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HomeMy Public PortalAbout10119 GREEN ST_Building__ A ROAD DDfT. FOR ANY /L".F. " C'Rr`-', c G.^`.,r•G K pp .DONE IN THE `ROAD RIGHT Or V✓AY. 7GA688A CE#8098-69 APPLICATION FOR BUILDING PERMIT ,f1 COUNTY OF LOS ANGELES ABUILDING DDRESS /G �/ ✓� DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST / CASSATT D. GRIFFIN, SUPT OF BUILDING CROSS ST. _ DISTRICT NO. TYPE /PROCESSED Y FOR APPLICANT TO FILL IN 5-- CONST. BUILDING / / r STATISTICAL CLA FICATION SEWER MAP ADDRESS `� I('� �= 4 IT h �T �I SK PG _CLASS.NO. DWELL/.UNITS LOT NO. BLOCK MAP STATE NUM ER / HWY. YES TRACT U•_AE ZgNE SPECIAL NO.OF BLDGS. /-t / CONDITIONS SIZE OF LOT 7}'L1 ,( Fj(7 I NOW ON LOT , /I USE OF BUILDING EXISTING BLDG. &i_� FJI,/���i/� YARD HWY STREET NAME EXIST. SETBACK WIDTH OWNER I✓ Cl �[. 1 FRONT l j MAIL C ,p P.L. ADDRESS /0/ f-+° `11l LLQAZ SIDE P.L. CITY % NO INSPECTION RECORD ARCHITEC ENGNEERT OR TEL. - NO. ADDRESS %U/ l je P-=40-- TEL. CONTRACTOR NO. ADDRESS DESCRIPTION OF WORK NEW ADD ALTER REPAIR /! DEMOLISH SQ. FT. p'e'7 NO. OF NO. OF SIZE 2 D D vG STORIES FAMILIES USE • STRUCTURE � C4 ATURE d—e-T n�v SIGN TURE OF i APPLICANT x"111 n APPROVALS DATE INSPECTOR'S SIGNATURE ADDRESS �� : 6R1nLc FOUNDATION: LOCATION FORMS,MATERIALS VALUATION $ �� FRAME: FIRE STOPS, BRACING, BOLTS PFURNACE:URNACE: LOCATION, FEE S I EE S O I GAS VENT, DUCTS 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH, INT. PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND LATH, EXT. STATE LAWS R GULATING BUILDING CONSTRUCTION. SIGNATURE OFA SCJ � �� HOUSE NUMBER COR- PERMITTEE ��, \\\ RECT AND POSTED ADDRESS FINAL - CLYDE N. DIRLAM, PRINCIPAL ST UCT RAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION UV M.o. CASH ti('�9 8 0 1 - APR 2 5 1 A 3.n U � ®� 1 APPLICATION FOR BUILDING PERMIT ] d COUNTY'OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO F1LL IN I hereby affirm that I have a certtflcate of consent to self insure, M%-DM ADDRESS or a cerftficede of Workera' COmpensathn Irtsurance,or a cedf led T copy thereof(Sec.3800,Lab.C.) GTY ZIP c. ifOa d Policy Na C�rY sag LOT No.of NOW CIN LOT ❑ Cwttfled copy is hereby fumleheci. O , �mss ❑ C-wttfied copy la hied wfth the scanty bdking hiapectionci&partnent Z,6,5-TRACT 2Z 1 3 LO7 3 113E mME MAP Na . Date Applicant A38E PMAE SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' �� COMPENSATION INSSURANCETM� 10°°r r.OF ? TEs (This secd n reed not be completed If the permit Is for one hundred D181"RY(;T GROUP TYPE CONST. FRE DOBE PROCESSED BY ddlars ($100) or leas.) I certify that In the performance of the work for which this permit Ls lamed, I shell not arnpicy any person In any manner ac as to Q,43NFFA TEL tia become Subject to the Nkxkera'Compensation Laws 3A7T3TCAL APT CONDO Date Appllca� ADDRESS a- SS t+a �DwE1L LRdT3 NOTICE TO APPLKANT.• If, after making this Certificate of D N S% d REQUIRED TUIAL SETBACK FROM EXIST Exarnptlon, you shoudid becorne subject to the Vrbrkers' CONTnACTOR TEL 40. SET BAG( YARD HWY PROP UNE YADTH Compeneati0n provision of the Labor Code, you must forthwith FRONT COmpfy with such prov4k)na or this perraft shall be deemed revoked. ADDRESS UG 40. PL SDE LICENSED CONTRACTORS DECLARATION CITY Lr.CLASS PL I hereby affirm that I am licensed ruderprovisbne of Chapter 9 SEWER MAP (commencing with Seotlon 7000)of Division 3 of the Business and SO.FT.317E NO.OF STORES N0.OF FAMUES Profb esans Code,and my poense le b full force and effect ! NEW ❑ BK PO ' a Lbenee Wrmber L1c.Clue OF vrOR1c ADD ❑ a Q Contractor Data W d W-5 ALTS R $ V ❑ I am exerihpt under Seo. H W E PAIR ❑ $ RAP.C. for this reason `d �K DEMOL ❑ LDP/c f _ MA W Date: USE OF Da"Na BLDG URM ❑ ture ?3 _ ,,..J�r�e APPLIC'.�NT(FfiJT) TEL Na - LDMA Fbmn r �f 4 ea owner of the property, or my empioyeee with wages as Z ACCT.T their ace compensation, wEl d0 the worts and the strricture la. ADDRESS O root intended or offered for sale (Section 7044, Bualness and MAL DATE � 50■50 1 Pro(eeaior>e Code.) wu,re AaPuc-axr OR FUTURE BUN-DING oCCLIPw+T HurXe A fuinaooua ravwAL _ ❑ I, as owner of the property, am'e)xkmlvefy oontracthg wtth OR A LIXTU E 000fD"OG A HAZArooue r,U,TEr3AL EQUAL TO OR uvea THAN Toe lcermed c0rrbadora t0 tenet uct the project (Section 7044, AMOUNTS SPEcr~ED ON THE HN7J�FiDOU9 wine lFORMASTCN GLADE? YES❑ '40❑ Business and Profess" Code.) - VA-L,THE INTENDED UeE OF THE BUIDL a M THE APPLICANT OR FUTURE BUILDING '� T{ ■ OCCLF WT REQUIRE P60LT FOR CONION STRUCTOR IIOOPGAT"R:10M THE SOUTH - ww 255 CONSTRUCTION LENDING AGENCY COAST AIs.OUALTY M&WaBAENT DISTRI r(8CACW eff PERMI TM CHECKLIST FOR. fU 2 I'�ITEMIDE!FA I hereby affirm that there Is a co+miructbn lendhhg agency for YES❑ No❑ C4 the performance of the work for which thta permft IS lssi (Sea Z O TOTAL 1-9- 75 m 3097,Ctv.C.) 'a'�EEaaus�r UNDE C1�►Or UNDER Tie LOS ANAND GELES C ��}A{ � .15 Lenders Name 1917:1 .3 2,CHAPTER 220�FOR 09W0�IO A F'1 YT FROM TT.THF�Z200 40HE BC � T 1� Larders Address •� O ofwW(A Alfa 1 certify that I has reed this applbatton and state umder penalty of iry�� � ha � P.C.FEE � �v PST FEE w Oraan0ee and correct tobul'ici g 000111--wol 12J10/9-1 COnatrucdon, and hereby authortze rexaaantatlyea of ttds County ISSUANCE FEE - io erTterr the property for tr,apeaion perp-an. - �d 2960 1. AN11:39 m AJ Q] NVESTK KrKD-N FEE TOU1L FEE . f u Ar■ �✓ 42 SEE REVERSE FOR EXPLANATORY LANGUAGE .-•�. I T--fes _ _ WORKERS'COMPENSATION DECLARATUDN r Insureby >6ffirmacer that 1,aye-a4-s' `ome.a�cEgnIns}o:,a1fy• ���I�I�� 1G FO BUI�DI G PERMIT � Insure, or a certificate of Workefs'Comperliatl�n lnsufanee, , or a certified copy thereof (Sec 3800,Lab. C.)' t COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Buil-D❑ Certified copy Is hereby furnished• FOR APPLICANT TO FILL IN ADDR SSSS t o t ci 57' ❑ Certified copy 1s filed with the county bullding Insp6c- BUILDING tion department. ADDRESS I0 II Q` P�/V V T'• LOCALITYNEAREST '/� Date Applicant CITY o.0-C CL ZIP CROSS GIIL�� v v CE3MFICATE OF DMMPTK)N FkOM WORKERS' �n X ZZ fl NO.OF BU G&rz- .ASSESSOR COMPENSATION,INSURANCE SIZE OF LOT OV NOW ON LOT MAP BOOK PAGE PARCEL - (This section need not be tom leted If.jhe permit b for ane lr�- — , hundred dollars (;100)or less• BLOCK ` r TEL i USE �CMAP } I c• tfy that fn the performance of the work for which this OWNER dobe- 0~ �' • {` COfDITKX4 a D15TRICT P TYPE FRE PROC65®BY s O It Is owed,i shall not employ any n In any manner U Pei'° ADDRESS 9 QiB , d OONST. ZOIE as to become subject to the Worker Compensation LRws. �/ �7 1/b �j"� „ pr, `� ZIP /�a v {\J �.. '� o .Date It •ZQ.• '3 .Appllcant COl STAT0TICALCVSSFPCATION AFT. F NOTICE TO APPLICANT- ff, after ma h s tate of AN TOR N //��qq - 0.73 •� , UJ Exemption, you shoukf become subj.g the Workers V� NO. 5--19 CLASS NO, �1_DWE3L UNfTS� IL Comperaation provlslons of the Labor Code, you must forth-. . 3 Ste'Ayam. 44&%NC/& SEWER M,,P. W with comply with such provlsloru or this permit shall be Tn- �' deemed revoked. CONTRACTOR NO.. BK P6,� 3 r VALIDAT UCENSED COWRACTORSDECLARATION IC I hereby affirm that I am licensed under provblons of Chapter 9 ADDRESS NO. VALUATFON (comnwr dng with Section 7000)of Dtvblon 3 of the Businew and Profeeskxr Code, and my Ilcense Is In full force and effect. CITY ?-Z20 CLASS r , SZ . • LlcenswNumber Llc.Class SIZE�IZ3RI � SNO.OF TOES Z NO.OF ONE _ � r725A Contractor pie bESCRIPTION OF WORK NEW El "oP o o'0 2 ADD. ❑ I am exempt under Sec o- /ON- Afew K f MAP-PJ ALTER E] FINAL [ a 4 2 6 5 0 B.&P.C. for this reason Fi+r+>,sI C. B C- i .bb /S REPAIR ❑ DA o 0 4 G C� S O L USE OF Date: EMST'IING BLDG. $ tlL C,•-`c Q DE,41OL ElR 1220-83 Sigi nature APPUCANT T KNI A.10 T NO. 9•ZO�i TEL eby OWNER- UILDER DECIARAT I heraffirm that I am exempt from the Contractors Gcofn"" J/1 Q C54 fie" 3 P• 240 -Z"o Law for the following reason (Section 7031.5, Business and , p, < PXofewlons Code):" I, as owner of the or m em with �AD� _ c �• o o L 7 PfO�tY, Y employees wages as their sole compensation,will do thework and the structure Is not Intended or offered for sale(Section 7044, Buslress and Professions.Code)_ M0V1NQ ❑ 1, aY owner of the'property, am.exclusively contracting OR NO. with licensed contractors to constructthe project (Sec- ADDRESS II _ tion-7044, Business and Professions Code) . IREDCONSTRUCTION LENDING AGOJCY 7 MS'YARD IP � yylpT 3 I hereby affirm that then Is a construction lending agency for FRONT the performance of the work for which this perTnit s.owed P. ^' ' °, rSec! 3097, Ov. C.) SIDE _ P.L. r F P. Lenders Name Lender's AddressP.C.FM: ! ;� P.n. F» I certify that I baw read this application and state that the FOS above infomwtlon b correct. I agree to comply with all County I J Y ordinances and ,State laws rekrting to building corWnxtlon, 7ofal FM and hereby authorize representatives o this County to enter n the above-mentioned Irupedlon purpwes w!!a PO!D�LANATORY IAMOUAGE s+p,atur.of App, COMPENSATIQN PECI MkAT1ON I hereby,afflrm that have a certificate consent;to nett ►pPLICATIQ FOR. BUILDING PERMIT Insure, or a certfflcote of Workgrs' Compensation Insurancra, or a certtfled copy therwf ; I . . . a {Sec �AQO, Lab. . )•.. 11. ... COUNTY'0115 LOS ANGBE5 BUILDING AND SAFETY Policy.No. �'+ comoi hy. - • ❑ Cerriied u furnished ,: R APPLICANT TO FILA IN �� hereby ADDRESS !o/!g Gov.ft>v, 5 7^ ❑ Certffted copy Is filed with the 0uhty building inapec- BUILDING - - . tion departmerrtr IO / �v/2 CG`�i ST' -trMPc .rT Date : ,- Applicant Cur �'�r,.o'c , /T_ `. - ZIP .. ; 'C I RTI FICATE OF ECMPTION FROM WORKERS sL7E d( T ilr x'C Z-5 �xriV oN LOT .. Z- '; - y� E.t Al, k. COMM4MT10N INSURANCE '(This yettlott need notbi-ompleted ff the permit is fof one bzA6. OOG� '+ ,r LOT NO. - PAGE * PARCEL hundred dollors'($100) or.leas.) ", r. TEL I certify tart Tn,the.pecforaiance•pf they work,'for,which this, permit to Issued, I sho,11 not employ any person In ariy.'mpnner - A QIRESS - tO 1•� �it%srry STS ro as to bebome subled 4o the Workere-Compensat)oo Laws004�0 MONS O ],1' CFfY —Aw2Atr .! T- IP- g/7�O' U -, .Date_Applicant, AR04RFCT pR - 0C CANT aJG Nb.- = DISTRI GROUP TYPE ' FIRE "PROCESSED BY 0 NOTICE TO'APPLI ff; after making thls'•Grtifiogte,of . .- Exenaptlon, .yers-•thould .aecome.-subject .to .the' Wpekerr` �q �T, ZONE Comperma-H9.n prdVlslons =Labor Laborodey.you must fgrtfi- ADDRESS' _ W vitth comply with such provfslons:or..thls permit shall be TEL STA CIASSIF1CATKxJ APT. CO Z deemednvoke&' -t'.' CONTRACTOR NO. U GE11P COfJ d2�4C FORS'1?�CLARATI ON• LIC Ci Ass NO. own i •UNG S I hereby affirm that Lim Ilcensrad under prpvlslon}ofC.hapw o ADDRESS ' SEWER MAP• (commendnq with Settfon 7000). DwXron 3 of thej&Alhesi _ and�sofeoom Code,and my Ilcerze.Js In fu l force arxi eff:c . CLASS PG, VALDAT,I FL NO- OF CH 1Jcerne rlumber� -lac Clans _ NO, OF VALUAIJON - Contractor, I�rx. DESCRI OF WORK NEW - � - .�j ...;1 ❑'I am exempt under /.► fola$4J !�G TER . B. f.0 for this reason y ; ; RI�AIR _ T �atw EXIS ll Nf3 O�aIC rica D(AAOL APPUCANT - Slgtwtun TEL FINAL OWNER-131DECLARATION NO. DA I hereby afflrm lhot'l am exempt front the Contractors Ucerise. _ Law for the followIN reaodn (Section 7WI.5,'BkWn* gnd,' ADDRESS R ns Code): aft L'1 1, as.owner of•fhe pr�o(»ky,-:or,my ert�ploypea-wRh l,0G•E wages as their able compehsatlbrf,will do.-the)ro "and' _ LbcALmY�� EM�� the strutture Is not Intended or offered for sare(Sectlbn.. ��1` +`. . 70", "1 F-0 and Prbfeasloos Code:) , MoviNt3.. OR.` NCS. ' - ❑ i, as owner of'th•pwprrrty,am exclu;lvely contracting - - �= -�- j 'j '`•. . with Ilcdnsed contractors.to r;onstrjct•the.project (Sec= ADostFSs 1 fir;=t , tion 7044, Business and,Profeaslops Code.) i CONST9UcTnON_LENDIN0 A*04Cl A� ROM f hereby affirm thatthwols a con&ructlon lending agency for the perfbrinanca of the�york for which this permit [}'Issued P.L. (Sec 3097, Civ. C..). - SIDE P.L. Lpnders Name y ksf ! ti :��1L�lt.r7 Parmll Fee LendersAddreq83 o I certify that I have•rood this application and state that the Issuoncra �1 iAMA AiL 1 1 � `,:' above Irlformwa lon.ls correct.i ogreq`to comppry,wfth all County InJ�arlg¢rlgh.Feq y ; ordingn eelss and State laws.reTatfap to 1jullding constructlon, Total Fee' / mAAA Peim and herZ authorrce representatives of this.County to enter ' 'upon they,,aboveynentlon6ddApropeJty for Iritl ectlon parpoiQea t SM t1MV1111111fe rOR LKM AMATO[Y LANGUAGN r•of or AuntDtrt� COUNTY OF L0.9 ANREIRa TEMPLE CITY 8 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1105120050 PHONE: (626) 185-0488 EET: LEGAL ID: NO. OF CONST -BU'IIDING ADDRESS: BK: 221 PG: 19 PC: 1 SQ. FT STORIES TYPE 10119 GREEN ST STRUCTURE: 6 V-B TEMP CA 917803334 ASSESSOR IN FOPMATION NTI&MER: NEAREST CROSS STREET: BALDWIN 8585-003-053 TRCFW9 PAGE: 597 GRID: B4 LOCALITY: TEX?LE CITY, C TENANT: EXIST BLDG USE: DR-IAC USE ZONE: R-3 ISSUED ON: PRO<MSSED BY: EXIST OCC GRP: 05/17/11 SR OWNER: TEL. NO: BLDG9. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE: LIU PETER H;PHI-QUYRN (626) 582-1860- 1,992 10119 GREEN ST TEND 917803334 FEES PAID DESCRIPTION OF WORK PJMVE RUSTING WOOD SHAKE INSTALS, EM31E LITE (PONDEROSA FEE DESCRIPTION: QUANTITY: DOM: AMOUNT: TILE) 7 LB DETACHED GARAGE APPLICANT: TEL. NO: BAT'IOFF, JOHN (714) 381-7974- D1 PLANCHECK W/O EN-HC 1992.00 VAL 82.10 AB BLDG PERMIT BLDGISSUANCE 21.80 SPECIAL CONDITIONS: 1— I����® AB STATE GREEN BLDG FSE 1992.00 VAL 1.00 ��//�{/` AC STRONG MOTION R&SID 1991.00 VAL 0.50 D2 PERMIT W/O EN-HC 1992.00 VAL 82.20 CONTRACTOR: TEL. NO: TOTAL FRES 193.60 APPROVALS DATE INSPECTOR SIGNATURE MODERN ROOFING (818) 843-5050- 2219 W OLIVE AVE, 9282 LIC. NO LO(LASION AND BSTBACRS BURBANK CA 91506 807881 + SOIIS ENGINEER APPROVAL ARCHITECT OR ENGIN=: TEL. NO: FOUND TION/TRENCH FORMS LIC. NO: SLAB UNDRR FLOOR RAISE) FLOOR FRAMING MAP NO: SU%TER MAP BOOK: PAGE: FIRE-ZONE: CMP: UNDERFLOOR INSUTATSON 147H269 3 00 FLOOR SHEATHING NO. OF FAMILIES: DWELLING UNITS: APT COPED: STAT CLASS: 0 Na 21 ROOF SHEATHING SCHOOL W17'HII HAZARDOUS SHEAR PANELS AIR QC7J=: 1000 FEET MATERIALS NO NO NO FRAME INSPECTION FIRE SPRINKLER HANGERS INSULATION WEATHRR STRIP INTERIOR LATH/DRYWALL • EXTERIOR LATH RATED FLOOR/CELL ASSEM. RATED WALE, AS9E4BL,Ig9 RATED SHAFTS OPENINGS T-BAR CEILINGS • ADDITIONAL DATA ON FILE LOT DRAINAGE REPORT ID: DPP-261 ROUTE TO: B90508 COUNTY OF LOS ANGE M TE24PLE CITY t 0508 BUILDING PERMIT DEPAR'11-= OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPT� TEMPLE CITY CA 91780 BL 0508 1105120049 PHONE: (626) 285-0488 EMT: LEGAL ID: NO. OF CONST BUILDING ADDRFi99: BK: 221 PG: 19 PC: 1 SQ. FT STORTES TYPE 10119 GREEN ST STRUCTURE: 22 V-B TEMP CA 917803334 ASSESSOR INFORMATION NUMBER: TTRARRST CROSS STREET: BALDWIN 8585-003-053 THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY, C TENANT: EXIST BLDG USE: RIS ID USE ZONE: R-3 ISSUED ON: PROCESSED BY: EXIST OCC GRP: 05/17/11 SR OWNER: TEL. NO: BLaGS. NOW ON LOT: VALIDaTION: FINAL DATE FI2CkL BY: CODE: LTU PETER HiPHI-QUYEN (626) 582-1860- 7,300 10119 GREEN ST TEHP 917803334 FEW PAID D&SCRIPTION OF WORK RI717VE EXISTING WOOD SHAKE INSTALL EAGLE LITE (PONDEROSA FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TILE) 7 LB MAIN HOUSE APPLICANT: TEL. NO: BA.TIOFF, JOHN (714) 381-7974 D1 PIANCT-SCK W/0 EN-HC 7300.00 VAL 155.90 AA BLDG PERMIT ISSUANCE 2 .80 SPECIAL CONDITIONS: �I��� AB STATE QREEN BLDG FEE 7300.00 VAL 1 1.00 AC STRONG MO'T'ION REBID 7300.00 VAL 0.70 D2 PERMIT W/0 EN-HC 7300.00 VAL 183.40 COFTRACT'OR: TEL. NO: TOTAL FEES 368.80 APPROVALS DATE INSPECTOR SIGNATURE MODERN ROOFING (818) 843-5050- 2219 W OLIVE AVE, #282 LIC. NO LOCATION AND SETBACKS BURBANK CA 91506 807881 SOILS ENG12= APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION TRENCH FORMS LIC. NO: SLATS UNDER FLOOR RAISED FLOOR FRAMING FAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CHP: UNDERFLOOR INSULATION 147H269 3 00 FLOOR SHEATHING NO. OF FAMILIES: DWELLING UNITS: APT GOND: STAT CLASS: G NO 21 ROOF SHEATHING SCHOOL WITHIN HAZARDOUS SHEAR PANELS A-IR QUALITY: 1000 FEET lO'.TERT AT 9 NO NO NO FRAME INSPECTION FIRE SPRINKLER HANGERS INSULATION/WEATHER STRIP INTERIOR LATH DRYWALL EXTERIOR LATH RATED FLOOR CE IL ASS Ell. RATED WALL ASST MB= RATED SHAFTS OPENINGS T-BAR CEI.IJN'GS + ADDITIONAL DATA ON FILE LOT DRAINAGE REPORT ID: DPP-261 ROUTE TO: BS0508