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HomeMy Public PortalAbout4943 FIESTA AVE_Building__ • APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDIN ADR I herebyaffirm that I have a certificate of consent to self insure, I ING DD ` tJL� 1 �1/LGGC� or a certificate of Workers' Compensation Insurance,or a certified Iej ^ copy the of( 3800b-C.) - • T /1 e ZIP ��Al/`, LOCALITY Policy N Company IZE OF LOT NO.OF BLDGS.NOW ON LOT El Certified copy is hereby furnished. NEAREST CROSS ST. ❑ Certified copy is filed with the ouhty building inspection TRACT BLOCK LOT NO. d partm nt ' USE ZONE MAP NO. ASSES,S.OR MA BOOK P�/ PAY Date 1 Applicant OfI..JC !i SPECIAL CONDITIONS o CERTIFICATE OF EXEMPTION FROM WORKERS' OWNEV7 TEL NO. COMPENSATION INSURANCE WITHIN 1000 FT.OF SCHOOL? . ves No (This section need not be completed if the permit is for one hundred ADDRESS DISTRICT GROUP TY CONST. FIREIZONE PROCESSED BY dollars ($100)or less.) U s D� CITY I certify that in the performance of the work for which this permitD� is issued, I shall not employ any person in any manner so as to ARCHITECT OR ENGINEER TEL NO. Gam' become subject to the Workers'Compensation Laws. STATISTICAL CLASSIFICTCONDO Date Applicant ADDRESS CLASS NO. DWELL UNITS s iMq NOTICE TO APPLICANT.' If, after making this Certificate of, REQUIRED TOTALS AM 1.FROM -° Lr�T ,r-u Exemption, you should become subject "to" the Workers' C TR CTO` / , EL N SET BACK YARD HWY PR V`LIN� �-A TFf' Compensation provisions of the Labor Code, you must forthwith i `1 Q °'M r • comply with such provisions or this permit shall be deemed revoked. FRONT CHECK f l;°=E I P Y p p DRE �y� IC. O. P L LICENSED CONTRACTORS DECLARATION b rtN4 SIDE C Y LI CL SS PL I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORIES NO.OF FAMILIES •,- Professions Cod an my�li� nse is in full force and effect. NEW BK PG Lf=j ! ,_,•`'t} C-[�, , a DES IPTI N F RK ADD ❑ VALUATION i_}�'- 1 F,1 L° t;�0 License N �� Lia CI ss � t� 4 �• $ �O � U Contractor Date �^>- l �� ALTER ❑ ❑ I am exempt under Sec. REPAIR ❑ $ 0 BAP.C.for this reason DEMOL ❑ V LDMA P/C# W Date: USE OF EXISTING BLDG. URM ❑ n' Signature �'2 /' Z P11L''ICA T(P`RIN• _ J E Q LDMA Perm# ❑ 1, as owner of the property, or my employees with wages as N� Gly 1 �� � C1' Z A their sole compensation, will do the work and the structure'is ADR S /; O ; c not intended or offered for sale (Section 7044, Business and 0 -6 �� (d�Q-r G� 5• I IiAL DATE Professions Code.) 1�... O WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL 1 TLt 3S OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE EI 1, as owner of the property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY TATA VES 13 NO 1:1379 . 35 licensed contractors to construct the project (Section 7044, 1 I HL Business and Professions Code.) 7 WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING 'CHECK •�+. 9 c'33.5 OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH t COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR ((1- °111 i U CONSTRUCTION LENDING AGENCY GLI IDENES. CCllff''��{•!TC•�! I hereby affirm that there is a construction lending agency for YES ElNO 1:1N the performance of the work for which this permit Is Issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING 3097,Civ.C. N ) CHECKLIST.I UNDERSTAND MV REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE. 0000-000 g ,,,- 6195 : TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS b•• Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. •�L• EL Lender's Address 07;— '''� a O OWNER OR AGENT o I certify that I have read this application and state under penalty O of perjury that the above information is correct. I agree to comply P.C.FEE �� PERMIT FEE with all county ordinances and State laws relating to building •7 cons- ction, and hereby authorize representatives of this County ISSUANCE FEE to t up tis ab entioned property for in pectin pur se a INVESTIGATION FEE TOTAL FEE m / S' of Applicant or Agent Dale SEE REVERSE FOR EXPLANATORY LANGUAGE APPLICATION F'1. Y ��®TNG PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT,TO FILL IN BUILDING ADDRESS �- I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS I r I T '577 or a certificate of Workers' Compensation Insurance, or a certified I:Er S copy thereof ( fe 8.•0,•RLab.C.) J&& - rl AL CITY - ZIP X71~ Q LOCALITY Policy No.her ` i` . �) Company ) ✓Ccj' —C�JC�v .,_ '(i— ":== �,� SIZE OF LO NO.OF BLDGS.NOW ON LOT ❑,krtified Copy is hereby furnished. NEAREST CROSS ST. Certified copy is filed with the county building inspection TRACT-, BLOCK +' LOT NO. department. 9 ,+ USE ZONE MAP NO. Date Applicant 3�l.t,l. ,-'/Irff�t� ASSESSOR MAP BOOK PAG EC PARCEL el r Cj F_- I SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER (, TEL NO. COMPENSATION INSURANCE tJ r ZS--1 69 WITHIN 1000 FT OF SCHOOL. YES No This section need not be completed if the permit is for one hundred ADDRESS ( P P O �� O D DISTRICT GROUP TYPE CONST. FIRE ZONEaSSED BY dollars ($100)or less.) CITY ZIP I certify that in the performance of the work for which this permit % III— g DCA is issued, I shall not employ any,person in any manner so as to V\ ATM"TEB OR ENGINEER _ !`J TEL NO. `•� .O� .7/ e /Ac �fl ` Cit�- O� become subject to the Workers'Compensation Laws. - STATISTICAL CLASSIFICATION APT CONDO � Ig ,L Date Applicant Sin. ADDRESS CLASS NO. ©� DWELL UNITS J / NOTICE TO APPLICANT. If, after making this Certificate of �J I. V F� V---A.. (A)• 6001 tit I3 J-6- REQUIRED TOTAL SETBACK•.FROM EXIST Exemption, you should become subject to the Workers' CONTRACTOR,/ TEL NO. SET BACK YARD HWY PROP.. , WIDTH Compensation provisions of the Labor Code, you must forthwith G[9l�f - jLc Lt, r! FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS/` LIC. O. P L LICENSED CONTRACTORS DECLARATION `l J � SIDE j CITY LIC.CLASS P L L I ;._; I hereby affirm that I am licensed underprovisions of Chapter Q,te .'• SEWER MAP - (commencing with Section 7000)of Division 3 of the Business and SQ.FT SIZE NO.OF STORIES NO.OF FAMILIES f_ _'S''' G Professions Code,and my license is in full force and effect. NEW BK PG ® } - D SCRIPTION OF WORK ADD ❑ VALUATION 00 ...... .4L'-'` ==C License Number � Lic. Class _ ....__ Contractor" %l/./�_ - Date ='% � � �� ALTER ❑ ElI am exempt under Sec. REPAIR El $ f� t� B.&P.C. for this reason DEMOL C3 °t� LDMA P/C# LL DatE �® USE OF `'� EXISTING URM ❑ EA+-tI�, 11,(00 I// - _._... _ ..:''r'Cr Cr Signature �• � •�'�"t-- APPLICANT(P T) TEL NO. 1` LDMA Perm# ❑ I, as owner of the p� erty, or my employee wi h wages as N V✓r I I g D O their sole Compensati , will d0 the work and the structure is ADDRES �• � not intended or offered for sale (Section 7044, Business and LGil��l F tJ D (;OV IJ I p FINAL DATE Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCC PANT HANDLE A HAZA DOUS MATERIAL ❑ I, as owner of the property, am exclusive) contracting With OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE Y AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY licensed contractors to construct the project (Section 7044, - YES❑ NO Business and Professions Code.) WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY Ml NAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES. I hereby affirm that there is a construction lending agency for YES❑ NO a the performance of the work for which this permit is issued(Sec. I HAVE READ THE HAZARDOUS MD PERMITTING 3097, Civ.C.) CHECKLIST..I UNDERSTAND MY M REQUIREMENTSATERIALS INFORMATION UNIGUIDE AS UNDER THE LOS ANGELES COUNTY CODE, N TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS Lender's Name �� MATERIALS REPORTING AND FOR OBTA NG A PERMIT FROM THE SCAQMD. -�--. ;:II o Lender's Address OWMMO� 0 o I certify that I have read this application and state under penalty J. 4 of perjury that the above information is correct. I agree to comply P.C.FEE ��/') PERMIT FEE with all county ordinances and State laws relating to building ` rs a construction, and hereby authorize representatives of this County �• ISSUANCE FEE to ente/ pon t{fe a Ove- e�f�ned property for inspect'(3 rposes. 1�i��-L"•- 9bn 0'—� INVESTIGATION FEE TOTAL FEE S,naiore 1 p ipo t or Agen, c SEE REVERSE FOR EXPLANATORY LANGUAGE ', COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS _ RESIDENTIAL ADD BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA - BL 0508 9804300059 PHONE: (818) 285-0488 EXT: ~ LEGAL ID: NO. OF CONST NEW BUILDING ADDRESS: TR: 11454 LT: 41 SQ. FT STORIES TYPE OCCUP GROUP 4943 FIESTA AV STRUCTURE: 0 1 VN R3 TEMP CA 917803817 ASSESSOR INFORMATION NUMBER: GARAGE: NEAREST CROSS STREET: LOWER AZUSA 8590-019-023 OTHER: 640 1 THOMAS PAGE: 597 GRID: A5 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: USE ZONE: ISSUED ON: PROCESSED BY: EXPIRES PN- EXIST OCC GRP: 08/21/98 UT 08/21 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: _ ODE: TRINH TONY;LAM KELLY 1 47,360 4943 FIESTA AV /?- TEMP 917803817 FEES PAID DESCRIPTION OF WORK GUEST HOUSE (640 SQ. FT.) NO KITCHEr, NOT TO BE USED AS FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: RENTAL APPLICANT: TEL. NO: NGUYEN (626) 918-8906- B1 PLANCHECK W/ENERGY 47360.00 VAL 718.37 1139 GLENVIEW RD. AA BLDG PERMIT ISSUANCE 27.75 SPECIAL CONDITIONS: WEST COVINA, CA AC STRONG MOTION RES,ID 47360.00 VAL 4.74, B2 PERMIT W/ENER6Y, 4.7360:,00 VAL 844.:97 C��� TOTAL FEE 1,595'.83 CONTRACTOR: TEL. N0: --� � APPROVALS DATE INSPECTOR SIGNATURE REACH CONSTRUCTION (818) 282-0042- l' 419 N. ATLANTIC BLVD., #207 LIC. NO LOCATION AND SETBACKS MONTEREY PARK, CA 91754 695753B ARCHITECT OR ENGINEER: TEL. NO: �� / �� FOUNDATION/TRENCH FORMS LIC. N0: �_` SLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION 3 01 S'ST LEVEL FLOOR SHEATH NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS -- i NO 21 �'�� 2ND LEVEL FLOOR SHEATH SCHOOL WITHIN HAZARDOUS ROOF SHEATHING AIR QUALITY: 1000 FEET MATERIALS NO NO NO ti�� ���� A �,-//� r�� FIRE DEPT. FRAME INSPECT REQUIRED TOTAL SETBACK FROM EXIST i, ������ _ BLDG DEPT. FRAME INSPECT SET BACK YARD: HWY: PROP LINE: WIDTH: Z` FRONT PL- i -�' SHEAR PANELS SIDE PL- ' Gf / INSULATION/WEATHER STRIP INTERIOR LATH/DRYWALL EXTERIOR LATH LOT DRAINAGE SMOKE DETECTION DEVICES FIRE DEPARTMENT APPROVAL REPORT ID: DPR261 ROUTE TO: BS0508 COUNTY OF LOS ANGELES .TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1301110016 PHONE: (626) 285-0488 EXT: LEGAL ID: 1 NO. OF CONST NEW 1 BUILDING ADDRESS: ITR: 11454 LT: 41 1 SQ. FT STORIES TYPE OCCUP GROUPI 4943 FIESTA AV I (STRUCTURE: 204 1 V-B R3 I TEMP CA 917803817 1 ASSESSOR INFORMATION NUMBER: 1 GARAGE: NEAREST CROSS STREET: 18590-019-023 I OTHER: THOMAS PAGE: 597 GRID: A5 LOCALITY: TEMPLE CITY CAI I I I (TENANT: IEXIST BLDG USE: RESID JISSUED ON: PROCESSED BY: 1 (EXIST OCC GRP: R3 101/28/13 SR (OWNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: IFINAL TE FINAL BY: CODE: 1 ITRINH TONY;LAM KELLY (626) 255-2273- 1 12,000 14943 FIESTA AV 1 1 I (TEMP 917803817 I FEES PAID IDESCR PTION OF WORK I 11NSTALLATION OF 12 ROOF MOUNTED SOLAR PANELS I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( 1 (APPLICANT: TEL. NO: I I I 11VEZZY, MICHAEL (951) 300-0788- IP1 RES PV PC<10KW 153.90 1 1 13080 12TH ST 1AA BLDG PERMIT ISSUANCE 27.80 (SPECIAL CONDITIONS: 1 IRIVERSIDE CA 92509 IAB STATE GREEN BLDG FEE ' 12000.00 VAL 1.00 I 1P2 INSPCT RES PV <10KW 138.00 I I I I TOTAL FEES 320.70 I (CONTRACTOR: TEL. NO: 1 1APPROVALS DATE INSPECTOR SIGNATURE 1 (ELITE ELECTRIC (951) 681-5811- i 1 I 19415 BELLEGRAVE AVE LIC. NO 1 ILOCATION AND SETBACKS I I (RIVERSIDE CA 92509 418242 I 1 I (SOILS ENGINEER APPROVAL I I 1ARCHITECT OR ENGINEER: TEL. NO: 1 (FOUNDATION/TRENCH FORMS 1 I 1 1 LIC. NO: 1 ISLAF./UNDER FLOOR I I I I I I 1 IRAISED FLOOR FRAMING I I I I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 1 (UNDERFLOOR INSULATION I I I 1144H269 L 99 3 001 1I I I I 11ST LEVEL FLOOR SHEATH INO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: I I I I I 1 1 NO 20 1 12ND LEVEL FLOOR SHEATH I I I 1 SCHOOL WITHIN HAZARDOUS 1 (ROOF SHEATHING I I I 1AIR QUALITY: 1000 FEET MATERIALS 1 I_ I I I 1 NO NO NO 1 IFIRF. DEPT. FRAME INSPECTI I I I I IBLDG DEPT. FRAME INSPECTI I I I 1 1SHEAR PANELS I I I I I I I I (INSULATION/WEATHER STRIPI I I I I 11NTFRIOR LATH/DRYWALL I I I I I I 1 (EXTERIOR LATH I I I I I I I ILOT DRAINAGE I I I I I I I ISMOKE DETECTION DEVICES I I I I I I I I I IFIRL DEPARTMENT APPROVALI I I I- ADDITIONAL DATA ON FILE I (REPORT ID: DPR261 ROUTE TO: BS0508 I I I I I I I I I