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Home My Public Portal About5716 GOLDEN WEST AVE_Building__ DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERbUT COUNTY OF LOS ANGELES Ilk 8 Ankh, WM. J. FOX. CHIEF ENGINEER FOR APPLICANT TO FILL IN /' FOR OFFICE USE ONLY DISTRICT NO. PLANCK.NO. ' ERMIT NO. BUILDING ,4_/ ADDRESS LOCALITY , RECEIVED BY DATE OF APPL DATE ISSUED IrNEAREST BUILDING �tt N f OWNER ADDRESS %S MAIL , ADDRESS LOCALITY NEAREST 1 ^ 1 NO. 0: g CROSS ST. lo► e FIRE NO.OF ® TYPQ ROUP ARCHITECT 09 TEL. ZONE PLANS 6d ENGINEER f NO. BLDG. - '-e c' / Da No. A DREG® SETBACK LINE T / L.r APPROVED CONTRACTOR / No. SY D(AT[ _ - USE APPROVED ADDRESS ZONE9Y DATE LEGALd��0 Oct CORRECTIONS a '� DESCRIP/[TIION LOT NO. BLOCK TRACT 'A -0) -- J-/ -�T' y -�NO.OF BLDOS. SIZE OF LOT /d /� Q I NOW ON LOT UBE OF NO.OFNO.OF EXI TING,BLDG. FAMILIES ROOMS DESCRIPTION OF WORK }( NEW j ALTERATION ADDITION \ O A REPAIR MOVING DEMOLISH or SIZE Q Q NO. M9 - ROOMS STORIES WALL +f ROOF Fir^ COVERING �/vCG cs COVERINGUSEOF BUILDIN NEW / zz I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION INSPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS.MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE STOPS. SIGNATURE Or BRACING,BOLTS PERMITTE LATH, INT. AUTHORIZED AOT LATH, EXT. 76A639A-3 2-50 $ ` �/� P.C.8 PLASTER,INT. ��•i/, FEE % PLASTER.EXT. VALUATION ®� FINAL s,..,eoyA), FEE WORKERS' COMPENSATION DECLARATIONI herey affirm that I have a certificate of consent to self - insure, or a certificate of Workers' Compensation Insurance, A P P L I CATI PM, FOR �BUILDING.-PERMIT ora certified copythereof (Sec 3800, Lab C ) ,;• COUNTY'OFLOS ANGELES " ' BUILDING AND,SAFETY Policy No Company " " ❑ Certified co is hereby furnished FOR APPLICANT TO FILL IN BUILDwG PY Y r t / ADDRESS ❑ Certified copy is filed with the county building,inspec- BUILDING J (4 OL Aft. do department. Date rsr r^ \ 't CITY L, ZIP LOCALITY « ppO OF BLDG CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT NEARESCROSS ST r y r COMPENSATION INSURANCE ° u ASSESSOR' (This section needrnot be completed if the permit is for one, TRACT BLOCK LOT NO MAP BOOK' _ *' PAGE PARCEL hundred dollars ($100) or less.),°'_ TEL{ „ `• ,,, 4 OWNER' Vv a' NOL D A�� USE ZONE MAP I certify that in'the,performance-of the work for which this NO permit is issued,,)shall,not employ,any person in,any.manner ADDRESS C AV Z SPECIAL so as to become subject to the,Work CONDITIONS --� I ers Compensatiori Laws �,/ �� ._ -_ O ' - CITY �1 f Ll: �(T ZIP / U Date Applicant ARCHITECT OR TEL DISTRICT' 'GROUP TYPE 'FIRE P�ESSED11Y,,,", Q NOTICE TO APPLICANT If, after making this-Certificate of ENGINEER NO " '" CONST ZONE U Exemption, you ,should become subject to the Workers' Q Compensation provisions of the Labor Code, you must..forth- ADDRESS ( �✓ % w w with comply with such provisions or this permit shall be TEL STATISTICAL CLASSIFICATION. APT CONDO W N deemed revoked CONTRACTOR NO. �/ / Z' « - LIC' -CLASS-NO DWELL UNITS — �- _ LICENSED CONTRACTORS DECLARATION ADDRESS NO I hereby affirm that I am licensed under provisions of Chapter 9 SEWER MAP « (commencing with Section 7000)of Division 3 of the Business LIC and Professions Code,and my license is in full force and•effect. CITY CLASS BK _� t: VALIDATION SQ FT NO OF NO OF CHECK License Number Lc Class SIZE STORIES FAMILIES ONE VALUATION v DESCRIPTION OF WORK NEW u•(y-d Contractor Date s& , O ° ADD ❑ ► N i ❑I am exempt under Sec • ,ALTER. ❑ •• � - B BP.0 for this reason ' REPAIR ❑ ; USE OF Date' � EXISTING BLDG � 'WWW DEMOL ❑ - ` - > • Signature APPLICANT i l. g OWNER-BUILDER DECLARATION (PRINT) -- NO , FINAL 'L r� /� < , DATE I hereby affirm that I am exempt from the Contractor's License `; ADDRESS N tet"L'�z �� V Lk" s N Law for the following reason_ (Section 7031 5, Business and FINAL 1; P(of Bions Code) - PRESENT By ttT e ,I, as owner of-the ro ert ''or m employees with - BUILDING p L � A�•4 1 °re"� p P. Y. YADDRESS _ wages as their sole compensation,will do-the work and 3303 _ 175.b5 the structure is not intended or offered for sale(Section LOCALITY rr�C' 7044, Business and Professions Code ) MOVING TEL' �1: �. 1 ITEC ' CONTRACTOR NO. t • h .I '` - e ❑ I, as owner of the property, am exclusively contracting i >c 5 TOTAL' 1' _s with licensed contractors to construct the project (Sec- ADDRESS ;tion 7044, Business and Professions Code )' '' ' - CHECK� 7 5 REQUIRED TOTAL SETBACK FROM `AEXIST GHEt•K 17 ,°� i CONSTRUCTION LENDING AGENCY, SET BACK - YARD HWY PROP LINE WIDTH I hereby affirm that-there is,a construction lending agency for FRONT CHANGE' °L.I!_i the performance of the work for which this permit is'-issued P L j; r (Sec 3097, Civ C ) SIDE Lender's Name p 0000-0001 6/ 619,-', P C Fee SPermit Fee 15. . LDMA Ref # 677 a 1 i -"AN 9s Lender's Address76 t.i a I certify that I have read this application and state that the Issuance Fee f LDMA P/C# , o _ above information is correct I agree to comply with all County Investigation Fee_ L 8 ordinances and State laws relating to'building construction, Total'Fee /. �✓ i LDMA Perm # Q and hereby authorize representatives of this County to enter m -upon the above-mentioned property for'inspection Pyr � . / ^ Fz�c: A 1"-)7' G j[iL Y SEE•REVERSE FOR EXPLA_NATORY LANGUAGE ; Signature of Applcant or Agent -Date - ' CO,JNTY 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 1312100031 PHONE (626) 285-0488 EXT ILEGAL ID. I NO OF CONST BUILDING ADDRESS ITR 6561 LT 458 1 SQ FT STORIES TYPE 5716 GOLDEN WEST AV I (STRUCTURE V-B TEMP CA 917802503 (ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET LAS TUNAS 1 18587-028-021 1 THOMAS PAGE 597 GRID A3 LOCALITY TEMPLE CITY CAI ITENANT - IEXIST BLDG USE: RESID USE ZONE R-1 JISSUED ON PROCESSED BY IEXIST OCC GRP 112/3'0/13 SR JOWNER TEL NO: IBLDGS NOW ON,LOT VALUATION 1F A:� DATE FINAL BY CODE 1 ILAN, MING-CHEN (626) 309-0727- 1 500 15716 GOLDEN WEST AV ITEMP 917802503 FEES PAID 1D SCRIP ION OF WORK 1 IBATHROOM REMODEL 1 !FEE DESCRIPTION QUANTITY UOM• AMOUNT 1 JAPPLICANT: TEL NO- I ISAME AS OWNER - IAA BLDG PERMIT ISSUANCE 27 80 I 1 JAB STATE GREEN BLDG FEE 500.00 VAL 1 00 ISPECIAL CONDITIONS I JAC STRONG MOTION RESID 500.00 VAL 0 50 1 JB2 PERMIT W/ENERGY 500.00 VAL 48.10 1 TOTAL FEES 77 40 I 1 ICONTRACTOR. TEL NO 1 IAPPRCVALS DATE INSPECTOR SIGNATURE 1 ISAME AS OWNER - I I LIC NO ! ILOCATION AND SETBACKS I I I I I ISOILS ENGINEER APPROVAL 1 1 JARCHITECT OR ENGINEER TEL NO I FOUNDATION/TRENCH FORMS I J LIC NO SLAB/UNDER FLOOR JRAISED FLOOR FRAMING IMAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP J UNDERFLOOR INSULATION 3 001 1- I FLOOR SHEATHING INO OF FAMILIES DWELLING UNITS APT/COND STAT CLASS 1 NO 21 1 1ROOF SHEATHING 1 SCHOOL WITHIN HAZARDOUS ISHEAk PANELS JAIR QUALITY 1000 FEET MATERIALS 1 NO NO NO I J FRAIIiE INSPECTION I IFIRE SPRINKLER HANGERS I I I I I I JINSULATION/WEATHER STRIPI I I 1 JINTERIOR LATH/DRYWALL I 1 I (EXTERIOR LATH I 1 I IRATED FLOOR/CEIL ASSEM I J I J J IRATED WALL ASSEMBLIES I 1 IRATED SHAFTS/OPENINGS J I I I I I I IT-BPR CEILINGS ILOT+DRAINAGE I I IREPORT ID DPR261 ROUTE TO BS0508 I I I I I I