HomeMy Public PortalAbout6329 ENCINITA AVE_Building__ APPLICATION FOR BUILDING PERMIT
FOR APPLICANT TO FILL IN (PPFt o, rvPe OFIY)
eu1Lo1NG Z 3 N T - COUNTY OF LOS ANGELES
AooR Ess DEPARTMENT OF COUNTY ENGINEER
CIT v ZIP C)nEpn BUILDING AND SAFETY DIVISION
NO.OF BLOGS. BUILDING
SIZE OFLOT NOW ON LOT ADDRESS bY
TRACT t I7—t 1-5 BLOCK LOT NO.Ili LOCALITY' -
TEL.IVI I Ke NEAREST
OWNER Il��(E�J� NO. CROSS ST.
ASSESSOR / -
ADDRESS MAP BOOK /P GE PARCEL
�+ �/� DISTRICT' .GROUP TYPE FIRE PROC E55E0 BY
CITY 1 t ZIP Q.�J / CONST. ZON �/
ARCHITECT OR - TEL. �` U
ENGINEER NO.
STATISTICAL C�LjASSIFICATION SEWER MAP
ADDRESS SS/..��.CLASS NO."?/
_DWWELL,UNITS �` B �G.
CONTRACTOR' LOC /1/I E NAO�U
U , O
ADDRESS NO. n SPECIAL
LIC. / CONDITIONS
CITY CLASS
ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO
CONSTRUCTION LENDER
NAME AND BRANCH BLDG.SETBACK IFR OM - d
FRONT PROP. LINE OF ISTREETI
ADDRESS CITY _ TOTAL SETBACK FROM TYPE OF EXISTING
HIGHWAY } YARp _ C
SO. FT. NO. OF NO. OF - CHECK FRONT PROP.. LINE HIGHW V WIDTH O
512E STORIES FAMILIES ONE
+ = D LL
DESCRIPTION OF WORK I NEW ❑
ADD ❑ BLDG.SETBACK FROM Z
S1DE PROP. LINE OF ISTR—
/ ALTER ❑ HIGHWAY } YARD = TOTAL.SETBACK FROM TYPE OF EX15TING
/�� � REPAIR❑ SIDE PROP. LINE HIGHWAY WIDTH
USE OF W�l/� ¢ D
EXISTING BLDG. IDEMOL ❑
APPLICANT TEL CORNER CUTOFF YES ❑ NO
T)
)PRINN0. _
BY
(PRINT)
IN OPEN SPACE YES ❑ NO ❑
_ IN COASTAL ZONE YES ❑ NO ❑
VALUATIONS Vbe CATEGORICAL EXEMPTION YES E] NO E]
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION ENVIRONMENTAL
AND STATE THAT THE ABOVE- IS CORRECT AND AGREE TO COMPLY IMPACT E%EM PTIO&OECLA RA TION SIGNED (DATE)
WITH ALL ORDINANCES ANO LAWS REGULATING BUILDING CON-
STRUCTION, I CERTIFY THAT IN DOING THE WORK AUTHOR RED IMPACT REPORT PROCESSED (DATE)
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
LABOR CODE OF THE 5 DF CALIFORNIA IN ELPTING TO
WORKME CD PENSATI N IN Ufl
SIGN4TU E
P ERMITT _ ///�
ADDRESS / /
FINAL / BY
I
_ - TEL DATE 5 /
CITY 0` 0 NO. L' 71
MAKE CHECKS PAYABLE_ TU' FEE FEES21
HARVEY T. BRANDT. COUNTY ENGINEER '711—/
PLAN CHECK.VALIDATION - K o. - =ASH PERMIT VALIDATION CN. � M.O. CASH
2 B �dl
]6A 638A CE9903 7/73 3
.. 1 5 D 11Ay 24
1,. 0. 2 12 5 ,&`N
I cl.a r �,�e� c c C 443-/579
*APPUICATIOIN FOR COUNTY OF LOS ANGELES
BUILDING PERM IT DEPARTMENT OF COUNTY ENGINEER .
BUILDING'AND SAFETY DIVISION
BUILDING
FOR APPLICANT TO FILL IN
ADDRESS,ADDRES .BUIDING
ADIDRE55 0 l -NGI •! LOCALITY
NEAREST 60-CITY I L �. • - Zip - CROSS ST, 0-e
NO.OF BLDGS. ASSESSOR
SI ZE OF LOT NOW ON LOT MAP BOOK PAGE. PARCEL
fr✓ DISTRICT GROUP TYPE FIRE ROCE!ED BY
TRACT/ep- / /SJ BLOCK LO`NO. U 3 D 4 �7 CONST1 ZJE )CE
OWNER Y 77h /� - NO.• a.- _
STATISTICAL CLASSIFICATION - SEWER MAP
ADDRESS h'Ne�` i CLASS NO. DWELL.UNITS �' BK��+PG
CITY' N �c ZIP , USE ZONE MAP
ARCHITECT OR �TREnL NO. �Q Q
ENGINEEP .� lL T/d,. ��� 7aA PECIAL
pp NDITIONS
ADDRESS !O y?i NC' ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑
TEL.
CONTRACTOR - NO. BLDG.SETBACK FROM
LIC FRONT PROP.LINE OF r` ISTREETI
XISTIN
ADDRESS IN HIGHWAY + YARD = TOTAL
NT PROPKLINSETBACFROEM HIGHWAY I TYPE OF JEWID HG
LIC.
CITY CLASS
CONSTRUCTION LENDER
NAME AND BRANCH BLDG,SETBACK FROM 0
ADDRESS CITY SIDE PROP.LINE OF ISTREETI
O •
SO.FT- NO.Of NO.OF CHECK = TOTALS ETBACK FROM TV PE OF EXISTING
SIZE HIGHWAY + YARD SIDE PROP.LINE HIGHWAY WIDTH w
8 STORIES FAMILIES ONE
=
DESCRIPTION OF WORK NEW ❑ - Z-
h� ADD CORNER CUTOFF - YES ❑ NO ❑
` ALTER ❑ IN OPEN SPACE YES ❑ NO ❑
USE REPAIR El
OF
BLDG. DEMOL ❑ IN COASTAL PERMIT ZONE . VES ❑ NO ❑
APPLICANT - TEL /'J •.j•p� . pA �li� � 1„r
IPRINTI NO.
BY ISIGNATUREI '
HEREBY ACKNOWLEDGE THAT HAVE READ THIS APPLICATION AND STATE '
THAT
THE ABOVE IS CORRECT AND AGREE i0 COMPLY WITH All ORDINANCES
AND LAWSUT REGULATING BUILDING CONSTRUCTION. CERTIFY THAT IN DOING THE
WORK ORCODE EO HEREBY EOF LIF EMPLOY ANY PERSON IN VIOLATION OF
"THE LABOR CODE A THE STATE OF CALIFORNIA IN RELATING i0 WORKMEN'S COM
PENSATION INSURANCE.SIGNATUR
PERMT TEES / FINAL ^��J � BY
DATE L., rl �'f.-a-•••�.
ADDRESS
�. F
CITY J, {•` NEl,O.`• •� ��� P.C. Fee$ , Permit Fee 21•S-D
VALUATION :5-z O v O d. O Issuance Fee . v
\ J CD e ro a �,.�•�
• •' '• i0 a eye Total Fee
PLAN CHECK VALIDATION cK.' .o. CASH PERMIT VALIDATION CK. M.o. cnsr
vI ve O.
2 8 8 AUG 15 *�- U .2 Q c I DO Co. GI
J (n Cne Do
3 _ ' Eb O Oe
Ad CH v
®f ]6AG36ACEN803A6/)) /sa 00 -
APPLICATION FOR BUILDING PERMIT
.F APPLICANT TO FILL IN (Print or IYPB only)
BUILDING COUNTY OF LOS ANGELES
ADDRESS DEPARTMENT OF COUNTY ENGINEER
CITY27Ee-lz,,zZIP BUILDING AND SAFETY DIVISION
�'f TiA NO.OF SLOGS. BUILDINGC
S1ZE OF LOT S� / S NOW ON LOT bb ADDRESS ^/
TRACT BL/O/C�K LOT NO. /T �O LOCALITY a.
TEL
NEAREST
OWNER yjL NO ;�y���� CROSS ST.
ASSSSOR
ADDRESS (i y o / /"�C�/y�� MAPF BOOK PAGE PARCEL
/ sem- DISTRICT GROUP TYPE FIRE SS�ED BY
CITY Of�L(%� / C ' ZIP /"tea CONST. ZSE
ARCHITECT OR � TEL Y
ENGINEER NO.
STATISTICAL CLASSIFICATION� SEWER M P
ADDRESS CLA55 NO.L // DWELL.UNITS BK PO
TEL.
CONTRACTOR NO USE ZONE NOP
LIG. - 1 .o SPECIAL
ADDRESS NO. .y6 CONDITIONS
CITY LIC.
CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑
CONSTR LENDER
NAME AND BRANCH BLDG,SETBACK FROM
FRONT PROP.LINE OF 157REE1) DU
ADDRESS CITY _ TOTAL SE T BACK FROM TYPE OF EXISTING CD
SO. FT. NO. OF NO. OF CHECK HIGHWAY } YARD - HIGHWAYWIDTH
SIZE )f0 STORIES FAMILIES ONE FRONT PROP. LINE CO
DESCRIPTION OF WORK
NEW } U
S� Qrj� ADDETBA
SETBACK K RR Al BLDGIN FROM
SID G. ETBA (STREET) Z
ALTER TOTAL SETBACK FROM TYPE OF EXISTING
REPAIR❑
Q K HIGHWAY } YARD - SIDE PROP. LINE HIGHWAY WIDTH
EXE ING BLDG._ DEMOL El +
APPLICANT T L CORNER CUTOFF YES ❑ NO ❑
BY (SIGNATURE) IN OPEN SPACE YES ❑ NO ❑
'1 IN COASTAL ZONE YES ❑ NO ❑
VALUATION bO1 UV CATEGORICAL EXEMPTION YES NO ❑
HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL
ANO STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE)
WIT HALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION. I 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'5 COMPENSATION S RAN[ .
SIGNATURE OF
PERMITTEE
ADDRESS
FINAL
TEL. DATE VIP/ 7 BY
CITY NO.
HAKE CIII.CKS P:4 AHLE 70r FEE $ FEE
HARVEY T. BRANDT. COUNTY ENGINEER
PLAN CHECK VALIDATION CI,. Mo. CASH fPERMIT VALIDATION ON. MQ. CASH
s a�rlov � 1 1 5.0 0 09c
96A638A CER80312/72 -
WO$KERS' COMPENSATION DECLARATION II
I hereby affirm that I have a certificate of consent to self //O O O pp ((/tea //p�� M gyp} �r��Y(p M[/�� l��}RO LS
insure, or a certificate of Workers'Compenstion Insurance, or !/'l\P.�LS�V(rYI��OUV FOR ✓���D�UV\l PERMT
�l1/y711��
a certifiedcopy thereof
(Sec.
3800, Lab. ) J COUNTYrOF LOS ANGELES BUILDING A SAFETY
Policy No.]E_Z�_L:ampony "'' CCK
' Certified co is hereby furnished. BUILDING 7
Pv v FOR'APPLC T TO FLL�N ADDRESS i
entified copy is filed with the county building inspec- BUILDING G
fion department. ADDRESS -Q/" LOCALITY
NEAREST
Date' . 'Applicant CITY 1, 21P CROSS ST.
CERTIFICATF-OF EXEMPTION FROM WORKERS' NO. OF BLDGS.. " ASSESSOR
COMPENSATION INSURANCE SIZE OF LOT .NOW ON LOT, MAP.BOOK PAGE PARCEL
(This section need not becompleted if the permit is for one - USE ZONE MAP �� ) _
/
hundred dollars ($100)or less.) TRACT OCK LOT NO. NO. d
/ TEL. SPECIAL
I certify that in the performance of the work for which this OWNER / NO. CONDITIONS PROCESSED BY O
permit is issued, shall not employ any person in any manner DISTRICT GROUP TYPE FIRE V
ADDRESS
so as to become subject to the Workers'Compensation.Laws. L CONST. ZONE 0
�j• O
It-
DateApplicantCITY ZIP - - STATISTICAL CI SIFICATION APT.1EQNDOrIJ
NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL..
) W
ENGINEER DWELL. UNITS_ .1
Exemption, you -should become subject to the Workers' NO. G-Oz N CLASS NO.__- y�
Compensation provisions of the Labor Code, you must forth- ADDRESS 3 2 SEWER MAP - 'Z
with comply with such provisions or this permit shall be TEL
deemed revoked. CONTRACTO NO ,SZGL5 BK. / PG• Ze
VALIDATION
LICENSED CONTRACTORS DECLARATION , - UC
I hereby affirm that I am licensed under provisions of Chapter 9 - ADD ESS O NO.ZVr�[/SrJ VALUATION ry
(commencing will,Section 7000)of Division 3 of the Business and LIC. rr O
Professions Code, and my license is-in full force and effect. CITY CLASS t`'y $ �C z'0 , 7.3 A -
SO. T. NO. OF NO.OF CHECK
License Numb 20 Py S—� Lic.Class C " �3 SIZE STORIES FAMILIES ONE
DESCRI T N OF WORK NEW '
Contractor �� •�� -Uate ^'Z�- / ADD .z • -.5 3 44
lent
am exempt from the licensing requirements as I am a
licensed architect or a registered professional engineer �.., ALTER Q FINAL .o e - 5344
acting in my professional capacity (Section 7051, r//C . / (`- y7 DATE
Business and Professions Code). REPAIR
USE OF � GlOs—$ 1
EXISTING BLDG. - DEMOI FINAL (`
Lic.or Reg. No. Date- APPLICANT - - TEL
BY w p�'4�/✓"�/
OWNER-BUILDER DECLARATION - - (PRINTI - - NO. 3yr_J7l I !/J��p
I hereby affirm that I am exempt from the Contractor's License !� 4
Law for thefollowingreason (Section 7031.5, Business and ADDRESS -
Professions Code): PRESENT
❑ BUILDING-
I, as owner of the property, or my employees with ADDRESS 0 0 7.4 A
wages as their sole compensation,will do the work and - -
the structure.is not intended or offered for sale (Section LOCALITY # o • e e e
7044, Business and Professions Code). MOVING TEL.
El1, as owner of the property, am exclusively contracting CONTRACTOR NO. - 2.e b 8 a 0 0
with licensed contractors to construct the project (Sec-
. tion 7044, Business and Professions Code). ADDRESS to • • 8 a 0 0 5 .
REQUIRED TOTAL SETBACK FROM EXIST,
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY• PROP. LINE WIDTH
I hereby affirm that there is a construction lending agency for FRONT C60'8-81
the performance of the work for which this permit is issued P1- _
(Sec. 3097, Civ. C.). SIDE
P.L.
Lender's Name - -
/
m Lender's Address P.C. Fee 5 Permit Fee '
wI certify that I have read this application and state that the Issuance Fee
above information is correct. I agree to comply with all County Investigation Fee
0 ordinances and State lows relating to building construction, Toml Fee p
d" andhe out ri rep esentatives of this County to enter
m upo a a., m ntion d property far inspection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
^ Signri pplicent or Age" Dote @s
i
I
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 0111290024
PHONE: (626) 285-0488 EXT: .
GAL CONST U
TR: 12115 LT: 40 BL: .001 SQ. FT STORIES TYPE 6329 ENCINITA AV -
STRUCTURE: VN TEMP CA 917801317
ASSESSOR INFORMATIONNUMBER: NEAREST CROSS STREET: LONGDEN
5382-023-032 THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY, C
ANBLDG : RES : R-1 ISSUED ON: PRO BY: EXPIRES ON:
EXIST OCC GRP: 11/29/01. VG 05/28/02
OWNER: TEL. NO: 8 DGS. NOW ON LOT: VALUATION: FINAL DATE FIL BY: . CODE:
DOAN, THUY 1 (626) 286-0299- 600 q-
6329
6329 ENCINITA AV ��•-
TEMP 917801317 S P DESCRIPTION—OF WORK
REPLACE 6 WINDOWS (SAME SIZE)
FEE DESCRIPTION: QUANTITY: LOM: AMOUNT: -
APPLICANT: . NO:
SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27-75
AC STRONG MOTION RESID 600.00 VAL 0.50 SPECIAL CONDITIONS:
D2 PERMIT W/0 EN-HC—�----- +600.00 VAL 43.65
Py�GELESTO(AL-FEES 71.90
CONTRACTOR: TEL. NO: �O�j �/� APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER
LIC. NO LOCATION AND SETBACKS
/ SOILS ENGINEER APPROVAL
ARCHITECT OENGINEER: L. NO: FOUNDATION/TRENCH/ FORM
LIC. NO:� 11„171 SLAB/UNDER FLOOR
RAISED 0FRAMING
RAP NO- SEWER MAP BOOK: PAGE: FIRE ZONE: C'0:!,U (1 O �� /� WV(3
�/J UNDER FFLOOR SOOATINS CATION
a J U t\I J_ IU�I<]IL1R\U
HING
OF FAMILIES: DWELLING S: APT : S —
NO 21El �„, ROOF SHEATHING
Y 44"11
CHOOL ZA D O_ O . ttk>?f, AN
};
AIR QUALITY: 1000 FEET MATERIALS 10 0 'i{+
NO NO NO Ii�p FRAME INSPECTION
REQUIRED SET BACK YARD: HWY: 0 PROPT8ACK FROM EXIST LINE: WIDTH: `6'7 SQ�VOe"i•h I SP INKL G
C 3t INSULATION/W ATHER STRIP
SIDE PL-
INTERIOR LAT AL
- EXTERIOR LATH
RATED FLOOR/CEIL ASSEW.
RATED WALL ASS MBLIES
RATED SHAFTS/OPENINGS
T-BAR CEILINGS
A NAG
REPORT ID: DPR261 ROUTE TO: BS0508
i0