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Home My Public Portal About6261 ENCINITA AVE_Building__ 16A638TIPIR 3 APPLICATION FOR UILDIN PERMIT TY OF LOS ANGELES" BUILDING TMENT OF,COUNTY ENGINEER nooREss BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST COLEMAN W. JENKINS.SUP T.OF BU140ING CROSS ST. ' DISTST NO. GROUP TYPE. P ESSED BY FOR APPLICANT TO FILL IN BUILDING / / STATISTICAL LASSI FICA TION` SE ER MAP ADDRESS r� BK CLASS NO, DW ELL UNITS LOT NO.� - Q p"( BLOCK USE ZONE. MAP , TRACT _ NO. . SPECIAL N0. OF aLp03. L CONDITI NS SIZE OF LOT NOw ON LOT USE OF n - - EXISTING Al ` BLDG. SETBACK FROM El. FRONT PROP. LINE OF (STREET) OWNER A NO. TYPE OF E%)STI NO' SETBACK HIOHWAY' + YARD TOTAL ADDRESS l HIGHWAY I 'I M C.L, ' CITYI f + ARCHITECT OR TEL. BLDG. SETBACK FROM ENGINEER NO. SIDE PROP. LINE OF (STREET) TYPE OF I WE%ISTINO SETBACK ' HIGHWAY ' + YARD '= TOTAL, } ADDRESS HIGHWAY IDTH )ROM C.L. 1 CONTRACTOR / / NO LIC ADDRESS ` NO D7 4- CORNER CUTOFF YES NO 0 ` H CITY IC SEE REVERSE SIDE FOR SPECIAL APPROVALS . w DESCRIPTION OF WORK itljhtlG; "q NEW ADD ALTERREAXIR OE MOLISH 50.FT. _ NO. O NO. OF f SIZE STORIES FAMILIES (�� /,Frs... f�nJf/�•y _�P]�,f� SUSE OF TRUCTURE a14 �d N /v/v •Y jtA7 R' vY" w�iQYW'C/Q SIGNA TORE OF T ACA lATS `~ 7/,/`'yt'�4'nin/u/�tc�,�AgAv'�'�rp A ••.A.Y-• �,.i+ PPLINT -4/ vSvG/.•TP Y'W_f:(O•V /J! /I�1fY/!��{,; VALUATIONS '� L1-fl " APPROVALS DATE /'INSPECTOg3'—BIGyffATUPE P.C. PMLFO FORMS,)MA�TERPALSLOAT ON FEE$ '^— FEE FRAME, FIRE STOPS, 1 HEREBY LEDGE THAT HAVE READ THIS APPL IUTION BRACING BOLT AND STATE TOUTHAT THETHE ORDINANCES IS CORRECT AND AGREE REGULATING COMPLY FURNACE: LOCATION WITH ALL COUNTY TI O, I CES ANO STATE LAWS THE WORK GAS VENT. DUCTS AUTO RIZ CONSTRUCTION,') CERTIFY THAT. IN GOING THE WORN TI ON F THE HEREBY WILL NOT EMPLOY ANY PERSON IN VIOLA. LATH. INT. TION OF THE LABOR CODC OF THE STATE OF CALIFORNIA RELAT- ING TO WORKMEN S COMPENSATION INSURAf CE LATH. EXT. SIGNATURE OF HOUSE NUMBER COR- / PERMITTEE RE POSTED / AooREss FI NALND 4-64 <9 µwzri..-y JOHN F. LEWIS. PRINCIPAL STRUCTURAL ENG PLAN CHECK VALIDATION CK, M.G. CASH _ PERMIT VALIDATION CK. M.G. CASH Lo2 9 8 5Dai23 1 D 4,00- COUNTY OF LOS ANGELES BUILDING AND SAFETY BUILDING ADDRESS BUILDING ADDRESS FOR APPLICANT TO FILL IN ^ i i `r -WORKER'S COMPENSATION DECLARATION V ,) I hereby affirm that I have a certificate of consent to salt insure, _ ;dor a Certificate of Workers'Compensation Insurance,or a certified —CITY ZIP e- .1 ,� CJ 91,7s-3. Copy thereof(Sec.3800,Lab.C.) q 17 F�yYr Q Q Ci LOCALITY-4 Policy No. Company SIZE O/F�L T NO.OF BLDGS.NOW ON LOT EVA,c t K( �JJ ❑ Certified Copy is hereby furnished. 6 4,�. NEAREST CROSS ST. 1f.J� 11 TRACT BLOCK LOT NON�'TDL 'N ❑ Certified Copy 19 filed With the county building inspection . �USEZONE MAP NO. department. ASSESSOR MAP BOOK PAGE PARCEL Date—Applicant SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL NO. I� YES NO COMPENSATION INSURANCE S G { –251"162_ WITHIN 1000 FT OF SCHOOL? ADDRESS (This section need not be Completed if the permit i3 for one hundred 6 a-- DISTRICT 'GROUP TYPE CONST.' FIRE ZONE DOES D BY dollars($100)or less.) CITY Z r./ /xry (�, , I certify,that in the performance of the work for which this permit C' `I �7 C" ..{/•yf/,,(u/" K is issued, I Shell not employ any person in any manner a0 a4 10 ARCHITE TOR ENGINEER I TEL NO. become subject t0 the Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT COND Date Applicant ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT: If, after making this Certificate 01REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject l0 the Workers' CONTRACTOR TEL.NO. SETBACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code. you must forthwithFRONT Comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL LICENSED CONTRACTORS DECLARATION CITY LIC.CUSS BIDE a PL p I hereby affirm that I am licensed under provisions of Chapter 9 SEWER MAP U (Commencing with Section 7000)of Division 3 of the Business and SO.FT SIZE NO.OF STORES NO.OF FAMILIES Professions Code,and my license is in full force and effect. NEW [I BK PG H DESCRIPTION OF WORK License Number Lic.Class R A? fy. v,- ADD ❑ _N $UAn N oO O w� Contractor Date •] ALTER 13z_ 3� c'A' REPAIR 11I am exempt under Sec. � p B.BP.C.for this reason �/�\YV DEMOL ❑ LOW PAC# Date: U F EXISTI BLDP. URM ❑ - 1 Signature A PLICANT(PRINT) � C TEL NO. LOMAPaene a ❑ 1, as owner of the property, or my employees with wages as `'t `-- �'� ..p �`•�T�T __ their sole compensation, will do the work and the structure is A RESS 1l., r F .i3�7 1i Ij, .1 not Intended Or offered for sale (Section 7044, Business and 1— C1 IiA Q 414CI FINAL A Professions Code.) - C 1 TTE{�E W ILL TH E APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL ❑ I, as owner of the property, am B%CIUSIVBI COOfreClin WI(h OR A MIXTURE CONGINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN Y g THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALSINFORIMTONGUIOEi FINAL > TICITAL 105 - 25 licensed contractors to construct the project.(Section 7044, YES❑ NO❑ . Business and Professions Code.) !:HECK - EQo„!5 WILL THE INTENDED USE MI THE BUILDING BY THE OR MODIFICATION IO FUTURE BUILDING OCCUPANT REQUIRE MANAGENIENT DISTRICT NORMODIFICATION FROM THECOLITH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST CHANGE •f I�I FOR GUIDELINES. I hereby affirm that there is a construction lending agency for YES❑ No❑ A the performance Of the work for winch this permit IS Issued(Sec. HAVE READ THE HAZARDOUS IMTERIALS INFORMATION GUIDE AND THE SGOMD �'} { [[ A r' 3097,CIV.C.J. PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES OOI)17-I II jQ 1 'Y': COUNTYCODE,TITLE2.CHAPTER2.MSECTIONS2.M.meTHROUGH21,lQCONCERNING _ {' �L, V 7`. Lender's Name HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE$GAQMD 98418 1 AN 'J°'�� Lender's Address aAHm�ASH.. o' I Certify that 1 have read this application and state that the above $� information IS correct. 1 agree to comply with all county P.C.FEE PERMIT FEE ^ ' FZ ordinances and State laws relating to building construction,and VJY hereby author §r p 3 atives Ot Is County to enter Upon ISSUANCE FEE - the a epK d �berty for' ion ur .00 n gb INVESTIGATION FEE TOTAL FEE - 2 SEE REVERSE FOR EXPLANATORY LANGUAGE, - WORKERS' COMPENSATION DECLARATION - I hereby affirm that I•hove a certificate of consent to self ////8\ O L1��1p� //8 �rl��p� L��p '^yr �y�s� insure, or a certificate of Workers' Compensation Insurance, - .(rOP11 IS��LI-A �0 V Il �II� L�/��D�� p�� _ or a certified copy thereof (Sec. 3800, lab.C.) '- COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company El .- - Certified copy is hereby'furnished. -FOR APPLICANT TO FILL IN BUILDINGgODREs$ ❑, Certified copy is filed with the county building inspec- BUILDING _ - tion department. - ADDRE55 6261 N. ENCINITA -.AVE TEMPLE 'CITY CALIF. 9178 ciTv TEMPLE. CITY ,CAzlp - 91780 LOCALITY TEMPLE CITY Date 'Applicant - NO. OF BLDGS. NEAREST CERTIFICATE OF EXEMPTION FROM'WORKERS' - SIZE of LOT 7628- - NOW ON LOTCRo55 ST. LONGE-DEN COMPENSATION INSURANCE T5904 278 ASSESSOR (This section need not be completed'if the permit is for one TRAC BLOCK' LOT NO. MAP BOOK• .5384 PAGED 11 PARCEL 016 ' hundred dollars ($100) or.less.) - x TEL OWNERRAMESH G—CHOKSHI . No. 286-9162 USE70NE MAP I certify that In the performance of the work for which this NO.CONDITIONS permit is issued, I shall not employ any person in any manner ADDRESS 6261 N ENCINITA AVENUE SPECIAL d so as to become subject to the Workers' Compensation Laws.' CITY TEMPLE CITY, CA. ZIP 91780 QU 'Date Applicant - ARCHITECT OR TEL. 714-592 I � NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER D.JOHNSON N DISTRI ROUP, TYPE FIRE PROCESSED BY Q Exemption, you should become, subject to the Workers' CONST. ZONE Compensatin provisions of.the Labor Code, you must.forth- ADDRESS' 110 S. EUCLA, SAN DIMAS 5.0 •3 �_ 3 I� wW with comply, with such provisions or this permit shall be OWNER BUILDER TE1445-0649- STATISTICAL CLASSIFICATION APT. CONDO.' N deemed revoked. CONTRACTOR — NO. .. _ _ Z LICENSED CONTRACTORS DECLARATION 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 LIC. - - SEWER MAP and Professions Code,and my license is in full force and,effect. CITY CLASS BK PG VALIDATION SQ. FT: NO. OF " NO. OF CHECK License Number LiC Class SIZE STORIES 1FAMILLB ONE VALUATION 1. .Contractor DESCRIPTION OF WORK REMOVE STORAGE NEW ❑ - - -Date _ AREA BEHIND GARAGE ADD•. ❑ S D ❑I am exempt under Sec. , B.BP.C. for this reason ALTER ❑ - , REPAIR ❑ f Date: USE OF -STORAGE _ . EXISTING BLDG. -STORAGE .'DEMOL-A,J Signature APPLICANTRAMESH G CHOKSHTIL 286-9162 FINAL OWNER-BUILDER DECLARATION (PRINT) NO. - I hereby affirm that l am exempt from the Contractor's License 6261 N. ENCINITA-- AVE TEMPLE DATE !4 IZ c Law'for the following reason (Section 7031.5, Business and ADDRESS FINAL � - ,,hK37 1=0.513 Professions Code): i I c PRESENT By ❑ BU I'DING 6261 N. ENCINITA AVE 1 ITEMS -t-Y 1, as owner of'the properly, or my employees with ADDRESS , 1 TOTAL. I - - wages as their sole compensation,will do the work and TEMPLE CITY, CA. 91780 - the structure is not intended or offered for sale(Section LOCALITY ! [ 7044, Business and Professions Code:) MOVING _ - TEL. > . . —, . . C.HECK, DCI.0 . ® I, as owner of the property, am exclusively contracting CONTRACTOR NO. - -with licensed contractors to construct the project.(Sec- ADDRESS - CHANGE � •00 tion 7044, Business and Professions Code.) ' REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SE7 BACK YARD TOTAL PROP. LINE WIDTH - / I hereby affirm that there is a construction lending agency for ch, performance of the WOFIE for vA ch th.. FRONT 0000-00,11 11/rGBIY�:' (Sea. 3097, Civ. C.). siDe 70511 1 AM' i 43 Lender's Name. _ m - P.C. Fee$ Permit Fee ��'00 ED MA Ref. # Lender's Address n D a I certify that I have read this n application and state that the Issuance Fee 8 LDMA P/C#above information is correct. I agree to comply with all County Investigation Fee , R- ordinances and.State laws relating to building construction, Total Fee 0/5 Q LOMA Perm. # aand hereby authorize resentatives f this County to enter 'upon the o m t d propert f inspection urpose - gy $EE REVERSE FOR EXPLANATORY LANGUAGE i� r PP tc nt cr Agent Date WORKERS' COMPENSATION DECLARATION" n R I hereby affirm that I•have.a'certificate of consent to self (/"LT�� A lTPON F®R B ((�n MNG PER(, / PT insure, or a certificate of Workers' Compepsation Insurance, , . Il (/;\ u LIG �,JJ LL u `U' PERMu or certified copy thereof (Sec 3800, Lab. C.) - . . - COUNTY.OF LOS ANGELES - BUILDING AND SAFETY Policy No. - Company I - IL�,J Certified copy is hereby furnish ed. FOR-QPPLICANT.TO-FILL IN- ELIDING 6261 N. ENCINITA AVENUE ❑ Certified copy is filed with the county building inspec- BUILDING. - " - `c I I •+ , • . 7 .. tion department. ADDRESS 6261' N ENCINITA 'AVENUE EMPL-E CITY, CA. 91780- - Date ApplicantCITY TEMPLE` CS-TY tXLIF.zi 91780 - LOCALITY TEMPLE CITY NO. OF BLDGCERTIFICATE OF EXEMPTION FROM WORKERS' . SIZE OF LOT,- 7628- `Now ON Lois - CROSS SNEAREST_ LONGEDEN • COMPENSATION INSURANCE ASSESSOR (This section need not be completed if.the permit is for one - TRACT 5904 BLOCK - LOT NO. "' - MAP BOOK 5384 PAGEO i l PgOE 6 hundred dollars ($100) or less.) RAMESH G CHOKSHI TEL. — OWNER NO. fig 2-- USE ON MAP ,I.certify'that in the,performance of the work for which this NO. ': _ > permit is issued, not employ any person in any manner ADDRESS N:• ENCINITA AVENUESPECIAL - 111 a so as to becomesubj 6261 subject to the Workers'Compensation Laws. CONDITIONS O ' CITY. TEMPLE CITY, CA' zip 91780 - U Date - Applicant, - ARCHITECT OR. D.JOHNSON . TEL71�r�-59 - NOTICE TO APPLICANT: If, after making.this Certificate of .. ENGINEER tvg769 DISTRICT GROUP TYPE ,-- FIRE OCESSED BY O Exemption,.you should become subject to the - R t �(•� CONSi. y / Compensation provisions of become Labor Code, you must Workers'forth- ADDRESS 110 S EUCLA AVE SAN DIMAS C UX - •/�L`' with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APIE.- CONDN N deemed revoked. CONTRAcroR OWNER—BUILDER No- 45-0649 Z LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. - DWELL. UNITS— AL hereby affirm that I am licensed under provisions of Chapter ADDRESS NO. (commencing with Section 7000)of Division 3 of the Business LIC - - SEWER MAP and Professions Code,and my license is in full force and effect. CITY, CLASS BK PG VALIDATION SQ. FT. NO. OF NO. OF CHECK License Number. _ Lic Class SIZE 519 STORIES 1 FAMILIESONE ADDITIONS VALUATIOX1 Contractor Date DESCRIPTION OF WORK NEW ❑ - S a ..9.. 6 . _ & REMODELING -ROOMS-.519 - ADD—O D . ❑I am exempt under SeaALTER SQ . FT S 8.8P.C. for•this reason F-1 ^ Date: USE OF REPAIR . - - EXISTINGBLDG. RESIDENTIAL DEMor'❑ t ... Signature APPLICANTRAMESH G CHOKSHI TEL286-9162 - OWNER-BUILDER DECLARATION- (PRINT) NO. FINAL _ ;• F, I hereby affirm that I am exempt from the Contractor's License 6 261 N. ENC , -_ Law for the following reason(Section-7031.5', Business and ADDRESS FIN 1 " Professions Code):. PRESENT. 6261 -N ENCINITA 'AVE - BY ! , ACCT. JC .a ElBUILDING _ At I, as owner of the property, or my employees with ADDRESS �,•/// I' - c the compensation,will do the workand - I v P C-07 ` 265.'10 (J(\I ocqurv.TEMPLF, CITY, CA. 91780 / t the structure is not intended or offered for sale Section T to �n 7044, Business and Professions Code ) ( MOVING TEL D � �.� 1 I iGtt� �L property, Y g CONTRACTOR NO. • i ITAL 265 .' 50 /O C .'50 T I, as owner of the am exclusive) contracting V -with licensed contractors to•construct the i:project•(Sec- ADDRESS ' tion 7044, Business and Professions Code. - 2' 5.,50 HEf:Y, - o.. •- an i PA ng egaincy for REQUIRED TOTAL SETBACK FROM EXIST. _ �• CONSTRUCTION LENDING AGENCY SET BACK YARDHWY PROP. LINE WIDTH f CHANGE .MILL 'Theperformance of the work for which this permit is issued P.L. (Sec. 3097, Civ, C.). .SIDE PL. IJL'00-00171 11/2 :/�9 Lender's Nome _ m LDMA Ref. R t 7 d 7065 1 AM 7:4;, ' P.C. Fee$ Permit Fee .. . ... ...... - Lender's Address ' a I certify that I have read this application and state that the lssvance Fee f D ✓ Q' LDMA P/C R D 8 above information iscorrect. I agree to comply with oil County ' Investigation Fee ordinances arid State laws relating to building construction, Tawl.Fee LDMA Perm. N a and hereb r au ori ggresentatives f this Cou ty toe ei � upon e- n d propert f inspecfi ap es. � ' SEE REVERSE FOR EXPLANATORY LANGUAGE / \ SI ra re of Applicant or Agent Date C