HomeMy Public PortalAbout10765 GRAND AVE_Building__ i
76A638A CE 4803 3-69 -�
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS J
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPT OF BUILDING NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN DISTRICT/NNO. GROU TYP.F,CLIMST, PR CE E ol
(PRINT OR TYPE ONLY) `� Li'
BUILDING �n STATISTICAL CLF�JSSI�FICATION SEWER MAP
ADDRESS lo765 E. Grand Te le Cit CLASS NO. � OWELL.UNITS BK PG
LOT NO. BLOCK USE ZONE MAP .�
^ NO. i,)L
TRACT '{J�' SPECIAL
N0. OF BLOGS. CONDITIONS
SIZE OF LOT NOW ON LOT
USE OF
EXISTING BLDG. Residence BLDG. SETBACK FROM
TEL. FRONT PROP. LINE OF (STREET)
OWNER Bemice NO. _
TYPE OF EXISTING SETBACK HIGHWAY + YARD - TOTAL
HIGHWAY WIDTH FROM C.L.
ADDRESS 10765 E• Grand
CITY Temple CityBLDG.SETBACK
ARCHITECT OR TEL.
ENGINEER N0. SIDE PROP. LINE OF (STREET)
�
TYPE OF EXISTING SETBACK HI Y + YARD = TOTAL
[APPLICANT
SS HIGHWAY WIDTH FROM C.L.
TEL. + _
ACTORgo NO. �C'
SS 337 S. Wooft AVea NO LICX59496 CORNER CUTOFF YES ❑ N ❑ O
�., Los ]es CLASS C— SEE REVERSE SIDE FOR SPECIAL APPROVALS oc
TRUCTION LENDER
AND BRANCH V
SS W
a
N
T. NO. OF NO. OF ❑ Z
STORIES FAMILIES NEWUSE —
CTURE Reroof ADD ❑
ALTER ❑
REPAIR
TURE OF DEMOL ❑
M -C>
VALUATION $ 536.00 APPROVALS DATE INSPECTOR'S SIGNATURE
PMT FOUNDATION: LOCATION
FEE $ FEE $ ��-�� FORMS MATERIALS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION FRAME: FIRE STOPS,
BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION,
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUC- GAS VENT DUCTS
TION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I
WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE LATH, INT.
OF THE STATE OF CALIFORNIA IN RELATING TO WORK ME 'S COM-
PENSATION INSURANCE.
SIGNATURE OF j+� '�yJ�• /,/�► LATH, EXT.
PERMITTEE Rigid 9p.1. Co. HOUSE NUMBER CORRECT
tR AND POSTED
ADDRESS-337S pho FINAL
JOHN F. LEWIS, PRINCIPAL ST RAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH - PERMIT VALIDATION ST
M.O. CASH
r 5 d 5 8c-_ Jtkl 6 1 0 9.0 oN
76A638A CE#803 2-63APPLICATION FOR BUILDING PERM T
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS /jJ
BUILDING AND SAFETY DIVISION LO CA L I T" /j/y.
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. /-
DISTRICT N GR9_VP TYPE PROC SS B
FDRE
OR APPLICANT TO FILL IN CONST.
BUILDIADDRENG
�� �- `�' � , STATISTICAL CLASSIFICATION SEWER MAP
�,,/ sIVCLASS. NO. DWELL. UNITS'V ' (Ji— BLOCKWATER NOT REQUIRED RECEIVEDQ CERTIFICATE:
33J' NO 0,5MAP —/ HIIGRCVLE) STATE MAJOR SECOND,�J 6— NOWONLOTNO. OF S NUSEZONE SPECIAL
CONDITIONS
LDG. TEL. Jc:� ENO. CBULDING YARD HWY STREET NAME EXIST.
�` SETBACK WIDTH
U (p � Q 1L'.D - ,s FRONT I
LRE
TECT OR TEL. P. L.
EER NO. SIDE
P. L.
SS / O
T E V
ACTOR („� `? ?` NO. � C �
` kw
[[,,, ...�. yam^ )Q
SS r\�� Wp) I� 1vidA 1 '
DESCRIPTION OF WORK JVa
° Z
ADD ALTER REPAIR DEMOLISH
. n1 NO. OF NO. OF
/V STORIESFAMILIES
F �j/L 1100)/%
TURE *&74)-
TURE FICANTTION � O'Q�
APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. PMT. / ,S'-CY FOUNDATION: LOCATION
FEE / (i FORMS, MATERIALS
FRAME: FIRE STOPS.
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. 1r
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS E
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 C PENSATION INSURANCE.
LATH, EXT.
SIGNATURE F _ /�/ � HOUSE NUMBER COR-
PERMITTEE /✓- _ RECT AND POSTED
ADDRESS_ ., O. j, L r. !� FINAL ``.•_�.t: t.
JOHN F. LEWIS. PRINCIPAL ST R RAL ENGINEER
PLAN CHECK VALI ATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH
usa 3 4 1 31 DEC 11 1 D 1 8.50-
L-4
-fai%Vab CE 14;
APPLICATION FCR BUILDING PEMI_r
COUNTY OF LOS ANGELES ASSESSOR
DEPARTMENT OF COUNTY ENGINEER MAP BOOK /� / PAGE PARC%L
BUILDING
BUILDING AND SAFETY DIVISION ADDRESt /`J-74 S
COLEMAN W. JENKINS, "P'T OF ISUILDIH0 LOCALITY Xv
R T T FILL NEAREST
CROSS ST.(Print or tYD* only)
L 1 Q
DISTRICT NO. ROUP TYPE ESSED BY
BUILDING CONS
ADDRESS
STATISTICAL CL IFICATION SEWER MHP
LOT NO- BLOCK CLASS NO DWELL,UN17'S" .. BK PO��
TRACT - USE ZONEfiCIA
c
NO.OF BLOGS. No
b+�
SIZE OF LOT NOW ON LOT / L
USE OF , TTT��� DII'IONS
EXISTING BLDG.
TEL
OWNER NO. LDG,SETBACK FROM
ADDRESS dF TPROP.LINkOF (SYI'kEE.T)
TYPE OF TI 1U(K KIGHWAY } Y Ps = #OTXL
CITY HIQHWA WI G.L. -
ARCHITECT O TEL. 4 _
ENGINEER NO. BLDO.SETBACK FROM
ADDRESS SIDE PROP.LINE Of' (S-rkEt T)
TEL.. �j y r]^t TYPE OF ISTING SETBACK HIdR**'? k - TOTAL
CONTRACTOR NO. �JJ /'614 HIGHWAY WIDTH FROM C.L
ADDRESS a LIC NO q g + _
LIC.
CITY ` CLASS- CORNER CUTOFF YES - NO
CONSTRUCTION LENDER 4i
NAME AND BRANCH SEE REVERSE SIDE FOR SPS APF5R0VAL,S M
ADDRESS
SQ. FT. -NO. OF / NO. OF NEW ❑ Z
SIZE V STORIES / FAMILIES
USE OF ADD
STRUCTURE Q
ALTER ❑
REPAIR❑
SIGNATURE OF
APPLICANT DEMOL ❑
VALUATION i 8mD APPROVALS DATE INSP TBIi'i GiGXATVR■
/ FOUNDATION: LOCATION
FEE ! FEE S i7 S FORMS MATERIALS
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAV[ READ THfS APPLICATION BRACING BOLTS
AND STAT[ THAT THE ABOVE IS CORRECT AND AIR[[ TO COMPLY 'FURNACE: LOCATION,
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING COX- GAS VENT, DUCTS
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIIED
HEREBY I WILL NOT EMPLOY ANY PRNSON IN VIOLATION OF THE LATH, INT.
LABOR CODE OF THE STAT[ OF -CALIFORNIA IN RELATING TO
WORKMEN'S COMP[N TION INSUR NC[. LATH, EXT.
PSIGNATURE OF HOUSE NUMCER COR-
ERMITTEE RECT ANb POSTED
ADDRESS FINAL Z
p
_ JOHN1. LEWIS. PRANCIIP*LSTR1fCTURAL E 9INEER
PLAN.CHECK VALMATION KMA. CASH PERMIT VAWATroN .'CK. M.O.
W. WH
L o 2 7 6 RJ APR 4 1 21.75—
a ,
IAP
TION
ere affi� I��e a certlflmte�ofAcon{wit to Jeff �Y. \�
Insure, or a :! ftpate of Y(orkec� Compenstrtlon Insurance, A P P L CATION ..FOR -BUILDING P E RM I T
or a certified copy thlTeof (Sec 3800,J ab.jl� ) COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy N?t. Company
❑ 4.Certified copy.ls hereby famished FOR APPLICANT TO FILL IN ,ppm 1676-C a it QMAfp,1+0�
0:. .tt on deed cDp department.
with Jfq cou,ra.ty building Inspec-- BurLDINo G �3
ADDRESS 0 li S d
Date Applicant Crry li Z1 PTr
IDCALIT y
y- NO. OF BLDGS. NEAREST
CSMHCATE OI`:D(ZEW1QN FROM WQRKOZS' SIZE qF LOT, NOW ON LOT I CROSS ST.
COMPENSATI Ot4F j NSU RANCE' ASSESSOR
Is section need noF be cgmpleted-ff the pgrml( Is for on• TRACT BLOCK LOT NO. ASAP BOOK PAGE PARCEi J
unfired dollars ($1 OD).or leei.)
, OWT�t I --J USE MAP
I certify that In the.perfgrrnante of lite^work for which this
,permit is Issued;IAholl not employ.anyp"n In any Manner ADDRESS
so.as to become sub)ect to the.Workert Cbmpensaflori' _ O
CITY ZIP
Date noon t ARCHITECT OR TEL
D P TYPE FI PROCESSED,-BY Q
'
NOTICE TO if, r,making H'hh. ificate of Eta NO. —' Optbfi. . ZQNE
Exemption, .you should become su4 ect to the Workers' V
Compensation provisions of the Labot- o¢e, you mud forth- ADDkIESS
co
deemedwith.-complyrev with .such provJsloos or, this permit.shQll be Ta-NO SfATISTH AL TK>N _ APT. CONDO.. Z
deemed revoked. .. •'' � CONTRACTOR NO.
LICENSED CONTRACTORS DECLARATION. uC Oma fd0: UNITST_
I hereby affirm that I am Ilcensed under pto'vl.Oons of.Chaphr 9 ADDRESS
(commencing with Section-7000)of.Division 3 of the Business LK SEVER ASAP
and Profiwlons Code,and my license is In:full force and effect. crry.. CLASS B� VALtDATFON
sa. NO. of NO. OF a-MCc
Ucen'se Number. Uc. Clara �' STORIES FAMILIES ONE
. - ElVALUATFON
Dmmm.)N OF wcI x �7
Contractor �a}e NEW ;
❑I am exempt under Sec Pl�Jr #AMN W ® , _
ALTER: El
BAP.C. for this reason # hk�J !m.1 1nREPAIR'❑ ;USE-OF
-.
DusTiNG BLDG. DEMOII ❑
Signature APPUM b 7/ FiiAL
OWNER-BUILDER DECLARATIONNT) DATE
I hereby affirm That I am exempt from the Contractor's Ucerua � .� ��
Law for the following reason;(Section 7031.5; Business and Filb41` r
Professions Code): _ .. .
BUILDING \ .r i
❑ , 1, as owner of the prop", or my employees with App � ■*
wag"as their sole comperuatiorr,wIH std the work 4nd. _ .= 1 A•^l �+� .o�ap
the structure Is not lnterrded'or offeTed for sale{Section LOCAUT �" --, 11T.�xr
.�y� 7044, Businesrand PrQfe■slons CNo.NG NO
l�l ,I,-as ownerof the property, am exclusively contracting �y•�A�
with licensed contractors to constrid the project.(Sec- EADD
C
tion 7044, �ualnea and Professions Code.) -. , �� , �t■�
+ : T
CONSTRUCTION LENDING AGENCY YARD EiMr1 ; '•}`1'. �� -
I hereby affirm tbdt thwwrva construction Ifnding agency for WAR
the performance of the work for *hlch fhla pecrhlt is Issued ■
(Sec 3097, Civ. C.). .
t ��yy--yyyy��.
r. Leddees Name - ••.VIJLR.JrIMIi 7/l2j'8
LDMA W. 1
Lendsus Address T
P. Perm"F� 1 i fllllslig
I certify that I fidve.read thA application and scute that the 4.ua O LDMA P/C f
above Informptlon Incorrect. I agree to comply with all County Fee
ordinances and State laws relating to bultding const, lion; Taal FM i LDAM Perm
and hereby authorize representcrav".of this Ci unty to enter
•above=mentloned for Inspection,pu
fl■Fr RW POR DIPLANATORY LA0604"
Sigrwtvrs of A*Ikmiv&Agent
COUNTY OF LOS ANGELES TE 4PLE CITY # 0508 BUILDING PERMIT
DEPART OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR
,.. - BUILDING AND SAFETY / LARD DEVELOPMENT TEMRLE CITY CA 91780 BL 0508. 1108100002
PHONE: (626) 285-0488 ETP:
LEGAL ID: NO. OF CONST BUIlaING ADER£gS:
TR: 13384 LT: 31 BL: .001 UN: .002 SQ. FT STORIES TYPE 10765 GRAND AV
STRUCTURE: 2200 V-B TEMP CA 917803545
ASSESSOR INFORMATION NUMBER: xJUZEST CROSS STREET:
8574-004-019
1Z-10lA.9 PAGE: 597 GRID: D4 LOCALITY: T1r2rvl•F CITY CA
TENANT: EXIST BLDG USE: REBID USE ZONE: R-1 ISSUED ON: PROCESSED BY:
EXIST OCC GRP: 08/10/11 SR
01QqER: TEL. NO: BLDG9. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE:
MATSUURA MA.9AKAZU - 2 6,000
10765 GRAND AV
TEMP 917803545 FERS PAID DMCRIPTION OF WORT
COMPLETE TEAR OFF, SHEATH, INSTALL EDGE NERTAl., 15 LB FELT 30
FEE DESCRIPTION: QUANTITY: OOPS: AMOUNT: YEAR COMP ROOF
APPLICANT: TEL. NO:
LAM, BRUCE - AA BLDG PERMIT ISSUANCE - 27.80
AB STATE GREEN BLDG FES 6000.00 VAL 1.00 SPECIAL CONDITIONS;
AC STRONG MOTION RESID 6000.00 VAL 0.60
D2 PERMIT W/O EN-HC 6000.00 VAL 149.70 _
TOTAL FEES 179.10
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
LAM, BRUCE PHUONC3 (626) 393-9089-
9640 OLIVE STREET . LIC. NO LOCATION ASID SETBAr
'TMPT•R CITY, CA 91780 NONE
SOILS RNEER APPROVAL
ARCHITECT OR ENGIN=: TEL. NO: FOUNDATION TRENCH FORMS
LIC. NO: 9LAB/UND9k FLOOR
RAISED FLOOR FRAMING
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMB?: UNDERFLOOR INSULATION
147H277 3 Ob
FLOOR SHEATHING
NO. OF FAMILIES: DOLLING UNITS: AFT/GOND: STAT CLASS:
0 NO 21 ROOF SHEATFIING
SCHOOL WITHIN HAZARDOUS SHEAR PANELS
AIR QUALITY: 1000 FEST MlNTE R I AL.9
NO NO 190 FRAME INSPECTION
F= 9 vn hair,� HA14GE RS
INSULATION/WEATHER STRIP
I27IERIOR LATH/DRYWALL
EXTERIOR LATH
RATED FLDOR/CEI, ASSEMI.
RATED HALL ASSEMBLIES
RATED SHAFTS OPENINGS
T-BAR CEILINGS
LOT DRAINAGE
REPORT ID: DPR261 ROUTE TO: RS0508
• COUNTY OF LOS ANGELES TEMPLE CITY 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORIS 9701 LAS TUNAS ALTERATION/REPAIR
'BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1108100003
PHONE: (626) 285-0488 EXT:
LEGAL ID: NO. OF CONST BUILDING ADDRESS;
TR: 13384 IT: 31 BL: .001 UN: .002 SQ. FT STORIES TYPE 10765 GRAND AV
STRUCTURE: 500 V-B TEMP CA 917803545
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET:
8574-004-019 THOMAS PAGE: 597 GRID: D4 LOCA=: T34PLE CITY CA
TEtANT: EKIST BLDG USE: GARAG USE ZONE: R-1 ISSUED ON: PROCE95ED BY:
K7TRT OCC GRP: 08/10/11 SR
OWNER: TEL. 190: BLDGS. NOW ON LOT: VALCIATION: F,114AL DATE FINAL BY: CODE:
MAT'SIIURA MASAKAZU - 2 1,000 I �^
10765 GRAND AV 7yTlNenl
TEMP 917803545 FEES PAID DMCILIPTIC114 OF WORK
Q'lWLLRI'E TEAR OFF, RESSUFAITH, INSTALL 15 LB FELT, INSTALS, 30
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: YEAR COMP ROOF
APPLICANT: TEL. NO:
LAW, BRUCE - AA BLDG PERMIT ISSUANCE 27.80
AB STATS GREEN BLDG FEE 1000.00 VAL 1.00 SPECIAL CONDITIONS:
AC STRONG MOTION RESID 1000.00 VAL 0.50
D2 PERMIT W/O`EN-HC 1000.00 VAL 65.40
TOTAL FEES 94.70
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
LAM, BRUCE PHUONG (626) 393-9089-
9640 OLIVE STREET LIC. NO LOCATION AND SETBACKS
TEMPLE CITY, CA 91780 NONE
SOPLS E 4GTNFF t APPROVAL
ARCHITECT OR ENGIb=: TEM. NO: FOUNDATION/TRENCH FORMS
LIC. NO: SLAB UNDRR FLOOR
RAISED FLOOR FRANQNG
MAP NO: SEWER MAP BOOL: PAGE: FIRE ZONE: CMP: UND,-RFL00R INSULATION
147H277 3 00
FLOOR SHEATHING
NO. OF FAMILIES:: DWELS._II4G UNITS: APT CON D: STAT CLASS: +
0 NO 21 ROOF SHEATHING
SCI-NOOL WITHIN HAZARDOUS SHEAR.PANRLS
AIR QUALITY: 1000 FEET MATERIALS
NO NO NO FRAME INSPECTION
FIRE SPRINKLER HANGER9
ON/WEA= STRIP
INTERIOR LATH{ DRYWALL
EXTERIOR LATH
RATED FLOOR CIEIL A.9SEM.
RATED 10ULL ASSEM T,
RATED SHAFTS OPENINGS
T-BAR CEILINGS
LOT DRAINAGE
REPORT ID: DPR261 ROUTE TO: BS0508