HomeMy Public PortalAbout6413 GOLDEN WEST AVE_Building__ APPLICATION FOR BUILDING PERMIT
FOR APPLICANT TO FILL IIS (Print or +yo• only)
BUI ING COUNTY OF LOS ANGELES
ADDRESS DEPARTMENT OF COUNTY ENGINEER
CIT ZIP BUILDING AND SffETY.Divmioy
N .OF BLDGS. BUILDING /
SIZE OF LOT NOW ON LOT ADDRES `
TRACT OCK LOT NO LOCALIT
TEL. NEAREST <115
OWNER NO. CROSS ST.
ASSESSOR
ADDRESS MAP BOOK PAGE P RCEL
DISTRICTG PE FIRE ED Y
CITY ZIP
T. ZONE
AR IT C TE
ENGINEER dde
STATISTICAL CLASS FICA TION- SEW P
CL-
ASS CLSS NO-9/ DWELL.UNITS L "//I.,
CONTRALTO - TE E ZONE MAP
NO.
ADDRES SPECrAL
LIC. CONDITIONS
CITY CLASS
ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑
CONS RUCTION LENDER
NAME AND BRANCH DG.SETBACK FROM
RONT PROP.LINE OF (STREET) S
ADDRESS CITY _ TOTAL SETBACK FROM TYPE-OF EXISTING CL'
SQ..FT / NO. OF NO. OF CHECK IGNWAY t YARD — HIGHWAY WIDTH
SIZE. STORIES FAMILIES ONE FRONT PROP. LINE
DESCRIPTION OF WORK NEW
DD G.SETBACK
SI LINE OF (STREET)
rrALTER ❑ HIGHWAY + YARD = SET OM TYPE OF EXISTING
Q C� EPAIR❑ DE P L E IGHWAYI WIDTH
USE L� EMOL [:1 #
EXISTING BLDG. '
APPLICANT TEL CORNER CUTOFF YES ❑ NO ❑
(F RINT) O.
BY (SIGNATURE) IN OPEN SPACE YES ❑ NO ❑
IN COASTAL ZONE YES ❑ NO ❑
VALUATION l��O
CATS SO RICAL EX¢MPTIOH YES❑ NO ❑
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL
AND }TATE THAT THE ABOVE Il CORRECT AND AGR¢E TO COMPLY IMPACT— EXEMPTION DECLARATION SIGNED (DATE)
WITH ALL ORDINANCE[ AND LAWS REGULATING BUILDING CON-
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROLES SED (DATE)
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
LABOR CODE OF THE STAT[ OF CALIFORNIA IN RELATING TO
WORKMEN'S CO MP[NSA ION INSURANCE.
SIGNATURE OF
PERMITTEE
ADDRESS
eall FINAL BY
TEL. TE
CITY N0. t
pm
MAKE CHECKS PAYABLE TO: P.C. ♦ FEE
HARVEY T. BRANDT. COUNTY ENGINEER
PLAN CHECK VALIDATION CK. N.O. -H _ PERMIT VALIDATIONCK. M..g. CASH
218tiJUL X 6 2 3 D 7.20
76A698A CESSOS 7/73 2 1 9 CZ JUL �6 1 D 1 .'J V �'y�
76AS38A D85-9 3-6E
r APPLICATION FOR BUILDING PERMIT 1
DIVISION OF BUILDING AND SAFETY ADDRESS '-
Department of County Engineer
County of Los Angeles LOCALITY T. C
WM.J. FOX.COUNTY ENGINEER NEAREST L I
CASSATT D. GRIFFIN, SUP=T OF BUILDING CROSS ST.
DISTRICT O. GROUP TYPE SEWER MAP
FOR APPLICANT TO FILL IN BK P
p� �j q.
CONST. z
ADDRESS /�J tr rJ /V .Gt,f/ NUMBER p�O40,3 HWY STATE YES
LOT NO. ;��. T7 Ll, .q-L BLOCK USE ZONE SPECIAL
CONDITIONS
TRACT / y
SIZE OF LOT (Gr /` f' I NOW ON LOTS `- BUILDING YARD HWY STREET NAME EXIST.
SETBACK WIDTH
USEOF
EX STTING BLDG. FRONT 0 0 _^�O /a't
J
` �J P. L. LL'` V GC
OWNER �J• N= J l 41f4 SIDE
MAIL
P. L.
ADDRESS -a LGa Jt/, ��IrJ//
O TRACT DWELL. 1 UNIT
,l �1 `/ 5 INDUSTRIAL
TE�s� NO. /lam t DWELL. 7 UNIT 6 PUBLIC BLDG.
CITY
ARCHITECT OR TEL. 2 DUPLEX 1 UNIT 7 ADDN.. ALT.. ETC.
ENGINEER NO. 3 APT. UNITS
8 MISCEL.
ADDRESS 4 COMMERCIAL
t
CONTRACTOR TNEOL.. INSPECTION RECORD
ADDRESS
DESCRIPTION OF WORK
_ U
NEW 11_/
ADD ALTER REPAIR DEMOLISH _
SO. FT. yp NO.OF ) NO. OF j
SIZE STORIES I/ FAMILIES { _
USE OF STRUC51 URE —
SIGNATURE OF ,
APPLICANT APPROVALS .3'1
ADDRESS C DATE INSPECTORS SIGNATURE
FOUNDATION: LOCATION
P.C. $ /(1 ! FORMS= MATERIALS®V FEE L/ T FRAME: FIRE STOPS,
VALUATION BRACING.BOLTS
FEE ; FURNACE: LOCATION,
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GAS VENT, DUCTS ..
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH= INT.
AND STATE LAWS REGULA G BUILDING CONSTRUC-
TION. ' 1
LATH.EXT. _
SIGNATURE OF HOUSE NUMBER COR- /
PERMITTEE RECT AND POSTED
ADDRESS ' FINAL
WM.J.FOX,COUNTY ENGINEER ATION C. N. DIRLAM, CHIEF BLDG. INSPECTOR
5 4 1 8 L/f{�'FR 2 5 I 38-00 Inm
1 ''{ R$•'C�hA�NSATION`Dr�aA�AT7brl � �.. .. , .. . ... ._ ._yc.�� : ,,_5 - .:. _..__..,.._ .. �.. . . ... _. l _ - � _�.. .. .-. _ .
sure, ac6r (hat I.have.a certificate *tion lqz to - APPLICATION- fOld SUILDING PERMIT �
Inisurb, or q certificate o{Wor{c'pri Corhpesptlon Insurance,
or-18 certified copy Rheredfi (5ea.`3800;'lab: C )' -- — _' - •• ... - - -
� t�, n-�- - COUNTY OF LOS ANGELES SUILbING AN8
P,ollcyNo., +SS7 Cgmpany IVQr• Tl�!_ _ _�_ _ -
�ertfed copy Js'here by-.fumisbed: 1, ;•. FOR APPLICANT TO FILL-IN � 3
( rtlfiQd'copj7 b fHpd'w'th rtiq`cQUnty Uulldlri{I Itiapec- BLIILDINE3 -
"'-kbrl d.parrrr5ent:; "A ,., .� r ADDI�ss 6413 �i0"�dP-Lt'We3t .
'}'� !�"• w - _ .,.rte..� ._._ -. _
Date'`92� �i:, App7lcanr-�-Thsaa a'kRfa .xX`n_. U[y Temple C,l t zip 9178b IOGaiMi
tEg
TIFItg OF EMPTION FROM-WORKERS" - _ __. .._ T NQ;OFBL9GSc-
L�OMPNSATIONINSURANG :t : H SIZE OF LOT f NOW.ON T
(Th Ni id211on'h4' d not be'-com ret6d-tf.•fhe:permtt•li:fo1,onq ---- - r �' ( T rw ;:c•,. }.
�dgdred".doI�I�7'(�1DQ) Jl �. TRACT 9Lock OTNO. N�001C' PAGE ` P.U2C
f rbrtf#y''lntlirtAs"'e rieef of�hp wak.forwhl .thfs ta-
'`J' Steil --NO- 4461916
}sb fT - No. I v'
�ertrllt i*i I ed f d note Proy'dny n 1n'ghy' nn"er x;l'
` so mods
s as tca becom`iublect to�}re WoFkers Cbmperlsatdn Law1. - - - I ..i `*
bate - Appiw6t', (�
' NOiIE TC3' AIiPLICAlVT"if 'after1knakln'q'thlr`Qertfficgte of ARCd FECT OR
TYpf
Ex.rriptiori ",you Lh6urd beevrriol ibblect to the•Workers' ENQIN�t NO.
�j �j cbt sr. zoNE
(iompeniation,provlslon� of.4he Labor'C3db,'Yov-meaT4orth- Sit. sr
with• corv�py with,.sych-.provisroo .Qr.,-thti- ermIt,shgll be -
d*pm4dtavDka+d:'. .. _ ' v ::' r. c•,_ .,d
796�3928.1 CONTRACTOR -I`�Bssie� t�[ - Co, � � �n�ticµ°�ss'� T'°" AFF_, ....
UCENSED CONTRACTORS DECLARATION r;:. - - - - - - - CLASS NO.� `DWflLr6' r5
I fiergby affirm that.I dm ILtensed under provlsiotn of E�pter9 ADDRESS' 8• o. Lotus. Ave. No:448101 .
of on of &nl > SEWER MAP
(com ng.� 7*I n fTe1�s, -
ProfessJ CodQ, dnd nTY Ilce li full force an�bffecl. _ : P8S8deF1& - tiAss C�3 - -- .-,: 1 VALIDATION
1 5 p SO Fr —" NO.OFBO E 1
• L�cens"- beF`44841 1 Llt`Cttlsa� 'C- /L SITS` STORK +'
VI�lUAl10N_ r ;
Contr«tor`l ssie Rfi (O:' ��' 1':2 - DESCk1 ThNof'woRK,Tear , ff-exist' N�`" i '6 912:00
,° 1eF. ins TreA
[].I am exempt under Sac y, - - - -- -
„ y
:B.BP.0 ior'thls feaiQn - - Alit. 41
USE
a°;G BLDG. res i ISE�nol .5'9 3 2 A
SSI naturir _.. �_
TEL FINALq / �,- ay o. 0 0 0:o 1 I
OWNER$UILDER DECLARATION (PRINT) NO. 796-392
pAj2_G!
1 h�r.by af#Irm that.l am exempt from.the_Conirc�-'s LicenseADDRESS' 38- - - p
Law for the,following:fbdsorr:(5i6oflbn,7031.5,.Business and
Prafb s7or5s'Calib): -;._ �. _. FIZESENT n - :_. ' )
-. .�.Y a o o 9Ei7.J2�.'.j
13UttDING- _ l I
-,1` ¢s owner of ihip pro-pprty bC_my smploxees with
wg4A arohvir sole tompen}at7on,iylll q the wo do _ LOCJUJTY
trut �Q�,2.7 '`, •6..
thsacture(s not Ir� r;cIeo or offered for sale(Sectlon
-7044,13 -gnd PrOfesslonstCode}:, - ---- -- -- -- - - - TEL -
NO _
p^ I, as owner of tho property,am exclusively contracting - - - .__ _... - -. _ - - - -- • -._ :_- ---- _
-wlth licensed contractors-to tonstroct the project (Sec- -T
'tion 7044, Business and Profeislons Code) ADDRESS S' 1� '.
GOf�STRUCTiO►d LENDING AC NCY'__ �. _.-. - BACx' YARD -FIWY PROP. LIhE )(15E
I hereby.'dfflrm that there is a cBniJtectlor�'lending agency for FRpNf t' . . c.. '
. th&.perfdrmance-of.th• work fur which this permit Is Isaued
-(,Sec. 3097, CLµ, C.�. sly.
P.
LarKWs Dame
WYAW.
-- - Y
P.C.-Fee-$,
Lerxbr't Addrss}
J_certify that-I hdve this application and state tbgt_the -14suance Fee P/"
above Informatlon is cbrred.'r agree tp comply with ell County _ in reselating tj b} l�ingcpt
-gr�,5aTetalFM
gnd }sris6y outfwrize representaver's".iQI !LDAAA r1
of this County to.ante{
upon the alpove-medtioned property fo In on Purposes.
Kerine't�Il w�nscirel,. bwrier'.
-Date
_-
COUNTY OF LOS ANGELES TEI4PLE CITY 1 0508 BUILDING PERMIT
DEPARTXM?r OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR
BUILDING AND SAFELY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1008020018
PHONE: (626) 285-0468 ETT:
LEGAL ID: NO. OF CONST BUILDING AD6DR&99:
ON FILE SQ. FT STORIES TYPE 6413 GOLDEN WEST AV
STRUCTURE: V-B TEMP CA 917601423
ASSESSOR INFORMATION 3UMBER: NEAREST CROSS STREET:
5383-017-026 T7-1064t9 PAGE: 597 GRID: Al L4XIA-.ITY: TEMPLE CITY, C
Tom ': E3= BLDG USE: REBID USE ZONE: R-1 ISSUED ON: PROCESSED BY:
EZSST OOC GRP: 08/02/10 SR
ONNER: TEL. NO: BLDGS. NOW ON LOT: VAIZATION: F F CODE:
STERLING, LOIS - 11,000
6413 GOLDEN WEST AV
TTS 917801423 m m .
FEES PAID DOCRIPTI10N OF WORE
REROOF TEAR OFF RESHEATTRG IN Ti+T•r, 30 YEAR COMPOSITION
FEE DESCRIPTION: QQANTITY: DOM: AMOUNT:
APPLICANT: TEL. NO:
FITTER AN, JOHN H (626) 301-9546- AA BLDG PERMIT ISSUANCE 27.80
237 W. CHESTNUT AB STATE GREEN BLDG FES 11000.00 VAL 1.00 SPECIAL CONDITIONS:
MONROVIA, CA AC STRONG MOTION RESID 11000.00 VAL 1.10
D2 PERMIT W/O EN-HC 11000.00 VAL 234.00
TOTAL FEES 263.90
CONTRACTOR: TEL. NO: APPROVALS DATE INBPECPOR SIGNATURE
F=STU INR CONSTT2=ON (626) 301-9546-
237 W. CUE3TNUT AVENUE LSC. NO LOCATION AND SETBACKS
MONROVIA CA 91016 884981
SOILS E 12EER APPROVAL
ARCHITECT OR ENGINIZER: TEL. NO: FOUNDATION/TRENCH FORMS
LIC. NO: SLAB ER FLOOR
RAISED,FLOOR FRAMING
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION
153H269 3 00
FLOOR SHEAT[-lT9G
NO. OF FAMILIES: PWELLING UNITS: APT/COAD; STAT CLASS:
NO 21 ROOF SHEATT-FM
SCHOOL WITHIN HAZARDOUS SHEAR PANELS
AIR QUA=: 1000 FEET MATT I LS .
NO NO NO FRAME INSPEC`ION
FIRE SPRINKLER HANGERS
INSULATION/WEATHER $TRIP
INTERIOR LATH DRYWALL
EXTERIOR LATH
RATTED FLOOR CE EL A59EM.
RATED WALL ASSEMBLLES
RA= SHTFT9 OPE7ING3
T-BAR CEILINGS
LOT DRAINAGE
REPORT ID: DPR261 ROUTE TO: BS0508