The URL can be used to link to this page

Home My Public Portal About5335 FRATUS DR_Building__ TEMPLE CITY uv� 76AS38A CE#803 I-67 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMEERENT OF COUNTY ENGINADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A JENSEN SUPT OF BUILDING CROSS ST DISTRICT N - G TYPE ES Y FOR APPLICANT TO FILL IN �j' v CONST a BUILDING ��jj STATISTICAL CLASSIFICATION SEWER MAP ADDRESS�� U3 T. BK CLASS NO---aDWELL UNITS S— Pj LOT NO ryJFAT P + BLOCK WATER q CERTIFICATE NOT REQUIRED RECEIVED- TRACT &If 5/zMAP J� HIGHWAY SIZE OF LOT77)(/� ~J I NO OF BLDGS NO (/ ICIRCLE) STATE MAJOR SECOND LOCAL NOW ON LOT /Z/,P Al USE ZONE SPECIAL USE OF CONDITIONS i t EXISTING BLDG OWNER S Vllj l NO i7,03 B ILDING ' ' EXIST ' ..cv ` /-� �,I� ,SETBACK YARD HWY STREET NAME WIDTH ADDRESS jj✓ � C K FRONT /�� (i y C ARCHITECT OR T77 EL P LV �`-� ENGINEER NO - ,SIDE', P L ADDRESS TEL `� INSPECT�,ON/IRECORD= O CONTRACTOR S.�'il�i,� NO' ��/�� V ADDRESS a r „ DESCRIPTI'ON OF WORK I O y CL ' t NEW /ADD i'ALTER REPAIR DEMOLISH _ ,Jy �Z SO FT , NO OF NO OF $IZE lmay- d / 'I STORIES I/ FAMILIES USE OF STRUCTURE;7_,�5/ ^A i5-e_ dy'," SIGNATURE APPLICANT �. , VALUATION$ - / , APPROVALS / J•DATE' �tINSPECTOR SISIGNATURE PC ��J�J ° PMT P FOUNOATIUN'd_OCATISNr .,C��` ea I/••/��,f�i�/_ FEE $� ' I/I/ I FEE $ 'FORMS,NIAT,ERIAL'SV ��'/ .,.,�'rP" i./4'�L�r.�?�i?_ _ 'FRAME FOP,S, I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS`APPLiCATION, � " BRACING,G, BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY t 'FURNACE LOCATION, 1 j WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS 1 BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- TI IOLA- LATH, INT i' �� 1� � q fl/1,11 ' TION OF THE LABOR.COD E OF THE STATE OF CALIFORNIA RELAT p r'l �I ING TO WORKMEN S COMPENSATION INSURANCE N �.�' p y i} ��. •_l 7. ^-►,, LATH,EXT L 1 i '✓)l' _V w SIGNATURE /� ~ HOUSE NUMBER COR- PERMITTE �! RECTAND POST.ED ,%,.�d;1,,1A • ADDRESS FINAL PLAN CHECK VALIDATION cK �M D. Golan CLYDE PERMIT VALIDATIONTR c uRIAo ENGINEER Lr,Es�7, 2 5 5 �n,Ed 1 0 4 8.0 C' APPLICATION FOR. BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS BUILDING ADDRESS I hereby affirm that I have a Compensation of consent to self Insure, i 5 J 9- c - or a certificate of Workers'Compensation Insurance,or a certified CITY ZIP copy thereof(Sec 3800,Lab C) � Policy No 6 Wa)aO-7 Company S�e�4-1 ar- LOCALI SIZE OF LOT- NO OF BLDGS NOW ON LOT ❑ Certified copy is hereby furnished I NEAREST CROSS ST Certified copy Is filed with the county building Inspection TRACT BLOCK LOT No department USE ZONE MAP NO J �7 Date Applicant � ASSESSOR MAP BOOK PAGE PARCEL // -/fILI 4R TS OI— SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL N COMPENSATION INSURANCE �I`5 /1 S WITHIN 1000 FT OF SCHOOL? res No ADDRESS ' (This section need not be completed If the permit Is for one hundred7J?J �. �^ DISTRICT GROUP TYPE CONST' FIRE ZONE PROCESS BY dollars($100)or less) CITY //_� zIP I certify that In the performance of the work for which this permit � C;+-/ 3 Is Issued, I shall not employ any person In any manner so as to ARCHITECT OR ENGINEER TEL NO V 1 C�f� LLL 11 become subject to the Workers'Compensation Laws STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO DWELL UNITS NOTICE TO APPLICANT If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CONTRACTOR TEL NO��O�I SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith _10 A` FRONT comply with such provisions or this permit shall be deemed revoked ADDRESS LIC NO PL `T 1 SIDE LICENSED CONTRACTORS DECLARATION Cir' LIC CLASS �- PL p I hereby affirm that I am licensed under provisions of Chapter 9SQ FT SI NO O STORES NO OF FAMILIES SEWER MAP � (commencing wlth,Section 7000)of Division 3 of the Business and Professions Code,99d my licen a Is In full force and effect 3 d NEW ❑ BK PG 29�0 q DESCRIPTION OF WORK VALUATION License Number Llc Class 3 ADD ❑ Q,c'eb�- v I u-,G t-- ti Contractor Date C _- ALTER E] $ ❑ 1 am exempt under Sec S REPAIR $ B&P C for this reason DEMOL ❑ LDMA P/C# Date USE OF EXISTING BLDG URM ❑ Signature ICANT PINT) TEL NO � LDMA Penn# ❑ I, as owner of the property, or my employees with wages as O A.,i. i s their sole compensation, will do the work and the structure Is A DRESS not intended or offered for sale (Section 7044, Business and 4 FINAL DATE C ,�s0 r 1 . Professions Code) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL j S i OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN Q 1 1 P E'i= ❑ I, as owner of the property, am exclusively contracting with THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL > _ licensed contractors to construct the project Section 7044, 6� 25 Business and Professions Code) WILL THE INTENDED USE OF THE BUILDING BY THE p j ( YES❑ NO❑ TOTAL _6 m `_6 OCCUPANT REQUIRE A PERMIT OR CONSTRUCTION OR MODIFICATION FROM THE R FUTURE SOUTH CHECK '105.225 CONSTRUCTION LENDING AGENCY FOR COAST AIR DEL NES QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST ` hereby affirm that there Is a construction lending agency for YES El NO El G� ll ) the performance of the work for which this permit Is Issued(Sec 1 HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD 3097,CIV C) PERMITTING CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES - 7 COUNTY CODE,TITLE 2 CHAPTER 220 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING 01300-NO =!21/0 Lender's Name HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD Lender's Address 2496 1 Am, 4 OWNER OR AGENT 0 1 certify that I have read this application and state that the above PC FEE PERMIT FEE Information Is correct I agree to comply with all county r1 ordinances and State laws relating to building construction,and O( her authorize represent ti es of this County to enter upon ISSUANCE FEE ve m Honed spectlon pu�ose-� 13- 00 a (0001 'D INVESTIGATION FEE TOTAL FEE yatft of AMIc.M.Agmd DM SEE REVERSE FOR EXPLANATORY LANGUAGE