY + YARD _ TOTAL SETBACK FROM TYPE OF EXISTING pY,
ADDRESS CITY SIDE PROPLINEHIGHWAY WIDTH V
SO.FT, NO OF NO.OF CHECK '+ _ u
SIZE STORIES FAMILIES ONE ❑ USE ZONE MAP 0 Q 3 0
DESCRIPTION OF WORK NEW
e' SPECIAL d
ADD � - CONDITIONS N
ALTER ❑ DATE L �J Z BY I / Z
REPAIR 0
USE OF DEMOL EI �+Lo• C.�
EXISTING BLDG, ✓/V'7 ✓ _
APPLICANT i L LO 3 S Lf 0 �'1 0 9,'5 A
(PRINT) O. i
G # e e o:e 2.3
BY ISIGNATUREI Q
L>L� 2e'e4320
THAT TION AND STATE w
THE BABOVE FI50WAGE CORRECTT ND'AGR E R ACOMPLYAWfPPItHAALLL ORDINANCES iL =
AND LAWS REGULATING BUILDING CONST ',ION.I CERTIFY iHAT 1N DOING THE '_ �o'e'e'(L 2 O Q
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF U
THE LPENSABOOR CODE OF THE STATE OF CAL( RNIA I N RELATING TO ORKMBN SCOWz 07,07-80
L V
SIGNATUREof g 1 0 9.b A
PERMITTEE
ADDRESS z zz
.#Z o'e.e e o 1
rEL. 2 2 e'e 6 1.00
CITY N G Q
La . . . 61.00.
P.C. Fee$ 3,.1 EI Permit Fee .S > O 7.07'—8 0
Issuance Fee :E
W
6
Total Fee
1
\VORKERS'`COM,PENSATION DECLARATION
I hereby„offirm'�that I have a certificate of consent to self n �� l�� �n =OR
OD n n�n D�NG PERnnOlT •�
i•' .Insure, or a certificate of Workers' Compensation Insurance, (�=J (/ u uv v LrL u V u LUr u u
or a certified copy thereof (Sec. 3800, Lab. C.)
'.1�z7-Y7� COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. Company NCompany ['7"U 21, Ti J?- .c..., p
❑ ILDING
Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS
A
® Certified copy is filed with the county building inspec- BUILDING ^
tion department. ADDRESS 2( �a.. �:�a H✓C. NEAREST
�)� /, C t NEAREST
' Date '1 Z Applicon5- /i`7+`CKbCiI / — CITY ZIP CROSS ST. '
CERTIFICATE OF EXEMPTION FROM WORKERS
r NO.OF BLDGS. r ASSESSOR
. COMPENSATION INSURANCE SIZE Of LOT Qo 1K 1 qo NOW ON LOT L MAP BOOK PAGE PARCEL
(This section need not be completed if the permit is for one USE ZONE MAP - 2[l)V
hundred dollars ($100)or less.) TRACT BLOCK LOT NO. NO. 4
,^, /n1 TEL. (1 SPECIAL
I certify that in the performance of the work for which this OWNER l cJ NO. ' `' CONDITIONS IL
permit is issued, I shall not employ any person in any manner ! ,N •� ,}. A DISTRICT G UP TYPE FIRE PR ED BY CI
ADDRESS' g' c( v<. ��(� J CONST. ZO cc
so as to become subject to the Workers'Compensation Lows. e
Jcc
CITY T, C_ - zlr O
Date-Applicant O.STATISTICAL CLASSIFICATION APT. NDU
NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL.
Exemption, you should become subject to the Workers' ENGINEER NO. CLASS NO.�DWELL. UNITS_ 1
Compensation provisions of the Labor Code, you must forth- ADDRESS _ SEWER MAP
with comply with such provisions or this permit shall be z
deemed revoked. // 1 G' TEL” BK. 1 PG, VALIDATION -
CONTRACTOR o (.o.. rc.c`:a-., 'NO. L
LICENSED CONTRACTORS DECLARATION U LIC �'2L
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS v o S % NO" 4 1. VALUATION
(commencing with Section 7000)of Division 3 of the Business and LIC. y�
Professions Code, and my license is in full force and effect. I CITY to." _JJ¢ .. CLASS tS E /d'?-cry i D ;2'3 0 1.3 A
SQ. FT. tj� NO.OF I NO.OF r CHECK
License Number ¢77/ 15 LL Lic Class 113 SIZE o STORIES FAMILIES 1 ONE # °'°'e n e 1
Contractor F'{lsnn(y (..oNs� t ate -f!//, DESCRIPTION OF WORK A a. L^L.-7 NEW E] E ( °.171.75
ADD_ ❑
❑ I am exempt under Sec. -. ALTER ❑ FINAL •,°I1 7 1.7 5
p v
B.BP.C. for this reason V REPAIR ❑ DATE/""/! 0 e 2 6':8 5
Date: USE OF DEMOL E] FIN
-
EXISTING BLDG. t By
Signature - APPLICANT , ,L", _ I ( TEL. n _
OWNER-BUILDER DECLARATION PRINT M1�i t c%h.stX-L i .. NO. 7 —S"7 �2f
I hereby off irm that I am exempt from the Contractor's License ADDRESS O¢� �d�4u� S fi, pi S l❑ w
Law for the following reason (Section 7031.5, Business and
Professions Coder PRESENT
❑ `
I, as owner of the property, or my employees with BUILDING
DDRESS
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. _ .1
❑ I, as owner"of the property, am exclusively contracting CONTRACTOR NO.
with licensed contractors to`construct the project (Sec- ADDRESS \\\
'tion 7044, Business and Professions Code). \ _
CONSTRUCTION LENDING AGENCY `SET�BACK TOTAL PROP SETBACK WIDTH `}`s 'R,v s s* ��._'�,4• ' (.
.YARD HWY . `
I hereby affirm that there is o construction lending agency for FRONT
the performance of the work for which this permit is issued P.L D•. '
(Sec. 3097, Civ. C.). SIDE t '
P.L.
Lender's Name _
1
P.C. Fee E Permit Fee
Lender's Address _
I certify that I have read this application and state that the Issuance Fee J
above information is correct. I agree to comply with all County Investigation Fee
ordinances and State laws relating to building construction, Total Fee
1-7 d and hereby authorize representatives ofthisCounty to enter r � �1
uPon the above-mentioned property for inspection purposes.
^ ).`0�,,4waj -F/" SEE REVERSE FOR EXPLANA70RY LANGUAGE
Signature of Applicant or Agent Dote ®s
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 9704300002
PHONE: (818) 285-0488 EXT:
GAL NO. 0 MOT !BUILDING ESS:
ON FILE SO. FT STORIES TYPE '6214 ENCINITA AV
STRUCTURE: 0 VN TEMP CA 917801639
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET:
5385-001-015THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY
TENANT: EXIST BLDG USE: RESIU___ USE ZONE: ISSUED OC B ON:
EXIST OCC GRP: 04/30/97 LC 04/30/98
OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE:
CHOW LIANG CHIU;JEN SIU - - 4,100
6214 ENCINITA AVt
TEMP 917801639 FEES PAID D SLR ^O—V4R:
RE-RODF HOUSE ONLY; TEAR OFF EXISTI G' , SHEETING TO REMAIN
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: COVER W/COMPOSITION SHINGLE
APPLICANT: TEL. O: . .
J W ROOFING SERVICES (818) 572-9797- AA BLDG PERMIT ISSUANCE 27.75
AC STRONG MOTION REBID 4100.00 VAL 0.50 SPECIAL CONDITIONS:
D2 PERMIT W/0 EN-HC- 11 (r4700.00 VAL 79.45
=L�TOTAL 'FEES � 707.70 -
CONTRACTOR: TEL. N0: V _ \ APPROVALS DATE INSPECTOR SIGNATURE
J W ROOFING SERVICES (818) 572-9797-
DE AALENA LIC. NO , LOC AND SETBACKS
ROSE C
ROSEMEAD CA 97770 _ 6621496C39
SOILS ENGINEER APPROVAL
ARCHITECT OR ENG ER: T— EL. WO—:--- 7OOUNOATION//.�FO S—
LIC. NO: — i- I' � SLABIUNDER_FLOOR
RAISED OORR 7F1G
MAPXXfi: SEWER MAP BOOK: PAGE: FIRE ZON3: CMPOr r'��u lO �� V V �f���9 UNDERFLOOR INSULATION
V V FLOOR SN I INT
OAS:�(:LC[NG 11 ITSc�DT] Abo CL (� ROOF SHEATHING
NO 21 O G
SC�H O�II iTHI AZA O UT �j/t /' i '�G SHEAR ND ELS S
AIR QUALITY: 1000 FEET MATERIALS
NO NO NO, • ❑ �Q�\\ FRAME.. INSPECTION
REQUIRED TA S EXI_
SET BACK YARD: HWY: PROP LINE: WIDTH:
FRONT PL- &I�e�c� INSULA ION/WEAT ER STRIP
SIDE PL- U u
INTFRIOR LATH RY ALL
EXTERIOR LATH
RATED FLOG /C SSEM.
RATED WALL ASSEMBLIES
RATLD SHAFTS/OPENINGS
T-BAR CEILINGS
OT DRAINAGE
REPORT ID: DPR261 ROUTE TO: BS0508