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HomeMy Public PortalAbout6210 GOLDEN WEST AVE_Building__ _ TEED. CETT �c.esa.�ffiec> s/.o A'PPLICATION FOR BUILDAI3mIT, - 1" COUNTY.,OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY,ENGINEER ADDRESS BUILDING AND-SAFETY DMSION LOCALITY - - JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A.A. JENSEN-SUP'T OF BUILDING CROSS ST DISTRICT NO. GROUP •NpF.- P SED BY f -FOR APPLICANT,TO FILL IN �� , CONST. BUILDING // Q STATISTICAL CLASSIFICATION - SEWER-MAP ADDRESS G O BK - ` �. _ CLASS NO DWELL:UNITS• ' LOT NO. - LO MAP STATE YES NO NUMBER (J HWY. TRA USE ZONE SPECIAL NO OF BLDGS. /f') CONDITIONS SIZE OF LOT % NOW ON LOT - A A'" USE OF V•� EXISTING BLDG BUILDINGEXIST. EL. SETBACK YARD HWY R ET NAME . WIDTH OWNER' NO. FRONT P L ADDRESS SIDE ARCHITECT OR TEL. P.L. ENGINEER INSPECTION RECORD - ADDRESS - NO. - Q1 CONTRACTOR NO. O ADDRESS V DESCRIPTION OF WORK u� NEW ADD ALTER REPAIR DEMOLIS SQ.FT. NO OF _ a pr SIZE STORIES FAMILIES - N USE OF OL. h= 10 - STRUCTURE SIGNXTURE'OF 1 APPLICANT VALUATION$ - APPROVALS DATE INSPECTOR'S SIGNATURE ' FOUNDATION: LOCATION ' FEE $ -' FEE $ FORMS, MATERIALS - FRAME: FIRE STOPS( 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- - BRACING, BOLTS - PLICATION AND STATE THAT THE ABOVE IS CORRECT AND FURNACE LOCATION, AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND GAS VENT DUCTS' STATE LAWS REGULATING BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED 1 LATH, INT. - WILL NOT EMPLOY ANY PERSON IN VIOLATION OF IHE WORKMEN'S COMPENS TION LAWS OF IFORNI LATH, EXT. SIGNATURE OF HOUSE NUMBER COR- �02 PERMITTEE RECT AND POSTED ADDRESS FINAL 3 �- CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL ENG PLAN CHECK V TION ' OK. M.O. CASH PERMIT VALIDATION- 'CK.' M.O.` cash Lfil�o 3 3 1 8 iVii�R 3 1 D' 2.C?-��" •tri ®� `7 0 76AG38A CE#803.9-60 FOR—BUIL ' APPLICATIONO BUIL D I N G PRM I T COUNTY OF LOS ANGELES BUILDING DEPAR'T'MENT OF COUNTY-ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST DISTRICT NO. GROUP .r�.pE P ESSED BY FOR APPLICANT TO FILL IN J CONST BUILDING STATISTICAL CLASSIFICATION I SEWER MAP. ADDRESS AY BK ...-r CLASS NO DWELL UNITS LOT NO K MAP �.(r ��Q .3 STATE YES O NUMBER aL�� HWY. TRACT USEZONE SPECIAL NO Or BLDGS CONDITIONS , SIZE OF LOT r NOW ON LOT USE OF / EXISTING BLD BUILDING YARD HWY STREET NAME - EXIST TEL SETBACK WIDTH OWNE r NOAr 7 3A FRONT ' PL ADDRESS SIDE ARCHITECT OR T L P L ENGINEER NO INSPECTION RECORD ADDRESS _ n' TEL 0 CONTRACTOR NO ADDRESS O ESCRIPTION OF WORK W _ a NEW ADD ALTER REPAIR EMOLIS - h SQ FT.- + NO OF Z SIZE , / ,2 STORIES FAMILIES USE OF STRUCTURE SIGNATURE OF - APPLICANT VALUATION$ r ' APPROVALS DATE INSPECTOR S SIGNATURE PC - PMT FOUNDATION LOCATION ` FEE $ FEE $ FORMS, MATERIALS l FRAME FIRE STOPS, IHEREBY 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 BUILDING CONSTRUCTION I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED I SHALL NOT LATH, INT EMPLOYANY PERSON IN ANY MANNER 50 AS TO COME SUBUECT TO THE WORKMEN S COMPENSATIO LAWS OF CB IFORNIA LATH,EXT ' SIGNATURE OF HOUSE NUMBER COR-: PERMITTE RECT AND POSTED ADDRESS FINAL CLYDE N. DIRLAM, PIRINCIPAL STRUCTURAL EN PLAN CHECK VALIDATIO K. M.O. H PERMIT VALIDATION CK M.O. CASH �Jc17 0 3 a 2 1 o .2 .0 0 WORKERS' COMPENSATION DECLARATION APPLICATION FOR BUILDING PERMIT hereby affirm that I have a certificate of consent to self insure, or a certificate of Workers'Compenstion Insurance or - a certified copy thereof (Sec 3800, L ) COUNTY OF-LOS ANGELES BUILDING AND SAFETY Policy No Company Certified copy is hereby furnished FOR APPLICANT TO-FILL IN', BUILDING ADDRESS Certified copy is filed with the county building mspec- BUILDING tion d part en ADDRESS LOCALITY ��� ��� NEAREST -Date Applicant T ZIP CROSS ST ER ICA E OF EXEMPTION OM WORKERS' NO OF BLDGS ASSESSOR COMPENSATION I RANCE SIZE OF NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be comp) ed'if the permit is for oneUSE ZONE. MAP, hundred dollars ($100)or less ) T K f Q LOT GO/' (7 NO r TEL SPECIAL 'I certify that in the performance'•of the woik for which this OWN NO40�1 CONDITIONS \O permit is issued, I shall not employ any person in any manner DISTRICT GROUP TYPE FIRE PROCESSED BY V so as to become subject to the Workers'.Compensation Laws ADDRESS it „� COGN•ST E O`er Date �' Applicant • � STATISTICAL CLA SIF TION APT CONDO V ARCHITECT EL / NOTICE TO APPLICANT If, after making ,this Certificate of ENGINEER NO 63� W Exemption, 'you should become subject to' the Workers' CLASS NO DWELL UNITS tZ Compensd1Ation'provisions of the Labor Code, you must forth- ADDRESS SEWER AP 1A with comply;with such provisions or This permit shall be deemed revoked CONTRACTOR Np BB# PG? VALIDATION LICENSED CONTRACTORS'DECLARATION LIC �j I hereby affirm that lam licensed under,provisions of Chapter 9 ADDRES NO 3/Jr� V,ALUATION (commencing with Section 7000)of Division 3 of the Business and LIC Professions Code, and my license is in full force and effect CITYAZI CLASS . SQ F ` NO OF NO OF CHECK License Num b 20 Lic Class�� SIZE O STORIES FAMILIES ONE • g - NEW DESCRIPTION OF WORK 21 ,0 6 2 A Contractor % Date Q I ampt from the licensing require__7 SOS as I am a ^, ADD licechitect or a registered professional engineer ALTER ' FINAL # 0 0 0 0 2 1 acting in my--professional capacity (Section 7051,• �,� �p_ �, IR DATE Business and Professions Code) USE OF FINAL J G;_ 2'O ° 5 0,4 0 s EXISTING BLDG DEMOL _ `-"p--_`^ Lic or Reg No Date APPLICANT TEL By 5 0,4 0 U OWNER-BUILDER DECLARATION _ PRINT) - NO �� I hereby affirm that I am exempt from the Contractor's License Lly 0 9, 0.8,-8 1 Law for the following reason (Section 7031 5, Business and ADDRESS Professions Code)- PRESENT El BUILDING ' 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 intend-ed or offered for sole'(Section LOCALITY 1•+O E1 3 A 7044, Business and Professions Code) MOVING TEL I, as owner of the property, am exclusively contracting CONTRACTOR NO % #'0•0 0 0 0 1 with licensed contractors to construct the project (Sec- ADDRESS hon 7044, Business and Professions Code) 2,c -97. 00 REFee TOTAL SETBACK FROM EXIST CONSTRUCTION LENDING AGENCY HWY PROP LINE WIDTH I hereby affirm that there is a construction lending agency for a o a 97. 00 63 the performance of the work for which this permit is issued (Sec 3097, Civ C ) 09„08-81 Lender's Name P 7�• Permit FeeLender's Address I certify that I have read this application and state that thessuance Fee above information is correct I agree to comply with all County Invordinances and State laws relating to building construction, pand hereby authorize representatives of this County to enterTotal Fee aup the abo e-mentioned roperty for inspection purposes a SEE REVERSE FOR EXPLANATORY LANGUAGE Signature o Applicant 0 r Agent ote ©s WORKERS' COMPENSATION DECLARATION ``.k,A►eb -' 4irm that I have a certificate of consent to self y APPLICATION FOR IBUILDING..' PE'RMIT ,insu; or a certificate of Workers' Compensation Insurance, or atrfied copy thereof (Sec •3800, Lab C )- COUNTY OF LOS•ANGELES` BUILDING AND SAFETYY Policy No Company ❑' Certrfied copy is hereby fur'nislied FOR APPLICANT TO FILL-'IN . A,�DREu ❑ Certified copy,is fileddwith the county building inspec- BUILDING. - //• •- - . - -• -; 10, icon department: ADDRESS (9O a �5 1 - _ CITY 4 C l _.� ZIP'. O LOCALITY ,.Date, I NO OF BLDGS CERTIFICATE.OF EXEMPTION,FROM WORKERS" — I NEAREST a: SIZE OF LOT D a" NOW ON LOT CROSS ST COMPENSATION INSURANCE !, ASSESSOR (Th is.section need not be completed if the permit is,for orie TRACT. BLOCK LOTNO ` MAP BOOK; I PAGE PARCEL 'hundred'dollars'($100) or less) TEL` p USE ZONE MAP OWNER, \) NO'�0�� NO I certify that in the performance of the work for which*this ? permit is issued,,)shall not employ an erson in an manner ADDRESS" - SPECIAL - � P P Y Y'P Y_ O QN '.�e CONDITIONS � - O so as to,becomesubject to the,Workers'Compensahon_Laws - ,,V x . G ZI'P'- CITY I 0' Date Applicant- " , ARCHITECT OR TEL t DISTRICT— GIROUP.J,TYPE FIRE PROCESSED BYNOTICE TO APPLICANT If,=-after•maki'n this Certificate,of ENGINEER.. NO gCONST ! ZONE Exemption,,,you should become subject td the Workers' c 1 / w=-Compensation provisions of the Labor Code, you.must forth- ADDRESSQa V ; N W1 `comply,with. such pPovisionsror,,this,fpermit•shall be TEL STATISTICAL CLASSIFICATION APT CONDO Z deemed revoked, :.' CONTRACTOR-- NO- _ �. LICENSED'CONTRACTORS'DECLAR "ION• LIC CLASS NO DWELL UNITS >,,l herdF y affirm That I am licensed under.provisions of Chapter 9 ADDRESS NO SEWER MAP, ,(commencin'g,with Section 7000)of-Division 3 of the Business UC and;Professions Code,and my,license is in full force and effect CITY CLASS BK PG VALIDATION' ^ SQ FT, NO OF '• NO OF -CHECK 1 Licerise Number Lic Class ;° SIZE STORIES FAMILIES ONE VALUATION { a•.f� • - - - 'DESCRIPTION OF'WORK - _ NEW ❑ ; ' Contractor Date 2 ❑ ADD Y I am exempt under Sec- &IVLOl= fikA) ALTER B&P C-,for,this reason (A fM,VQ $ a • Date USE OF REPAIR _ EXISTING BLDG DEMOL ❑ Signature, APPLICANT ?EL -FINAL OWNER-BUILDER DECLARATION- (PRINT) NO < DATE _ 4 I hereby affirm that I am exempt from the Contractor's License - t. °'Law for the following'reason (Section 7031'5, Business,'and ADDRESS FINAL Professions Code) PRESENT _ r _ By ^.x 4- * a BUILDING VN I-, as owner.of the property,, or my employees with ADDRESS wages as their sole compensation,will do the work and '' ""' ` ' 't �_ €tilt: n s the structure is riot mtended,or-offered LOCALITY for sale(SecTion A 7044, Business and Professions Code )- MOVING- - TEL rADDR ' NO y ,, ❑ I;as owner of the,propefty, am exclusively contracting. with licensed contractors,to,construcT the project (Sec- I' Ition_7044, Business and Professions Code ) - L TOTAL SETBACK FROM' ' EXIST s I ttt_ `� L%-;s CONSTRUCTION LENDING AGENCY` YARD Hwy PROP LINE WIDTH' 5' I hereby.affirm,that there is a construction lending agency for the performance of the work for which this permit is issued - i !(Sec 3097, Gv C )Lender's Name LDMA Ref #• y 'AL Ecti- Permrt•Fee O `.'�'l=` -1=l • 1 - Lenc!6r's Address ' I certify that haJe•read this applicaTion and state that the Issuance Fee ' LDMA P/C# ► �� ri m, ` ' rF 8 above information is correct I agree to'comply with all County Inves_tigation'Fee ordinances and Sta{e lawsrelatmg to building,construction, Total Fee LDMA Perm # < - and�hereb authonze repr entatives of this County to enter m upon the hove-mention property for inspection,purposes }` ` " 1• °' ' �% Y 'SEE REVERSE FOR EXPLANATORY LANGUAGE � •. • _-� _' � ` Signature of Applicant fAgent Date 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 1201300050 PHONE (626) 285-0488 EXT LEGAL ID: NO OF CONST BUILDING ADDRESS ON FILE SQ. FT STORIES TYPE 6210 GOLDEN WEST AV ISTRUCTURE 2000 V-B 1 TEMP CA 917801704 ASSESSOR INFORMATION NUMBER- NEAREST CROSS STREET 15385-025-034 I THOMAS PAGE 597 GRID A2 LOCALITY- TEMPLE CITY, Cl TENANT 1EXIST BLDG USE. RESID USE ZONE- R-1 JISSUED ON. PROCESSED BY. 1EXIST OCC GRP _ 101/30/12 SR 1 OWNER TEL NO 1BLDGS NOW ON LOT VALUATION IFIN ATE FI Y CODE 1MONTESANTI, STEVE (626) 287-4046- 1 7,000 1 / 16210 GOLDEN WEST AV Ike 1TEMP 917801704 1 FEES PAID DItSCAPTION OF WORK I I 1TEAR OFF EXISTING ROO ON HOUSE ONLY RE-ROOF WITH 25 YR 1 1 IFEE DESCRIPTION QUANTITY: UOM AMOUNT 1FIBERGLASS SHINGLE RE-ROOF PATIO WITH BUIL-UP CLASS A HOT 1 1APPLICANT TEL NO �I IMOP SYSTEM I 1DICKEY, JOSH (562) 944-5817- IAA BLDG PERMIT ISSUANCE 27 80 1 I 113021 LAKELAND RD IAB STATE GREEN BLDG FEE 7000 00 VAL 1 00 1SPECIAL CONDITIONS 1 1SANTA FE SPRINGS, CA IAC STRONG MOTION RESID 7000 00 VAL 0 70 1 1 ID2 PERMIT W/O EN-HC 7000 00 VAL 166 60 1 i TOTAL FEES 196 10 1 1CONTRACTOR TEL NO 1APPROVAILS DATE INSPECTOR SIGNATURE 1CASSADY ROOFING, INC (562) 944-5817- 1 1 113021 LAKELAND RD LIC NO 1 1LOCATION AND SETBACKS 1SANTA FE SPRINGS CA 531906 C39 I 1 1 1 1 1 1SOILS ENGINEER APPROVAL 1 1 1ARCHITECT OR ENGINEER TEL NO - IFOUNDATION/TRENCH FORMS 1 I I 1 LIC NO 1 1SLAB/UNDER FLOOR 1I 1 I I I 1 1 1 1RAISED FLOOR FRAMING I I I IMAP NO SEWER MAP BOOK PAGE FIRE ZONE- CMP 1 _ 1UNDERFLOOR INSULATION I 1 1 1153H269 3 001 1 11 1 I 1 1FLOOR SHEATHING 1 1 INO OF FAMILIES DWELLING UNITS ,APT/COND STAT CLASS I 1 II I 0 NO 21 1 IROOF SHEATHING 1 1 SCHOOL WITHIN HAZARDOUS 1 1SHEAR PANELS 1 T I 1 1AIR QUALITY 1000 FEET MATERIALS 1 1_ 1 1 1 NO NO NO 1 1FRAME INSPECTION 1 1 1 1 1 1FIRE SPRINKLER HANGERS 1 1 1 I I I I I I INSULATION/WEATHER STRIPI 1 1 1 11NTERIOR LATH/DRYWALL I I I 1 IEXTERIOR LATH 1 1 1 1 1RATED FLOOR/CEIL ASSEM 1 1RATED WALL ASSEMBLIES 1 1 1 1 (RATED SHAFTS/OPENINGS 1 1 1 1 I I I I I 1 1 1T-BAR CEILINGS I I I 1 1LOT DRAINAGE 1 1 1 _ 1 1 1 1REPORT ID DPR261 ROUTE TO BS0508 1 1 1 1 1 I I I I I