HomeMy Public PortalAbout4937 GOLDEN WEST AVE_Building__ ENT OF BUILDING AND
�EPA-RT Cl�NTY OF LOS ANGELESAFE G 27 1g;B U ' L ® ' N
WM. J. FOX, CHIEF ENGINEER APPLICATION
FOR APPLICANT TO FILJIN
FOR OFFICE USE ONLY
DISTRICT NO. FLAN FK. oe REC.No. PERMIT NO. �J
BUILDING
ADDRESS
RECEIVED BY DATE OF APPL. DATE198�D
_LOCALITY 71
..��
NEAREST
CROSS 9T. BUILDING
ADDRESS
OWNER
MAIL LOCALITY
ADDRESS NEAREST
CROSS ST.
TEL
CITY - NO. FIRE I NO. DF I TYPE GROUP.
ZONE PLANS \ '
ARCHITECT OR TEL -
ENGINEER f'; NO. BLDG. ORD. NO.
SETBACK LINE
ADDRESS .. L
USE APPROVED
TEL ZONE BY DATE
CONTRACTOR/ NO. HOUSE NUMBERING
ADDRESS r MAP NUMBER_ If: NO. ASSIGNED BY
LEGAL C- -- CORRECTIONS
DESCRIPTION LOT NO. BLOCK
TRACT ) -- �' -
_T NO. OF BLOCS.
SIZE OF LOT I NOW ON LOT
USE OF �_ I FAMILIES
BO �
EXISTIN BLDG.
DESCRIPTION OF WORK
0
REPAIR DEMONEW LITION
ADDITION ZD
r
94. FT. �•'"` NO.OF
SIZE i 3 1 ROOMS STORIES
EXT.WALLROOF
COVERING ��:•- COVERING
USE
USE OF STRUCTURE
INSPECTION FOR APPROVALS
OCCUPANCY AS INSPECTOR'S SIGNATURE DATE
FOUNDATION: LOCATION _
FORMS, MATERIALS
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP-
PLICATION AND STATE THAT THE INFORMATION GIVEN IS FRAME: FIRESTOPB, x-�-•t` F2 b�J�'
CORRECT. BRACING, BOLTS pA/�•{•ti- O
IAGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION,
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. GAS VENT, DUCTS
SIGNATURE OF LATH, INT. .e,�
PERMITTEE .�
LATH, EXT.
ADDRESS
PLASTER, INT.
AUTHORIZED AGT.
PLASTER, EXT.
d P.C.$
M1� FEE HOUSE NUMBER COR-
RECT AND POSTED
VALUATION FEE FINAL
76AS38A DBS 3 7-51
l
76AWSACIOS033-5e APPLICATION FOR BUILDI
COUNTY OF LOS ANGELES EUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE. COUNTY ENGIN[[R MEAREST
COLEMAN W. JENKINSJSuF'T OF DUILDIHa CRO"ST.
DISTRICT N O T E PR D
FOR APPLICANT TO FILL IN CONST.
aUILDINO STATISTICAL Cy4YSIFICATION S lewER Ar
ADDRESS - y Bi( PC)
ClAS9 NO. FJ-—DWELL UNI TD
LOT NO. CK USI! 0 MAP, -'
TRACT O
XL SPECIAL
Mo. OF SLOGS.
SIZE OF LOT NOW ON LOT,
USH OF
BLDG. SETBACK FROM
TEL. /_ �� FRONT PROP. LIN[ OF
O N N lLJ TYPE OF [XISTIMS SETBACK HISHwAY YARD = TOTAL
C
ADDRESS "32 Lklasz AJ -
CITYLSrr
BLDG. S[TSACK FROM '
AIRCH EQ TEL. SIDS PROF. LI11[ OF' ST'R[ET
ENGINEER NO.
TYPE OF BXISTLNG SETBACK HIGHWAY + ,' YARD TOTAL
ADDRESS HIGHWAY WIDTH FROM C.L.
TEL. ' _
CONTRACTOR NO
LIC CORNER CI,ITOFF YES NO'L 8
ADDRHSS NO
CITY LL SEE REVERSE SIDE FOR SPECIALAPPROVALS
DESCRIPTION OF WORK
NEW ADD ALTER REPAIR DEMOLISH / Z
SCLFT. NO. OF NO. OF
SIZE STORIES FAMILIES
USE OF
STRUCTURE
SIONATURE OF , 7
APPLICANT
VALUATIbN$ I .00
� APPROVALS DATE INSF[ 'S SIGNATURE
P.C. PMT. /OUN-DATION, LOCATION /
FEH$ FEE$ I (/ V FORMS MATERIALS `Y
FRAME, FIRE STOPS,-
I HUMMY ACKNOWL[DO[ THAT I HAVE READ THIS APPLICATION El ACING DOLT
AND STAT[ THAT THE ABOVE IS CO RRKCT AND AOR. TO COMPLY FURNACEI LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS R[GULATINO GAS V T. UCTO
7UILDINO CONSTRUCTION. I CG]ITIFY THAT. IN DOINO THE WORK
AUTHORIZED HKMSY I WILL NOT EMPLOY ANY P[}eSON IN VIOLA. LATH. INT. oe
TON Oh TH[ LA*OR COD[ OF TH[ STAT[ OF CALIFORNIA RELAT- ./
ING TO WORKMEN'S COMPENSATION INSU. a. q�� I46&//� LATH. I[XT. -
BIGNATURE OF ��' '
PERMITTEE HO NUMBER COR-
.. � � 44 A'F
ADDRESS FINAL �L
JOHN F. LEWIS. PRINCIPAL ST RAL ENGINEER
PLAN CHECK VALIDATION cx. M.O. CASH _ PERMIT VALIDATION TF
M.O usrl
( ,e3 9-7 " NW22 1 D �q-4)0 g
' I
D BUILDING
VYM. J CouNTY �Ia1Nm� APPLICA OIC
BUILDING
FOR APPLW.J n a TO Mf IN ADDRuf
BUILDI=NNG ! I
B u= 44z LOCALITY t
N XAR EST
LOCALITY CAOt1 ST.
tA
RKST DISTRICT NO. PLA>i. OR Rsa. No. POIMrr-NO.
vim By DATIK OF APDL. A W
L
RES/
U!>t ZONKr"L-p
GR Fl ZONt
GUY 1 Tom,
H IT'KCT Tw- ZONING Q+TU
INt� NO. AITROVm ST-
AM Rns DUILDING / �•Mo•
SSTNACK LINst
TI— ArrRov>m DAM
TRACTOR NO. BY.
HOUSR NUMMKRING
L KGA MAF NUM■ O. A"IaNK'H
DESCRIPTION LOT NO ee FLOCK
!� DATIt �,Q��, 1O� INfPICTOR
TRACT yM
NO. OF SLDUS.
SIZi OF LOT NOW ON LOT
MKOF I AM NO. OF
O
DESCAMON OF MXMo
NKW ALTIGIATION ADD ON
RKPAIR DIEMOLITION .
Sq. FT.
F
NO. O
ME ROOM• STORIES
EXT. WALL ROOF
COVKRIN COVQRING
US[OF R
I
Ovms
INSPKCTOR'd SIGNATURt DATL
I HKRIMY ACKNO'WL CDat THAT 1 HAVS RZAD THIS AP- FFORM STOPS,
PS, �y
PLICATION AND STATi ?NII THAT INFORMATION GrirM If BRACING, BOLTS
CORRI=.
I AGRKR TO COMPLY WITH COUNTY ORDINANCES ��,��� LOCATION,
AND STAT[LAWS RigJ,{L�.TI ILDINaol UCTION. GAS VENT DUCTS
SIGNATURE OF LATH INT.
P23tM I
LATH QIT.
ADD
INT.
AUTHORaID AGT.
FLASTXR, QT.
s
P. O.; HOUSK NUMI9ER COR-
!�t R[CT AND POHTm
VALUATION F>Q 'w�► FINAL
76Aau r8 s a-il
APPLICATION FOR -BUILDING ,PERM.IT-
COUNTY OF LOS ANGELESBUILDING AND SAFETY
WORKER'S COiMPENSATiON DECLARATION FOR APPILCa RT'TO FILL IN 8e
I hereby'affirmthat 4'have a certificate of coneent to aetf Irm",
a'a .of Workers' Carpbnaat n Insurance,or a cer#tfied _ -
copy tfierAof Lab C) S si V Crt Y PL F, G ZIP LOCALITYPdIc,y"° QTY 4aT NO.OF SLOGS,NOW ON LOT
❑ Certf(ied copy Is hereby fumlohed. hJEAREST CROSS ST.
D cop'y b rSled wRh tt,e tx,bino b TRACT LOT No,
r E MAP Na
Dte rt i ASSESSOR VAP BOOK PAGE PAACEt
SPEG44L CONDrrlON8
CERTIFICATE OF EXEMPTION FROM WORKERS' TEL No' D/
CO#APENSAno-N INSURANCE 1000 Fr.OF SCHOOL? YES NO
(Thle eecOw need not be comple7ed If the perrM Is for'one'hurdredQ3 C-,OI,D LUl�fj7 b I7tSTFaCT aRouP GONST. FFE DOPE By
CITY
(Isr
'doa ($100)or k)&&)I certify that In the.perforrrnhce'of ihb Mork for which't?gs pwrnft --� PKi
Is issued. I aha➢ not employ WN3)eroon in any manner so as-to AACIiTECT OF-ENO WEER _ TEL NO.
become ,L
bece sub}ect to the WOrkerb'COnXWM5On Lcwe-- 344TI9TKJ�L AAT CONDO
We Appal ant ADDRESS CLAss Na DWELL UNa'S,
NOTICE 70. K'.APPLT: If, atter making t* Cor1floete of itECU ED lOI L SETBACK FROM EXIST
Exemption, you should become' oubjeat tO the \hbrl a T¢NO SET BACK )AM Hwl' PROP LSE WIDTH.
Conponsatbn prbvfaiorn-oc the L'pbor Code, you must forthw4th M o A7���•CT 'y 6
corrpty with such.provlefons or.thh-permit ahalI be deemed revoked. app gg PFF1�oNT • }
LJCENSED CONTRACTORS DECLARATION ME 0
I hereby affirm thed I am Il¢eneed rriderprwiobrr of Chapter 9 8EWER MAP U
(cogarnenokV wR 3ectlOA 7Q00)of DtvialOn 3 of the Buslneaa and. sa FT..SuE Na OF STOFE8 NO.OF FAMIL"
ProNeolorb Code, 1* is h full force and effect, NEW BK. Pv O
J
L4oeriee D I c�aa C oescR>PZ1oN of woFtK ADD. ❑ % v
LA
cantraoror ALL P P N S _ ALTER 11 $ D
bEU F5i l P[PE rtA6141AJ S . cn
D I am exempt Under—Soc. REPAIR ❑ $ Z
BAP.a for thio romon 50(kV7tC5;C A55 1• Lo mp. 2q DEMOL ❑ LOMA PSG+
Deta USE of f 1�FZ G� URM fl 1
sowture
f`1IJ �/ _rx�
❑ I, ea owner of the property,or my emp♦oyeee with wages ea ) 7 i Oft l DPr iD �l Z�r I-T * - ANT.T
their Sole conpensanor4 wM da the work and the struoture Is ADDRESS 3
hot ih*rded Or alm d fbr sale (Soodon 7044, Business and 0�v FNOXprUr rLL� Avr- -LO bil D b Pw,,,lea-[ 1 ITEMS
Profesala,e co(e.) o �ocr�CANTCONtQayo�FE[JULo a ora o M
t� l W. owner bt the property, am exek wety cormeciir,g vrrm A,�M ON THE HAZ�roova LPUMRL e.FORwKncN cm ? PI AL By TOTAL 1-58 ,85'
keneed Contra�tdra to whet i" the project (Section 7044, �❑ W 158.-&5
Buekieea and Profeealone code.) waL Ta-E Kron®use7,1��ofrrTHE eioLm dr THE ora wtugE w■ .ra �•
CONSTRUCTION LENDIW.AQENCY s tesJo►rot1011.411.��OIKKLET r�F40M THE SOUTH ( I�]
I.hereby aNirm that Vere to a conshibcdon lending agency for vee❑ .,a
the psrbrman�e of the work for which thiapermft b lsaued(Seo.
3097,ON.a) iwuerarinTfE uvase aoeNO T LOO THE SCACAU P916� 0000-"l 9 COUNTYCOUNTYY
Lenders Name TITLEoo4on�
will* 4303 1 All 9-2
Lerlwa Addreeb . . . 0�"
C„mv.,
I certYY that I hoe read tie appllral n and state under penefty
of p m)-i y that the above WOrmation Ja oorrecL 1 kyve tO oomply PC,FEE PEFW FEE /
g) with all Canty mdharoea end Vawe miathnd
g to biing
3f and jym of U* Canty tBSIIAIJC�FEE p�
to for l - C;? ,.J
-� , INVESTUAI-PON FEE TOTAL FEE .
2V SEE REVERSE FOR EXPLANATORY LANGUAGE
_ l
COUNTY OF LOS ANGELES TEPLE CITY 0 0508 BUILDING PERMIT
bEPARTMENT' OF PUBLIC WORMS 9701 LAS TUNAS ALTERATION/REPAIR
BUILDING AND SAFETY / LAMD+DEVELOPMFNTI TEMPLE CITY CA 91780 BL 0508 1108180038
PHONE: (626) 285-0488 ETT:
LDGAL ID: NO. OF CONST BUILDING ADDRESS:
TR: 5342 LT: 9 BL: .001 SQ. FT STORIES TYPE 4937 GOLDEN St8<`4T AV
STRUCISTRE: V-B TEMP CA 917803938
ASSESSOR INFORMATION NUMBER: NY-XR.EST CROSS 9T'R=: T124PLE CITY
8589-018-022 THOMOLS PAGE: 597 GRID: A5 LOCALITY: TF?SLE CITY, C
TTaU+NT: EX= BLDG USE: RESID USE ZONE: R-1 ISSUED ON: PROCESSED BY:
EZr4T OCC GRP: 08/18/11 SR
OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: F DATE BY: CODE:
HAMA4937 O KINZGOLDEN
WE TZIE (626) 318-4470- 750 1
4937 GOLDEN SIFi4T AV
TE?� 917803938 FEES PAID CRIPTIOA OF WORK
SROWER PAN, NEW SHOWER VALVE APO PATCHING DRYWALL
FEE DESCRIPTION: QOANPITY: UOM: AMOUNT:
APPLICANT: TEL. NO:
MISOLASAO, nAx= (626) 716-2273- AA BLDG PERMIT ISSUANCE 27.80
5118 CALMVT9W AVE AS STATE GREEN BLDG FEE 750.00 VAL 1.00 SPECIAL CONDITIONS:
BALDWIN PARR 91706 AC STRONG MOTION REBID 750.00 VAL 0.50
B2 PERMIT W/ENERGY 750.00 VAL 71.90
TOTAL FEES 101.10
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR 91GTUk- E
DAN MIKOLA.9I0 CONSTRUCTION, INC. (626) 338-0055-
5118 CALKVIEW LIC. NO LOCATION AND SETBACKS
BALDWIN PARR CA 91706 855601-B +
80119 ENGINEII2 APPROVAL
ARCHITECT OR E9IGIIEKER: TEL. NO: FOUNDATION/TRENCH FORMS
LIC. NO: SLAB UNDER FLOOR
RAISED FLOOR FRAMING
MAP NO: SEWER MA-P BOOL: PAGE: FIRS ZONE: CMP: UNDERFLOOR INSULATION
144H269 3 00
FLOOR SHEATHING
NO. OF FAMILIES: DWEJ-TNG ITS: APT GOND: STAT CLASS:
0 NO 21 ROOF SHEATHING
SCHOOL WITHIN HAZARDOUS SH AR PSS
AIR QUALITY: 1000 FEET MATERIALS
NO NO NO FRAME INSPECTION
FIRE SARI PUR ER HANGERS
INSULATION WEATHER STRIP
nrf&RIOR LATH DRYWALL
EXTERIOR LATH
RATED FLOOR/CEIL A39EM.
RATED WALL ASSEMBT-1
RATED SHAFTS 0PENLNG9
T-BAR CEILINGS
` ADDITIONAL DATA ON FILE
LOT
REPORT ID: DPR261 ROUTE TO: BS0508
• COUNTY OF LOS ANGH R9 TEMPLE CITY 1 0508 BU=IN3 PERM T
DEPARTMET OF PUBLIC WORKS 9701 LAS TUNAS RILSIDENTIAL ADD/ALT/REP
BUILDING AND SAFETY / LAND DEVELOPWf TEMPLE CITY CA 91780 BL 0508 1307240003
PHONE: (626) 285-0488 ETT:
LEGAL TO: NO. OF CONST NEW BUILDING ADDRESS:
TR: 5342 LT: 9 BL: .001 SQ. FT STORIES TYPE OCC9P GROUP 4937 GOLDEN WEST AV
STRUCTURE: 237 1 V-B R-3 TEOfP CA 917803938
ASSESSOR INFORMATION NUMBER: GARAGE: NEAR&ST CROSS STREET: LA ROSA
8589-018-022 OTHER: 116 1 V-B D THOMAS PAGE: 597 GRID: AS LOCALTI'Y: SLE CTTY CA
TENANT: EXIST BLDG USE: USE ZONE: ISSUED ON: PROCESSED BY:
EZIST OCC GRP: 09/09/13 SR
OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: BY: CODE:
GONZALEZ, SERGIO - 40,330
4937 GOLDEN WFiST AV U4 41
TEMP 917803938 FEES PAID IPTI OF STORK 11
(1) ROOM ADDITION BEDRM, BATHRM, CLOSET 237 SF. (2) COVER
,FEE DESCRIPTION: QUANTITY: DOM: AMOUNT: PATIO 116 SF. (3) INTERIOR PEMDEL ADD LINEN CLOSET S HALL
APPLICANT: TEL. NO: WAY TO BEDRM #3 AND ENLARGE OPENING BE'IWEEN LIVING RM AND +
HAN, FREEMAN (626) 796-5899- B1 PLANCHECK N/ENERGY 40330.00 VAL 636.80
AA BLEG PERMIT ISSUANCE 27.80 SPECIAL CONDITIONS:
AB STATE GREEN BLDG FEE 40330.00 VAL 2.00
AC STRONG MOTION RE-SII) 40330.00 VAL 4.00
B2 PERMIT W/ENIRGY 40330.00 VAL 749.20
CONTRACTOR: TEL. NO: 08 CERTIF OF OCCUPANCY 101.40 APPROVALS DATE INSPECTOR SIGNATURE
LANT IX DEVELOPMENT LLC (626) 379-4900- _ TOTAL FEES 1,521.20
560 W MAIN STREET C278 LIC. NO LOCATION AND SETBACKS
ALHAMBRA CA 91801 668443
SOILS EFGINERR APPROVAL
AR CT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS
HAN, FRMM-9LN (626) 796-5899-
9923 NADINE STREET LIC. NO: SLAB/ORDER FLOOR
TEMPLE CITY, CA 91780 668443 * +
RAI FLOOR FRAMING NO: SEWER PAP BOOL: PAGE: FIRE ZONE: Cffi1: UNDERPLOOR INSULAT'IO
3 00
IST LEVEL FLOOR SHEATH
NO. OF FAl]=S: DifIIS,IING UNITS: APT/CND0 : STAT CLASS:
0 NO 21 2ND LEVEL FLOOR SHEATH
SCHOOL WITHIN HAZARDOUS ROOF SHEATHING
AIR QUALITY: 1000 FEET MATTU?JALS
NO NO 190 FIRE DEPT. FRAME IN.9PECT
BLDG DEPT. FRAME INSPECT
SHEAR PANELS
INSULATION W&A= STRIP
INTERIAA LATH DRYWALL
EXTERIOR LATE
LAT
SMOKE DETECTION DEVICES
FIRE DEPARTMENT APPROVAL
+ ADDITIONAL DATA ON FILE
REPORT ID: DPR261 ROUTE TO: BS0508