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Home My Public Portal About5612 GOLDEN WEST AVE_Building__ 6A638AACE*,Bb3 9-68 APPLICATION FOR BUILDING PERMIT ILII COUNTY OF LOS ANGELES BUILDING �" / J !- DEPARTMENT OF COUNTY ENGINEER ADDRESS J (o Z Q l[/`e/{/ W eS rt BUILDING AND SAFETY DIVISION LOCALITY j� JOHN A. LAMBIE, COUNTY ENGINEER NEAREST /r COLEMAN W. JENKINS, SUP T OF BUILDING CROSS ST L7-- Q Al CL FOR APPLICANT TO FILL IN DISTRICT NO. GR UP TYPE PROCESSED BY . (Print or type only) 6 CONST Game-,,— el I: e-,, e FEXISTING STATISTICAL CLASSIFICATION SEWER MAP CLASS NO.�_DWELL,UNITS� BK PGfO ` C C OL`K USE ZONE NADP SPECT L NO.OF SLOGS CONDITIONS NOW ON LOTDG. BLDG.SETBACK FROM (`e� TE FRONT PROP LINE OF 4/a/c7_/� STREET) OW NE NO. TYPE OF EXISTING 'SETBACK HIGHWAY + YARD = TOTAL ADDRESS a HIGHWAY WIDTH FROM C L CITY G � + -2-o - 2G3 BLDG.SETBACK FROM (STREET) ARCHIT CT OR TEL. SIDEPROP LINEOF ENGINEER NO. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL 1 ADDRESS HIGHWAY WIDTH FROM C.L TEL + = a CONTRACTOR NO. C LIC. ADDRESS NO _ CORNER CUTOFF YES ❑ NO C CITY CL SS SEE REVERSE SIDE FOR SPECIAL APPROVALS c CONSTRUCTION LENDER CL NAME AND BRANCH Z ADDRESS SQ. FT NO OF NO. OF NEW, �❑ ' SIZE STORIES FAMILIES i USE OF �� ADD' ❑ STRUCTURE ' ALTER ❑ REPAIR❑ , SIGNATURE APPLICANT DEMOL , VALUATION $ loo �� • APPROVALS) ` DATE INSPECTOR'S SIGNATURE R.0 PMT, O G FOUNDATION:-LOCATION FEE $ FEE $ �'�'� FORMS, MATERIALS FRAME FISTOPS, I HEREBY ACKNOWLEDGE THAT i HAVE READ THIS APPLICATION BRA CIRE NG BOLTS S AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, I WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS I STRUCTION. I CERTIFY THAT IN DOING THE WORK'AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH,*INT,' LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COMPE TION IkSURANCE. LATH, T. ,. SIGNATURE OF HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ' - 71 ADDRESS FINAL -? ` JOHN IF LEWIS PRINCIPAL STIR U RAL ENGINEER PLAN CHECK VALIDATION CK M 0.' CASH PERMIT-VALIDATION CK M O CASH nr_,9.5 6 5 kPrz 2 4 0 6.0 O N 4 76A638A CE 48036-62APPLICATION FOR BUILDING PER T COUNTY OF LOS'ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST WILLIAM A JENSEN, SUPT OF BUILDING ! CROSS ST DISTRI T NO GROUP TYPE P ESSED BY FOR APPLIC T TO FILL IN `J coNsr BUILDING CLASSIFICATION SE ER MAP �J ADDRES �� STATISTICAL CLAK G CLASS NO DWELL UNITS LOT NO CK WATER . NOT REQUIRED RECEIVED " CERTIFICATE. • -• TRACT MAP HIGHWAY CA NO OF BLDGS NO ) (CIRCLE) STATE MAJOR SECOND, SIZE OF LOT NOW ON LOT USE ZONE PECIAL ' USE OF - •I CONDITIONS EXISTING B D TE 1 (9 OWN - NX f BUILDI G YARD HWY TR ADDRESS ET NAME EXIST SETBACK FRONT WIDTH ARCHITECT OR - TEL P L ENGINEER NO SIDE P L �. ADDRESS GRADING PERMIT REQUIRED O TE CONTRA 0 APPROVED: u h ADDRES FINAL . a. DESCRIPTION S 0 W NEW ADD ALTER EPAIR DEMOLISH d -N SQ FT NO NO OF _ Z SIZE S ORIES FAMILIES USE OF ' S UCTU � e . • SIGN URE OF AP ICA NT VALUATION-$ APPROVALS DATE INSPECTOR'S SIGNATURE PC PMT FOUNDATION LOCATION - FEE $ FEE $ FORMS, MATERIALS FRAME FIRE STOPS, _ 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION I 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 I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH, INT TION OF THE LABOR CO THE STATE OF CALIFORNIA RELAT ING TO WORKMEN S CO S INS NCE ' - LATH, EXT SIGNATURE HOUSE NUMBER COR- PERMITTEE RECT AND POSTED L ' ADDRESS FINAL p2•3 �j ol JOHN F LEWIS PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION CK M'O CASH _ PERMIT VALIDATIONO,, M o CASH r �1Lo 3 0 3.7 DEC 2 1 D 6.0 0;- 76A 638A 01:893 9-68 w. APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING - 6-Z; /Z- y / DEPARTMENT OF COUNTY ENGINEER ADDRESS J Z; /Z- e�^G Cie cc e5 BUILDING AND SAFETY DMSION LOCALITY « "Xe- JOHN A. LAMBIE, COUNTY ENGINEER NEAREST COLEMAN W. JENKINS, SUPT OF BUILDING CROSS ST !'0/e r� FOR APPLICANT TO FILL IN DISTRICT NO. GROUP TYPE �y PROCESSED BY (Print or type only)• , 6 4' CONST.,,/ BUILDING STATISTICAL CLASSIFICATION SEWER MAP 6 ADDRESS v QK CLASS NO. DWELL•UNITS &,E::7BK PG,Q LOT NOE Q ! ��! O LOCK U E ZONE MAP NO TRACT �� SPECIAL NO.OF BLDGS CONDITIONS SIZE OF LOIICa,"67 NOW ON LOT USE OF EXISTING BLDG. BLDG,SETBACK FROM/G/_/eA/ GJN 5�. OWNE"AE �j] NOL/� /� FRONT PROP LINEOFC-`� �O -(STREET) C.•� "� [ TYPE OF EXISTING SETBACK HIGHWAY + YARD - TOTAL ADDRESS G 99HIGHWAY //WIDTH FROM C L CITY C BLDG.SETBACK FROM ARCHITECT OR TEL. SIDE PROP.LINE OF (STREET) ENGINEER NO. TYPE OFEXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C.L. TEL• + = a CONTRACTOR NO. CL ADDRESS Np CORNER CUTOFF YES ❑ NO LIC. G CITY CLASS 1 SEE REVERSE SIDE FOR SPECIA APPRMV LS CONSTRUCTION LEND Z NAME AND BRANCH G � r j ADDRESS E SO,j FT OF NO. OF NEW SIZE STORIES FAMILIES USE OF ADD STRUCTURE y ALTER ❑ SIGNATURE OF EPAIR❑ APPLICANT �l /DE�JM.O�L [jVALUATION $ APPROVALS DATE INSP C .R's 51 A URE v FOUNDATION: LOCATION P.0 {' FEE $ d - _�� FEE $ 3 06 �� FORMS, MATERIALS FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS A AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE- LOCATION, / WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS STRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY CI WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT. LABOR ODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COMPE SATION INSURANCE - LATH, EXT. 6 SIGNATURE I �, HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS FINAL PLAN CHECK VALIDATION0.- - M O cnsH _ JOHN F LEWIS PRINCIPAL STR URAL ENGINEER PERMIT VALIDATION CK M D CASH ` -ArI r'9 5 1 7 APR 2 2 •� 3 D 6 7.0 5 A , j D 15.75 v t�_ � b0 — APR 21g 1D 13 , E �„ WORKERS' COMPENSATION,DECLA RATION hereby affirm that I have a certificate of consent to self" APPLICATION F O R., B U I L D I N G PERMIT insure, or a certificate of Workers'Compempenstion Insurance, or a certified coy there f✓SeS_ 00, lab C COUNTY OF LOS ANGELES' BUILDING AND SAFETY Pal tc any, r• BUILDING /Certified copy s hereby furnished F.OR APPLICANT TO FILL IN ADDRESS L5(/0/';L- ❑ Certified copy is filed with the county building mspec- BUILDING Tio 'department �n' � ADDRESS LOCALITY �Applicant� j/ ) /F�a ��v� \ e Womi NEAREST Date CITY CROSS ST ' ERTIFI TE OF EXEMPTION FROM WORKERS' OF DGS ASSESSOR COMPENSATION INSURANCE SIZE OF LOT W LOT MAP BOOK PAGE PARCEL (This sechon'need not be completed if the permit is for one USE ZONE MAP C:;� .hundred dollars ($100)or less ) TRACT BLOCK LOT NO NO d CL ` TEL / SPECIAL y - _ - a 1 certify that in the performance of the work for which this OWNER NO CONDITIONS O permit is issued, I shall not employ any person in any manner .. DISTRICT GROUP TYPE FIRE PRO ESSED BY U so as to become sublect to Workers'Compensation Laws ADDRESS V CONST ZONE rx Date a Applicant CITY ZIP STATISTICAL CLASSIFICATION CPT CONDO U 'NOTICE TO APPLICANT If, after, making This Certificate of ; ARCHITECT-OR TEL W ENGINEER �vv�. NO CLASS NO DWELL UNITS CLExemption, you should become subject to the' Workers' #A 'Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP. _ with' comply with such provisions or this permit shall be deemed revoked CONTRACTOR TEL BK �PG;/0 VALIDATION LICENSED CONTRACTORS DECLARATION ' I hereby affirm that,l am licensed under provisions of Chapter 9 ADDRESA&T ON (commencing with Section 7000)of Division 3 of the Business and LIC _ Professions Code, and my'Itc" n is in full force and effect CITY fuQLllil1. CLASS $ SQ FT NO OF NO OF CHECK License Number Lic Class SIZE STORIES FAMILIES ONE (font ro / - at DESCRIPTION OF WORK NEW 17 ADD I am xempt from the licensing requirements as I am a {� �/{/� (� licensed architect or a registered professional engineer ALTERiit FINALIt— Lic acting in, my professional capacity (Section 7051, REPAIR DATEBusiness and Professions Code) USE OFFINAL DEMOL EXISTING BLDG BY4or Reg No "Date APPLICANT TEL OWNER-BUILDER DECLARATION PRINT)' Gtw� OZ / 0/O rY I hereby affirm that I am exempt from the Contractor's License ct. /.0// /f/ (/X Law for the-following reason (Section 7031 5, Business and ADDRES S Professions Code) PRESENT 'ET BUILDING I, as owner of the property, or my employees with ADDRESS /1 wages as their sole compensation,will do the work and LOCALITY �`5 6 v 0 A the,structure f'- snot intended or offered for sole,(Section 7044, Business and Professions Code) MOVING TEL 1, as owner of the property, am exclusively contracting CONTRACTOR, NO # 0 0 0 0 0 with licensed contractors to construct the project (Sec- ADDRESS 1 2}0'o' ,; 0 0 tion-7044, Business and Professions Code)- REQUIRED TOTAL SETBACK FROM EXIST 1 CONSTRUCTION LENDING AGENCY SET BACK YARD HWY' PROP LINE WIDTH o 0 0 5 2 0 0 I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which,this permit is issued PL b'=8 2 (Sec ,3097, Civ-C-•) SIDE PL Lender's Name Lender's Address P C Fee$ Permit Fee ✓ I certify that I have read,this application and state that the Issuance Fee i �0 f above information is correct I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, Q d and h e authorize rep this County to nter Total Fee p• upo t e ov._men neFprojoertr',inspectionjurposes \ SEE REVERSE FOR EXPLANATORY LANGUAGE, Signature of Applicant or Ag nt 'Dae - r ®s COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT I DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0509120018 PHONE (626) 285-0488 EXT l LEGAL ID NO OF CONST BUILDING ADDRESS TR 11131 LT. 15 BL 001 SQ FT STORIES TYPE 5612-GOLDEN WEST AV STRUCTURE 2500 VN TEMP CA 917802520 ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET: 8588-012-025, - - THOMAS PAGE 597 GRID A3 LOCALITY TEMPLE CITY, C TENANT EXIST BLDG USE RESID USE ZONE R-1 ISSUED ON PROCESSED BY EXPIRES ON EXIST OCC GRP 09/12/05 JK 09/07/06 OWNER TEL NO BLDGS NOW ON LOT VALUATION FIN]�L�TE FINAL VAN ETTEN, GARY (626) 285-5996- 7,000 5612 GOLDEN WEST AV " TEMP 917802520 FEES PAID DESCRIPTION OF WORK REMOVE EXISTING ROOF, INSTALL 1/2° CDX 30 FLET AND 40 YR FEE DESCRIPTION QUANTITY UOM AMOUNT ELK CLASS A COMPOSITION SHINGLES 4 SF. FLAT HOUSE AND GARAGE APPLICANT: TEL NO J N DAVIS ROOFING (626) 815-1279- AA BLDG PERMIT ISSUANCE 27 75 235 E COLORADO BL AC STRONG MOTION RESID 7000 00 VAL 0 70 SPECIAL CONDITIONS PASADENA, CA 91101 D2 PERMIT W/O EN-HC 7000 00 VAL 166 20 TOTAL FEES 194 65 CONTRACTOR TEL NO. APPROVALS DATE INSPECTOR SIGNATURE J N DAVIS ROOFING (626) 815-1279- 235 E COLORADO BLVD #202 LIC NO LOCATION AND SETBACKS PASADENA, CA 91101 57212SC39 SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER. TEL NO FOUNDATION/TRENCH FORMS LIC NO SLAB UNDER FLOOR RAISED FLOOR FRAMING MAP NO SEWER MAP BOOK- PAGE FIRE ZONE CMP UNDERFLOOR INSULATION 147H269 3 01 FLOOR SHEATHING NO OF FAMILIES DWELLING UNITS APT COND STAT CLASS NO 21 ROOF SHEATHING SCHOOL WITHIN HAZARDOUS 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- INSULATION/WEATHER STRIP SIDE PL- INTERIOR LATH/DRYWALL EXTERIOR LATH i RATED FLOOR/CEIL ASSEM RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS * ADDITIONAL DATA ON FILE ` LOT DRAINAGE REPORT ID DPR261 ROUTE TO BS0508