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Home My Public Portal About4820 FIESTA AVE_Building__ WORKERS .JMPtNSATION DE LAPnNNTION —7 I hereby affirm that I avear gvrtiflfate of1tonsent to self e insure, or a certificate of Workers' Compensation Insurance, APPLICATION FOR BUILDING PERMIT or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company BUILDING❑ Certified copy,is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS E Certified copy is filed with the county building inspec- BUILDING 1� y'� tion department. ADDRESS p[�C/ LOCALITY C 17'W Date Applicant CITY PL� e/ IP NEAREST 9/ Q CROSS ST. CseJ CERTIFICATE OF EXEMPTION FROM WORKERS' NO OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT p� NOW ON LOT O/V e MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one USE ZON MAP ` hundred dollars ($100)or less.) TRACT 1 6 47BLOCK LOT NO. / NO. TEL (' ,�,�) SPECIAL y- I certify that in the performance of the work for which this OWNER / / r No'. -b�' Z CONDITIONS permit is issued, I shall not employ any person in any manner L,-�-�L/oQ/� �y IS RICT GR UP TYPE FIRE PROCESSED BY O so as to become subject to the Workers'Compensation Lo s. ADDRESS /V pC(/ ; 1471-E5'7-)q CONS. ZO / V �i 7—, Date 3 Applica CITY / G (J�` ZIP // �� STATISTICAL CLASSIFICATION rrAPT. ]CONDO. 111 ARCHITECT OR TEL. NOTI TO APPLICANT: If, a r making this Certificate of ENGINEER NO. LU Exemption, you should become subject to the Workers' /` CLASS NO. DWELL. UNITS Compensation provisions of the Labor Code,.you must forth- ADDRESS / SEWER MAP with comply with such provisions or this permit shall be ,r TEL. deemed revoked. CONTRACTOR r/ NO. BK.L 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 CLASS $ -2--C) pop- Contractor Contractor Date SQ. FT. NO. OF NO. OF / CHECK License Number Lic.Class SIZE STORIES FAMILIES / ONE DESCRIPTION OF WORK t NEW ❑ $ ❑ I am exempt under Sec. Yect) ADD ALTER ❑ FINAL µ, ms B.BP.C. for this reason ��}� G� REPAIR ❑ DATE USE OF DEMOL �Q Date: EXISTING BLDG. ❑ By AL Signature APP IC NTT ✓ //, OWNER-BUILDER DECLARATION /Y a I hereby affirm that I am exempt from the Contractor's License ��a0 ,f 4/ T' e Law for the following reason (Section 7031.5, Business and ADDRESS ✓ - 4 7," A Professions Code): PRESENT # a o 0 0 0 1 ❑ BUILDING I, as owner of the property, or my employees with ADDRESS 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. I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS ° r `� 7. 8 tion 7044, Business and Professions Code). REQUIRED YARD HWY TOTAL SETBACK FROM EXIST. to o J U J CONSTRUCTION'LENDING AGENCY 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. , 0 7 D' - (Sec. 3097,.Civ. C.). SIDE.. .: FO P.L.:. F Lender's.Name t Lender's Address P.C. Fee$': Permit Fee Z t I certifythat I have read this application and state that the PP Issuance Fee s j < above information is correct. I agree to comply with,all County Investigation Fee $ ordinances and State laws relating to building construction, Total Fee' ell u and hereby authorize representatives of this County to enter __.Il N7 ` 9upon the above-mentioned property for inspection purposes. �_�4 OQ SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Ilate Os COUNTY OF LOS ANGELES ; TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0106190044 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST NEW BUILDING ADDRESS: TR: 14647 LT: 1 SQ. FT STORIES TYPE OCCUP GROUP 4820 FIESTA AV STRUCTURE: 298 1 VN R3 TEMP CA 917803814 ASSES5OR INFORMATIO NUMBER: GARAGE: 630 1 VN U1 NEAREST CROSS STREET: LOWER AZUSA 8590-017-007 OTHER: THOMAS PAGE: 597 GRID: A5 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: USE. ZONE: ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 06/22/01 JK 12/19/01 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE d, Y: CODE: JORDAN, PHILLIP; PAMEL (626) 285-6401- 42,500 ?� �1 4820 FIESTA AV — RM TEMP 917803814 FEES PAID DESCRIPTION OF WORK ADDITION OF BATHROOM & LAUNDRYRM, AND 3 CAR DET/GARAGE FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. NO: SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RESID 42500.00 VAL 4.25 SPECIAL CONDITIONS: B1 PLANCHECK -W/ENERGY 42500.00 VAL 660.43 B2 PERMIT,:W%ENERGY, " ' 42500.00- VAL 776.99 TOTAL 'FEES,' . 1,469.42 CONTRACTOR: TEL. N0: APPROVALS DATE INSP TOR SIGNATURE SAME AS OWNER LIC. NO LOCATION AND SETBACKS l SOILS ENGINEER APPROVAL N A ARCHITECT OR ENGINEER: TEL. NO: rS - _ FOUNDATION/TRENCH FORMS LIC. NO: 1 av, SLAB UNDER FLOOR RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: I i� O UNDERFLOOR INSULATION 3 01 �N0. Of FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: ST LEVEL FLOOR SHEATH NO 21 j%d L fND LEVEL FLOOR SHEATH SCHOOL WITHIN HAZARDOUS U� ROOF SHEATHING AIR QUALITY: 1000 FEET MATERIALS m+ NO NO NO FIRE DEPT. FRAME INSPEC REQUIRED TOTAL SETBACK FROM EXIST--BLDG DEPT. FR ME INSPECT SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- SHEAR PANELS SIDE PL- 0 INSULATION/WEATHER STRIP INTERIOR LATH/DRYWALL V7 O/ EXTERIOR LATH .tel LOT DRAINAGE SMOKE DETECTION DEVICES FIRE DEPARTMENT APPROVAL REPORT ID: DPR2611 ROUTE TO: BSO5O8 COUNTY OF LOS ANGELES , TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS DEMOLITION BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0106220053 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: TR: 14647 LT: 1 SQ. FT STORIES TYPE 4820 FIESTA AV STRUCTURE: 288 TEMP CA 917803814 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LOWER AZUSA 8590-017-007 THOMAS PAGE: 597 GRID: A5 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: GARAG USE ZONE: ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 06/22/01 JK 12/19/01 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE- + BY: CODE: JORDAN, PHILLIP; PAMEL (626) 285-6401- 500 4� 4820 FIESTA AV TEMP 917803814 FEES PAID DESCRIPTION^ F WUKK DEMO OF EXISTING ATTACHED 1CAR GARAGE APPLICANT: TEL. N0: FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75 02 DEMOLITION INSPECTN 163.50 SPECIAL CONDITIONS: TOTAL FEES 191.25 CONTRACTOR: TEL. NO: SAME AS OWNER APPROVALS DATE INSPECTOR SIGNATURE LIC. NO �`� `: �'� PEDESTRIAN PROTECTION -- " SEWER DISCONNECTION ARCHITECT OR ENGINEER: TEL. N0: ABANDON PRIVATE DISPOSAL LIC. N0: - --- '--= '_, ;};i UNDERGRND STRUCT REMOVAL AND SOIL RECOMPACTION MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: X 01 NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: NO 23 N SCHOOL WITHIN HAZARDOUS AIR QUALITY: 1000 FEET MATERIALS ' NO NO NO REPORT ID: DPR261 ROUTE TO: BS0508