HomeMy Public PortalAbout10535 FREER ST_Building__ CA
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76A638A GE X803 2'63 APPLI CATION FOR BU I LD I NG;PERM,T
COUNTY OF LOS ANGELES' BUILDING . v
-DEPARTMENT-OF COUNTY ENGINEER ,- ADDRESS 5
-BUILDING AND SAFETY-DIVISION LOCALITY, _ tel
JOHN A.'LAMBIE. COUNTY ENGINEER NEAREST. r. �•
WILLIAM A. JENSEN, SUP r of BUILDING CROSS ST
DI
SIC N -GR TY P - 'BY
FOR APPLICANT TO FILL 'IN'. d, } co ST.-
BUILDING STATISTICAL'CLASS FI CATION - '• BK -PG
S ER MAP '
CLASS NO DWELL-U NITS
LOT NO /� -- „5, ' /'33T-/tr r'G •oCK WATER��•'' NOT.REQUIRED .RECEIVED'
CERTIFICATE;' _ � .^•.
TRACT - /`' `. - MAP- \/ HIGHWAv. '-: ._ . . . -
• NO rOF BOLDGS. NO C'/, L (CIRCLE) STATE
•M'AJOR-SECON LOCAL-,'
SIZE OF LOT L/ X 33 -NOW ON LT USE ZONE" •SPECIAL. -
k ."
USE OF CONDITIONS
EXISTING-SLDG - - -
- - -TEL
OWNER �' -,� ��sc e! NOC•/•u'S 64! 'BUILDING "•EXIST `
SETBACK. -'_YARD HWY � = ST�REETjNAME';-= ..SWIDT.H"
ADDRESS ��'j j «/ �f'• �C '�� ' FRONT _ •` -•
.ARCHITECT OR - .. TEL 'P L ,
ENGI'NEER+' NO SIDE
a,c
ADDRESS , ''P L r -1 �s ,'���/► -/:I O
- - TEL 1 ��: �t`!�, �� /Jlw •". 1..•'• •a-.- V
CONTRACTOR-' No -
ADDRESS - /�riGy7// �oJ�f • '�9S`-..J_`+. A ..a6�': •O�
DESCRIPTION_ OFWORK
NEW ADD_ ALTER REPAIR • DEMOLISH
,�`'aB.
SQ FT 'NO OF " NO ,OF irPBe"
SIZE /C.i X '� STORIES I/ .. FAMILIES If
USE.OF, -- .7 ,Y:d' .s$ �?l".-ci.wP�Ch' 'a+��� .�'/9:*�� d•
STRUCTURE .'� -/`d- p 6�• - '!f, ., r
SIGNATURE OF - -
VALUATION
•- APPROVALS M'" A_TE/ _.INSPECTOR'S SIGNAyTU E
-,PC - - PMT FOUNDATION LOCATION_ J
FEE $ FEE $ r /' FORMS, MATERIALS O'"' , .7f -
` FRAME FIRE STOPS., 1
f" -
I HER AC KNOWLEDGE•THAT I HAVE READ THIS,APPLICATION BRACING, BOLTS f �G7�4 '� .S`•A
ANDT 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 I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA'
TION OF THE LABOR CODE OF,THE STATE OF CALIFORNIA RELAT- LATH, INT 'I•,' ,
ING TO WORKMEN'S COMPENSATION INSURANCE' LATH, EXT.' r
SIGNATURE,OF - HOUSE NUMBER COR- _
PERMITTEE �I�_ RECT'AND.POSTED'•' •J'•'� :• r ,(L'• II a _
ADDRESS_ - - FINAL
r,
JOHN F LEWIS PRINCIPAL'STRUCTURAL EN N R
PLAN CHECK VALIDATION"' 'CK MO CASH - -PERMIT-VALIDATION• CKI, M o CASH'
' " 'O 3' 3 4 7 �G: ,LLCF1 D., r.1 O ` • '�.V'�/ �' 1 r
_ - •m -
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 SL 0508 1201250066
PHONE: (626) 285-0488 EXT:
ILEGAL ID: NO. OF CONST I BUILDING ADDRESS: 1
ITR: 11290 LT: 14 BL: B I SQ. FT STORIES TYPE 10535 FREER ST 1
I (STRUCTURE: 32 V-B I TEMP CA 917803446
(ASSESSOR INFORMATION NUMBER: 1 I NEAREST CROSS STREET:
18585-021-034 1 THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY, Cl
ITENANT: (EXIST BLDG USE: RESID USE ZONE: R-1 IISSUED'ON: PROCESSED BY:
(EXIST OCC GRP: 101/25/12 SR
(OWNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: IFINAL DATE FINAL BY: CODE:
IIBERRI CARLOS;SUSAN (626) 622-7021- 1 9,500 11y�
110535 FREER ST I _ s I
ITEMP 917803446 I FEES PAID 1DESCRIPTION OF WORK I
1 I ITEAR OFF 7/16 SHEATHING INSTALL #30 FELT PAER GAF SHINGLES 1
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( I
1APPLICANT: TEL. NO: I I I
ICRUZ, JEFF - IAA BLDG PERMIT ISSUANCE 27.80 I_ 1
IAB STATE GREEN BLDG FEE 9500.00 VAL 1.00 ISPECIAL CONDITIONS: I
IAC STRONG MOTION RESID 9500 00 VAL 1.00 1 I
ID2 PERMIT W/O EN-HC 9500.00 VAL 217.10 I I
I _I TOTAL FEES 246.90 1 I
ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE 1
ALWAYS RELIABLE ROOFING . (626) 723-9536- 1
11788 MATCHLEAF AVE LIC. NO 1LOCATION AND SETBACKS 1 1 1
IHACIENDA HEIGHTS CA 91745 903930 C39 I I , I I I
ISOILS ENGINEER APPROVAL I I I
(ARCHITECT OR ENGINEER: TEL. NO: IFOUNDATION/TRENCH FORMS I I I
LIC. NO: I:41AB/UNDER FLOOR I I 1
IRAISED FLOOR FRAMING I I I
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 1 - 1UNDERFLOOR INSULATION I 1
1147H273 3 001 1 I I I
I I IFLOOR SHEATHING I
INO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS I L
1 0 NO 21 1 IROOF SHEATHING
SCHOOL WITHIN HAZARDOUS 1 ISHEAR PANELS -%
(AIR QUALITY: 1000 FEET MATERIALS
1 NO NO NO I !FRAME INSPECTION
I I ;FIRE SPRINKLER HANGERS 1 1 I
I JINSULATION/WEATHER STRIPI I I
INTERIOR LATH/DRYWALL I
I I I I I
jEXTERIOR LATH 1 1 I
' IRATED FLOOR/CEIL ASSEM. I
IRATED WALL ASSEMBLIES I I I
1 !RATED SHAFTS/OPENINGS I I
IT-BAR CEILINGS I I
I
' !LOT DRAINAGE I I
IREPORT ID: DPR261 ROUTE TO: BS0508 1 I
1 I i I I I
77
WORKERS' COMPENSATION DECLARATION
'in;u,, b�
'r a certif carte ofave a Workersr1Compensat on ensuran elf APPLICATION FOR BUILDING., PERMIT
or n,�tified copy thereof (Sec. 3800, Lab.•C.) . a.,
? COUNTY OF LOS ANGELES ' BUILDING AND SAFETY
PolicyAci. Company
BUILDING C
ElCertifiedcopy is hereby furnished. FOR.APPLICANT TO FILL IN ADDRESS Jt
❑ Certified copy is filed with the county building inspec- BUILDING0
tion department. ADDRESS 1 p�/� "
Date Applicant CITY !� + zy ZIP" / • a LOCALITY
NO. OF BLDGS _ NEAREST r
CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT • CROSS S7.
COMPENSATION INSURANCE ASSESSOR -
(Th'is'section'need 'not be completed if the permit is for one'" TRACT BLOCK w LOT NO. • MAP BOOK PAGE µ PARCEL
hundred dollars ($100).or less.)" '•' , TEL.
• OWNER"C/}/1L � rl -"NO, 6.�3 USE"ZONE, t MAP
I certify-that in the performance of the work for which this _ _ + NO.
Y SPECIAL >-.
P is issued, I shall not employ any person in any manner ADDRESS Q Flyer / CONDITIONS
so as to become,subject to theWorke Comp nsation-Laws. 00
CITY "/ Q / Gl'- zip ,
Date � Applicant - - ARCHITECT OR - _ TEL 1� DISTRICT GROUP TYPE FIRE $ROC �
NOTICE TO APPLICANT: If, a making this.Certificate of ENGINEER iV f NO.'Z2 O0�
9 CONST.•, ZONE O
.Exemption, you .should b ome subject to the Workers' P
Compensation provisions of the Labor Code,.you must forth- ADDRESS /V Y1 3 CL
with comply with such,pro0isions or this permit,-shall -be TEL t - STATISTICAL CLASSIFICATION AP CONDO. N
d '� NO 7,A27,6001
deemed revoked. CONTRACTOR )I/e(S/� ._
LICENSED,--CONTRACTORS DECLARATION, t, A �J / 1l LIC _ CLASS NO. DWELL :UNITS
J1 hereby affirm that I"am licensed a-nder provisions of Chapter 9 ADDRESS .Z V J/7 V /• ✓ P� NO SEWER P
(commencing,with Section 7000)of Division 3 of the Business .• �y� J ,/ n� LIC. .
CITY./'�!>�7�ek C/ff CLASS '
cw and Professions,Code,and*my license is in full.force and effect. BK. pG VAGDATION
_ SQ. FT. NO. OF NO OF CHECK
License Number 3j 0 �- Lic. Class" SIZE STORIES FAMILIES ONE
r VALUATION
Contractor• Date" /
DESCRIPTION OF WORK 1--All) , d NEW ❑ S.
® "lTJJ� 0� ADD
❑I a exempt under Sec. TT
L ALTER'-:❑ 'I^-'/7 /�y/�� O V
B.&P.0 for this reason FikTlnsivi—� REPAIR ❑. $.I L10/
Date: _ USE OF
EXISTING BLDG DEMOL ❑
Signature APPLICANT TEL. FINAL /
OWNER-BUILDER DECLARATION (PRINT) NO. DATE
I hereby affirm that I am exempt from the Contractor's:License
'Law for the following-reason (Section 7031.5,•Business'and ADDRESS FIN �'' / i .•
Professions Code): PRESENT Y / (T JL
BUILDING�❑ I, as owner of the ro err , or m 'em to ees with "'� "'' ' '°i+ > 1� �� "* "`
P P Y Y P Y, ADDRESS"•_ _ v� -,-,- C
wages as their sole compensation,will do the work and 3307
the structure is not.intended or offered"for.sale(Section-
7044;
Section '4 LOCALITY_ . 1 I E�
7044; Business and Professions Code.) MOVING' TEL.
CONTRACTOR 1; NO. ti �-
❑ 1, as owner of the property, am exclusively contracting - :a,'., ,i !,._, L TOTAL, :.-1`�p __e0
with licensed contractors.to construct-the project (Sec '
tion 7044, Business and Professions-Code.) ADDRESS (HECK 19Q°`_A3
REQUIRED TOTAL"SETBACK FROM EXIST. r•
CONSTRUCTION LENDING AGENCY. SET BACK YARD HWY PROP. LINE WIDTH -CHAHUE'
I hereby affirm that there is a construction•lending'agency.tor FRONT
the performance of the work-for which this permit is issued P:L r, x �., `.•;„ j\�•,�
(Sec. 3097, Civ..C.). SIDE 1
P L. . _ �-• 0000-0001 9/11/89
Lender's Name ■
.. rr� 'o, LDMA Ref #. 5613 1 Aid 8: r �
P C. Fee$ Permit Fee
Lender's Address
o 1 certify that I have.read this application and state that the Issuance Fee O .50- LDMA P/C# ,•
8 above information is correct. I agree to comply with all County Investigation Fee
o - ordinances and State laws.re'lating to building construction, Total Fee (30, .rJ LDMA Perm # - '�i•
a and here y authorize representatives of This County to enter
2 upon above- ntioned property for inspection purposes.
:;
0AP/ SEE REVERSE FOR EXPLANATORY LANGUAGE..
Signature of Applicant or Agent Date �'