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Home My Public Portal About10239 FREER ST_Building__ TEMPLE CITY 7EA888A CE y803�1-81 APPLICATION FOR BUILDING. PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS : BUILDING AND SAFETY DMSION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST. ,i2• - iJ4 -.-..VCT NO. GROUP TYPE PRO SED BY 'FOR APPLICANT TO FILL IN -- CONST. - BUILDING /�i c� STATISTICAL CLASSIFICATION SEWER MAP ADDRESS C571 BK PG CLASS.NO. DWELL. UNITS LOT NO. - - BLOCK WATER NOT REQUIRED ❑ RECEIVED p CERTIFICATE: TRACT / MAP x. HIGHWAY STATE MAJOR SECOND, LOCAL NO.OF BLDGS. . NO.,. M (CIRCLE) SIZE OF LOT. NOW ON LOT USE ZONE SPECIAL USE OF +� CONDITIONS EXIST,NGJBLDG. OWNER�/. TEL / O.. -bb- P Pelf, NBUILDING EXIST. SETBACK YARD HWY STREET NAME WIDTH ADDRESS ,Z[r}'- �eW►}�1� C% ,/3/Ltf'• FRONT ARCHITECT OR frEL. P. L. ENGINEER NO. SIDE P.L. ADDRESS TEL. INSPECTION RECORD p CONTRACTOR Q 444 NO. U ADDRESSrj O DESCRIPTION OF WORK u W IL NEW ADD ALTER REPAIR DEMOLISH N SQ.FT. // NO.OF NO.OF Z IZE (p STORIES FAMILIES / USE OFry STRUCTURE ('S SIGNATURE OF APPLICANT VALUATION$ �- APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. .�"I' FOUNDATION: LOCATION FEE $. FEE $ FORMS,MATERIALS _7 7> ,d - a - FRAME: FIRE STOPS, - ^ �_1'744 �4 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS '�33 AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS BUILDING CONSTRUCTION. ICERTIFY THAT IN DOING THE WORK 1 ! AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH, INT. TION OF THE LABOR CODE OF THE STATE OF C IFORNIA RELAT- ING ING TO WORKMEN'S COMP NSATION INSU AN 1 v Iy LATH,EXT. I� SIGNATURE OF HOUSE NUMBER COR- PERMITTEE RECT AND POSTED �1 v y ADDRESS — �'� FINAL 11 " CLYDE N. DIRLAM, PRINCIPAL STR � URAL ENGINEER PERMIT CHECK VALIDATION cK. M.O. CASH PERT VALIDATION cK M.O. CASH L11vo 6 5 3 6 i i„R 12,z 3 D 3 7 54 L,tLo77761-4S) APR16 1 D 7 4.5 0laeatl?,4�' 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 1004290081 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: ITR: 29148 LT: 7 SQ. FT STORIES TYPE 10239 FREER ST (STRUCTURE: 600 V-B TEMP CA 917803314 (ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: ARDEN 1 16585-005-032 ' THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY, Cl (TENANT: IEXIST BLDG USE: RESID USE ZONE: R-1 JISSUED ON: PROCESSED BY: 1 IEXIST OCC GRP: 104/29/10 SR OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: IFINAL DATE FINAL BY: CODE: I ADAMS, EDWIN ALLEN (626) 444-6177- 1 1,200 110239 FREER ST I TEMP 917803314 FEES PAID IDESCRIPTION OF WORK IREPLACE ONE SECTION OF SHINGLES I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 (APPLICANT: .TEL. NO: I I ISAME AS OWNER - IAA BLDG PERMIT ISSUANCE 27.75 1 I I IAB STATE GREEN BLDG FEE 1200.00 VAL 1.00 ISPECIAL CONDITIONS: 1 IAC STRONG MOTION REBID 1200.00 VAL 0.50 1 1 1 ID2 PERMIT W/O EN-HC 1200.00 VAL 82.20 1 1 IFR INV WORK W/O PERMIT 126.50 DOL 128.50 ICONTRACTOR: TEL. NO: I TOTAL FEES 239.95 (APPROVALS DATE INSPECTOR SIGNATURE I ISAME AS OWNER - I I I I LIC. NO ILOCATION AND SETBACKS ISOILS ENGINEER APPROVAL I I 1ARCHITECT OR ENGINEER: TEL. NO: IFOUNDATION/TRENCH FORMS I I I 1 LIC. NO: 1 (SLAB/UNDER FLOOR I I I I 1 IRAISF.D FLOOR FRAMING I I 1 IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( (UNDERFLOOR INSULATION I 1 1 1147H273 3 001 1 1 I 1 I I IFLOOR SHEATHING I I I INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I i 1 NO 21 1 IROOF SHEATHING 1 1 1 SCHOOL WITHIN HAZARDOUS I 1SHEAR PANELS I I I (AIR QUALITY: 1000 FEET MATERIALS I 1 I I 1 NO NO NO I (FRAME INSPECTION I I I I EX"IR (FIRE SPRINKLER HANGERS 1 I �� (INSULATION/WEATHER STRIPI 1 C (INTERIOR LATH/DRYWALL I I I IEXTERIOR LATH I IRATED FLOOR/CEIL ASSEM. I I 1 IRATED WALL ASSEMBLIES I I I IRATED SHAFTS/OPENINGS I I T-BAR CEILINGS ILOT DRAINAGE I I I 1 IREPORT ID: DPR261 ROUTE TO: BS0508 I 1 1 1 I I I I I I APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANG I`�ES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS !/ 7 I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS L�S 3 or a certificate of Workers' Compensation Insurance,or a certified copy thereof(Sec. 3800, Lab.C.) Q _ ZIP _ LOCALITY �!Y " � /F Policy No. Company IZE OF LOT NO.OF BLDGS.NOW ON LOT 7 ❑ Certified copy is hereby furnished. NEAREST CROSS ST. ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. USE ZONE MAP NO. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL - SPECIAL CONDITIONS , CERTIFICATE OF EXEMPTION FROM WORKERS' i( OWNER�� TEL NO. COMPENSATION INSURANCE i WITHIN 1000 FT.OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred ADDRESS /� C�"/" DISTRICT GROUP TYHt�CONST. FIRE ZONE PROCESSED BY dollars ($100) or less.) lt—e— CITY ZIP 1 certify that in the performance of the work for which this permit r + �� y�, /3 is issued, I shall not employ any person in any manner so as to l� subject to the Workers'Compensation Laws. ARCHITECT OR ENGINEER TEL NO. become sub 1 p ( 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. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith �v� FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. P L LICENSED CONTRACTORS DECLARATION SIDE CITY LIC.CLASS P L I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 of.the Business and S� T.44NO.OF STORIES NO.OF FAMILIES NEW 1:1 BK PG Professions Code,and my license is in full force and effect. J Poo.License Number Lie. Class D XIP 2l ❑,WORK ADD VALUATION �^� O Contractor Date �,/F ALTER ❑ $ ��e �'✓ V ElI am exempt under Sec. / REPAIR El $ F- B.&P.C.for this reason ✓L�' � �i DEMOL ❑ V LDMA P/C# W Date: SE OF EXISTING BLDG. V URM ❑ i 0- Signature APPLICANT(PRINT) TEL NO. LDMA Perm.# tltC41 M41 T' Z as owner of the property, or my employees with wages as Z heir sole compensation, will do the work and the structure is ADDRESS 0 JrM 108-90 . FI AL DATE not intended or offered for sale (Section 7044, Business and I Q Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL �� ` V ,� ❑ I, as owner of theproperty, am exclusive) contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE„ VV Y g AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY� licensed contractors to construct the project (Section 7044, YES El El �V/ 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 QUAUTY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR GUIDELINES. I hereby affirm that there is a construction lending agency for YES❑ No❑ w the performance Of the Work for WI11Ch this permit IS ISSUed(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING 3097, Civ.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS 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 OBTAINING A PERMIT FROM THE SCAQMD. o Lender's Address OWNER OR AGENT O o I certify that I have read this application and state under penalty 9 of perjury that the above information is correct. I agree to comply P.C.FEE PERMIT FEE / o with all county ordinances and State laws relating to building a constructi n, and hereby authorize representatives of this County ISSUANCE FEE Q CD 10 to en pbn the o e mentioned property for inspecti ri purp es. 10 INVESTIGATION FEE TOTAL FEE co H _2. /� (0 s. Aoai�ca 9e SEE REVERSE FOR EXPLANATORY LANGUAGE