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Home My Public Portal About4827 GLICKMAN AVE_Building__ TEMPLE C1141� 7GA935A CE#608, 1-61 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. / DIST C N G TYPE - E BY FOR APPLICANT' TO FI IN `I1 CONST. C BUILDING n STATISTICALC IFICATION S ER MAP ADDRESS ^�s.v BK CLASS.N_ O. DWELL.UNITS7� --_S LOT NO. I BLOCK WATER NOT REQUIRED E 17TH RECEIVED TRACT (J 9 /�� CERTIFICATE: MAPJ I� HIGHWAY STATE MAJOR SECON , LOCAL NO.OF BLDGS. NO. - (J (�� (CIRCLE) SIZE OF LOT I NOW ON LOT USE ZONE SPECIAL USE OF / CONDITIONS EXISTING 56DG. TEL. OWNER BUILDING EXIST. SETBACK YARD HWY STREET NAME WIDTH ADDRES - C FRONT 1 ARCHITECT OR TEL. P. L. ENGINEER NO. SIDE ADDRESS A EL. INSPECTION RECORD 00 T CONTRACTOR NO. ADDRESS Ilia O DESCRIPTION OF WORK w CL V) NEW AD ALTER REPAIR DEMOLISH Z SQ.FT. NO.OF NO.OF �IZE STORIES FAMILIES USE OF STRUCTURE SIGNATURE OF APPLICANT VALUATIONS I APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. FOUNDATION: LOCATION FEE $ FEE $ FORMS,MATERIALS FRAME:FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS 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 AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH, INT. TION OF THE LABOR DE OF THE STATE OF CALIFORNI ELAT- ING TO THE - MPENSATI INS R CE. LATH,EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS FINAL CLYDE N. DIRLAM, PRINCIPAL STR RAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH r . C-9 76A638A CE 4803 6-62 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELESBUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS /{/ J ( �( (t Q BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST Qf WILLIAM A. JENSEN. SUPT OF BUILDING CROSS ST. P W"« /', -f A DISTRIC NO. GROU TYPE ROCESSED BY FOR APPLICANT TO FILL IN 0 rj ,( CONST. BUILDING STATISTICAL CLASSIFICATION SEWER MAP ADDRESS A_BK f YG CLASS. NO. DWELL. UNITS LOT NO. le BLOCK WATER NOT REQUIRED ® RECEIVED ❑ CERTIFICATE: TRACT 2-- NAOP O o HIGHWAY STATE MAJOR SECOND, OCA NO.OF BLDGS. v SIZE OF Lo-(2, NOW ON LOT JE Z SPECIAL USE OF CONDITIONS pee- EXISTIW BLDG. .}� 3s`/ O UILDING h� EXIST. SETBACK YARD HWY STREET NAME WIDTH A FRONT ARCHITECT Ofr TFi . P. L. ENGINEER NO. SIDE P. L. } ADDRESS - 0. O CONTRACTOR { U ADDRESS p; DESCRIPTION OF WORK W NEW ADD ALTER REPAIR DEMOLISH a' . FT. �^�') NO. OF NO. OF ' N SIZE — V STORI FAMILIES USE OF STRUCTURE SIGNATURE OF APPLICANT VALUATION $ 0 APPROVALS J DA-YE INSPECTOR'S SIGNATURE �y �Xp v} Lr FOUNDATION: LOCATION '°` FEE y�/ FEE $ FORMS, MATERIALS _ `_ FRAME: FIRE STOPS. 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. WITHALL 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- LATH, INT. TION OF THE LABOR CODE OF THE STATE OF CALIFOR RELAT- _ ING TO WORKMEN'S COMPENSATION INSURANCE. LATH, EXT. SIGNATURE OF - ,,. HOUSE NUMBER COR- PERMITTEE RECT AND POSTED = ' ADDRESS FINAL JOHN F. LEWIS, PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION cK. 1 M.U. CASH L,- ,o8977QJ DEC 2823 D 28.5 OA L,1LO 1 5 2 1 FEB 28 1 0 5 7 . C - ffV11 76A638A CE#803 6-62 APPLICATION FOR BUILDING PE I'T' COUNTY OF LOS ANGELES ADDRESS DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. DISTRICT NO. Gr TYPE � SSED BY FOR APPLICANT O ILL IN J1'D CONST._V BUILDING / STATISTICAL CLASSIFICATION S ER MAP ADDRESS BK CLASS. NO._�G/�QQ�DWELL. UNITS.— •PG LOT NO. BLOCK- - WATER CERTIFICATE: NOT REQUIRED19 RECEIVED TRACT (% Fez MAP HIGHWAY STATE MAJOR SECOND OCAL NO. OF BLDGS. NO.nG®/ (ZIRCLEI SIZE OF LOT NOW O USE ZONE SPECIAL USE OF /1 /// CONDITIONS EXISTING BLDG. OWN b BUILDINGEXIST. / SETBACK YARD HWY E/Ei 7NAME WIDTH ADDRESS FRONT ARCHITECT OR TEL. P. L. ENGINEER NO. SIDE P. L. G. ADDRESS Z,7 O CONTRACTO �/�� V ADDRESS O DESCRIPTION OF WORK u W CL NEW ADD ALTER REPAIR DEMOL" .N Z SQ. FT. NO. OF NO. OF SIZESTORIES FAMILIES USE OF STRUCTURE c i r SIGNATURE OF = APPLICANT VALUATION-$ APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. FOUNDATION: LOCATION FEE S r-� FEE $ FORMS, MATERIALS FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATI �' GAS VENT, DUCTS BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE W RK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN OLA- LATH, INT. TION OF THE LABOR CODE OF THE ST OF CALIFORNIA ELA - ING TO WORKMEN'S COMP SATO RANCE. /� LATH,EXT. SIGNATURE OF / f� HOUSE NUMBER COR. PERM ITTEE / RECT AND POSTED ADDRESS FINAL JOHN F. LEWIS, PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION c . M.D. CASH 4. 0 COUNTY OF LOS ANGEfES 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 000,1120043 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: TR: 10992 LT: 8 UN: .002 SQ. FT STORIES TYPE 4827 GLICKMAN AV STRUCTURE: 0 VN TEMP CA 917804019 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LOWER AZUSA 8585-012-038 THOMAS PAGE: 597 GRID: B5 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: RESID USE ZONE: R- ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 01/12/00 UT 07/10/00 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DAT FINAL BY: C CHAVEZ SERVANDO;NORMA (626) 442-4209- 1 4,300 ?-00O 4827 GLICKMAN AV 4 TEMP 917804019 FEES PAID DESCRIPTION OF WORK TEAR OFF/HOUSE AND GARAGE, RESHEET, ND INSTALL 25 YR.ELK FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: COMP.' SHINGLE APPLICANT: TEL. NO: J N DAVIS ROOFING 628214665 AA BLDG PERMIT ISSUANCE 27.75 2 E. LA PORTE AC STRONG MOTION RESID _ 4300.00 VAL 0.50. SPECIAL CONDITIONS: ARCADIA, CA D2 PERMIT W/0-EN HC- '�'4300.00 VAL 132.60 - - --= OTAL FEES 160.85 :T CONTRACTOR: TEL. N0: = -- :` APPROVALS DATE INSPECTOR SIGNATURE J N DAVIS ROOFING CO. (626) 821-4665- 2 EAST LA PORTE #A LIC. NO LOCAT;ION AND SETBACKS ARCADIA CA 91006 572125 C39 - : SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. N0: f jh �� -i �. ? �, FOUNDATION/TRENCH FORMS LIC. N0:r' _ ; I - I lllllhl', SLAB/UNDER FLOOR IF -- -- - RAISED FLOOR FRAMING ' I ' MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMF:= -j = ;; ;;i,% s -,� �" ;::_,• ; ;i UNDERFLOOR INSULATION 144H273 3 01 '' I t l.l•i FLOOR SHEATHING NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS:-- - - --- -- — - - - - - � NO 21 `- -` -- -_I\._ - ROOF SHEATHING / SCHOOL WITHIN HAZARDOUS ' -I SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO NO /• FRAME INSPECTION REQUIRED TOTAL SETBACK FROM EXIST ', FIRE SPRINKLER HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- a`;�C,, "^ .`' - 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 REPORT ID: DPR261 ROUTE TO: BS0508 APPLICATION FOR BUILDING PERMIT � COUNTY OF LOS ANGI?"—I-ES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING A QaDRESS dOS ,�E/y� lZ•r�„�r� I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS J/ or acertificate of Workers' Compensation Insurance,or a certified copy thereof(Sec.3800, Lab.C.) CITYL" ie 0-4 ZIPS. 17RtO LOCALITY w� Policy No. Company SIZES OF LOT NO.OF BLD S.NOW ON LOT LG ❑ 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. ASSESSOR MAP BOOK ,p PAGE PARCEL 2 Date ApplicantQ SPECIAL CONDITIONS /,��f CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER 1 TEL NO. / 1' COMPENSATION INSURANCE TIS' tJ(42-L1,;2bq WITHIN 1000 FT.OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred ADDREC S"1 dollars ($100) Or less.) pr,( v ,f cj,�-I`Yj('el DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY I certify that in the performance of the work for which this permit •QZY ZIF 7 is issued, I shall not employ any person in any manner so as to �O - !� ' become subject to the Workers' ensation Laws. ARCHITECT OR ENGINEER TEL NO. 0 'Y� /� STATISTICAL CLASSIFICATION APT CONDO ✓Date Applicant aye D tcJ "� 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 OZ_A enc "LfTU ``l-')5 - E FRONT comply with such provisions or this permit shall be deemed revoked. ADDRES _ LI NO. P L ,,LP LwL �i 1D ((� SIDE LICENSED CONTRACTORS DECLARATION CITYLIC Ass P L I hereby affirm that I am licensed underprovisions of Chapter 9 C-v-°�'t-u I 1, +- - SEWER MAP (commencing with Section 7000)of Division 3 of the Business and FT.SIZE NO.OF STORIES NO.OF FAMILIES Professions Code,and my license is in full force and fect. �� NEW BK PG a License Number (04 Lic. Class - I DE CRIPTION.OF WORM,, ADD ❑ VALUATION O /�� Contractor Date ! - I�--J`� GL f D C l v 4c Y' as ALTER El $ '712f, (r Zam exempt under Sec. REPAIR ❑ 0 B.&P.C. for this reason � ��/® DEMOL ❑ LDMA P/C# W Date: ''C USE OF EXISTING BLDG. URM ❑ IL Signature APPLICANT(PRINT) TEL NO. LDMA Perm# - ❑ I, as owner of the property, or my employees with wages as Z their sole compensation, will do the work and the structure is ADDRESS O not intended or offered for sale (Section 7044, Business and FINAL DATE Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIALi / i OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE El 1, as owner of the property, am exclusively_contracting with Q AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY 5 licensed contractors to construct the project (Section 7044, Business and Professions Code.) YES 1-1 NO El WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING ———... .-....._r.... OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)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. )'_t�'du•• �• - = _.-D m I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING N ,CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, r 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. 0 Lender's Address 0 OWNER OR AGENT 0 1 certify that I have read this application and state under penalty 0 of perjury that the above information is correct.I agree to comply P.C.FEE ' j PERMIT FEE o with all county ordinances and State laws relating to building ��' v _ � - 00 < construction, and hereby authorize representatives of this County ISSUANCE FEE 71 yco en r upon the aboy mentioned property for inspection purposes. \�-� -/J-t/q INVESTIGATION FEE TOTAL FEE / } a igpat plicant orAgen� Date I SEE REVERSE FOR EXPLANATORY LANGUAGE