HomeMy Public PortalAbout4871 FRATUS DR_Building__ 78A838A CE#809.7 58 APPLICAT I O N FOR BUILDING PERM-IT 1
BUILDING AND SAFETY DIVISION BUILDING 4�f
noDREss
Department of County Engineer �f
County of Los Angeles LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
CASSATT D GRIFFIN, SUPT OF BUILDING CROSS ST /
DI STRICT NOGRO P I TYPE SEWBER MAP G
FOR APPLICANT TO FILL IN
/� CONST
ADDRESS f F7/BUILDING
OJ�ys .(/Y� -
STATISTICAL CLASSIFICATION
LOT NO BLOCK CLASS NO DWELL UNITS
MAP -2 STATE YES 1<0
Z � ` NUMBER 0 CI HWY
TRACT / USE Z NE SPECIAL
NO OF SIZE OF LOT x- I NOW ON LOTS��I,�� CONDITIONS
USE OF
EXISTING BLDG BU- NGEXIST
YARD HWY STREET NAME
1� v SETBACK WIDTH
OWNER `��rC FRONT
MAIL ^� J vA-h L
ADDRESS S SIDE
TEL ' P L
CITY ;S rt rim NO `f �� 'INSPECTION RECORD
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ARCHITECT OR TEL
ENGINEER NO _
ADDRESS
TEL _/ D
CONTRACTOR '/3- ' r� NO tS
ADDRESS R /2 �- S- %SA K 0a6 k I e l
DESCRIPTION OF WORK
NEW / ADD ALTER REPAIR DEMOLISH
SIZE T / �_76) NO OF N STORIES / LIES
U E OF STRUCTU$
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t �.iY i APPROVALS
SIGNATURE OF
APPLICANT `" � DATE INSPECTOR S SIGNATURE
ADDRESS 2a'-� �Qh L'u�H�LFOUNDATION LOCATION w'
FORMS MATERIALS -4J'1C1
$ /� C S FRAME FIRE STOPS �-
7 FEE BRACING BOLTS Q `�
VALUATION // FURNACE LOCATION - / tt40
FEE L�f� GAS VENT DUCTS
171 -
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH, INT
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND I I_
AGREE TO COMPLY WITH LL COUNTY ORDINAN ES AND
STATE LAWS REGUL ^ LDI C NS UCTION LATH EXT _
SIGNATURE OF �-- HOUSE NUMBER COR-
PERMITTE RECT AND POSTED
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ADDRESS �� Z AH FINAL 'g-'y YVI.�!%LGC
JOHN A LAMBIE, COUNTY ENGINEER CLYDE N DIRLAM, PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION - M o CASH PERMIT VALIDATIO cK M o CASH
LAC,p 7 2 5 APR 16 1 6 6.0 0 In -
LA077257—un APR 16 1 24,00 ��
WORKERS'COMPENSATION DECLARATION
I hereby affirm that I have certificate of consent to self A P P L I CAT I O N �T O R- BUI L D I N G PERMIT
insure, or a certificate of Workers' Compensation Insurance,
/r Feftified copy thereof (Sec 3800, Lab C )
'11 ' f 7- `Z�/ COUNTY OF LOS ANGELES_- BUILDING AND SAFETY
o,! No 0 7,Z 7YZ Company J P'M 1L! �ut'JJ�// /�
PY y FOR APPLICANTJO FILL IN BUILDING
ertified co is hereby furnished
` ADDRESS
Certified copy is filed with the county building inspec- BUILDING Q 7 �' �)
tion depart enntt ADDRESS �J / /� fA- r✓� del'
l' LOCALITY (E
NEAREST
Date _ 1ST// ��d/ Applicont, '/y/� a CITY P �� 1 / - ZIP 171/p g CROSS ST
CERTIFICATE OF EXEMPTION FROM WORKERS' / NO OF BLDGS ASSESSOR
COMPENSATION INSURANCE SIZE OF LOT 5I /` NOW ON LOT - MAP BOOK PAGE PARCEL
(This section need not be completed if the permit is for one USE ZONE
NO MAP //
hundred dollar's ($100)or less ) TRACT r BLOCK LOT I NO _ td
TEL - J SPECIAL '
I certify that in the performance of the work for which this OWNER fiHieS %✓A G uv NO �/ CONDITIONS H =d
permit is issued, I shall not employ any person in any manner ,/ r s ISTRICT GROUP TYPE FIRE, PROCESSED BY O
so as to become subject to the Workers'Compensation Laws ADDRESS `jc7 FA u S 1)l V l� CONST ZONE, V
�o - 3
Date Applicant CITY e 1�t e r / ` ZIP 7 STATISTICAL CLASSIFICATION APTI—
NOTICE TO APPLICANT If, after making this Certificate of ARCHITECT OR TEL
Exemption, you should become subject to the Workers' ENGINEER NO CLASS NO DWELL UNITS a
Compensation provisions-of the Labor Code, you must forth- ADDRESS - SEWER MAP
with comply with such provisions or this permit shall be �e �} o
deemed revoked a CONTRACTOR C NO 7 �` 6 BK PG, VALIDATION
LICENSED CONTRACTORS DECLARATION 4:1 1 1 / �� f� 1:1Co
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS oZ ro OI� •L/ 4`' JIMO 3��7VALUATION '
(commencing with Section 7000)of Division 3 of the Business and i LIC /
Professions Code, and,m/y license is in full force and effect CITY ���/(�/ /✓ /7 CLASS �6/ $
lY �Oy tCJ / SIWZE__ b STORIES NO-OF INO F MILLIIES CONEK
License Number Lic Class
Contractor
y5 D / DESCRIPTION OF WORK NEW E]/ ate $
/ -
I am exempt under Sec /,-/vU M �L7,0 / DUN ,ADD _ Q
rT l ALTER E] _ FINAL
B&P C for this reason - REPAIR DATE (V
Date USE OF R - FINAL
EMOL
EXISTING BLDG _ - - -r BY
Signature APPLICANT TEL
OWNER-BUILDER DECLARATION PRINT NO -
I hereby affirm that I am exempt from the Contractor's License ADDRESS
® 2389.7 A
Law for the following reason (Section 7031 5, Business and
Professions Code) PRESENT
#� o'a a -2 3
BUILDING _ +
El I, as`owner of the-property, or my employees with ADDRESS 2 50 0 3 ] 5 O
wages as their sole compensation,will do the work and
the structure is not intended or offered for sale(Section LOCALITY _ _ , y o o ,0'3 7.5 0 i
7044, Bbsiness and Professions Code) MOVING TEL 01R'SJ —8 4
I,-as owner of the property, am exclusively contracting CONTRACTOR NO _ -
with licensed contractors to construct the project (Sec- g 3 8 9,8 A `
tion 7044, Business and Professions Code) ADDRESS
REQUIRED TOTAL SETBACK FROM EXIST # o i o 0 0 0
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP LINE WIDTH ;
I hereby affirm that there is a construction lending agency for FRONTpoll- _ ,2 0 0 4 9 8 8
the performance of the work for which this permit is issued P L t `
(Sec 3097, Civ C ) SIDE Or$ 4 9 ca;
g PL
v Lender's Name '
Lender's Address P C Fee$ Permit Fee
I certify that I have read this application and stale that the Issuance Fee n
above information is correct I agree to comply with all County Investigation Fee ry�
ordinances and State laws relating to building construction, Total Fee ® `c
u and hereby authorize representatives of this County to enter III
upo a above-ment o�ned� property for inspection purposes
a tA4146 ___9: /r O♦ ���Q+ SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Applicant or Agent Date - ®s
T
a r - COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR
BUILDING AND SAFE-EY,/-LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 9909240014
PHONE: (626) 285-0488 EXT: DUPLICATE
LEGAL ID NO. OF CONST BUILDING ADDRESS
TR: 22321 LT: 14 SQ. FT STORIES TYPE 4871 FRATUS DR
STRUCTURE 400 VN TEMP CA 917803718
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LOWER AZUSA
8590-029-009 THOMAS PAGE 596 GRID: J5 LOCALITY• TEMPLE,CITY, C
i
TENANT: EXIST BLDG USE, RESID USE ZONE: R-1 ISSUED ON: PROCESSED BY. EXPIRE ON:
EXIST OCC GRP- 09/24/99 VG 03/ 00
OWNER: TEL NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY CODE:
MADIGAN, JOHN (562) 468-6851- 1,000
4871 FRATUS DR Z-
TEMP 917803718 FEES PAID DESCRIPTION OF WORK
CONVERT GARAGE BACK T ORIGINAL US
FEE DESCRIPTION: QUANTITY: UOM• AMOUNT:
APPLICANT: TEL NO
R L CLOTWORTHY CONSTRUCTION (909) 698-2945- AA BLDG PERMIT ISSUANCE 27.75
AC STRONG MOTION RESID 1000.00 VAL 0.50 SPECIAL CONDITIONS:
D2 PERMIT W/0 EN=HC1000 00 VAL 65.40
�X4GELESTO�,T'®FEES 93.65
CONTRACTOR: TEL. NO: �j �/� APPROVALS DATE INSPECTOR SIGNATURE
R L CLOTWORTHY CONSTRUCTION (909) 698-2945-
40960 CALIFORNIA OAKS RD LIC. NO LOCATION AND SETBACKS
SUITE 143 381880
MURRIETA, CALIFORNIA 92562 SOILS'ENGINEER APPROVAL
ARCHITECT OR ENGINEER: TEL. NO: // FOUNDATION/TRENCH FORMS
LIC N0 1111111 SLAB/UNDER FLOOR
RAISED FLOOR FRAMING
MAP NO: SEWER MAP BOOK: PAGE. FIRE ZONE- CMP 00,1,n f1�n O /7 3 UNDERFLOOR INSULATION
II U JU 8 ILIA FLLLJJJ <111IL1K(u FLOOR SHEATHING
NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS:-
NO 21v 0 ROOF SHEATHING
SCHOOL WITHIN HAZARDOUS 17 SHEAR PANELS
0 ��
AIR QUALITY: 1000 FEET MATERIALS 0 E3
NO NO NO ,' FRAME INSPECTION
REQUIRED TOTAL SETBACK FROM EXIST iso ®dam FIRE SPRINKLER HANGERS
SET BACK
YARD: HWY: PROP LINE: WIDTH:
FRONT PL- ,+ sej'v-C�-T ajtl INSULATION/WEATHER STRIP
SIDE PL
INTERIOR LATH/DRYWALL
EXTERIOR LATH
RATED FLOOR/CEIL ASSEM.
RATED WALL ASSEMBLIES
RATED SHAFTS/OPENINGS
T-BAR CEILINGS
LOT DRAINAGE
i
REPORT ID DPR261 ROUTE TO BS0508