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Home My Public Portal About5742 GOLDEN WEST AVE_Building__ U ' ® ' I ADDREISS 4`7 Y d C-6,&` R?V �o5's /— APPLICATION NEARE TY 'To Cr DIVISION OF BUILDING AND SAFETY NEAREST CROSS ST. � ry O A• �V C I'� tfl�9A P Department of County Engineer DISTRICT NO. RECEIPT NO. PERMIT NO. County of Los Angeles 1'_� G ,2-0 t WM. J. FOX, COUNTY ENGINEER GROUP DATE RECEIVED &ATEISSUED CASSATT D. GRIFFIN, SUPT OF BUILDING � _^ �O FOR APPLICANT TO FILL IN TYPE CONST. RECEIVED BY ISSUED BY, r OWNER MAPII'' �} XES, r1 f MAIL `1 q NUMBER :2 / sHWYE �y+� ADDRESS �J USE ZONE SPECIAL CITY TEN L. 'j / CONDITIONS ARCHITECT 13R TEL. �Vor;, ENGINEER NO. / BUILDING YARD HWY STREET NAME EXIST. ADDRESS SETBACK WIDTH ,,j_ FRONT CONTRACTOR / NO,TEL. P. L •L I --nn BIDE ADDRESS 40111� ' P. DATE CORRECTIONS INSPECTOR BUILDING _5-7 ADDRESS /► �� M� t�„�� LOT NO. _S J-6 Qef-L0-r-9 .n�BLOCK TRACT Imo/r �� 72 -,3 7 r-I CS N r' NO. OF SLOGS. I' SIZE OF LOT &0 `� I NOW ON LOTUSE OF J >. EXISTI NOB DG D W/r 4= -1i DESCRIPTION OF WORK v NEW ADD ALTER REPAIR DEMOLISH Z S0.FT. NO. OF NO.OF ID" SIZE STORIES FAMILIES USE OF STRUCTURE U NO.OF EMPLOYEES 4 � •`. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- PLICATION AND STATE THAT THE INFORMATION GIVEN IS APPROVALS IN8PECTOR'S81G4iTiURE DATE' CORRECT. 1AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION: LOCATION AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FORMS,MATERIALS FRAME: FIRE STOPS, SIGNATURE OF BRACING,BOLTS PERMITTE •y� FURNACE: LOCATION. ADD RESB /1 CTJ GAS VENT,DUCTS �J LATH, INT. AUTHORIZED AOT. J41LATH, EXT. $ 1 P. C.18 HOUSE NUMBER COR- VALUATIONFEE RECT AND POSTED FEE �(, Q-0 "FINAL �. 11 ( /, •-.../ 76A63BA DBB 3 12-43 h�;Ner WORKERS' C?MPENSATION DECLARATION 'hereby-offirm`tho`,I.have o certificate=of consent to self APPLICATIONFOR RlilILDI,NCa PERMIT ihsure, or a cet�tificate of Workers' Compensation Insurance, orr-a certified copy thereof (Sec 3800, Lab C ) COUNTY-OF LOS ANGELES BUILDING AND SAFETY ' Policy No•' Company. M.,. , BUILDING El .Certified copy,is:hereby furnished FOR APPLICANT T_O-FILL'IN ADDRESS ❑- Certified copy`is,ftled•wrth.the county b'uildtnd!nspec- " - ` BUILDING /� 1 (�� tion department ADDRESS 5 7 V fAC4e,-Y\. B� Date Applicant OF Cl Q e G� ZIP �.O-� LOCALITY L "xtiCERTIFICATE•OF EXEMPTION FROM WORKERS'`. SIZE OF LOT Ss✓� NO . OD NOW ON LOTS �, CROSS SST ' cCOMPENSATION INSURANCE' '(This''section•need not be completed if the-perrrtii'is for one:." f TRACT ' ASSESSOR •hundred+dollars ($100) or less )' y'- ', '`` t �� BLOCK OL NO MAP'BOOK PAGE PARCEL OWNER V NO - - USE ZONE:., MAP'•, - - ' 1 certify that int the performance•of.,the work for which t is NO t permit is issued, I shall not employ'any p 'CONDITIONS on-in ma er ADDRESS ' W1 ' SPECIAL O SO as to,become subject to.,the.Worker C p s ion ws U ,.o-,.4.., ` =.y' :C' CITY ZIP , Date/ Applicant ARCHITECT OR' TEL t DISTRICTS G OUP TYPE FIRE PROCESSED BY 0 NOTICE•TO APPLIGANT If, after mdktng this Certificate of ENGINEER - NO 2CON ST E O ExempTion,•,you should.-become, subject ,to the Workers' ) La w Compensation.provis'ions of the Labor'Code, you-must forth- ADDRESS with comply, with such provisions or this permit shall be TEL STATISTICAL CLASSIFICATION, , -', ,, AP CONDO Z deemed revoked "' „ CONTRACTOR NO LICENSED CONTRACTORS DECLARATION LIC ;CLASS NO - DWELL•UNITS I hereby affirm thatl ADDRESS NO am licensed under provisions•of Chapter 9.•.- .. SEWER MAP - (commencmg,with Section 7000)of.Division 3 of the Business LIC and Professions Code;and my,,jicense'is in full force andteffect CITY CLASS NO BK PG -VALIDATION SQ FTion NO OF CHECK Licene Number Lic Class SIZE STORIES RIES FAMILIES ONE VALUATION p ` DESCRIPTION OF WORK NEW D v $ J e Contractor Date a ' ADD' ❑ � I am exempt under Sec-` ALTER ❑ L A4- n B&P,C for this reason. RIR ❑ M1 Date USE OF, EPA _. J EXISTING BLDG DEMOL ❑ �, '4 t Signature' ti- APPLICANT TEL - FINAL 1 L r~ ?' "OWNER-BUILDER DECLARATION ' `(PRINT), NO r` s . . _ DATE ,�'Z�Z� •'� '.y..„, I hereby affirm that,l dm exempt-from the Contractor's License Law,for th 'following reason (Section 7031 5, Business and ADDRESS FINAL `+1+f Profes s'Code) _ PRESENT .gy. � hILL•p.ga BUILDING i 1 I, 'as owner of the property, or my employees withj ADDRESS v va,; , wages as their sole'compdrisation,will do the work and ";, " ' , ;' ;k,.3307., � �o ) the structure is not intended or offered for sale(Section LOCALITY M '7044; Business and Professions-Code ) • '_ MOVING •-- - TEL ' l-ITEMS CONTRACTOR NO t I,-as owner of the property, am.exclusively contracting 3 with licensed*contractors to construct the project (Sec- .T - "' f '.^„ y -• TOTAL ' ' �L�,�'e �� ADDRESS - _ H tion 7044, Business,and'Professions Code ) ? U" {c r REQUIRED TOTAL SETBACK FROM EXIST y 5 •t^•HK 153.00 CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP LINE 0 WIDTH, I hereby affirm that there is a construction lending agency for FRONT =. _` ,- i _'. �.WE, 5-the performance of the'work for which this'Oermit•is issued P L" E -• (Sec 3097, Civ C )' SIDE - •, t 4 '7s ► I Lender's Name i rT ^ p� //�1 Re 3> ! Lend'er's Address PC Fee s v Permit Fee t V H id}�rj 1 {��i :} 'I o I certify that I have read this application and state that-the Issuance Fee LDMA P/C'# . 8 above information is correct I agree to'comply with all County InvestigationyFee /, �/ '•' _ ordinances an ate law ela to building construction, Total Fee r IFMA Perm # a and Hereby T nze repre e a ves of this County to enter upon the �e- nne r erty for inspection SEE REVERSE,FOR EXPLANATORY LANGUAGE � Signature of Applicant or Agerii , Dote C+� n !..J - . WbRKERS',- MPEN$ATION DECLARATION ) ' hereby�a cdr tifica I haver certificate of consent to Self APPLICATION FOR BUILDING P E RM I_T ' insure, or a certificate of Workers' Compensation Insurance, , or a certified copy thereof (Sec 3800, Lab, C.), •a _ COUNTY OF LOS'ANGELES BUILDING AND SAFETY - - Policy No Company BUILDING '. ❑ Certified copy is hereby;furnished. FOR APPLICANT TO FILL INADDRESS' /V ❑ : Certified copy:is filed with the county building inspec-, BUILDING ADDRESS J Q Q; k 't tion department. Date ~Applicant CITY 1 i ZIP LOCALITY � NO OF BLDGS NEAREST- CERTIFICATE OF EXEMPTION'FROM WORKERS'_ SIZE OF LOT NOW ON LOT CROSS ST COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one TRACT `` BLOCK LOT N MAP BOOKPAGE PARCEL-' hundred dollars ($100) or'-less ) TEL USE ZONE-, MAP• OWNER�� NO �- MA NO I'certify that tri the performance of the work for which this SPECIAL a permit is issued, I shall not employ any person in any'manner ADDRESS CONDITIONS h so as,to become subject to the,Workers'Compensation Laws CITY ZIP' r U Date Applicant ARCHITECT OR TEL DISTRICT GROUP TYPE' t . FIRE OCESSED BY 0 NOTICE TO APPLICANT If, after making this Certificate.of ENGINEER - - NO Exemption, you should become subject to the Workers' CON NE j U LU Compensation provisions of,the Labor Code; you must forth- ADDRESS_ �'� i GV v with comply with such provisions or this permit shall be TEL ;Z STATISTICAL CLASSIFICATION,. AP CONDO _._ . deemed revoked, _ „ • CONTRACTOR _ NO - LICENSED CONTRACTORS DECLARATION' LIC CLASS NO DWELL UNITS• I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO + �• P- • (commenting with Section 7000)of Division LIC SEWER MAP t- 3 of the Business -° " r and Professions Code,and my license is in full force and effect CITY CLASS BK VALIDATION SQ FT NO OF NO OF CHECK f' ' License Number Lic: Class SIZE STORIES FAMILIES ONE VALUATION' ContractorDate DESCRIPTION OF WORK ADD •❑ ' Elam exempt under Sec ►, , ALTER ❑ B&P C for this reason REPAI $ Date - . USE OF - ^ EXISTING BLDG DEMO Signature APPLICANT TEL FINAL OWNER-BUILDER DECLARATION (PRINT) NO I hereby affirm that I am exempt from the Contractor's License DATE ' Law for the following•reason (Section 7031 5, Business and ADDRESS FINAL' r i ' Prof moons Code).' PRESENT '` By JL as as owner of the'property, m CJ I, ro , or employees with BUILDING,- P P Y Y em ADDRESS tP Y •. - wages as their sole compensation,will do the work and _ ti> . . T ryj I the structure is not intended or offered for sale(Section LOCALITY , 3301 60•'-- ❑ 7044, Business and.Professions Code ) MOVING TEL 1 ITEMS 1, as owner of the property, am exclusively contracting CONTRACTOR NO with licensed contractors to construct the project (Sec- ADDRESS y TOTAL 60 - 0 tion 7044, Business and Professions Code ) C:NECK _(� ,�� REQUIRED TOTAL SETBACK FROM' EXIST ' CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP LINE WIDTHi I hereby affirm that there is a construction lending agency for FRONT C•HANG .CIL I the performance of the'work for which this permit,is.issued PL ' (Sec 3097, Civ C ) SIDE Lender's Name '• 01160-0001 -K/l s J"'� - •LD MA Ref # - -7 - 7 - i AM i fi o t'tC n P C Fee$ Permit Fee !43 f 1 A 110`L Lender's Address 0 1 certify that I have read this application and state that the Issuance Fee �� V LDMA P/C# 8 above information is correct I agree to comply with all County Investigation Fee ordinances and State jaws relating to building construction, Total Fee 11161r, LDMA Perm # Q and hereby thorize repr entatives of this County to enter, • upon then7 m t ne roperty for inspection purposes w •'"• = ` - - - y •-• �- a l � �_A -..-j T �7 � SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date r 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 1212050036 PHONE (626) 285-0488 EXT. (LEGAL ID: I NO OF CONST BUILDING ADDRESS, I ITR- 6561 LT 455 UN 002 I SQ FT STORIES TYPE 1 5742 GOLDEN WEST AV I I _ISTRUCTURE V-B TEMP CA 917802503 I (ASSESSOR INFORMATION NUMBER I 1 NEAREST CROSS STREET LIVE OAK I 18587-028-016 THOMAS PAGE 597 GRID A3 LOCALITY TEMPLE CITY CAI ITENANT (EXIST BLDG USE. RESID USE ZONE R-1 (ISSUED ON PROCESSED BY: I (EXIST OCC GRP - 112/05/12 SR I (OWNER- TEL NO 'IBLDGS NOW ON LOT VALUATION 1FINAL D TE FINAL BY CODE I '(PIERCE PAUL R (626) 209-0634- I 24,000 I - 15742 GOLDEN WEST AV I 1 ITEMP 917802503 FEES PAID JJfSCRIPTION OF WORK 1 I IKITCHEN AND 2 BATHROOMS, TER BATHROOM, REPLACE EXISTING I IFEE DESCRIPTION QUANTITY UOM AMOUNT (APPLIANCES & PLUMBING FIXTURES REPAIR DRYWALL AT AREAD OF 1 (APPLICANT: TEL NO I IREPATRS _ SAME AS OWNER - IAA BLDG PERMIT ISSUANCE 27 80 I IAB STATE GREEN BLDG FEE 24000 00 VAL 1.00 ISPECIAL CONDITIONS IAC STRONG MOTION RESID 24000.00 VAL 2 40 I , 1 JB2 PERMIT W/ENERGY 24000 00 VAL 497 00 i 1 IFR INV WORK W/O PERMIT 339 60 DOL 339 60 I CONTRACTOR TEL NO I TOTAL FEES 867.80 (APPROVALS DATE INSPECTOR SIGNATURE ISAME AS OWNER - I I I I _ LIC NO I _ ILOCATION AND SETBACKS I SOILS ENGINEER APPROVAL I -I I (ARCHITECT OR ENGINEER. TEL NO _ (FOUNDATION/TRENCH FORMS I - I - I I•_� I I I - LIC NO (SLA-`/UNDER FLOOR _ IRAISED FLOOR FRAMING IMAP NO SEWER MAP BOOK PAGE FIRE ZONE. CMF' (UNDERFLOOR INSULATION I I150H269_ 3 001 I I - IFLOOR SHEATHING 'INO. OF FAMILIES DWELLING UNITS APT/COND STAT CLASS I I I 0 NO 21 I IROOF SHEATHING 1 1 SCHOOL WITHIN HAZARDOUS I - �� ISHEAR.PANELS (AIR QUALITY 1000 FEET MATERIALS NO NO NO I 7 (FRAME INSPECTION _ I IFIRE SPRINKLER HANGERS I' - 4 _ I (INSULATION/WEATHER STRIPI I _ I 11NT-'RIOR LATH/DRYWALL I I (EXTERIOR LATH I IRATED FLOOR/CEIL ASSEM IRATED WALL ASSEMBLIES I - IRATED SHAFTS/OPENINGS 1T-BAR CEILINGS I t' • - JLOT,DRAINAGE " IREPORT ID DPR261 ROUTE TO BS0508 WORKERS' COMPENSATION DECLARATION insure,bora certificatffirm e of Workers' Compensat on ensurance, _ A P P L I CAT I O N- 'F O_ R' BUILDING PERMIT or c certified copy`thereof(Sec 3800, lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY ! ' Polcy No - Company - ❑ Certified copy is hereby furnished BUILDING FOR APPLICANT TO FILL IN. ADDRESS •� - ❑ Certified copy is filed with the county building'inspeo- BUILDING ,tion department ADDRESS /' n✓1 DateApplicant 4 CITY ZIP 1 ° LOCALITY NO OF BLDGS NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST COMPENSATION INSURANCE ° ASSESSOR ~ (This section need,not be completed if the permit is•for one TRACT BLOCK LOT NO MAP BOOK •_ �� PAGE �� PARCEL hundred,dollars'($100) or less')°' " - TEL � ? OWNER NO "'�dtSJ. USE,ZONE MAP- I certify that in'the performance of the work for-which this, NO permit is issued, I sRall not employ anyaperson m ONDITIONS• any'manner ADDRESS yyf - SPECIAL , , d C -so as to become subject to the Worker;,Compensation Laws ,, s OU CITY ' ZIP d' Date Applicant ARCHITECT OR TEL -DISTRICT ` GROUP I TYPE FIRE PROCESSED BY NOTICE TO APPLICANT -If, after makingthis Certificate of - ENGINEER - NO, CONST ZONE "U Exemption,. you •should become subject to the Workers' p Compensation provisions of the,Labor Code, you must forth- ADDRESS . - �6 `3 V a ...with comply with such provisions or this permit shall be TELSTATISTICAL CLASSIFICATION APT ICONDO Z deemed revoked ., CONTRACTOR NO — LICENSED CONTRACTORS DECLARATION LIC 'CLASS NO C;2_/ DWELL'UNITS I hereby affirm thctd am licensed under provisions'of Chapter 9 ADDRESS NO (commencing with Section 7000)of Division 3 of The Business " LIC 'SEWER MAP and Professions,Code,dnd my license is in full force and effect - CITY CLASSBK, PG VALIDATION SQ FT NO OF NO OF CHECK License Number Lic Class SIZE I STORIES FAMILIES ONE VALUATION Contractor Date bESCRIPTION Jr WORK (J` N NEW ❑ $ / t Y ❑I am exempt under Sec `Q ADD ❑ ALTER .❑ -B&P C for this reason ~' REPAIR ❑ s , Date USE OF EXISTING BLDG " t DEMOL ❑ Si nature APPLICANT w TEL g OWNER-BUILDER DECLARATION (PRINT) NO FINAL' ; DATE : �,Z=Z _ I hereby affirm that I am exempt from the Contractor's License -, Law for the following reason (Section'7031 5, Business and ADDRESS FINAL L r essions Code) ' PRESENT - BY - - r;1r; ,a BUILDING 1, as owner of the property, or my employees with ADDRESS ; wages as their sole compensation,will do the work and331-`7 ---' the structure is (not intended or offered for sale Section LOCALITY ' tt I 7,044, Business and Professions Code ) MOVING TEL Poot E; CONTRACTOR NO❑ EM .I;as,owner,of the,property, am exclusively contracting ;_» . ` �,[:11h1 _ �-_� ,.� Z.,• with•licensed contractors to construct the project (Sec- - tion 7044, Business and Professons Code ) ADDRESS REQUIRED TOTAL SETBACK FROM EXIST CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP LINE WIDTH (jr•!"°" I hereby affirm that there is a construction lending agency for FRONT' •the performance of the work for-which this permit is issued •'P L ' (Sec 3097, Civ 'C ) SIDE Lender's Name _ P L -. J f1," !=,i W LDMA Ref # x a AI'l"�_'_i 7 P C Fee$ Permit Fee r� Lender's Address LL� 0 1 certify that,l-have'read this'application and state that the Issuonce Fee 4� J LDMA P/C# 8 above mformati n is correct I gree to comply with all County Investigation Fee ordinances a State Taws at to building construction, Total Fee a LDMA Perm # andhereb hors a ntatives of this County to-enter upon th e i e property-for inspection purposes " SEE REVERSE FOR EXPLANATORY LANGUAGE r Signature of Applicant or Agent Date WgRKERS' COMPENSATION DECLARATION • to s 'Insure bor a certif cafe of Worke srint Compensation ificate eInsuran of APPLICATION F,.O'R, BUILDING .P E RM I T or a certified copy Thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. - Company BUILDING S-7 ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING �] tion department. ADDRESS S / q2, XA OWMO DateST Applicant CITY G �- ZIP LOCALITY I NO. OF BLDGS. CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT ` IO ' NOW ON LOT "31 CROSS CROSS ST. COMPENSATION INSURANCE ASSESSOR �j.� G / (This section need not be completed if the permit is for one TRACT �S C' BLOCK LOT NO. �� MAP BOOK �� PAGE !/+�0 PARCEL��(� hundred dollars ($100) or less.) TEL USE ZONE MAP OWNER NO 3 NO. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner ADDRESS ;M _ / SPECIAL CONDITIONS so as to become subject to the Workers'Compensation Laws. O CITYZIP U -t•r Date Applicant ARCHITECT O ' DISTRICT GROUP TYPE FIRE"' PROCESSED BY NOTICE TO APPLICANT: If, after makingthis Certificate of ENGINEER CONST. ZONE;•- • Exemption, you should become.subject To The Workers' U Compensation provisions of the Labor Code, you must forth- ADDRESS - fI W with comply with such provisions or this permit shall be TEL. S ATISTICAL CLASSIFICATION "APT. CONDO.:" Z deemed revoked. CONTRACTO NO. _ LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. C-2-1 DWELL. UNITS I hereby affirm That I am licensed under provisions of Chapter 9 ADDRESS NO. 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 PG. Y. SQ. FTNO. OF NO. OF i CHECK License Number Lic. Class SIZE 9� STORIES FAMILIES \ ONE VALUATION Contractor Date DESCRIPTION OF WORK � NEW ❑ $ ° N-JADD , 11-?tV�^ f_-i a L Lf El am exempt under Sec. , - - ' - .B.&P.C.-for this reason 1 ALTER 01 REPAIR Eli Date: USE OF _ _ EXISTING BLDG. DEMO ❑ Si nature APPLICANT TEL. g (PRINT). NO. -U�3�( FINAL OWNER-BUILDER DECLARATION DATE 7— 7, 13 I hereby affirm that I am exempt from the Contractor's License- FINAL s:'AL Law for'the following reason (Section 7031.5,Business and ADDRESS �LG'!L FINAL —r-:: RjoJessions Code): PRESENT By I, as owner of the property, -employees with BUILDING P . P Y or m Y' P Yees ADDRESS `-,Yyvs;;` 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. ElCONTRACTOR NO. —'?;' I, as owner of the property, am exclusively contracting - -•• - _.... .,., with licensed contractors to construct the project (Sec- i"?'?f ;•t, -, ADDRESS ) tion 7044, Business and Professions Code.) CONSTRUCTION LENDING AGENCY SETT REQUIRED YARD HWY TOTAPROPALINEFROM WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.L. k (Sec. 3097, Civ. C.). SIDE P.L., Lender's Name, ��';•.,��, rti.. $ G/'7 o� LDMA Ref. Lender's Address P.C. Fee$ // Permit Fee ��/ V a a 1 certify that I have read this application and state that the Issuance Fee oF#- 7LDMA P/C# above information is correct. I agree to comply with all County Investigation Fee D 0 ordinances d State I ws r ting to building construction, Total Fe LDMA Perm. # a and here thoriz re r e ❑fives of this County to ent upon t a e-mentio d operty for inspection rpos s. a SEE REVERSE FOR EXPLANATORY LANGUAGE Signature o Applicant or Agent Dat