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Home My Public Portal About6221 HART AVE_Building__ 7GA638A CE#803 8-63 APPL(LITTON FOR BU0LIDING PERMIT r. COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER A°DREss - s' BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. . .DISTRjCT NO. G TYPE P BV FOR APPLICANT TO FILL IN v . CONST. G BUILDING STATISTICAL CLASS( (CATION SEWER MAP ADDRESS '62 1 North Hart BK PG CLASS. NO. DWELL. UNITS LOT NO. < BLOCK WATER NOTREQUIRED ❑ RECEIVED CERTIFICATE. ❑ CERTIFICATE. TRACT V -- MAP NO. OF BLDGS. NO. �(/ ('C RCLE> STATE MAJOR SECOND, LOCAL SIZE OF LOT NOW ON LOT USE ZO E SPECIAL USE-OF ` - { CONDITIONS EXISTING BLDG. TEL OWNER C, W. Revn(-)lNO. BUILDING. EXIST. SETBACK YARD HWY STREET NAME WIDTH ADDRESS 6221 North Hart,* Temle City FRONT ARCHITECT OR TEL. - P. L. ENGINEER NO. SIDE P. L. >' ADDRESS d V1Y ROOF Coe TEL. 7 CONTRACTOR NO. :�T 1n r7 g 0.50 ADDRESSQ DESCRIPTION OF WORK a ' V1 NEW ADD ALTER XX REPAIRXX DEMOLISH Z SQ. FT. - NO. OF NO. OF SIZE STORIES FAMILIES 1 USE OF STRUCTURE Residence SIGNATURE OF APPLICANT VALUATION $ 1297e00 - / APPROVALS DATE INSPECTOR'S SIGNATURE P.C. - PMT. FOUNDATION: LOCATION FEE $ FEE $ FORMS. MATERIALS FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT i HAVE READ THIS APPLICATION . BRACING. BOLTS AND STATE THAT THE ABOVE 15 CORRECT AND AGREE,TO COMPLY FURNACE: LOCATION. WITH ALL COUNTY ORDINANCES 'AND STATE LAWS REGULATING GAS VENT. DUCTS 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 COMPENSATION INSURANCE. ' Virgin Roof Co. LATH. EXT. SIGNATURE OF . HOUSE NUMBER COR- PERMITTEE. RECT AND POSTED A ADDRESS (' FINAL Y� + JOHN F. LEWIS. PRINCIPAL STR RAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH_ J t;o 0 7.,6 5 MAR 2 5 1 A 1 150- 0 , r , , .:... ,.. ..•.w.v e - .. r-,. n - .....v.. _. � w..r„r...tV'rte,-,- , •,.n >- y,._., .._. WORKERS,COMPENSATION j., _ s - here47i affirm that'I r have,a certificate of consent to self D O (�' M O DR D O nn insure„or a certificate of Workers' Compensation Insurance, 0 V LJ V F_��'Y LJ L D O�.�i �LI V LI or a'cerl,fied copy thereof (Sec, 3800, L'ab. C.) - - - --•- __- -- -- - - - -COUNTY OF LOS AIIGELES 03U LDIWG I�WD SAFETY Policy.No:- Company - Certified copy is,hereby furnished.. FOR APPLICANT TO FILL IN BUILDING ADDRESS Certified copy is filed`with`the county building'inspec-. BUILDING ,q , cion department. ADDRESS' `l+ • - Dote Applicant' CITY � ✓' T. ZIP-' ®v' { LOCALITY , i @� C _-.NO:,OF BLDGS: NEAREST._ CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT W.X liJ'7 1.5 COMPENSATION'INSURANCE NOW ON LOT CROSS 5_T._ . (This-section need not be-completed'-if the permit,is for one - -' _ . - - :- AS R, x„ , TRACT �- BLOCK LOT NO. MAP;B OK : PAGE,. PARCEL hundred dollars ($100)or less.) /'- _ OWNER- �TG TEL. ' NO_ USE Z E MAP certify that in the performance of,t w r for which,this SPECIAL - permit is issued,1 shall not employ a p so in Y manner " so'as to bec7;� subject to the'Wor n laws. ADDRESS '' - CONDITIONS O Date O PPLICAN T'If,1i after m eking this CITY_ 0 CITY- Date pp ARCHITECT OR TEL. DISTRICT,-: G OUP J:CTYPEE�T FIRE P CESSEDBY Certificate of ENGINEER - NO. 0 "VIS Exemption, you should become bject' to then Workers' I/ -i LU Com ensation rovisions of-the tabor Code'; ou.must forth- �r` _ V__. ILNE P P Y ADDRESS ' .with, comply (with such provisions or this permit shall be. -•- -__. __••-- deemed revoked. TEL STATISTICAL,CLASSIFICATION APT. CONDO CONTRACTOR NO. LICENSED CONTRACTORS DECLARATION . _ __.. .. _._..__ .._ ^ LIC.`- ......•: CLASS'NO: DWELL. UNITS_ Iaffirm that Ilam licensed under provisions of Chapter 9 ADDRESS NO. hereby (commencing,with,Section 7000)of Division 3 of.tlie Business and _ :. LIC. -•• - SEWER M4P, Professions Code, and my license is in#ulI'force and effect. CITY ." . CLASS _ - "VALIDATION- BK. PG. ri - - - _ SQ.:FT.,, �T NO.-0F, NO,OF license Number Lic.Class" SIZP w� STORIES FAMILIES ONE VALUAT ON DESCRIPTION OF WORK NEW ... i padContractor Date " ADD $ ❑ I am exempt_under Sec. - -. _. _ _ _ _..: ❑ _. _ _ ` ALTER ❑ D ^ REPAIR B.&P:C. for this reason -❑ _ USE OF. Date DEMO ❑ �7.Oa1 EXISTING BLDG. ,Q LL Signature APP(PRINT) NO. �I� FINAL fy .i n' A OWNER-BUILDER DECLARATION ;_ _ _ DATE- lei #;o'e e o e - d herebyaffirm that I am•exempt from the•Contractor s License Law for the following ieoson (Section 7031.5,'Business and ADDRESS �22 'I C� FIWA I Professions'Code K. .. ... PRESENT i By - - BUILDING J24:88 ' I, as owner of the property, or my employees with A7.DDRESS. _ _ - __ _ .. x wages as.their sole compensation,will do the work and - F'- ' "O 'Ol 1''�(J,,8.8 U LOCALITY +. the structure is not intended or offered for sale(Section k i 7044;Business and Professions Code)." '" MOVING'"- " " - "" TEL ''0 Q O O'- 8 I as owner of the property;am exclusively contracting CONTRACTOR NO' a 8 .w ith licensed contractors to construct the protect (Sec- tion 7044, Business and Professions Code). ADDRESS -: I, REQUIRED.:._ - YARD HWY` .-TOTAL SETBACK'PROM._. I T.'_ c_ �'• " CONSTRUCTION LENDING AGENCY _ SET BACK PROP. UNE WIDTH " I hereby affirm that there is a construction lending agency for FRONT the performance of work-for which this permit is issued - -P.L. - (Sec. 3097, Civ. C. SIDE P.L. Lender's Name . o CDMA Ref. # P:C:Fee$ -- . .- Permit-Fee Lender's Address ' I certify t-I have read.this application and.state..that the .-. - Issuance Fee O•,-,-- CDMA'P/C-# -- a above of rm tion is correct. I agree to comply with'all County Investigation Fee _ ordin es,a. St to Id'ws-relating to building construction, Total Fee CDMA Perm. # - - rid reby th riz_ presentotives of this County to enter m- he a e—' ned p open-for inspectio purposes. < µ SEE REVERSE FOR EXPLANATORY LANGUAGE i , Signature of Applicant or Agent -'Date- WORKMMCC%MPENSAITION DECLARATION �v, rmsure boraafceriii cone ofaWorkersrve a iCompensat on Insura!n elf [P P L CAU O U V O o � d D.0 Gil G JP E M vG�i 0� '4 � Gr a ceriY#incl copy thereof (Sec. 3800-Lab:C ) _. - , COUNTY OF LOS ANGELES ' BUILDINGAND SAFETY Policy No. - Company. Q copy y FOR APPLICANT TO FILL IN BUILDING 1�✓ Certified co is; furnished. 3 ADDRESS Certified copyis filed with the county building inspect BUILDING Tion department. n ADDRESS �rt 2 ` � Y►� i�tl V� Dare n Applicant ~ CITY P +ZIP^` O LOCALITY CERTIFICATE FROM"WORKERS' "_"' y �9 NO.-OF BLDGS.-. NEAREST. — - COMPENSATION INSURANCE _•:' "' SIZE OF'LOT ��/� l`0 NOW ON LOT CROSS ST. _ (Thi's sectionlneedtnot be completed„if.:the peemit,is•forone - - ' hundred dollars ($100)or.less.) , TRACT BLOC OLNO ( - : Q K �' MAP BOOK PAGE PARCEL ' �t/Q / USE ONE MAP. OWNER CVJV® "NO- 4l( ,I certify that in the performance of T e or for hick this _ I NO. y permit is issued,'I shall"not employ y so i n�manner tj A�ww/�- - - - I/ SPECIAL so as to'b come subject to the Wo• sat' n Laws. ADDRESS- TT®VBG CONDITIONS O. t _ u CITY - - - ZIP_ fX Date �� Applicant_ ARCHITECT OR TEL NOTICE O A PLICANT: .If, afte"r along fhis`Cerhficate of DISTRICT OUP TYPE FIRE. PRO ySSED BY. _ ENGINEER NO. CONST ZONE Exemption; you,should become subject`to the."Workers' ., e / U Compensation.provisions,of the Labor Code;.-you must forth- ADDRESS.with complywith'such provisions or this,•permit shall.be"-=• deemed revoked 0910 TEL. STATISTICAL CLASSIFICATION APT. CO O- " CONTRACTOR NO. LICENSED CONTRACTORS DECLARATION!< LIC. -" CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of'Chopter 9 ADDRESS NO. SEWER MAP ( g with Section 7000)of Division 3 of the Business andLIC.- commenun Professions Code, an8"my license is in full force and effect: CITY CLASS BK� VALIDATION SQ. FT.s t NO. OF NO. OF-:' CHECK License Number Lic.Class” SIZE "[ STORIES FAMILIES ONE • � VALUATIO/N)_ _ _ t+, t: DESCRIPTION'OF-WORK S,I .i.._ NEW V - - Contractor Date $ • � ZADD D I am exempt under Sec -' D � {{ ALTER a B.BP.C. for this reason �REPAIR__Q $" USE OF . ., ..�._ � .... __. .. . ..:... ..Date: .. - DEN10L Q • EXISTING BLD - Signofure _ = _ APPLICANT TEL v' FINAL PRINT) � �^' �(�"r , NO. L�S-I�S I O:� A . ., OWNER-BUILDER DECLARATION _ DATE•• -•I hereby affirm.that l.arn.exempt•from the Contractors License � ` 1 �L Law for the following'redsoh (Section 7031.5, Business and ADDRESS FINAL' #,o 0 0, W. Z-_ ssions-Code) PRESENT _ _ By _ ZV _ BUILDING I, as owner of the property, or my employees with ADDRESSVV wa ges as their sole compensation,will do the work and o;0 2 Jr 61 3 the structure is not intended or offered for sale(Section LOCALITY t 7044, Business and Professions Code). "" MOVING"` :"`"- - ' TEL. r• j JJ� 1, as owner of the property, am exclusively contracting: w CONTRACTOR NO. 1 O Q O O 8 8 , wd with licensed contractors to construct the'project,(Sec- +y ADDRESS - tion 7044, Business and Professions Code). _ REQUIRED.._ _TOTAL SETBACK.FROM. i t CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH Thereby affirm that there is a construction lending agency for FRONT the performance of the work-;for which this-permit is issued P.L.- - - } (Sec. 3097, Civ. C.). SIDE m _.. .. ... _ _ .. . _ .-• -- -- - ._.: P.L. a . 'i Lender's Name m _ - -- P:C. Fee$ Permit fees 3 LDMA Ref. # _. Lender's Address I c rt', that I have read this. and state-.that the Issuance-Fee ((/ LDMA P/G# - D a ab e i formation is correct. l agree to comply with all County Investigation Fee 0 or Atb nd State laws relating to building Construction, _ _ - Total Fee 3 - 1 LDMA Perm. # - - -' a u orize representatives of this County to enter e- entioned property for inspecti n purposes. a SEE REVERSE FOR EXPLANATORY LANGUAGE - Signature of Applicant,or Ag n -- .. Dolie v i i s COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS DEMOLITION BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0803270006 PHONE: (626) 285-0488 EXT: (LEGAL ID: ( NO. OF CONST I BUILDING ADDRESS: I ITR: 5904 LT: 211 I SQ. FT STORIES TYPE ! 6221 HART AV ! I (STRUCTURE: ! TEMP CA 917801631 1 (ASSESSOR INFORMATION NUMBER: ! ! NEAREST CROSS STREET: LONGDEN 15384-007-023 ! ! THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY, Cl I ! I I (TENANT: !EXIST BLDG USE: SWIMM USE ZONE: (ISSUED ON: PROCESSED BY: EXPIRES ON: 1 I !EXIST OCC GRP: 103/27/08 SR 09/23/08 1 !OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: IFINAL DATE FI BY: - CODE: 1 ISTEINBERG ROBERT D;PHYLLIS A (626) 287-5411- 1 1,000 I ! 16221 HART AV I I I 1TEMP 917801631 ;I FEES PAID IDESCRIPTION OF WORK ! 1 ! (DEMOLISH/FILL SWIMMING PO L I I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( I. !APPLICANT: TEL. NO: I I !. SAME AS OWNER - IAA BLDG PERMIT ISSUANCE .27.75 1 I 102 DEMOLITION INSPECTN 163.50 ISPECIAL CONDITIONS: 1 I ! TOTAL FEES 191.25 I ! ICONTRACTOR: TEL. NO: 1 (APPROVALS DATE INSPECTOR SIGNATURE ! 1SAME AS OWNER - 1 _ 1 ! 1 LIC. NO 1PEDESTRIAN PROTECTION I I 1 1 II I I . 'SEW2.R DISCONNECTION ! I I (ARCHITECT OR ENGINEER: TEL. NO: - (ABANDON PRIVATE DISPOSALI I I I LIC. NO: 1 IUNDERGRND STRUCT REMOVALI I I I 1AND SOIL RECOMPACTION 1MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: ! I I 1153H265 011 V ��-4 ` ! I I ! I I I INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I I NO 24 e 4Ke I SCHOOL WITHIN HAZARDOUS I �` ! (AIR QUALITY: 1000 FEET MATERIALS' I ! NO NO NO ! ! I I I I ! ! ! I I ! I I I ! I I I I I I I ! I I ! I I I I I I I I ! I ! I I ! I 1 I I I I I I I I I I I I I I I I I I I I I I I I I IREPORT ID: DPR261 ROUTE TO: BS0508 I I I ! I I ! I !