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Home My Public Portal About9035 HERMOSA DR_Building__ APPLICATION FOR BUILDING PERMIT � . FOR APPLICANT TO FILL IN (Print., WPe ..IY)' BUILDING USES d5�-- COUNTY OF LOS ANGELES , ADDRESS DEPARTMENT OF COUNTY ENGINEER C TY , 1G.' �Cy/( L' ZIP BUILDINGCAND SAFET DIVISION - LDING SIZE OF LOT Sa kr� NOW OON LOTS. ADDRESS' 3S �j TRACTS UL � BLOCK LOT NO. (J LOCA LIT ' 'ten lLL .�`'4n^�/ TEL. NEAREST OWNER _ 1+�. C&Q-' .. . NO. CROSS ST. " ,Nr. ASSESSOR ADDRESS - �y - MAP BOOK - PAGE PARCEL DISTRICT GROUP' TYPE' FIRE C SED BY CONST. 'ZONE CITY ZIP Ayn, ��/// 'ARCHITECT OR - TEL ENGINEER NO. STATISTICAL CLASSIFICATION SEWER MAP ADDRESS (�f) -CLASS NO.-'-/ DWELL,UNITS BK PG CONTRA CTO - (UEL I'v TOL' �'_.,? US ONE MAP -3 NO v A DDRESS`yc�z � {y/T[ / NO. .' ` SPECIAL LIC. ✓ CONDITIONS CITY - 'C 1A55 '- ' ROAD DEPARTMENT APPROVAL REQUIRED YES NO ❑ CONSTRUCTION LENDER NAME AND BRANCH BLDG.SETBACK FROM FRONT PROP.LINE OF ISTR EETI ADDRESS CITU ' HIGHWAY. } YARD - TOTAL SETBACK FROM TYPE OF: EXISTING SQ.-FT... NO. OF NO. OF� CHECK - FRONT PROP. LINE HIGHWAY W(DTH SIZE STORIES FAMILIES 'ONE OESLRIPTION OF WORK NEW '.❑ + O U_ ADD IS L"DG.SETBACK FROM SIDE PROP, LINEOF (STREET) CO ALTER'❑ HIGHWAY } YARD p TOTAL SETBACK FROM TYPE OF EXISTING U dREPAIRE] SIDE PROP. LINE HIGHWAY WIDTH. GO EXISTING SLOG. EMOL ❑OF + _ Z APPLICANT TEL CORNER CUTOFF YES [:1 NO ,❑ (_PRINT) - _ _ .NO. ' _ BY (5I G NA'T URE). IN OPEN SPACE.- - YES,ff NOE] Q JN COASTAL PERMIT ZONE YES,❑ NO ❑ VALUATIONS I.HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION' AND STATE THAT THE ABOVE IS CORRECT-AND AGREE TO COMPLY - - - WITHALL ORDINANCES AND LAWS REGULATING BUILDING.CON- �` ST RUC TI ON. 1 CERTIFY. THAT IN DOING THE WORK AUTHORIZED _ - HEREBY'I WILL NOT EMPLOY ANY.PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF*CALIFORNIA IN RELATING TO ' ,WORKME N'S COMPENS IQN-I S, SIGNATURE OF. PERMITTEE - ADDRESS FINAL 77 LDATE By CITY // . NO �)/i71 �� ! / bIA KE CIIECKS PA}A ULE• TO. EE ' - P.C.. , $: PMT.,Q - HARVEY T. BRANDT, COUNTY ENGINEER FEE' I ..PLAN CHECK VALIDATION' cK. Mo. CASH. PERMIT VALIDATION. CK." M.O. CASH 413 SrJUL 15 1 -D 2 1.7 5 • APPLICATION FOR BUILDING PERMIT A FOR.,' PPLICANT TO FILL IN (PR nr Or rY D< o lv) BUULDI NGCOUNTY OF LOS ANGELES .ADDRESS 35 �YTCr"� /rGOSA DEPARTMENT OF COUNTY ENGINEER Gt'% ZIP - - - -- BUILDING-AND .SAF TY_DIVISION,, ., NO.OF BLOCS. BUILDING SIZE OF LOT I�d X JNOW ON LOT -ADDRESS- TRA C.��CLF v ��BLOC K) �_�My� LOT NO, Q LOCALITY./ y - - - OWNER�1a�.N Y�ILLC AL TEL. NEAREST NO. CROSS ST. ASSESSOR A DDR E S 5 MAP BOOK PAGEPARCEL DISTRICT GROUP TYPE FIRE ESSED BY CITY ZIP -OBv .. CONST,., ZONE ARCHITECT OR - TEL. - -- 5 ENGINEER NO., - STATISTICALCLASSIFICAT N ADDRESS CLASS NO.!22�/ _OWELI UNITS BK h_,,PG CONTRACTOR '� L NO -- ZONE NOP<• L/ _ ADDRESS L<7�[At!<T<//� OEvdlG COEDIT ONS ,CITY C%�, �L - CLArROADEPARTMENT APPROVAL REQUIRED YES❑ No�o CONSTRUCTION LENDER <]0-a ( 2T NAME AND BRANCH I/V V NG BLDG.SETBACK FROM O - -- --- FRONT PROP.LINE OF Zh''V�y"� (STREET(_ V ADDRESS CITY - HIGHWAY } YARD _ OTAL SETBACK FROM TYPE OF EXISTING C SQ. FT NO. OF / NO. OF - CHECK FRONT PROP. LINE HIGrAV 'WIDTH O SIZE STORIES ( FAMILIES ONE U ' DESCRIP ION OF WORK' NEW ❑ v. BLDG.SETBACK FROM Z VV ADD IDE PROP. LINEOF - iSTREET) c� ALTER ❑ TOTAL SETBACK FROM TYPE OF EXISTING HIGHWAY ALTER YARD = - HIGHWAY] WIDTH �^ /�- REPAIR[ SIDE PROP. LINE OF EXISTING BLDG. 5 ' A(.{'�np/"/�/a-� DEMOL ❑ } APPL PRIH) /1,e7 -70L CORNER CUTOFF YES ❑' NO ❑ BY (_SIGNATURE) 'CJIJ IN OPEN SPACE YES ❑ NO ❑ - IN COASTAL ZONE YES ❑ NO ❑ VALUATION - 74'aa - CATE GORICgL EXEMPTION ' YES❑ NO ❑ HEREBY ACKNOWLEDGE THAT I HAVE HEAD THIS APPLICATION ENVIRONMENTA AND L STATE THAT THE ABOVE I5 CORRECT AND,AGREE TO COMPLY ' IMPACT EXEMPTION DECLARATION SIGNED '(DATE) WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- 5TFEC TION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED -(DATE) . HEREBY IWILL NOT EMPLOY-ANY PERSON IN-VIOLATION Of THE' LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WONNEIEN'S COMPENSATI N INSURANCE. /%r/( _H� / S I ./'. /NRIJH/ IN S9�.�GT ✓ O/]i �� SIGNATURE OF PERMITTEE - ADDRESS � O'CITY /C/G NO. FINAL BY DATE MAKE CHECKS PAYA L3LE 7-0: P. E c, T_ FEE Y -$ PMT.$ HARVEY T. BRANDT. COUNTY ENGINEER FE- A� 5 PLAN CHECK VALIDATION CN, MO- CASH PERMIT VALIDATION CN M.D. CASH 's 4-4n.IUN 19 1 0 6.2.2 5 0 76A638A CEP803 ]/J3 WORKERS' COMPENSATION DECLARATION APPLICATION FO� ILDING PERMIT I hereby affirm..that I have a certificate of conserit to self insure, or a certificate of Workers'Compenstion Insurance, or a certified copy thereof (Sec. 3800, Lab. C.) ---'COUNTY COUNTY OF LOS ANGELS BUILDING,AND SAFETY Policy No. Company Certified copy Is hereby farni;Fed. - FOR APPLICANT,TO-FILL IN ADDRESS III B SCl_ rt ❑ Certified copy is filed with the county building inspec- BU ED"' 33 tion deportment. ADDRESS 0,35 LOCALITY Q,-,� p NEAREST Date Applicant CITY / �w ZIP O CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS ASSESSOR COMPENSATION INSURANCE - SIZE OF LOT ,$D.iC I S0 NOW ON LOT I MAP BOOK 538 PAGE O$] PARCEL o S (This section need not be completed if the permit is for one USE ZONE MAP DO , hundred dollars ($100)or less.) TRACT 0 BLOCK LOT IN ,}-� NO. ' TEL. f ��(( x SPECIAL y I certify that in the performance of the work for which this _ OWNER NO.A 8J'3_9T 1` CONDITIONS O permit is issued, I shall not employ any person in any manner DISTRICT GROUP TYPE FIRE ED BY U ADDRESS so as to become subject to the Workers'Compensation Laws. 'O CONST y Z19 Date Applicant CITY ZIP ed STATISTICAL CLASSIFICATION Aft/ - APT. CONDO. V ARCHITECT TEL. NOTICE TO APPLICANT: If, after making this Certificate of f W Exemption, you should become subject to the Workers' ENGINEER Ili NO. CLASS NO. C:LL DWELL. UNITS_ N Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP Z with comply with such provisions or this permit shall be deemed revoked. CONTRACTOR OWrI _(`— TEO. BK. PG, _ VALIDATION LICENSED CONTRACTORS DECLARATION LIC _ I hereby affirm that I am licensed under provisions.of Chapter 9 ADDRESS - _ NO. (commencing with Section 7000)of Division 3 of the Business and LIC VALUATION Professions Code, and my license is in full force and effect. _ CITY CLASS SO. Fi. Q NO.OF NO.OE CHECK License Number Lic.Class SIZE STORIES FAMILIES ONE ❑ S Contractor x - Date DESCRIPTION OF WORK NEW I am exempt from the licensing requirements as I am a / ADD " licensed architect or a registered professional engineer, ALTER - FINAL acting in my professional capacity (Section 7051, - REPAIR DATE IJ Business and Professions'Code). t - USE OF FINAL - / _ EXISTING BLDG. DEVICE By 4_s - Lic. or Reg.Na. Date APPLICANT TEL - OWNER-BUILDER DECLARATION - (PRINTI - NO. -" I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 703).5, Business and ADDRESS Profe Bions Code): PRESENT ' BUILDING - . . as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and the structure is not intended or offered for sole (Section' LOCALITY - - _ ^'-.3 5'6 7,A 7044, Business and Professions Code). MOVING TEL # e she o 7 I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS - 2 - 2 0500 tion 7044, Business and Professions Code). - -- SET UIREDBACK TOTAL ROP. LISETBACK FROM EXIST. .e.a `` CONSTRUCTION (ENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH' 2 O U O OE I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.L. i 0 41,0 8-82 (Sec. 3097, Civ. C.). SIDE - - - - P.L. Ir Lender's Name _ _ __ Lender's Address P.C. Fee 5 Permit Fee ' I certify that I have read this application and state that the Issuance Fee /' ,✓ a .above information is correct. agree to comply with all County Investlgmlon Fee -. .. _0D ordinances and State laws relating to building construction, Total Fee and hereby authorize representatives of this County to enter mupon the ave enti ned property f spection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Signotore of Applicant or Agent D e , ®E 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 0403240012 PHONE: (626) 285-0488 EXT: LEGAL ID: 0. OF CONST BUILDUG ADDRESS: TR: 5904 LT: 308 SQ. FT STORIES TYPE 9035 HERMOSA DR STRUCTURE: VN TEMP CA 917801836 ASSESSOR INFORMATION N BER: NEAREST CROSS STREET: 5384-016-044 THOMAS PAGE: 596 ' GRID: H3 LOCALITY: TEMPLE CITY, C EXIST BLDG USE: RESID USE 0 : R-1 ISSUED, N: PROCESSEDEXPIRES ON: EXIST OCC GRP: 03/24/04 VG 03/19/05 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DAVE FINAL BY: CODE: LINDA MILLER A M (626) 285-1902- 4,500 49-2 9035 R LINDA DR GG 7 TEMP 917801836 S PAID DESCRIPTION OF WORK REPLACE 3 WINDOWS (SAME SIZE) AND 1 FRENCH DOOR FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: T-91- N0: SEARS HOME IMPROVEMENT (800) 807-9886- AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RESID 4500.00 VAL 0.50 SPECIAL CONDITIONS: D2 PERMIT W/O EN-HC 4500.00 VAL 132.60 TOTAL FEES 160.85 CONTRACTOR: TEL. N0: APPROVALS DATE INSPECTOR SIGNATURE SEARS HOME IMPROVEMENT (800) 807-9889- 10315 SLUSHER DR LIC. NO LOCATION AND SETBACKS SANTA FE SPRINGS, CA 721379C61 * SOILS ENGINEER APPROVAL ARCHITECT ORENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS LIC. NO: SLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: LMP: UNDERFLOOR INSULATION XX 3 01 FLOOR SHEATHING NO. OF FAMILIES: DWELLING UNITS: COND: SAT CLASS: NO 21 ROOF SHEATHING SCHOOL WITHIN HA ARDOUS R PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME INSPECTION REQUIRED OTAL S CK FROM E IST FIRE SPRINKLER HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- INSULATION/WEATHER STRIP SIDE PL- INTERIOR L- N R OR LATH/DRYWALL EXTERIOR LATH RATEDLOOR/CEIL ASS RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS * ADDITIONAL DATA ON FILE LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508