HomeMy Public PortalAbout5112 GOLDEN WEST AVE_Building__ _ I T '✓
TEMPLE CITY
>..�..a�.« H. APPLICATION FOR BUILDING P T
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS s
BUILDING AND SAFETY DIVISION LOCALmr
JOHN A. LAMBIE, CoUNTY EN41N?QR NEAREST
WILjJAM A. J or SuILDING CROSS ST. rl
DISTRICT NO. IO OUP -SPE ED QY
FOR APP11CANt TO FILL IN TYP
BUILDING STATISTICAL CLASSIFICATION SEVER YAP
ADDRESS � � �j
CLASP.NO UN vl
LOTNO.S . aFVv .3 BLOCK WATER NOT REQUIRED RECEIVED
TRACT �O /2 ���♦� / CERTIFICATE:
MAP HIGHWAY STATE MAJOR SECOND, LOCAL
NO.OF BLDGS. NO (CIRCLE)
SIZE OF LOT. NOW ON LOT USE ZONE SPECIAL
USE OF /'� CONDITIONS i
EXISTING BLDG T'T
OWNER D-If'rS NO.
UILDINO YARD HWY NAYS HXIST.
-c SETBACK WIDTH
ADDRESH G��S� 1/ FRONT
ARCHITE OR TEL P.L
EN OI NEER NO. SIDE
ADORE" TEL INSPECTION RECORD CL
O
CONTRACTOR /'! ^e } NO. (d
ADDRESS
DESCRIPTION OF WORK
f
r a
NEW ADD ALTER REPAIR DEMOLISH - N
8Q.I- NO.OF NO.OF / ?
IZE STORIES FAMILIES
USE OF
STRUCTURE
8I6INATURE OF
APPL I CANT ��((
VALUATION; -o-e
APPROVALS DATE INSPECTOR'I!!II GNATURE
P.C. PMT• d FOUNDATION: LOCATION F
FEE FEE FORM8 MATERIALS
NG
FRAME: FIRE STOPS, _
1 HERESY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACIBO LTH
AND STAT[THAT THE MOVE IR CORRIGT AND AGR[[TO COMPLY FURNACE: LOCATION,
WITHALL COUNTi' ORDINANCES AND •TAT1KLAW■ REGULATING GAS DUCTS
EUILD ING CO NETRUCnO N. I-C[1TTIPY THAT IN DOING THE WORK
AUTHORIZED HERESY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH INT
TION OF THE LASOR CODS OF HE STATE OF CALIPO RSLAT-
ING TO WORKMEN'S COMPEN ION INSURANCE
LATH EXT.
810NAT`U OF HOUSE NUMBER COR-
PERMITTE R.ECT AND POSTED
ADDRESS
CLYDE N. DIRLAM, INC PAL RAL ENGINEER
PLAN CSECS VALIDATION ax K-m CASH PERM VALIDATION X-o. CASH
L'r004910 Ja14230 1 .0U `•
L o05 .0 0 JUL 14 1 a 45 .00
5 Q
r APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
WOFUCEI S COMPENSATION DECLARATION POR APPU AWr TO FILL M Buses Abse ,`/
1 herby aoue,lflnm that I have■ owdMosle of oweent to aetf InBUILD NO ADDRESS L�Eat/ �if/L:S'T
or a cerd5cals of lhbnkeW Compensation Insurance,or a cerdW S
copy theyDof(8—3800,Lab.C.) Orrr
5. °
ry
P.&--y '=' s�of Lor No.of Now ON LOT
❑ CwMW copy b hereby ninWvxi NEAREST Close
rtlffed copy iliac Wath the county bull M W"Coon TRACT BLOCK LOT No
USE mrrE Na
D.Js � AeaE880R MAP BOOK PAGE P06RC8- M
sPSOrAL cormrrtoM
CERTIFK.ATE Of SUMS TION FROM WORIE' owrtER NO' YES No
COMPEIiSATION M$URANCE ,^� —O wrTMIN 1000 FT.OF SC sou
dCrKW a onneedbe completed If the permit Y for ore hundred ( IJ6Dt .sTA}CT GROUP TYPE FRE"N' PFKK ES6ED BY
DP
or low)
I oerttty that In the pwfornrrwe of the work for Mhlah this permk -C r 8 0
Is baled. I stall not enlpioy wry pawn In any manner so ss w ARCHrTECT OR M03WEER TEL W.
become subject to tar Workers'compwmffdon Lary, smKn8TFC.AL C_AeelaCx-ION APT CONDO
Dale Applicant ADS CLAN NO. DWELL UNITS
NfOUCE TO ,APPIUCAN T., If, after making this CerttM1cafe of REWIRED ro�U SETBACK FROM DOS
Exemption, you should become subject to the Workers' OR TEL NO SETBACK 101RD HAY PROP LIE 11IIDTT-I
CompersatJon provlelons of the Labor Code, you must forthwtth o
comply wtth such provblons or this pwnitt ahei I be deemed T•vdmd. ,Ly}/��_ PROM r
PL
SIDE
LICENSED CONTRACTOFtS DECLARATION U PL
PL
I hereby afllmn that I am Ikmsed under provblorts d Chapter 8 seVv�1 MAP
(OOmmenclIV%th seatlon 7(M.of Dtvblon 3.of the Bustneaa and eaFT.9UE rro.of B STOFFNO.OF PAMIL®
Professkrr Code my Ilcerw b In hut]force and arleot. NEW ❑ BK PO ,
Lk 0rse luUc Class OF WORK ADD ❑ VALUATION
o a o a t— r O N # dd
ALTER ❑ z
❑ I em exempt under 800.
REPAIR R
B.SP.a for this n exon S '• , r DEMOL ❑ LOW P/C 0
cels umP_OF DQSiINo BLDG URAA ❑
8ipnstlre APR-ICA1NT(PINT) TEL No. LDMA Perm 1 1
Eller I, as owof t10 propertX or my ernployees wfth wages as ACCT.4r
their sole oomperrarioxi,will do the work and the smicture Is ADDRESSFF
not amended or offered for sale (Section Tau, Business and FINAL DA 3307 116.K
R-ofeap'lans Code.) WILL THE APPLICANT OR FUTUFr Nu<Daa OCCUF T HADLC A HAZARDOUS YQaFtiAL 1 ITEMS
❑ 1, se owTw Of the property, em w0h OR A IDITME CONWONG A HAZARDOUS WON AL aOUAL TO OR GFEWM THAN ac+ Y TW AMOUNn SPIOrm ON Tl-!HMZARDOUe WO RiNL 94.00&09FO1 Q JWV
Ilaerred oont wton to om-a l nt the project.MectSon 7x14. ,,m ElNo ElTOTAL 116_94-3
&Akw w and Professions code.) [
WILL TM NTlDm UN Of TM B•DOQ BY TW APPLKWIT OR FUTUFV1 R.DM
OCCUPOWT RmI"A Paraa"rPoq COftlTFilOTpN OR IDpa�g4lpN r'F10M T}C SOUTH 4T\
CONSTRUCTION LENDMG AGENCY
ooAeT AA OLIAUTY MA►aAoe�rr DrTRICr{��e�PsaaTrs�e a raaFar rrr
mnn
I hereby dM m that there to a constnuctlon Iendtr>q sperxy for r�❑ ,D❑
the perforce of the work for wl id this permit Is issued(Seo
317,Ck a). I HWM READ THE FMZAFDUODLA�W46VALB Mi*M&OaXN QLAM AID nff eCAQw
COM TM-K&
M�Q.EI
;Ta-uW'W i W SWTTAND wi)M uoH 1M OCNICE*POMM"MWM UNDW THE LOS Niro.
Lenders MHarne AZMDOFIO W4iaALe F9- OD.
1ORTM AND POR 00TANNO A PWAXT FROM TFQ SOA ' lA.t;.11.��1 �/ 1/?0
Lander.Address C�aAdWIT 0418 1 Ali 7:41
o I cw&y that I have read tads applballon and state that the above P.C.FEE PB�LT F� ,
is correct. nee to compfy wfth all carrty S
bukd]np oormtruction,and , (J
SM9 npnserthrbves b Courrty to rsajANcE D
/ WESTKIAT1oN PEE TOTAL FEE
91131 REVERIE FOR 0A AHATORY LANGUAGE
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OFPUBLICWORKS 9701 LAS TUNAS ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT TEIPLB CITY CA 91780 BL 0508 0705180015
PHONE: (626) 285-0488 EXT:
LEGAL ID: NO. OF CONST BUILDING ADDRESS:
TR: 9481 LT: 9 13L: .001 UN: .002 SQ. FT STORIES TYPE 5112 GOLDEN WEST AV
STRUCTURE: 484 VN TE1P CA 917803940
ASSESSOR INFORMATION N07iBER:
1PRIREST CROSS STREET:
8589-008-012 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY, C
TENANT: EXIST BLDG USE: R&SID USE ZONE: R-1 ISSUED ON: PROCESSED BY: EXPIRES ON:
EXIST OCC GRP: 05/18/07 SR 05/12/08
OSOIER: TEL. NO: BLDG9. NOW ON LOT: VALUATION: DATE F CODE:
BARONI, OSCAR (626) 309-9490- 3,000
5112 GOLDEN WEST AV
TEMP 917803940 FEES PAID DESCRIPTION OF WORK
Dgn. 7HED GARAGE TEAR OFF J REROOF METH 30 YEAR COMPOSITION
FEE DESCRIPTION: QU+NPIT'Y: UCM: AMOUNT: SF1201LE9 PLYWOOD AND FELT PAPER
APPLICANT: TEL. NO:
SAME A9 OSQQER - AA BLDG PERMIT IS ANCE 27.75
AC STRONG MOTION RE9ID 3000.00 VAL 0.50 SPECIAL CONDITIONS:
D2 PERMIT W/O EN-HC 3000.00 VAL 99.00
FR INV HORS M/0 PERMIT 128.50 DOL 128.50 `
TOTAL FEES 255.75 1`� �•�\ ,
COLPPRACLOR: TEL. 190: APPROVALS BATE INSPECTOR SIGV URE
SAME AS OWNER
LIC. NO LOCA�ION AND 9r.TaACKS
SOT7-9 ENGINEER APPROVAL
ARCHITECT OR ENGINNER: TEL. NO: FOUNDATION TRENCH FORMS
LIC. NO: SLAB/LENDER FLOOR
RAISED FLOOR FRAMLNG
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION
147H269 3 01
' FLOOR 9HEATHI1..aG
NO. OF FAMILIRA: D'WULLING UNITS: APT COND: STAT CLASS:
NO 21 ROOF SHEATHING
SCHOOL WIT= HAZARDOUS SHEAR PANIIS
AIR QUALITY: 1000 FEET MATERIALS
NO NO NO FRAME INSPECTI ON
REQUIRED TOTAL SETBACK FROM EXIST FIRE SPA'T20= HANGERS
SET BACK YARD: HWY: PROP T, : WIDTH:
FRONT PL- _ lmSd=ONNEATHzR STRIP
SIDE PL-
=Y RIOR LATH DRYMALL
RZTERIOR LATH
RATED FLOOR CELL ASSEN.
RATED {OPLL ASS100LrSS
RATED SHAFTS OPENINGS
T-BAR CELL-TWE
LOT DR A 2ZAGE
REPORT ID: DPR261 ROUTE TO: 1390508
COUNTY OF LOS ANGELES TII4pLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/RRPA312
BUIIaZNG AND SAFR'TY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0807100023
PHONE: (626) 285-0488 ETT:
LEGAL ID: NO. OF CONST BUILDING ADDRESS:
TR: 9481 LT: 9 BL: .001 UN: .002 SQ. FT STORTRS TYPE 5112 GOLDEN WEST AV
IKIIST
TRUCTURE: V-B TEMP CA 917803940
ASS&SSOR INFORMATION NUMBER: NRIREGT CROSS SEREST:
8589-008-012 THOMAS PAGE: 597 GRID: A4 LOCAL.ITY: TEVEPL�E CITY, C
TENANT: AST BLDG USE: RF9ID USE ZONE: R-1 I ON: PROCESSED BY: EKPT-P ON:
OCC GRP: 07/10/08 SR 01/06/09
ON3MR: TEL. NO: BLDG9. NON ON LOT: VALUATION: DA� CODE:
BAR4NI/NVkGAI.LANfi,9, OSCAR/SYLVTA (626) 309-9490- 2,000
5112 GOLDEN WEST AV 7T
TEHP 917803940 FEES PAID DESCRIPTION OF WORK
PATIO COVER TRETJ= 1001 LJ24L 57'
FEE DESCRIPTION: QUANTITY: DON: AMlOUN7:
APPLICANT: TEL. NO:
SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75
AC STRONG MOTION REBID 2000.00 VAL 0.50 SPECIAL CONDITIONS:
Al BU=ING REVIEW FEE 54.70
D2 PERMIT W/O EN-HC 2000.00 VAL 82.20
FR INV WORK W/O PERMIT 128.50 DOL 128.50
CONTRACTOR: TEL. NO: 71= FEES 293.65 APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OICEZR -
LIC. NO LOCATION AND SETBACKS 00,
SOTT.a ENGIMER APPROVAL
AR.C=CP OR ENGINEER: TEL. NO: FOII2=oN TRENCH FORMS
LIC. NO: SLAB UNDER FLOOR
RAI.BED FLOOR FRAMING
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION
147H269 3 01
FLOOR SHEATHING
NO. OF FTMTT,rR9: DWEIJ ING UNITS: APT COND: STAT CLASS:
NO 21 ROOF 9HRAT IINI l
SCHOOL WITHIN HAZARDOUS SHEAR PANELS
AIR QUALITY: 1000 FEET MATERIALS
NO 190 NO p FRAME INSPECTION
REQUIRED TOTAL SETBACK FROM EXIST FIRE 9 HANGERS
SET BACK YARD: HWY: PROP T, : WIDTH:
FF.OIPT PL- INSULATION/W&THEA STRIP
SIDE PL-
TATrERTOR LATH DRYWALL
EXTERIOR LATH
RATED FLOOR/CETL ASSEM.
i
RATED WALL ASSEMBLIF68
RATED SHAFTS OPENIlQG9
T-BAR CEILINGS -
LOT DRAIHAGR
REPORT ID: DPR261 ROUTE TO: BS0508