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Home My Public Portal About5632 GOLDEN WEST AVE_Building__ - APPLICATION FOR BUILDIN-G� PERMIT = :1 FOR APPLICANT•TO FILL IN (Print or type only) ;= _i tiff BUILDING r BUILDING _ ADDRESS c ADDRESS �LE CITY ZIP . LOCALITY NO.OF BLDGS ,SIZE OF LOT NOW"ON LOT NEAREST CROSS ST a x: ASSESSOR TRACT � BLOCK . LOT NO MAP-BOOK PAGE PARCEL) /� TEL STI RICT GROUP TYPE FIRE ROCESSED BY OWNERlER NO {� t CCdt�'�\.�� NE ADDRESS .->t/.+.� I •' STA+TISTICAL L 81FICATION-_='1, SEWER AP Mg_ CITY '� .ZIP . ' t. ASS NO .DWELL UNITS -' BK PG ARCHITECT OR _ �_.., TEL ENGINEER NO US E MAP NO ADDRESS - - - � SPECIAL • N ROAD TEL '` CONDITIONS .CONTRACTOR E -• AD DEPARTMENT A707t5VAL REQUIRED, LIC. S� - 'ADDRESS NO BLDG SETBACK FROM- LIC • FRONT PROP•LI NE OF CLASS CONSTRUCTION LENDER HIGHWAY } YARD = TOTAL SETBACK FROM TYPEtOF EXISTING FRONT+PROP LINE HI HWAY WIDTH NAME AND BRANCH. ADDRESS' - "�""�`_ CITY SQ FTu NO.OF ' NO OF CHECK BLDG'SETBACKFROM - C) SIZE / STORIES s - -FAMILIES- ONE SIDE PROP. LINE OF (STREET) NEW '❑ HIGHWAY } - YARD _ TOTAL SETBACK FROM TYPE OF EXISTING O DESCRIPTION OF WORK E r - SIDE PROP LINE HIGHWAY •WIDTH U 5 / // ADD. } LTER ❑ Z T — Pf�AIR❑ - CORNER CUTOFF '_ .-YES ;., NO r❑. _ _ 'USE OF EXISTING BLDG qCZ EMOL ❑ IN OPEN SPACE. - ,v r,,YES ❑ _,. NO ,❑ APPLICANT .rr, TEL y� IN COASTAL•ZONE YES ❑ NO ❑ (PRIN,T),' 4. R NO.� PYA L BY (SIGNATURE) ENVIRONMENTAL CATEGORI CAL EXEMPTION YES ND E]% a IMPACT EXEMPTION DECLARATION SIGNED - (DATE) VALUATION i' IMPACT REPORT PROCESSED (DATE) I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION - - AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION• I CERTIFY 'THAT IN DOING THE WORK AUTHORIZED _ 'r HEREBY I 'W ILL HOT EMPLOY ANY PERSON,IN VIOLATION OF THE �'•t•""<<- ''. ' , _�I M' _ LABOR CODE OF 'THE STATE OF CALIFORNIA IN RE ATING'TO "��,Y �. f , '••x,w,y '*� ^+r_ WORKMEN'S CO MPE NSATI INS URANC SIGNATURE OF FINAL,+ `' BY Q,_- j�• _ •� - - PERMITTEE DATE ---- 'i /f/� /�''/f ��—n_ /I •'- ' ADDRESSxP C. $ � MT. • - ^.x P - FEE D FEE �� { �•_� TELj CITY -14 /� N O. + -G 2-(a L� 'PLAN CHEC " VALIDATION CK CASH ' PERMIT VALIDATION CK" M O CASH r 76A638B.,CE*803A 5/73 'iA'PPLICATION, FOR, BUJ LDING P,ERMIT'. .- - ,,FOR APPLICANT ITO FILL'IN;'.(Print or type only) 1` BUI L I N 4 `' + L COUNTY OF,LOS ANGELES ;r-• , DEPARTMENT O .COUNTY ENGINEER` ' r BUILDING SA Y .DIVISION• ' CITY ` V - ZIP .. NO BLDGS BUILDING 'S'IZE OF LOT - _ NOWON LOT ADDRESS �✓ .0- .i TRACT J BLOCK f LOT N_O" l' LOCALITY °. 'NO NEAREST L _ OWNER �_ + r TE7, CROSS�ST o- �Ce"•: x+, ASSESSOR,. ADDRESS L'r MAP BOOK, t PAGE ' _ PARCEL' ' "v.4 DISTRICT 1;GROUP TYPE x' E SSEO-BY CITY , , + "ZIP^ - - r.{/1�• QQ_ JCON ARCHITECT OR ' _TEL. - „V IJ ' „L v v ENGINEER NO STATISTICAL'CLASSIFICATION`,_' SEWER NIAP J _ 'ADDRESS"--- - �- - k= '` 'Y �'CLASS•NO.. DWELL UNITS - "BK, PG” a TEL . CONTRACTOR NO US ONE MAP, a. _ LIC. NO ;,ADDRESS - NO. + .�( SPE A •• ,�, �.' _ -- + v LIC'-ry I! CONDITIONS • ' `.+_• - CITY, CLASS' a RO AD'DEPA�RTMENT"APPROVAL REQUIRED"' 'YES NO = CONSTRUCTION LENDER NAME AND BRANCH BLDG'SETBACK FROM -- ' FRONT PROP L'INEOF• (STREET) ADDRESS - ,o.' CITY- . ,SQ, FT ,NO O - , NO. OF. CHECK HIGHWAY- }. ;YARD TOTAL SETBACK FROM TYPE`OF EXISTING + z „FR ON,T,,PROP LINE SIZE STORIFES'' FJES f 'ONE'; - HIGHWAY WIDTH •DESCRIPTION OF W10RK- BLDG;SETBACK ADD FROM _ STREET) E SIDE•PR'OF':LINE OF '• '� ' ElO (� LTR HIGHWAY +'} "`YARD = TOTAL,SETB-ACK FROM TYPE OF EXISTING C. REPAIR i SIDE PROP LINE, HIGHWAY WIDTH LLI C/) M- USE OF _ + .'} a". ,K4 = _ .. Z EXISTING BLDG. EMOL 0 ' A PPLICA'NTEL " CORNEOR`CUTOFF YES,• I NO 0 ' (PRINT) _ 7 N0. ... _ c BY (SI GNAT_UR IN QPE+N;Sp_ACE,' {„_4 YES,[:] NO COASTAL`PERMIT.ZONE El' , VALUATION) s �Q " . - ;� - -•" - � I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION + AND STATE»THAT THE ABOVE-IS CORRECT AND,AGREE,-TO COMPLY' - ;o �. - .-.• +', - ` WITH ALL ORDINANCES AND.LAWS 'REGULATING BUILDING ,CON- STRUC,TIONII ' CERTIFY IN DOING THE WORK AUTHORIZED 'HEREBY I WILL NOTYEMPLOY`ANY=TERSON IN VIOLATION OF THE LABOR CODE _ NE.STATE OF CA NIAyIN R TINNG_ TO WORKMEN'S C PE ATION INS U, A , SIGNATURE PERMITT.EE - - _ ,1 FINAL' - ,� •.' 1 BY TEL CITY, NO. DATE 'PMT,QQ °` 61AKE'CHEC S A}'ABLE, TO FEEP.0f• FEE'H HARVEY T. BRANDT, COUNTY ENGINEER " PLAN CHECK VALIDATION CK M O CASH PERMIT, VALIDATION. CK CASH I _ 78A838A CE#803 5/74 x + WORKERS' COMSATION DECLARATION hereby affirm that^I have a certificate of.consent to self A P P L I CAT I O I�1 F O U I L D I N G PERMIT_ Insure, or a certificate of Workers'Compenstistion Insurance, or , o certified copy thereof (Sec 3800, Lob C ) �^, COUNTY OF LOS ANG LE ' BUILDING AND SAFETY. PolicyNo_19D3/ Company J"IAM 4!;! /u; El Certified copy.a hereby furnishedFOR APPLICANT TO FILL IN ADDRESS Certified copy is filed with the county-building inspec- BUILDING // tion department ADDRESS C� LOCALITY, NEAREST ::r Date"Jr'L7�G Applicant CITY C ZIP, CROSS ST CERTIFICATE OF EXEMPTION FROM WOR S', NO OF BLDGS ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one USE ZONE MAP hundred dollars ($100)or less ) TRACT BLOCK LOT NO TEL SPECIAL l a I certify that-in the performance of the work for which this OWNER NO ' OaG3 ! CONDITIONS V permit is issued, I shall not employ any person in any manner - DIST ICT GROUP TYPE FIRE PR ESSED BY, ADDRESS S - (JL CONST ZONE so as to become subject to the Workers'Corripensation Laws iB O Date "� U Applicant CITY ZIP STATISTICAL CLAS CATION APT• CONDO' pp ARCHITECT OR TEL NOTICE TO APPLICANT If, after- making t Certificate of W Exemption, you should become subject to the -Worker's' ENGINEER NO CLASS NO IN UNITS N Compensotion,provisions of the Labor Code, you must forth- ADDRESS SEWER MAP Z With comply with such provisions or this permit-shall be TEL 1 deemed revoked CONTRACTOR NO yy y BK PG;, VALIDATION LICENSED CONTRACTORS DECLARATION LIC I hereby affirm that I am licensed under provisions of Chapter 9_. ADDRESS NO VALUATION ,(commencing with Section 7000)of Division 3 of the Business and / LIC D� Professions Code, and my license is in full force and effect CITY C el ,, C t - CLASS $ ?t, 'f R SQ FT NO OF / NO OF CHECK License Number J ?1 18°2 r Lic Classes SIZE, STORIES / FAMILIES ONE _ $ Contractor 61N&-AA-C__ Date 8 31 DESCRIPTION OF WORK �cd�C�J NEW ❑ / ElI am exempt from the licensing-requirements as I am a ADD d �Qi � licensed architect or a registered professional engineer ALTER ❑ FINAL actin in m professional, capacity Section 7051, DATE 9 Y P - P Y ( - REPAIR ❑ Business and Professions Code) USE OF DEMOL .❑ FINAL EXISTING BLDG ( - By ; ;\ Lic or Reg No Date APPLICANT TEL i OWNER-BUILDER DECLARATION i (PRINTIK�) !4 & NO LiZ I hereby affirm that I am exempt from the Contractor's License 'ADDRESS- �S�S �' -7 � Law for the following reason (Section 7031 5, Business and , Professions Code) PRESENT ❑ BUILDING ;2,5 2'11 'A I, as owner 'of the property, or my employees with ' ADDRESS wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY - # 0 0 0•o"0 1 7044, Business and Professions Code) - MOVING TEL �- j; as owner of the property, am exclusively contrlocting CONTRACTOR NO :2;-•1 0;61 0 01 with licensed;contractors to construct the project (Sec- o o = tion 7044, Business and Professions Code) ADDRESS // I 1 Q,6 Q Q v REQUIRED TOTAL SETBACK FROM EXIST CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP LINE WIDTH 051, 41 -8 1, I hereby affirm that there is a construction lending agency for iFRONT the performance of the work for which this permit is issued P L (Sec 3097, Civ C ) SIDE,- , IDES , . I P L Lenders Name _ _ _- _ ti �f'• Lender's Address- P'C Fee$ Permit Fee w I certify,That I have read this application and state that the, Issuance Fee above information is correct I,agree to comply with all County nvestigation Fee ordinances and State jaws relating to building construction, (F D ------ 0 and pheby authorize representatives of this County to enteTotal Fea "'uponb me toned property for inspection purposes a SEE REVERSE FOR EXPLANATORY LANGUAGE a Signature of; ant or Agent Date Os 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 BL 0508 0404060013 PHONE: (626) 285-0488 EXT: I-EGAL ID: 0. OF CONST BUILEYING SS: TR: 11131 LT: 18 SQ. FT STORIES TYPE 5632 GOLDEN WEST AV STRUCTURE: 2000 VN TEMP CA 917802520 ASSESSOR INFORMATION N NEAREST CROSS STREET: LIVE OAK 8588-012-028 _ -- THOMAS PAGE: 597 -GRID,: A3•x. LOCAL ITY:JEMPLE CITY, C TENANT: EXIST BLDG SID NE: IS PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 04/06/04 VG 04/01/05 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL D E FINAL BY: CODE: VIZCARRA FERNANDO L;JOAN B (626) 287-0263- 3,000 5632 GOLDEN WEST AV 2 TEMP 917802520 FEES PAID DESRR,IPTIOW OF WORK T/0 EXIST ROOF, REPAIR SHEATHING AND INSTALL YR COMP _ FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RESID 3000.00 VAL 0.50 SPECIAL CONDITIONS: D2 PERMIT W/O EN-HC 3000.00 VAL 99.00 TOTAL FEES 127.25 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO LOCATION D SETBACKS SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: . NO:. FOUNDATION/TRENCH FORMS LIC. NO: SLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP NO: SEWER MAP, BOOK: PAGE: FIRE ZONE: CMP,: UNDERFLOOR INSULATION XX 3 01 OCR SHEATHING N0. OF ILIE DWELLING UNITS: /GOND: STAT CLASS: NO 21 ROOF SHEATHING CH50 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- � IN ERIOR LATH/DRYWALL i EXTERIOR LATH M RATED,FLOORICEIL ASSEN. RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS LOT AINAGE REPORT ID: DPR261 ROUTE TO: BS0508 i -