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HomeMy Public PortalAbout5723 GOLDEN WEST AVE_Building__ 76A638A CE#8031-62 APPLICATION FOR BUILDING PERMIT �l COUNTY OF LOS ANGELES BUILDING I-- DEPARTMENT DEPARTMENT OF COUNTY ENGINEER ADDRESS c9 BUILDING AND SAFETY DIVISION LOCALITY -� d r'YL /r, C, , JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A JENSEN, SUPT OF BUILDING CROSS ST (--- DISTRICT NO GROUP TYPE ESSED BY FOR APPLICANT TO FILL IN R r / CONST F G STATISTICAL CLASSIFICATION . WER MAP �' CLASS NO DWELL UNITS J�'� BLOCK WATER NOT REQUIRED ❑ RECEIVED ❑ CERTIFICATE _ MAP HIGHWAY NO OF BLDGS NO �U (CIRCLE) STATE MAJOR SECOND, OCA OT NOW ON LOT USE ZONE SPECIAL • f CONDITIONS BLDG (, TEL OWNER NO BUILDING EXIST SETBACK YARD HWY NAYE WIDTH ADDRESS �Qy- FRONT ARCHITECT OR TEL P L ENGINEER - NO SIDE P L 4. ADDRESS �1 TEL CONTRACTOR4. NO ADDRESS Q DESCRIPTION OF WORK LLI a ' N NEW HADD ALteR REPAIR DEMOLISH Z SQ FT - NO OF NO OF SIZE STORIES F MILIES USE OF STRUCTURE SIGNATURE O APPLICANT VALUATION $ © a , APPROVALS DATE INSPECTOR'S SIGNATURE PC ^_ PMT % SQ FOUNDATION ON FEE FEE FORMS, MATERIALS FRAME FIRE STOPS. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION I WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS ! �jJ 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 CODE OF THE STATE OF CALIFORNIA RELAT. ING TO WORKMEN S COM LNSATION INSURANCE I LATH, EXT ;k' SIGNATUR HOUSE NUMBER COR- PERMITT RECT AND POSTED ADDRESS ^ FINAL 6 n� PLAN CHECK VALIDATION CK MO CASH JOHN F LEWIS PRINCIPAL STIR URAL ENGINEER PERMIT VALIDATION cK M O CASH Lo 4 2 9 7� SEPI 3 1 D 1 15 0, b APPLICATION .FOR BULING PERMIT ,l COUNTY OF LOS ANGELES " 5� BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS I hereby'affirm that I have-a certificate of consent to self Insure, BUILDING ADDRESS' et i or a certificate of Workers.Compensation Insurance,or a certified copy thereof(Sec 3800,Lab C) CITY---- ZIP ZIP :. p LOCALITY Policy No e Company / Q SIZE OF LOT.C" - NO OF BL S NOW ON LOT I] Certified copy is hereby furnished V0 X NEAREST CROSS ST ❑ Certified copy is flied wd_h the county,bulldmg Inspection TRACT BLOCK LOT NO department' USE ZONE MAP NO Date Applicant ASSESSOR BOOK" PAGE PARCEh / 3 CfJ(� SPECIAL CONDITIONS' , CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER 1 1 TE NO _ COMPENSATION INSURANCE 41/ T�' d D� WITHIN 1000 FT OF-SCHOOL9 YES No (This section need not be completed if'the permit is for one hundred ADDRESS r� v DISTRICT GROUP TYPE CONST FIRE ZONE 'PROCESSED BY dollars($100)or less) I certify that In the performance of the work for which this permit CITY ye ZIP Is'sssued, I shall not employ any person in any manner so as to ARCHITECT ORE GWEER - TEL NO L -r✓ becGRle ^b)eC to the Workers'Cp SatiO STATISTICAL CLASSIFFFFKATION APT CONDO Date7M %Applicant ` ADDRESS - CLASS NO DWELL UNITS NOTICE TO APPLICANT If, after making his Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CONTRACTOR J TEL NO SET BACK YARD HWY PROP LINE 'WIDTH Compensation provisions of the Labor Code, you must forthwith FRONT comply with such provisions or-this permit shall be deemed revoked ADDRESS LIC NO P L } SIDE a LICENSED CONTRACTORS DECLARATION CIT LIC CLASS PL .0 1 hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SO FT SIZE NO OF STORIES NO OF FAMILIES 0 Professions Code,and my license is in full force and effect NEW ❑ BK PG F- DES IPTION OF WORK - VALUATIONOil. U License Number Lie Class , ADD ❑ W Contractor Date ALTER $ don• IZ (n ❑ I am exempt under Sec rG REPAIR ❑ Z BBPC for this reason �G��_,G DEMOL ❑ LDMA P/C# s Date USE OF EXISTING E36CG v URM ❑ ^ 23 Signature APPLICANT(PRINT) ,J Ill TEL NO ��� LDMA Perm# �° ACC a ❑ I, as,owner of the property, or_my employees with wages as Z their sole compensation, will'do the work and the structure Is ADDRESS 1._ �f >> )� 0 33)I3 ; _ 50.50 not intended or dffered for sale (Section 7044, Business and �3 /�►• /��% W�S�' FINAL DATE Q Professions Code) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL �, _ a . 1 OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER_THAN THE _ C3 i, as owner of the property, am exclusively contracting > r AC'C' •r licensed contractors to construct the project (Section 70444,4, AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDES FINAL BY- T°g• Business and Professions Code) YES El -NO 11I�J' 1 r8°3 J WILL THE'INTENDED USE OF THE BUIOLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR ITEMS GUIDELINES _ _ - _ I hereby affirm that there is a construction lending agency for YES❑ NO❑" - - 'TOTAC ® , the performance of the work for which this permit is issued(Sec HAVE READ THE HAZARDOUS MATERIALSINFORMATION GUIDE AND THE SCAQMD PERMITTING t•�" 1 C 3097,CIV C) _ CHECKLIST I UNDERSTAND MV REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, - CHECK 20 f°3 TITLE 2 CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS CHANGE Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD V.'i-IFiIYVG °00 to Lender's Address Q OWNER OR AGENT I certify that"I have read this application and state under penalty a PC FEE _ PERMIT FEE (}000-000 23/ 0 of'pequry that the above Information is correct I agree to comply SQ 1 113 qi U) with all county ordinances and State laws relating to building' D• f o? i chi M construction, and• reby authorize representatives of this County - ISSUANCE FEE 30 - 7.�7 y 1 f'r I 6.'27. to on t ve-mentioned property for Inspects n p1goses t`I - INVESTIGATION FEE -' TOTALc\J XSUN B M DHIe d .J SEE REVERSE FOR EXPLANATORY LANGUAGE i WORKERS' COMPENSATION DECLARATION { WPPLICATION hereby affirm that I havecertificate of consent to self 1, FOR BUILDING "PERMITinsure, 'or a certificate of Worr kers' Compensation Insurance, 0r,p certified copy thereof (Sec 3800, Lab C ) COUNTY OF LOS ANGELES r BUILDING AND-SAFETY J,/ Policy No Company BUILDING 1:1Certified copy is hereby furnished FOR APPLICANT FILL IN ADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING tion department ADDRESS LOCALITY ��11 NEAREST Date Applicant CITY ZIP o CROSS ST CERTIFICATE OF EXEMPTION FROM WORKERS' OF BLDGS ASSESSOR COMPENSATION INSURANCE SIZE OF LOT lowON 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 BIqQK LOT NO NO TEL 0,6 SPECIAL IL I certify that in the performance of the work for which this OWNER NO CONDITIONS permit is issued, I shall not employ any person in an manner DISTRICT GROUP TYPCONST E FIRE PRO SSE BY U so to become subject to the Work pen do L s ADDRESS l 09 Da Applicant CITY yLCC ZIP / STATISTI-A CLASSIFICATION APT ]CONDO F- N TICE TO APPLICANT If, after making this Certif ate of ARCHITECT OR TEL U ENGINEER NO CLASS NO DWELL UNITS LU Exemption, you-should become subject to the orkers', 0. Compensation provisions of the Labor Code, you must forth- ADDRESS — SEWER MAP with comply with such provisions or this permit shall be _ z deemed revoked CONTRACTOR TEL j TE _ BK PG, VALIDATION LICENSED CONTRACTORS DECLARATION I - I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS O/ ' VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC Professions Code, and my license is in full force and effect CITY CLAS Poo. FT NO OF NO OF CHECK 'i License Number 1 is Class SIZE ;20 STORIES FAMILIES ONE $ i�R . � Contracto f�� .�iziY9►tate DESCRIPTION OF WRe Al AD E] I am exempt under Sec ALTER ❑ FINAL B BP.0 for this reason REPAIR O DATE �� USE OF FINAL - Date- EXISTING BLDG- DEMOL. ❑ By, �1 Signature APPLICANT TEL OWNER-BUILDER DECLARATION - PRINT NO 1 hereby affirm that I am exempt from the Contractor's License• ' a t ��� Law for the following reason (Section 7031 5, Business and ADDRESS Professions Code)- BUILDING ! ❑• 1, 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 7044, Business and Professions Code). MOVING TEL P 1 ,5 0 A I, as owner of the property, am exclusively contracting CONTRACTOR NO with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code) 2 0 1 0 6 1 3 REQUIRED TOTAL SETBACK FROM EXIST ' CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT , ° 0 1 0 5 1 3 the performance of the work for which this permit is issued P L " (Sec 3097, Civ C ) SIDE m PL Lender's Name PC Fee$ Permit Fee Lender's Address 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 Investigation Fee ordinances and State laws relating to building construction, Total Fee d and h -by authorize representatives of this County to enter up t a ove- n ed roperty for inspection purposes ' SEE REVERSE FOR EXPLANATORY LANGUAGE - y •_ Signature of Apph nt or Agent Date ®s COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD/ALT/REP BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0303050002 PHONE: (626) 285-0488 EXT: - LEGAL G ADDRE TR: 6561 LT: 462 SQ. FT STORIES TYPE OCCUP GROUP 5723 GOLDEN WEST AV STRUCTURE: 1099 1 VN R3 TEMP CA 917802504 ASSESSOR 0 A GARAGE: NEAREST CROSS STREET: LIVE OAK 8587-023-006 OTHER: THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY EN L G _USE: USE ZONE: ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 04/16/03 JK 04/10/04 OWNER: TEL. BL GS. NOW ON LO VALUATION: FINAL DATEF L C_ ODE: ZOVAK PETER;JOANNE - 87,000 5723 GOLDEN WEST AV TEMP 917802504 FEES PAID OF WORK- ADDITION OF 2BDRM, 2BATH, LAUNDRY & FAMILY RM (TTL WHEN DONE FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 4BR/3BA) PP EL. O'LEARY; TOM (626) 287-0927- B1 PLANCHECK W/ENERGY 87000.00 VAL 1,091.28 5823 AGNES AVENUE AA BLDG PERMIT ISSUANCE 27.75 SPECIAL CONDITIONS: TEMPLE CITY AC STRONG MOTION=RESID _ -87000.00 VAL 8.70 82 PERM IT.W/ENERGY -- _87000.00 VAL 1,283.87 t TO87000.00 2,411.60 °� k�'� • , CONTRACTOR: DATE NSPE R SIGNATURE AC OR: TEL. NO: TOM OILEARY CONSTRUCTION (626) 287-0927- 5823 87-0927 5823 AGNES AVENUE LIC. NO LOCATION AND SETBACKS TEMPLE CITY, CA 91780 489354 B-1 21 SOILS ENGINEER APPROVAL R 0 r� �'r'J� �1�� ` �.� T 0 FOR LIC. N0, TT., ill �; j - i SLAB/UNDER FL00 i � �v'11 RAISED FLOOR FRAMING MAPSEWER MAP B0O FIR CMP:. �� UNDERFLOOR INSULATION 1ST LEVEL FLOOR SHEATH NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLT§'S-.-- NO 2ND LEVEL FLOOR SFMH SCHOOL WITHIN HAZARDOUS �`,� ` /� - _ r ROOF H AIR QUALITY: 1000 FEET MATERIALS NO NO NO �� �_ ;,/; „i DEPT. FRARE SPECT RED A XIS it ���� G PT. NS SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL SHEPANELS SIDE PL- = A R -71 g INT R LA YWALL EXTERIOR LATH � r LOT DRAINAGE SMOKE DETECTION DMU-9- E DEPARTMENT APPROV REPORT ID: DPR261 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS r ' 9071 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9711200088 PHONE: (818) 285-0488 EXT: LEGAL 0. OF CONST BUILDING : TR: 6561 LT: 462 SQ. FT STORIES TYPE 5723 GOLDEN WEST AV STRUCTURE: 0 VN TEMP CA 917802504 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 8587-023-006 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY TENANT: EX S BL G USE: USE ZONE: ,R-1SSU ON: PROCESSED . (EXIST OCC GRP: 11/20/97 UT 11/20/98 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL CODE: ZOVAK PETER;JOANNE I 1 3,000 /Z12 5723 GOLDEN WEST AV L TEMP 917802504S PAID DESCRIPTION OF/WORK REMOVE AND RECOVER WITH 1/2' PLYWOOD, 25 YR. DEM. COMP. IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: SHINGLE 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' X3000.00 VAL 99.15 � L lE%jj ;/ 'j 127.40 CONTRACTOR: TEL. NO: v®� APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO C-1 LOCATION SETBACKS SOILS, ENGINEER APPROVAL ARCHITECT OR GINE . NO: 0 ON/TRENCH LIC. N0: SLAB/UNDER FLOOR tttttt RAISED R FRAMING MAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: ��/ � UNDER•FL R INSULATION 150H269 3 01 P ULB U C MIC S FLOT SHEATHING OF FAMILIES: DW APT/CON CLASS: 0 NO 21 I� co ROOF-SHEATHING q-,�._�n SCHOOLWI HA O S� P G AIR QUALITY: 1000 FEET MATERIALS NO NO NO �O ® FRAME INSPECTION REQUIRED SETBACK FROM EXIST O� TME-SPRINKLER HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- INSULATION/WEATHER S RIP SIDE PL- v��d INTERIO ALL EXTERIOR LATH RATED FL SE . R-ATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508 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 0411120017 PHONE: (626) 285-0488 EXT: GA NO. OF CONST BUILDING ADDRESS: TR: 6561 LT: 462 SQ. FT STORIES TYPE 5723 GOLDEN WEST AV STRUCTURE: 0 VN TEMP'CA 917802504 ' ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LIVE OAK 8587-023-006 THOMAS PAGE: 597 GRID: A3 - LOCALITY: TEMPLE CITY EXIST BLDGD USE ZONE: R-3 ISSUED 0 : EXIST OCC GRP: 11/12/04 JK 11/07/05 J OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINA BY: CODE: ZOVAK PETER;JOANNE 19,000 5723 GOLDEN WEST AV TEMP 917802504 FEES PAID UE-S-EMTIONOF WORK KITCHEN REMODEL FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. NO: O'LEARY; TOM (626) 287-0927- AA BLDG PERMIT ISSUANCE 27.75 5823 AGNES AVENUE AC STRONG MOTION RESID 19000.00 VAL 1.90 SPECIAL ONDI 0 : TEMPLE CITY AX BUILDING REVIEW FEE 54.70 82 PERMIT W/ENERGY 19000.00 VAL 404.58 TOTAL FEES 488.93 CONTRACTOR: T 0: APPROVALS DATE INSPECTOR S G ATURE TOM O'LEARY CONSTRUCTION (626) 287-0927- 5823 AGNES AVENUE LIC. NO LOCATION AND SETBACKS TEMPLE CITY, CA 91780 489354 B-1 SOILS ENGINEER APPROVAL FOUNDATION/TRENCHARCHITECT OR ENGINEER: TEL. NO: FORMS LIC. NO: SLAB/UNDER FLOOR IS I ED FLOOR FRAMING I P NO: SEWER MAP BOOK: PAGE: FIRE ZONE: P: UNDERFLOOR INSULATION XX 3 01 I FLOOR SHEATHING 0 : DWELLING UNITS: / 0 : STAT CL NO 21 ROOF'SHEATHING SCHOOL WITHIN HAZARDOUS SHEAi PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME INSPECTION REQUIRED EXIST- SPRINKLER HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- INSULATIONNEATHER STRIP SIDE PL- ' INTERIOR L T ALL EXTERIOR A RATED . i RATED WALL ASSEMBLIES RATED, H GS T-BAR CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508