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Home My Public Portal About6129 HART AVE_Building__ UP W) APPUCAMON FOR S' ' " NO PERNT COUNTY OF LOS ANGELES 6 BUILDING AND SAFETY , -FOR APPLICANT TO FILL IN BUILDING ADD; SS WORKER'S COMPENSATION DECLARATION � I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS `p or a certificate of Workers' Compensation Insurance, or a certified G 2-1 HAR+ AYv` copy thereof(Sec.3800, b.C.) CITY ZIP . 22 �'� TrMLr Gi(F, LOCALITY Policy No. ar�,.Company / S17_E QF LOT NO.OF BLDGS.NOW ON LOT El Certified copy is hereby furnished. eb 7( 184 S _ 14(p50 0 NEAREST CROSS S . ❑ Certified copy is filed with the co ty.building inspection TRACTS-y��e LOCK LOT NO. 2� arnUSE ZONE MAP NO. dept t. Date G/ Za Applicant, L �- ASSESSOR MP,P�OQI( PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER �pp TEL NO. COMPENSATION INSURANCE %Af4H � I IZ�� WITHIN 1000 FT.OF SCHOOL? YES NO (This section need not be completed if the'permit is for one hundred ADD ESS dollars ($100)or less.) 210 DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY CIT � ZIPq r77 G D/ I certify that in the performance of the work for which this permit, (.��/� (J //�� is issued, I shall not employ'any person in any manner so as to `� become subject to the Workers'Compensation Laws. AR HITECT OR ENGINEER TEL NO P afR ISS s1K 1—Y Hoo t �fX,'-7— l STATISTICAL CLAASSSIFFIICATION APT CONDO Date• Applicant ADDRE S G'�1 t/`�+•� Q r^1p _ h_ M V 1 t /// rpnU CLASS NO. df,7 DWELL UNITS NOTICE TO APPLICANT If, after making this Certificate of� � 1 r °r ,`wfMwAL �� ry� REQUIRED TOTAL SETBACK FROM EXIST Exemption, you Should become subject' to the Workers' CONTRACTOR ��`- ? TEJ�� O..2.p 7 SET BACK YARD HWY PROP LINE WIDTH Compensation provisions.of the Labor Code, you must forthwith' C//1(p�//�/ _ Q r�/ !�� FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC�NO-y p /J� P L �� _ ��V !a - J�./�✓ / SIDE f'_.i:f e1r, LICENSED CONTRACTORS DECLARATION CITY uc CLASS P L -_ - - I hereby affirm that I am licensed underprovisions of Chapter 9SEWER MAP 7- (commencing with Section 7000)of Division 3 of the Business and SQ.F.T.SIZE NO.OF,�TORIES NO.OF FAMILIES- - - - - - 33 [, t ' Professions Code,and y lice ns is in lull force and effect. NEW ❑ BK PG _ _ :.a License Number LiC.Class DESCRIPTION OF WORK ADD ❑ VALUATION D{ T t f"-3 t _,•__ O Contractor 1'F' Date /✓' E h) d 14oH j::- ALTER El � � ' v U W d F—T��F-12 3 CASE C - RE3EPAIR � ��• � t.;;t;j 0 El am exempt under Sec. $ Qj u`' B:&P.C. for this reason DEMOL ❑ "t* Date: - USE OF ISTING BLDG. URM ❑ _ Ja P Sfb�f4 fAL _�. Signature APPPLILIICAN PRIN ) TEL NO. LDMA Perm# 8 Z ❑ 1, 'as owner of the,property, or my employees with wages as U ��r��N o ' c '� `vI Z •' ��' i their sole compensation, will.do the work and the structure iS ^ ADDRESS i� F�s� r ��/��/ �(��j� �7 a 1fj,�,?�jy not intended or offered for sale (Section 7044, Business and 3Q NI ��1-l�{d.FY/ 1 AKN�7Y"•i•�94_ft_ I/g FINAL DATE Q' Professions Code.) r v WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL '. OR A MIXTURE CONTAINING,A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE /+7' El1, as owner of the property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL B > ACCT.e 8 licensed contractors to construct the project (Section 7044, VES❑ NO❑ , a- Business � •� Business and Professions Code:) . S \S`: .510,5.. 2791°2�J WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING - p OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH `>�' tiu.�F :.`,� : TTCML� CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FO ITEMS E S GUIDELINES. 1 _�• I hereby affirm that there is a construction lending agency for VES❑ NO❑ `_ , ':TC!TAL -29`5.01 N the performance of the work for which this permit is issued(Sec. �� 1 /'- �� I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AlTHE SCA RMITTI ('_(,I��, 2�,�,� 3097,Civ.C:) CHECKLIST. UNDERSTAND MY REQUIREMENTS UNDER THE LOS COUNT, CHECK a TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HA ROO � Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQM_Dom.'.� CHANGE .00 o Lender's Address O R R AG NEOENT o I certify that I have read this application and state under penalty 1 i R of perjur that the above information is correct.I agree to comply P.C.FEE /�� 9/ PERMIT FEE i�,r�� 9 fj .,0000-0001 11/22/9_r N with all ounty ordinances and State laws relating to building �i �t p eM 7 L constr �Ion, and hereby authorize representatives of this County ` ,��' �/ ISSUANCE FEE S`F 1'-r 1 F t i 1' 'TY ✓ to ent on the above-mentioned property for inspecti. PUr seS. -- / } ' ID a vuL•W INVESTIGATION FEE TOTAL se ai of ARRliam o Agem D.If fOf / SEE REVERSE FOR EXPLANATORY LANGUAGE\ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT- DEPARTMENT OF PUBLIC WORKS '9071 LAS TUNAS RESIDENTIAL ADD BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 96080700.12 s PHONE: (818) 285:0488 EXT: LEGAL ID: NO. OF CONST NEW BUILDING ADDRESS: TR: 5904 LT: 218 SQ. FT STORIES TYPE OCCUP GROUP 6129 HART AV STRUCTURE: .144 1 V R3 TEMP CA 917801629 ASSESSOR INFORMATION NUMBER: GARAGE: NEAREST'CROSS STREET: 5384-008=019 ' OTHER: THOMAS PAGE:. 596 GRID: H2 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: USE ZONE: ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 08/07/96 TC 08/07/97 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BYd CODE: TRAC XANH C;TA PHUNG MY (818) 288-8994- 2,800 - _q 9260 GUESS ST Z AZO ROSM '917701906 FEES PAID DESCRIPT N OF WOR, GAZEBO FEE DESCRIPTION: ` QUANTITY: UOM: AMOUNT.: APPLICANT:. TEL. NO: - T Y CONSTRUCTION INCE (818) 281-7307- AA BLDG PERMIT ISSUANCE 27.75' AC STRONG MOTION RESID 2800.00 VAL 0.50 SPECIAL CONDITIONS: AX BUILDING REV,LEW EE E Cv ^ 54.70'. D2 PERMIT WCEN=HC�L� �2800.00�L 99.15, TOTAL FEES) 182.10 CONTRACTOR: TEL.,NO: APPROVALS DATE INSPECTOR SIGNATURE T Y CONSTRUCTION INC (818) 281-7307- 104 S ALMANSOR LIC. NO d1/O� LOCATION AND SETBACKS ALHAMBRA, CA 91801 716679 (j SOILS ENGINEER APPROVAL ARC ITECT,OR ENGINEER:. TEL. NO: FOUNDATION/TRENCH FORMS LLC. NO: l�ii;7. SLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP N0: SEWER MAP BOOK: .PAGE: FIRE ZON3: CM01 p ��G UNDERFLOOR INSULATION NO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: '� _0' ST LEVEL-FLOOR.SHEATH Al NO 21 O O yam' ND LEVEL FLOOR SHEATH SCHOOL WITHIN HAZARDOUS ❑ 4,,,,.. ROOF SHEATHING AIR QUALITY: 1000 FEET MATERIALS ' NO NO NO D� 0 FIRE DEPT.-FRAME INSPECT REQUIRED TOTAL SETBACK FROM EXIST y�� BLDG DEPT. FRAME INSPECT SET BACK YARD: HWY: , PROP LINE: WIDTH: arvi � FRONT PL- u SHEAR PANELS SIDE PL- INSULATION/WEATHER STRIP INTERIOR LATH/DRYWALL EXTERIOR LATH LOT DRAINAGE SMOKE DETECTION DEVICES FIRE DEPARTMENT APPROVAL REPORT ID: DPR261 ROUTE TO: BS0568' 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 1204050020 PHONE: (626) 285-0468 EXT: ILEGAL ID: NO. OF CONST 1 BUILDING ADDRESS: 1 ITR: 5904 LT: 218 SQ. FT STORIES TYPE I 6129'HART AV I ISTRUCTURE: V-B I TEMP CA 917801629 1 (ASSESSOR INFORMATION NUMBER: 1 NEAREST CROSS STREET: GARIBALDI 1 15384-008-019 I THOMAS PAGE: 596 - GRID: H2 LOCALITY: TEMPLE CITY, Cl I I I I (TENANT: - (EXIST BLDG USE: RESID USE ZONE: R-1 (ISSUED ON: PROCESSED BY: IEXIST OCC GRP: 104/05/12 SR (OWNER: TEL. NO: JBLDGS. NOW ON LOT: VALUATION: JjjNAL DATE F BY: CODE: JZHANG, YIN OING (312) 965-5523- 1 3,000 1 I 19260 GUESS ST I I- ✓ G . �3 JROSM"917701906 1 FEES. PAID (DESCRIPTION OF WORK I I IREMODEL FOUR BATHROOMS 1 I _JFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:( I (APPLICANT: TEL. NO: I I I ISAME AS OWNER - IAA BLDG PERMIT ISSUANCE " 27.80 I 1 IAB STATE GREEN BLDG FEE 3000.00 VAL 1.00 ISPECIAL CONDITIONS: I IAC STRONG MOTION RESID 3000.00 VAL 0.50.1 1 JB2 PERMIT W/ENERGY 3000.00 VAL 108.90 1 I 1 _IFR INV WORK W/O PERMIT 342.20 DOL 342.20 1 I (CONTRACTOR: TEL. NO: I TOTAL FEES 480.40 (APPROVALS DATE INSPECTOR SIGNATURE ISAME AS OWNER - I I I I LIC. NO I ILOCATION AND SETBACKS I. I I I ISOI_hS ENGINEER APPROVAL I I I (ARCHITECT OR ENGINEER: TEL. NO: IFOUNDATION/TRENCH FORMS I I LIC. NO: 1 ISLAB/UNDER FLOOR I I I IRAISED FLOOR FRAMING _ IMAP NO: SEWER MAP BOOK: PAGE:- FIRE ZONE: CMP: ( JUNDERFLOOR INSULATION I 115OH265 3 001 1 1 1 J _1 JFLOOR SHEATHING 1 1 1 INO. OF FAMILIES: DWELLING UNITS: APT/COND.: STAT CLASS: I 0 NO 21 I IROOF SHEATHING SCHOOL WITHIN HAZARDOUS 1 SHEAR PANELS JAIR QUALITY: 1000 FEET MATERIALS NO NO NO ' (FRAME INSPECTION I IFIRE SPRINKLER HANGERS I I I . i JINSULATION/WEATHER STRIPI I I I f JINTERIOR LATH/DRYWALL I I � I I I I I (EXTERIOR LATH I I I I I I I I I I I IRATED FLOOR/CEIL ASSEM. I I I I I IRATED WALL ASSEMBLIES I I I I I I IRATED SHAFTS/OPENINGS I I I I I I I I IT-BAR CEILINGS I I I I I I 1 1 = ILOT DRAINAGE I I 1 1 I'REPORT ID: DPR261; ROUTE TO: BS0508 I 1 I 1 Y 1