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Home My Public Portal About9034 HERMOSA DR_Building__ >...]]]A CF(]0] 960 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUDREILDIss NO DEPARTMENT OF COUNTY ENGINEER aD BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMEIE.:COUNTY ENGINEER NEAREST WILLIAM A. JENSEN, SUP'TOFBUILDING CROSS ST. DISTRIOTO.NGROUP TYPE P ESSEDBY FOR APPLICANT TO FILL IN � c� CONST. V ADD EISS D3 STATISTICAL CLASSIFICATION ER MAP . PG CLASS.NO. DWELL. UNITS 8K at LOT NO. BLOCK MAP q1 STATE YES (C NUMBER .](["-[�' HWY. TRACT Cv USEZONE SPECIAL NO.OF BLDGS. I CONDITIONS SIZE OF LOT:!<V I NOW ON LOT USE OF EXISTING BLDG. BUILDING EXIST. //// TEL. SETBACK YARD HWY STREET NAME WIDTH OWNER e� ] VI. NO. / FRPOLNT ADDRESS o3 �L ]'W'i2� T L^. p� SIDE ARCHITECT OR TEL. P. L. ENGINEER - NO. INSPECTION RECORD ADDRESS a O CONTRACTOR Q+ /�{L��.jj NO � / U ADDRESS ('7 G IPiC4 / L � c��ni O DESCRIPTION bF WOR% r°�^'� J �� "� W NEW ADD ALTER REPAIR DEMOLISH SO.FT. NO. OF NO.OF SIZE //�� (( �a STORIES FAMILIES ITR UCTURE Ll�GL- SIGNATURE OF APPLICANT VALUATION$ / a O APPROVALS ATE INSPECT 'S SIGNATURE FOUNDATION: LOCATI ON FEE $ r� FEE $ �` FORMS.MATERIALS L / .n fd FRAME: FIRESTOPS. -IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS ANO STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, ' WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS J ,/ BUILD IN6 CONSTRUCTION. I CERTIFY THAT IN THE PERFORMANCE A OF THE WORK FOR WHICH THIS PERMIT IS ISSUED I SHALL NOT LATH, INT. EMPLOY ANY PERSON IN ANY MANNER $O AS TO BECOME SUBUECT TO THE WORKMEN'S COMPENSATION LAWS qF CALIFORNIA. �/ U . G /7 CATH, EXT. SIGNATURE OF ��(/. RECT' HOUSENUMBER COR- PERMITTE RECT AND POSTED ADDRESS CLYDE N. DIRLAM. PRINCIPAL STRjICfURAL ENGINEER , .PLAN CHECK VALIDATION CK. M.G. CASH PERMIT VALIDATION OK) M.O. DASH f, g 3 0 9� lJ^! G:'o 8 1 D 9.0 WORKERS' COMPENSATION DECLARATION • - hereby affirm that I havecertificate of consent to self APPLICATION FOR' BUILDING .PERMIT insure, or,p certificate of Workers' Compensation Insurance, - -. di rtified copy thereof (Sec. 3 Lab. C:)^ COUNTY OF LOSANGELESBUILDING*.AND SAFETY. Poly Compiny .- BUILDING � - ��•�j ✓/J • ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS �n' � K-/•£ Certified copy is filed with the county building inspec- BUILDING - - - - . tion de artment. ADDRESS L �.O O Dat Applicant C. , CITV ZIP V Q LOCALITY f91 �fi �lyG NO. OF BLDZ; NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT - CROSS ST. COMPENSATION INSURANCE - - ASSESSOR (This section need not be completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK - PAGE I PARCEL hundred dollars ($100) or less.) - - TEL. — USE ZONE MAP OWNER NO. - INC, I certify that in the performance of the work for which this _ SPECIAL > permit is issued, I shall not employ any person in any monner ADDRESSEE14 CONDITIONS O so as to become subject to the Workers'Compensation Laws. - CITY ZIP Date Applicant ARCHITFR OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY Q NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER " NO. - CONST. _ NE Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code,you must forth- ADDRESS ✓ -`•! N with comply with such provisions or this permit sholl be - TEL STATISTICAL CLASSIFICATION APT. CONDO. Z deemed revoked. CONTRACTQ NO. - - - • - LICENSED CONTRACTORS DECLARATION , +- '-- - - _ LIC. CLASS NO. 40 WELL. UNITS ADDRESS Z " NO. q8 - hereby affirm that am licensed under provisions of Chapter9 - SEWER MAP (commencing with Section 7000)ofDivision 3 of the Business ^1� LIC - CITY -pc , Ctg55 VALIDATION and Professions Cade,and my license is in full force and effect. BK. PG. ��11 �� SQ. FT. - . NO. OF NO. OF - CHECK _ License Num er 24?q �' Lic. Class SIZE STORIES FAMILIES ONE _ VALUATION Contract Date DESCRIPTION OF WORK t NEW ❑ ss O tQ Poo.'❑ - ❑I am exempt under Sec. ALTER ❑ - " B.BP.C. for this reason �- t REPAIR 9 ` Date: USE OF _ EXISTING BLDG. DEMOL ❑ .Signature - APPLI NT ` _ ` FINAL OWNER-BUILDER DECLARATION PRINT NO. I hereby affirm that I am exempt from the Contractor's License 7 _ 1� DATE!`,) ) r I 1 + Caw for the following reason (Section 7031.5, Business and ADDRESS-7�T. FINAL;� t Professions Code): - PRESENT By - BUILDING NC•i•I .i - ❑ I, as owner of the property, or my employees with ADDRESS F wages as their sole compensation,will do the work and - - - - Q ��`��1 _I]7 the structure is not intended or offered for sale(Section LOCALITY ► I� ` I . JI 7044, Business and Professions Code.) MOVING .- . .. .TEL. _ - 1 UEN . ❑ CONTRACTOR NO. ". I,as owner of the property,am exclusively contracting TO i AL 82® 00 with licensed contractors to construct ihe.project (Sec- ADDRESS � _ tion 7044,.Business and Professions Code.) _ CHECK -. REQUIRED. TOTAL SETBACK FROM - EXIST. - - CONSTRUCTION LENDING AGENCY - - SET BACK YARD HWY PROP. UNE WIDTH. I hereby affirm that there is a construction lending agency for FRONT CHANCE •I�l� the performance of the work for which this permit is issued P.L.' - (Sec. 3097, Civ.C.). . - SIDE - P.I. - Lender's Name (1000-00111 // LDMA Ref. N- - _ P.C. fee 5 Permit Fee C� , �•21`T 1I`�ill�J4Lender's Address - o I certify that I have read this application and state that the Issuance Fee ' LDMA P/C N 0 8 above information is correct. I agree to Comply with all County Investigation Fee - R. ordinances and State lows relating to building construction, Total Fee' LD"Perm. # m outhoriz preser�(afives of this County to enter B upon thea ov entianed pr Hy far inspection urpd s. a S _ SEE REVERSE FOR EXPLANATORY LANGUAGE re of Applica - nt Da •~ - u - +J COUNTY OF LOS ANGELES TEMPLE CITY N 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1205210064 PHONE: (626) 285-0488 EXT: (LEGAL ID: NO. OF CONSTBUILDING ADDRESS: 1 ITR: 5905 LT: 112 SQ. FT STORIES TYPE 9034 HERMOSA DR I (STRUCTURE: 27 V-B TEMP CA 917801841 (ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: ROSEMEAD 15387-014-009 J 1 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY, Cl (TENANT: (EXIST BLDG USE: REBID USE ZONE: R-1 ]ISSUED ON: PROCESSED BY: (EXIST OCC GRP: 105/21/12 SR I IOWNER: 'IBLDGS. NOW ON LOT: VALUATION: IF D T FI AL Y: CODE: TEL. NO: 1 IN}I.� j�/Fj N B ISTEVEN (626) 537-1360- 8,800 1 /`/.f/�,/J1( 1 It` L/N•X�y]\ 19034 HERMOSA DR (TEMP 917801641 1 FEES PAID ID CRIPTION OF WORK 1 IT/O OLD ROOF INSTALL RADIANT BARRIER INSTALL 30 YR COMP IEEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ISHINGLES (APPLICANT: TEL. NO: (ALFRED LOD (626) 622-8108- IAA BLDG PERMIT ISSUANCE 27.80 14533 SHIRLEY AVE JAB STATE GREEN BLDG FEE 8800.00 VAL 1.00 ]SPECIAL CONDITIONS: CEL MONTE CA 91731 AC STRONG MOTION RESID 8800.00 VAL 0.90 ID2 PERMIT W/O EN-HC 8800.00 VAL 199.80 TOTAL FEES 229.50 (CONTRACTOR: TEL. NO: IAOPROVALS DATE INSPECTOR SIGNATURE (GOLDEN KEY INC. (626) 285-9016- ] S 14533 SHIRLEY AVE LIC. NO ]LOCATION AND SETBACKS ] ISL MONTE, CA 91731 775115039 I JSOILS ENGINEER APPROVAL (ARCHITECT OR ENGINEER: TEL. NO: (FOUNDATION/TRENCH FORMS JLIC. NO: J JSLAB/UNDER FLOOR I IRAISED FLOOR FRAMING 1 ]MAP NO: SEWER MAP HOOK: PAGE: FIRE ZONE: CMP:( (UNDERFLOOR INSULATION 1150H265 3 001 I I (FLOOR SHEATHING I I I INC. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I 1 1 I 0 NO 21 1 (ROOF SHEATHINGiv �J SCHOOL WITHIN HAZARDOUS I SHEAR PANELS iT✓i ]AIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME INSPECTION ] JJ FIRE SPRINKLER HANGERS I JIINSUTATION/WEA THER STRIPI I I (INTERIOR LATH/DRYWALL (EXTERIOR LATH I I 1RATED FLOOR/CEIL ASSEM. I I I I I CRATED WALL ASSEMBLIES I I I RATED SHAFTS/OPENINGS ' ] T-BAR CEILINGS I I I J ]LOT DRAINAGE ] I I !REPORT ID: ➢PR261 ROUTE T0: 9S0508