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Home My Public Portal About6243 ENCINITA AVE_Building__ sA63EA E,ao -63 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES- BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY l JOHN A. LAMBIE. COUNTY ENGINEER NEAREST WILLIAM A. JENSEN, SUPT OF BLILOIHG CROSS ST. DIS�TgICT.NO.., - R NP YPE P GE ED BY FOR APPLICANT TO FILL IN. �h ONST' 1 BUILDING STATISTICAL CLASSIFICATION Y S 'WER MAP ADDRESS •6243 No. Encini-ta T.C . BK PG CLASS. NO. 'DW ELL. UNITS' LOT NO_ Z�U BLOCK WATER NOT REQUIRED RECEIVED ❑ CERTIFICATE: TRACT ' MAP HIGHWAv STATE MAJOR SECOND, LOCAL NO.OF SLOGS.. NQ IURCLEI SIZE OF LOT- NOW ON LOT USE ZONE SPECIAL USE OF CONDITIONS EXISTING BLDG. . .. TEL OWNER Walter Kidwell NO. 6UfL L .YARD HWV STREET NAME EXIST. SETBACK . WIDTH ADDRESS6243 No. Encinita T.C. FRONT ARCHITECT OR TEL. P. L. ( f, - ENGINEER NO. SIDE d ADDRESS J ��nn ��e-/ yy P. L 0 Virgin V it ion ROOf `C O TOA y W 5 I ADDRESS 600 S. an Gabriel Blvd. DESCRIPTION OF WORKSan Gab a Z NEW ADD ALTER REPAIR -DEMOLISH SQ-FT. NO. OF NO. OF. , SIZE STORIES FAMILIES USE OF STRUCTURE - - Re-roof HOuse & Att ,SIGNATURE OF _ APPLICANT •VALUATIONS 599.00 - '•,APPROVALS DATE INSPECTORS SIGNATURE FOUNDATION'. LOCATION FEE S FEE-56.00 FORMS. MATERIALS FRAME:'FIRE STOPS, I HEREBY ACKNOWLEDGE'THAT I HAVE READ THIS APPLICATION BRACING. BOLTS AND STATE_.THAT. THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS " 96ILDING CONSTRUCTION. 'I CERTIFY THAT IN DOING`THE WORK. • - AUTHORIZED HEREBY I WILL'NOT EMPLOY ANY PERSON IN VIOLA- - TION OF THE LAP CODE OF THE STATE OF CALI.ORNIA E RLAT� LATH. INT. ING TO WORKMEN' COMPENSATION INSURANCE. LATH. EXT. _ SIGNATURE OF " HOUSE NUMBER COR- l PERMITTEE p SSECT AND POSTED l ADDRESS 600 . San Gab el Blvd. FINAL - . • w �"_ ,3 L' ,,,,fl;. .., an Gabriel JOHN F. LEWIS. PRINCIPAL ST RAL ENGINEER PLAN CHECK VALIDATION K. M D. CASH _ PERMIT VALIDATION CK. M.G. CASH UrLo5 0 6 O o JAN 30 1 D 6.00 q 76ACSSA CE#809-%.38 APPLICATION FOR BUILDING PERMIT BUILDING AND SAFETY DIVISION BUILDINGDDRESS Department of Countyn Engineer A `� C/��. IC�C��//'f ✓� County of LOB Angeles LOCALITY JO/A- G 1T V JOHN A. LAMBIE, COUNTY ENGINEER '/ / ///--- CASSATT D. GRIFFIN, SUPT OF BUILDING CROSS ST. O�j/G �/V �T✓- DISTRICT NO. GROUP ILIANTYPE I SEWER MAP FOR APP CT TO FILL IN -rY- BK Pc _ CONST BUILDING// aate�// 77'� yy ,,(( J) /',./. ADDRESS QJ+i"]3NL/➢y7G%li%1$1{V� �e77)R'C�l///I7I' STATISTICAL CLASSIFICATION LOT NO. �Q (/ BLOCK CLASS. NOPJ�DWELL. UNITS . MAPSTATE IM N TRACT S/ O� MHWY BER �l USEZONE SPECIAL p y p NO, OF SLOGS. ( CONDITIONS / LE!{,ETJY SIZE OF LOT 6 f{I /l IS -NOW ON LOT c^ USE OF �J J - YO p JLTLDIFk EXISTING BLDG. /) e / �/ejJ.CG BUILDING EXIST. YARD HWY STREET NAME L. ).J. ) �/ J ) j SETBACK _ WIDTH OWNER y110_ (/ ! (,I^�Y"r(c./-( ) l%yW`.'�/1/ —FRONT / -/ AM AILDDRESS try 3 A/ �_'7T cry) I l lL /T t7� SIDE c O ,vC/e//�� /A",e. TEL P. L. . i'y'1! NO.A%6-122 INSPECTION RECORD ARCHITECT O TEL. ENGINEER NO. ADDRESS ll . KJcr7/ �1'?FA T�f? I/ E' ' CONTRACTOR T �l �A/�t�l. )"' NO.EL ADDRESS S A NSC. DESCRIPTION OF WORK ✓ T P/ n !A,f D Al NEW ADD ALTER REPAIR DEMOLISH - 1/ ��/+/^ SO. FT.' �O j J STORIES / FAMILIES / /V rl J�(Y SIZE 7 C q�/ USE OF STRUCTUREr) i we: 0,0A1c p SIGNATURE O (O _ APPROVALS /JT �F J�ID Q"A �- APPLICANT '' DATE INSPECTOR'S SIGNATURE ADDRESS y+ '� FOUNDATION: LOCATION FORMS, MATERIALS ,V/IYI III / /7F S P. C. s FRAME: FIRE STOPS. J�f�. FEE BRACING. BOLTS % U d //JA CB1 VVVV t s �p FURNACE: LOCATION. VALUATION GAS VENT. DUCTS / 0 FEE 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 LATH. EXT. STATE LAWS REGULATING BUILDING CONSTRUCTION. SIGNATURE OF HOUSE NUMBER COR- PERMITTEE RECT AND POSTED 7s � ADDREss l-` FINAL JOHN A. LAMBIE. COUNTY ENGINEER, CLYDE N. DIRLAM. PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION CK. K.O. CASH PERMIT VALIDATION CK. M.O. cns LAC07 4 7 0 APR24 1 8.0 U � f APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN tP 01 R, IVPs OPIV) Temple City BUILDING6245 Encinita COUNTY OF LOS ANGELES ADDRESS DEPARTMENT OF COUNTY ENGINEER �CITY Temple city ZIP / BUILDING AND SAFETY DIVISION yJ ANO.OF BLDGS. BUILDING r SIZE OF LOT OP ,J' NOW ON LOT ADDRESS J TRACT ` BLOCKLOT NO. LOCALITY TEL. NEAREST OWNER NO. CROSS ST. ASSESSOR ADDRESS MAP BOOK 61 PAGE 1EARCEL DISTRICT GROUP TYPE FIRE PROD SED BY CITY temple City ZIP � l CONST. ZONE ARCHITECT OR TEL. V ,0 J ENGINEER NO. STATISTICAL CLASSIFICATION SEWER MA-19 ADDRESS CLASS NO..a—DWELL.UNITS SK 17PG CONTRACTOR Rigid Mn. C - TEL. USE ZONE MAP ADDRESS T3.3.7 So. Woods Ave. NUJ. 94 6 _ 1 INO SPECTAL CITY Los Angeles LIC. C- CONDITIONS CLASS 39 ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑ CONSTRUCTION LENDER NAME AND BRANCH BLDG,S TBACK FROM FRONT ROP.LINE OF ISTREE TI ADDRESS CITY _ TOTAL SETBACK FROM TYPE OF EXISTING CO SO. FT. NO. OF NO. OF CHECK HIGHWA } YARD _ HIGHWAY WIDTH FRONT PROP, LINE SIZE STORIES FAMILIES ONE [Y _ O DESCRIPTION OF WORK NEW X❑ U ADD LU ❑ BLDGS ETBAC KFR OM REETI LU Reroof with composition SIDE PROP. LINE OF ALTER ❑ Z HIGHWAY } YARD = TOTAL SETBACK FROM TYPE OF XISTI NG REPAIR❑ SIDE PROP. LINE HIGHWAY IOTH USE OF + _ EXISTING SLOG. RegidpnLp DEMOL .❑ APPLICANT TEL CORNER CUTOFF YES ❑ NO ❑ (PRINT) N0. IN OPEN SPACE YES ❑ NO BY (SIGNATURE) ❑ Q IN COASTAL ZONE YES ❑ NO ❑ VALUATION 790.00 CATEGORICAL EXEMPTION YES[:] NO ❑ HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL AND'STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE) WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- STNUCTION. 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE) HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO _ WORKMEN'S COMPENSATION INSIaM INSMFG. COMPANY SIGNATURE OF PERMITTEE ADDaess ^ jif no. wo 21Is venue Los elesNoQ6 FINAL CITY . 3-5i81 DATE IIA f:/' C111:(:KS PAIABLE 70.' FEE $ � FEES 15.00 HARVEY T. BRANDT. COUNTY ENGINEER PLAN CHECK VALIDATION c, o. CASH _ PERMIT VALIDATIO «. M.O. DASH 5.9nSU 4 1 0 1 5.0 0 ey8 76A638A CEN80312/72 �ORKERS'COMPENSATIONDECLARATION n� nnnn(p� ((((��' � [E� n n n �,p-/� 2 /�� y� a /rL11� I� L5� `V- li=d 11 ��IICJ If��fl� �VuL��ull`CIV pLS.�II@7llo Il . B I hereby affirm that I,have a certificate of consent,to self O • O O insure or a certificate of Workers' Compensotton Insurance, or o certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company /'�/n ^ - '• E] Certified copy is hereby furnished. FO APPL ANT TO FILLIN ADDRESS BUILDING Certified copy is filed with'the county building inspac- BUILDING :7 '2 x/ wl r4-- _ 'tion department. ADDRESS ssf4�, ' J /f �{//V H I xT /s �� Dote Applicant CITY _ /!'I -- [(_JI • / ZIP I� v LOCALITY Y G ,'I CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT v X I7 5- NOW ONNO, OF LDGS. � NEAREST �/�; , COMPENSATION INSURANCE LOTpp CROSS ST. v 6W, (This section(need not be completed if the permit is for one TRACT' BLOCK LOi ASSESSOR hundred dollars ($100)or lass.) (l' ^-I MAP BOOK PAGE' PARCEL OWNER CP 1 IKNO NO�� O USE ZONE - MAP ' /�-.- certify that:in the performari ork for which this �p NO. Vw 7 P is issued, I shall not employ a pe on in any manner' � � i ENGI� �'� � / SPECIAL so as to co subject to the Wor ar ' mp nsation Laws. ADDRESS L�� +� FFF�� CONDITIONS' O Date /n G �l, CITY G'ss' `ry CI ZIP �! L D CO j 0 ApplicantNOTIC - "` D= ARCHITECT O j TEL. DISTRICT GSOUP TYPE FIRE PR CESSEDP.BY,. O Exemption; TO PPLI ANT: If, after subject to Certificate of ENGINEER V,40J S K• NO. ,11^ CONST. / ZONE H Exemption; you should become subject to the Workers' -��/�/y .•- '' `I- /j /� j(/ IY`/ /, v r V Compensation provisions of the Labor Code, you must forth- gDDRE55 vyVa 0"egr T �/�QU•3 �v�" W with comply with such provisions or this permit shalt. be TEL. STATISTICAL CLASSIFICATION APT. LrONDO. N deemed revoked.. CONTRACTOR NO. z LICENSED CONTRACTORS DECLARATION no LIC. .. CLASS NO. ' � DWELL. UNITS— - I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. (commencing with Section 7000)of Division 3 of the Business and LIC SEWER MAP Professions Code, and my license is in full force and effect. CITY CLASS - 'BK •.� VALIDATION - SQ..FT, - INC. OF _ NO IF CHECK License Number tic{lass SIZE STORIES I FAMILIES 1 ONE � I� NEW ❑ VALUATION �Q Contractor Date DESCRIPTION'OF WORK $ '2 /C1 O I am exempt under Sec. �/L(�(�Ky�i L� ADD J COO D ALTER ❑ B.BP.C. for this reason ✓h 1.. Al' EPAIR '❑ $ . Date: USE DEMOL ❑ ' ;2793,8A ' EXISTING BLDG. Signature APPLICANT n'L t IN0.7JN.J1'y) FINAL #_e•e,• e,e 5 PRINT I'V L/� V�V OWNER-BUILDER.DECLARATION - /� .sem p .DATE 1 hereby affirm that I am exempt from the Contractor's License gDDRE55 r" t EIuGi�L�� 1 G )/ b I .•`• 5 9,2 5 Law for the following reason (Section 7031.5, Business and FINAL 1 Professions Code): - - - By - �-1 ) BUILDING • •t• 5925�x I I, as owner of the property, or my employees with ADDRESS - T"�s wages as their sole compensation,will do the woik and D o9, 16 8�] the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING - TEL. - I, as owner of the property, am exclusively contracting CONTRACTORS NO. with licensed.contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code), CONSTRUCTION LENDING AGENCY REQUIRED YARD HWY TOTAL SETBACKFROM EX[S SET BACK 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.I. Lender's Name - LDMA Raf. R Lender's Address - P:C. Fee 5 Permit fee - /�T/ t 1 certify t ave read this application and state that the Issuance Fea S/ �a. LDMA P/C p - above int mal n is correct. I agree to comply with all County Investigation Fee ordinan es an State laws relating to building construction, Total Fee 7 and h eb o ihorjp@ representatives of this Coun y to eater LDMA Perm. N m ' upon a boned property for inspe<tio put pSes. /� !6 oJ/ SEE REVERSE FOR EXPLANATORY LANGUAGE ignaNre of Applicant or Agent D ta. - -- - ' /]Y /i _( «NORKERS C6MPENSATION DEQARATION J/ 1 fi e4y affirn ;\hail t e a certificate of consent,to.self //p�� r�f O �(/,a //p�� M �r�} RD D M •-O �p}-�I�y��pL�///L�� insure or a ce�'at �f Workers CompensaLon Insurance, - (/_1111 P��V!/'ll7�O,U V Il O`0U ��LMNIG V� �LS U�IU V II�� a or a certified co'y'Ihefeof (Sect 3800, Lab. C.) 1• - - ' - - `- r - - -- -�7 . . . , • - I . COUNTY OF LOS`ANGELES . BUILDIN'G AND SAFETY Policy No. Company FT Certified copy,is hereby furnished. • \ FOR APPLICANT TO FILL IN BUILDING 2 ) ' ADDRESS Certified copy is filed with the county building inspec- BUILDING2 G. (JN f rA- e tion department. ADDRESS 1 Gni /'f Tern+ & Ci rY ZIP iy�D - ; Date 's Applicant -. CITY LOCALITY - CERTIFICATE OF EXEMPTION FROM WORKERS' p - NO.OF BLDGS. ---- - NEAREST_. _� - _ ,. COMPENSATION INSURANCE '- ' SIZE OF LOT O X ,7 NOW ON LOT � CROSS ST. .. - .I ; (This'section need•not be-completed'ifthe'permit-is for,one U _ - -- - - - -- -�TL/ ASSESSOR.- ss " PA ✓. u 1 hundred dollars ($100) or less.) TRACT BLOCK LOT NO. MAP BOOK • PAGE, PARCEL. ' ,A� �s TEL Q U'E Z< i MAP S J p. ♦ OWNER - IT 1 #II WO NO DC7 .. certify thoL ui the performance of the work for which this ��/ �+ �j NGII�IT/$" Id permit is ued, shall not employ rson in any manner _ -- ADDRESS CONDITIONS _ 6', C so,as sorb come; 61ect,o the Wo rs rtWensation taws. - — - - - - - •• +- o. V s CITY-T��, - -_ZIP Date Applicant-" ARCHITECT L/ 1. �. TEL.• �QSN' .O NOTIC TO AP LIC N7. If, after making This Certificate of ARCHITECT 7�j-N FyaF�Y NO. QDY' DISTRICT ROUP TYPE FIRE _PROCESSED BY. ,F ENGINEER CONST., l ZONE V ' Exemption, y u should become' subject to-the Workers' '- V Compensation provisions of the Labor•Code, you'must forth- gDDRE55y�L/0 C.+ � {�T/�t 91Po' .5, . ' _ .'j s 6 with comply ,with. such. provisions or this„permit shall be - - - - - deemed revoked. •„ ,. TEL STATISTICAL CLASSIFIC TION APT .CONDO. Z CONTRACTOR NO. _ 1P LICENSED CONTRACTORS DECLARATION -- -- - - �•• - -—LIC,- - - - CLA55 NO.�t_DWELL. UNITS_ I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS G NO. SEWER MAP - �'r (commencing with Section 7000)of Division 3of the Business and . . .. ..LIC. .__ _ _ Pr fessions Code, and my license is in full force and-effect. - OTV _ CLASSBK`- - - 't VALIDATION PG ' SO. FT. NO. OF_ _ NO OF- _ CHECK__ license Number Lic.Class SIZE 0- STORIES - I FAMILIES ' ONE • ��-TLL VALUATION 1 _ Contractor Date - DESCRIPTION'OOF�W�ORRKAth,/� 'i' 11� - NEW 1:1 - - -r/NNfR-/.76.. 1-ICT r ADD $ j� U � Iam exempt under Sea ,-- _ _ ._ ._.. • BAP.C. for this reason . _ .r REPAIR _❑ - $ - —” _-- - - - " Date:- - USE OF D�N DEMOL ❑ EXISTING BLDG �•'G -- Signature - ` _ _ - APPLICANT TEL FINAL I g PRINT /�I' �J4 FINAL _ OWNER-BUILDER DECLARATION //'' PN' t1('I'II dN�O{/" '��V ..-DATE � - I hereby affirm that I am exempt from the ContractoKs License gDDRE5510 r"r I I�I (.` • D FIN ' 7 8 a 0 A ' Law for the following reason:(Section 7031.5, Business and ._ rof-ssions Code): - "--- - R - - By'I _- _ - • e'e,e � BUILDING 1, as owner of the property, or my employees with _ _ ADDRESS wages as their sole compensation,will do the work and '-- - I ° 2 2 Q 0 0 . the structure is not intended or offered for sale(Section - LOCALITY 7044, '1 1• .. 7044, Business and Professions Code. - MOVING'- TEL • e `EJI, as owner of the property, am exclusively contracting CONTRACTOR NO. 2 a 2 01:10,,6 - with'licensed'contractors to construct the-project (Sec- - - __ tion 7044, Business and Professions Code). ADORES$ ., - \ •• .O 9, 09 -B7 ) REQUIREDTOTAL SETBACK F I CONSTRUCTIONS LENDING AGENCY - SET BACK WARD- -HWY' PROP. UNE 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. - -- - -— - •� - - - - - - - -- (Sec. 3097, Civ. C.). SIDE m -Lender's Nome _ .- _ •- - _ -.. S _ _DMA Ref. # _ P.C. Fee$ _ _ _ ._ - Permit Fee Lender's Address - i _ .I_certify that I have read this opplication.and state that the IssuonceFee - - (V-aLJ ,L/ LDMA'P/C# abov m ation is correct. I agree to comply with all County Investigation Fee 'g ordin cgs nd State laws relating to building construction, _ ._ _ •_. Total Fee # - - u and reb authorize representatives of this Cou ty to niter - - LD Perm. - - q up n 1 e ve entioned property for inspec' put es. I 0 SEE REVERSE FOR EXPLANATORY LANGUAGE t 1 •Signatwe ohApplicant or Agent . ._. le. _.__ _ _.__.._. _. T. .. - - a- �_: - - _ . _. _ .. --. '01 / f \A WORKERS' COMPENSATION'DECLARATION_� • W l'ne eb affirm that I have a certificate of consent to self //(�� D �(/� //(]�� M �r�} I��Y OR 1p� �r•1��1p��[/�� I��y�//�� insure, or a certihcofe of Workers' Compensation Insurance QPPUC� MOfi�', Ll OILU !-=+.U.ROW'r ��UUIIVII�� ora'certifiecicopy' ,thereof (Sec. 3800,*Lab. C.) 1a1 1 ;y. .. - ' • . - COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy,No r• -• - Company L •— OCertified copy Is hereby,4urNshed., ... d'•. FOR APPLICANT TO FILL IN BUILDING - `�' - ADDRESS Certified copy is filed with the county building inspec- BUILDING - . lion de partmenl. - ADDRESS 6Z 3 . Date'! _ . .Applicant CITY /y/�Lt� L/ ZIP / ' ...0..._( LOCALITY " CERTIFICATE OF EXEMPTION FROM WORKERS' .[ .OF BLDGS.� •- NEAREST "f T• `COMPENSATION'INSURANCE SIZE OF LOT p " �3 NOW ON LOT Z ' CROSS ST ,q I (This'sectiori,need not be-completed if the permit is for one - ASSESSOR_, hundred dollars ($100)or.less.) TRACT S O BLOCK LOT�NO. F_e MAP BOOK :'S PAGE. PARCEL TEL. ._ USE ZONE MAP certify that in-the performance of the work for which this QWNE �. A'/OWE(jN d''6'' O. - •• } permit is rssued, I shalnot employ any person m any manner SPECIAL - - - - - -_T IL SO'as to become subject to the Woikers'Compenscition Laws. _ 'ADDRESS As Q 1C£- — CONDITIONS O ...,. V Date ':• Applicant - t - , r t• :•. CITY . .. _ ZIP NOTICPTO APPLICANTi'tlf; after making:this'Certificate of ARCHITECT OR TEL. DISTRICT _ GROUP TYPE - FIRE _PROCESSED BY Exemption you should become subject to the Workers' - ENGINEER NO. �,(/ CONST ; ZONE _ U Compensation provisions mfthe Labor Code, you-must forth ADDRESS J cVd -� ✓ _ .3 . IL with comply with such provisions or..this permit sholl be _ _ - - .. ..- _ _ _. - W deemed revoked:. . , , _ TEL. STATISTICAL CLASSIFICATION APT. CO DO.. . -1 Z c CONTRACTOR NO.. _ _ �l I LICENSED CONTRACTORS DECLARATION - -_ _ _ LIC. -CLASS NO. O� DwELL. UNITS__ , .1 hereby affirm that am licensed under provisions of Chapter 9 ADDRESS NO. (commencing with Se<tian 7000)of Division'3 of the Business and _ - _ ,___ - - • . LIC.. - _ - SEWER'WAP ' 1 Professions Code, and•my license is infull force and effect CITY '- " - - "VALIDATION .•, ,n..ri' SO. F_T.' _ __ _ NO, OF NO. OF CLASS ,CHECK BK. PG. . License Number- r Lia Class SIZE STORIES FAMILIES ONE VALUATION _ . Oro _ __ _ 18'6 8A DESCRIPTION OF WORK ... _.. NEW Controctor Date • .. O ADD f �`�e' '# se a ee Lam exempt under Sec. • - -u/�.// -_ S -ALTE_ D e * 3 a 0 0'. B.BP.C. for this reason USE OF REPAIR .E] S ' -" - '-•- -es-e 3.,3-O.O Fs - Dore: _ EXISTING BLDG. IDEL696 F_] '04. 1 8=85 - Signature ZZ FINAL OWNER-BUILDER DECLARATION DAT _I.hereby affirm.that.1 am exempt from the Contractor's License ADDRESS 6 Z .3 G..v�r� vs FINAL "T'• Law for the following reason (Section 7031.5, Business and / 'Professions C e - " ' �� PRESENT - BY :'L(i� _r/I QW� BUILDING T T - Il7]rXVI r 1 re pro erty�T' my emp oyees with _ ADDRESS t wages as their sole compensation,will do the work and the structure is nor intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). -' -' - '-" MOVING "- - '- - "' •' "TEL. - - - ' ' OCONTRACTOR NO. D I, as owner of the property,.am exclusively contracting with-licensed contractors to construct the project (Sec- tion 7044, Business and Professions Code). ADDRESS - ...: _ REQUIRED TOTAL SETBACK F . CONSTRUCTION-LENDING AGENCY - SET BACK YARD -HWY PROP. LINE WIDTH )TW 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 _ _ -. ._ . . . _ - _ ._. m Lender's Name - Sf G'O- LDMA Ref. # P.C. Fea$— - — - Permit Fee - ✓ - - Lender's Address w I certify.that Lhave read-this application and.state.that the _ _ - luuance Fee--- V J Li' - - LDMA P/C-# above information is correct. I agree to comply with all County Investigation fee $ _ordinances.and State laws relating to building construction, , u and hereby authorize representatives,of this County to enter - Total Fee-- -1 LDMA Perm:# mu �aboveofT7?;nl, erty for inspeon purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE em- Dots I - - - -- -- - - •-- - - Ort COUNTY OF LOS ANGELES TEMPLE CITY 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1110030056 PHONE: (626) 285-0488 EXT: ILEGAL ID: NO. OF CONST BUILDING ADDRESS: JTR: 5904 LT: 280 SQ. FT STORIES TYPE 6243 ENCINITA AV I ISTRUCTURE: V-B TEMP CA 917801640 1ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: 15384-011-018 1 THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY, Cl I (TENANT: (EXIST BLDG USE: RESI❑ USE ZONE: R-1 TISSUED ON: PROCESSED BY: 1 EXIST OCC GRP: 10/03/11 SR 1 I IOWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: IFINAL DATE III'L Y: CODE: 1 TUAN LAM, LY VIVIAN (626) 318-8298- 5,000 16243 ENCINITA AV 1TEMP 917801640 1 FEES PAID 1UESCRIPTION OF WORK 1 I I (REMODEL KITCHEN AND TWO BATHROOMS REMODEL 1 I IFFE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 I 1APPLICANT: TEL. NO: I I I ISAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.80 1 1 1A STATE GREEN BLDG FEE 5000.00 VAL 1.00 1SPECIAL CONDITIONS: I IAC STRONG MOTION RESID 5000.00 VAL 0.50 1 IB2 PERMIT W/ENERGY 5000.00 VAL 146.10 1 1 TOTAL FEES 175.40 CONTRACTOR: TEL. NO: I 1APPP.OVALS DATE INSPECTOR SIGNATURE 1 SAME AS OWNER, - I I I 1 LIC. NO I ILOCATION AND SETBACKS I I I I I I I I ISOILS ENGINEER APPROVAL 1 1 I I I IARCHITECT OR ENGINEER: TEL. NO: I 1FOUNDATI0N/TRENCH FORMS I I I I - I I 1 I LIC. NO: I SLAB/UNDER FLOOR I I I I I I I I IRAISED FLOOR FRAMING 1 1 1 I I I 1MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:1 (UNDERFLOOR INSULATION I I I 1153H265 3 001 1 1 I (FLOOR SHEATHING I I I IND. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I 1 1 0 NO 21 1 (ROOF SHEATHING I I I I _- 1 I SCHOOL WITHIN HAZARDOUS SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS 1 NO NO NO FRAME INSPECTION I I (FIRE SPRINKLER HANGERS I (INSULATION/WEATHER STRIPI I I I I I (INTERIOR LATH/DRYWALL I I I 1EXTERIOR LATH I I I I IRATED FLOOR/CEIL ASSEM. I IRATED WALL ASSEMBLIES I IRATED SHAFTS/OPENINGS I T-BAR CEILINGS I LOT DRAINAGE I I IREPORT ID DPR261 ROUTE TO BS0508 1 17"t •�`,�"` L'�=d. {'- 'G �-,�M4i,r`r/R'' f tia�' A:6.�"... �{t+:W*i'$i..�="�."Fyy SE;� +.3'`I e1f.' ��,,,3�"` 74Nc .yy� � r t'�,id!frtsn.7X:�c'=�'-�'.w''§h a F.�t`...f COUNTY OF IAS ANGELES TEMPLE CITY 4 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1112120001 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: ITR: 5904 LT: 280 SQ. FT STORIES TYPE 6243 ENCINITA AV ISTRUCTURE: V-B I TEMP CA 917B01640 IASS£SSOR INFORMATION NUMBER: NEAREST CROSS STREET: 15384-011-018 THOMAS PAGE: 596 GRID: _S2 LOCALITY: TEMPLE CITY, Cl I (TENANT: IE%IST BLDG USE: RESID USE ZONE: R-1 TISSUED ON: PROCESSED BY: 1 IEKIST OCC GRP: 112/12/11 SR IOWNER: TEL. NO: iBLDGS. NOW ON LOT: VALUATION: !FIN D�E FINAL 6Y: CODE: 1LAM, LY VIVIAN (626) 318-8298- 9,480 6243 6293 ENCINITA AV TEMP 917801640 1 FEES PAID DESCRIPTION OF WORK IWINDOW REPLACEMENT = RETRO FIT 17 WINDOWS I IEEE DESCRIPTION: QUANTITY: UCM: AMOUNT: ( 1 (APPLICANT: TEL. NO: II ' (SAME AS OWNER - AN BLDG PERMIT ISSUANCE 27.80 AS STATE GREEN BLDG FEE 4480.00 VAL 1.00 (SPECIAL CONDITIONS: IAC STRONG MOTION RESID 4480.00 VAL 0.50 1 ID2 PERMIT W/O EN-HC 4480.00 VAL 132.80 I 1 1 1 TOTAL FEES 162.10 1 1 (CONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE (SAME AS OWNER - I LIC. NO (LOCATION AND SETBACKS 1 � I (SOILS ENGINEER APPROVAL I I I t (ARCHITECT OR ENGINEER: TEL. N0: (FOUNDATION/TRENCH FORMS I I I I I LIC. N0: I (SLAB/UNDER FLOOR I I I I I RAISED FLOOR FRAMING I I I (MAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:j UNDERFLOOR INSULATION 1153H265 3 001 1 1 I I (FLOOR SHEATHING ING. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I 0 NO 21 1 IROOF SHEATHING I 1 1. I I I SCHOOL WITHIN HAZARDOUS SHEAR PANELS (AIR QUALITY: 1000 FEET MATERIALS NO NO NO (FRAME INSPECTION I FIRE SPRINKLER HANGERS I I I I 1 11N$GLATION/WEATHER STRIP( 1 1 I (INTERIOR LATH/DRYWALL I I I I _ I EXTERIOR LATH 'RATED FLOOR/CEIL ASSEM. I (RATED WALL ASSEMBLIES !RATED SHAFTS/OPENINGS T-BAR CEILINGS I I T I I I i I ILOT DRAINAGE 1REPORT ID: DPR261 ROUTE TO: 850508 1 I I 1 II I I I I I