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HomeMy Public PortalAbout9805 HOWLAND DR_Building__ WORKERS'COMPENSATION DECLARATION {� her y a4Um that have a certificate of consent to self APPLICATION FOR BUILDING PERMIT llSl {nsu 4rtificcre of Workers' Compensation Insurance, cl ified copy thereof (Sec. 3800, Lab. C.) - COUNTY OF LOS ANGELES BUILDING AND SAIfETY - Policy No. Company Q Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS ©Jr OCertified copy is filed with the county building inspec- BUILDING �j{ 7 \ tion deportment. ADDRESS / \ 0 (/.,' l� >v d ALJ LOCALITY tNEAREST ��I .y CJ O CROSS ST. Date Applicant _ CITY '�';_, m p j I_- C ZIP / CERTIFICATE OF,EXEMPTION FROM WORKERS' NO.OF BLDGS. 1� ASSESSOR COMPENSATION INSURANCE SIZE OF LOT -NOW ON LOT 'C. MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one q n /' US ONE MAP Z hundred dollars ($100)or less.) TRACT .1 d BLOCK LOT NO. r N0 f0 Fj -f SPECIAL I certify that in the performance of the work for which this OWNER C I�Z• /J s� 11' a aZ / _� CONDITIONS d ' / DISTRICT .GROUP TYPE FIRE ESSED BY O permit is issued, shall not employ any erson in any anner ADDRESS OS C W I .9 NO/ �` CONST ZONE so as to become:subject to the Work s'ComPensati/ "ws. QQ 0 Q g '14/' CITY M P E �: T ZIP f 7 O DateApplicant STATISTICAL CLASSIFICATION APi, CONDO. U NOTICE ACANT: If, after .liking this a ' icor of ARCHITECT OR iEl. -� / -Exemption, yshould become subject to he arkers ENGINEER NO. CIAS$NO.�DWELL. UNITS_ �. Compensation provisions of the Labor'Code, you must forth- ADDRESS SEWER MAP Vs with comply with such provisions or this permit shall be TEL ? deemed revoked. • CONTRACTOR --� O, BK, PG, VALIDATION LICENSED CONTRACTORS DECLARATION - LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. VALUATION (commencing with Section 7000)of Division 3 of the Business and Lic, Professions Code, and my license•is in full force and effect. CITY CLASS $ r� , SQ. FT. NO. OF NO. OF CHECK License Number Lic Class - 'SIZE 171 STORIES ,FTAMILIES ONE Contractor Date DESCRIPTION OF WORK r>{ !� ( I-t DOM NEW ❑ $ _ am exempt under Sec ADD ❑ALTER ❑ FINAL Z ❑ DATE 8.8P.C. for this reason REPAIR - USE OF DEMOL Date: EXISTING BLDG. ❑ B N Signature APPLICANT TEL. OWNER-BUILDER DECLARATION PRINT NO. - I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS r�Professions Code): PRESENT � � 7F� BUILDING LL_I \I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and n .. ♦` ) :, „�O the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL ,1 - „�Z-.. .i` IT I, as owner of the property, am exclusively contracting CONTRACTOR U NO. , with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). 25721 Q REQUIRED L SETBACK FROM EXIST. 1', . d CONSTRUCTION LENDING AGENCY SET BACK YARD HWY TOTAPROP. LINE WIDTH - I hereby affirm that there is a construction lending agency for FRONT • •,•-.1 the performance of the work for which this permit is issued P.L.. pool' \ (Sec. 3097• Civ. C.). SIDE a '] Q Q m P.L. Lender's Name 5 e a e 7 a Q Q FI Lender's Address P.C. Fee$ Permit Fee - �tx t. IQ21 -86 I certify that I have read this application and state that the Issuance Fee /a ' ✓ V ' a above information is correct. I agree to comply with all County Investigation Fee _ g ordinances and State laws relating to building construction, Total Fee r c - D and hereby horize repr s fives of y�is County to enter $ upon the o e-mention pr erty for r spect'on p rposes. a to SEE REVERSE FOR EXPLANATORY LANGUAGE , azure of Lic t or ge Dot es WORKERS'COMPENSATION DECLARATION affirm that I have certificate of consent to self APPLICATION FOR BUILDING PERMIT .� i ire, or o certificate sof Workers' Compensation Insurance, or a-certified copy thereof (Sec. 3800, Lab. C) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING ADDRESS OS Certified copy is filed with the county building inspec- BUILDING ` ('� ' u tion department. ADDRESS y S C to / LOCALITY NEAREST Date Applicant CITY c i O J ( ZIPp [c7 CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK I.— PARCEL (This section need not be completed if the permit is for one USE ZONE MAP �( hundred dollars ($100)or less.) TRACT Q BLOCK LOT NO. NO. —/ TEL. - _' SPECIAL y I certify that in the performance of the work for which this OWNER TY Z va q (a O f CONDITIONS _ - d permit is issued, I shall not employ any person in any ma ner 1 ,,/ p DISTRICT .GROUP TYPE FIRE PR ESSED BY, O sous to become subject to the Worke�ompens ows ADDRESS r'j G a.x /A •�'✓ �1C 1 1.1n /�� CONST.y. ZONE V "/�/.� �j /tit IVCY -•ST. Date_�L u'- Applicant CITY �•` �-r ZIP 7 ` STATISTICAL CLASSIFICATION APT. CONDO. O NOTICE TO APPLICANT: If, aft r ing t s is a of ARCHITECT OR TEL. V Exemption, you should become subjec to t e Workers' ENGINEER NO. CLASS NC­ Exemption, DWELL. UNITS_ 1 Compensation provisions of the Labor Code, you must forth- . . - N with comply with such provisions or this permit shall be 'ADDRESS 1! SEWECcR MAP �//' _ F2� Z deemed revoked. _ CONTRACTOR NO. BKL PG, !O VALIDATION - LICENSED CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC. Professions Code, and my license is in full force and effect. CITY CLASS $ 6 b D , SO. FT. (^ NO. OF NO.OF CHECK License Number Lic.Class SIZE STORIES FAMILIES ONE Contractor Date DESCRIPTION OF WORK � r L NEW E] S ADD D am exempt under Sec. C '( ALTER ❑ FINAL, - / q� B.BP.C. for this reason ,�.U REPAIR � DATE 6 VW USE OF / ❑ Date: EXISTING BLDG i Li `gaixC IDEMOT BNA d Signature APPLICANT TEL. T OWNER-BUILDER DECLARATION WRINTI NO. / 1 hereby affirm that I am exempt from the Contractor's License • Low for the following reason (Section 7031.5, Business and ADDRESS 44 ProfessionsCode):' PRESENT ,OBUILDING , I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and -OJ"- thestructure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. 1, as owner of the property, am exclusively contracting CONTRACTOR NO. 95 4 Q A with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). # n n 1 REQUIRED TOTAL SETBACK FROM EXIST, CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH 4 3,.6 3 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. \' • - 14-3.639 (Sec. 3097, Civ. C.). SIDE P.1. 0-9. 1 0-86 Lender's Name $ P.C. fee S - , - Lender's Address Permit Fee r W. I certify that I have read this application and state that the Issuance Fee // • 'J� < above information is correct. I agree to comply with,all County Investigation Fee ' g. ordinances and State laws relating to building construction, Total Fee r u dndherpkT authorize re es�tatives of this County to enter upon dove-menti 'p perty for inspection purpo es. - lT F7 - SEE REVERSE FOR EXPLANATORY LANGUAGE lure AlAsI nt D Ie ®s v APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY hM' W'ORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS ' 1 hereby affirm that I have a certificate of consent to self insure, BUILDING AD R SSS �� n D�, or a Certificate of Workers'Compensation Insurance,or a certified Id '•[ /p copy thereof(Sec.3800.Lab.C.) / LOCALITY Ci Policy No. Company SIZE OF LOi P NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. (Jr Z NEAREST CROSS ST. - ❑ department. f'earTRACT BLOCK LOT NO. Certified Copy IS filed with the COUniy building InSpeCllOn USEZONE MAP NO. Pi BOOK PAGE PARCEL Date-Applicant V'Q I SP CIAL CONDITIONS INICERTIFICATE OF EXEMPTION FROM WORKERS' YES No TEL.NO. COMPENSATION INSURANCE 27 y ��2C'�� 7 fl �� WITHIN 1000 FT.OF SCHOOL? ADDRESS (This section need not be completed if the permit is for one hundred _ ��jQ�� DISTRICT -GROUP TYPE CONST.' FIRE ZONE PROCESSED BY dollars($100)or less.) Cm .ZIP I Certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to ARCHITECT OR ENGINEER TEL.NO. become Subject to the Workers'Com a I. L W3. STATISTICAL CLAgSSIFFICATION APT CONDO Date r4�Appllcant ADDRESS CLASS NO.IL L_DWELL UNITS NOTICE TO APPLICANT: If, after making this Certificate of 1 REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should beCOfOB subject t0 the Workers' CONTRACTOR A TEL NO. SETBACK YARD HWV PROP LINE WIDTH Compensation provisions Of the Labor Code, you must forthwith ADDRESS / LIC.NO. FRONT comply with such provisions or this permit shall be deemed revoked. PL F 4A SIDE > LICENSED CONTRACTORS DECLARATION CITY P LIC.CLASS PL I hereby affirm that I am licensed under provisions of Chapter 9 SEWER MAP z (Commencing with Section 7000)of Division 3 of the Business and SD.FT SNO.OF STORES NO.OF FAMILIES / Professions Code,and my license is in full force and effect ,3 IZ NEW [IBK C PG O OESCR�TION OF WORK �7 ADD VALUATION t LVy License Number Lic.Class /7 D Contractor Date ALTER ❑ $ `'' - t Z -r� T. ❑ I am exempt under Sec. REPAIR 11 $ B.&P.C.for this reason r1-. OL ❑ Dale: USE OF EXISTING BLDG. URNi [ILDMA P/C# Signature APPLI ANT(PRINT) TEL.NO. LDMA Perm# 1, as owner of the property, or my employees with wages as A their Sole compensation, will do the work and the structure is AD RESS not intended or offered for Sale (Section 7044, Business and FINAL/Jp��TE cf Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A 7.RDOUS MATERIAL �! �•!7 OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN ❑ I, a3 owner tr the property, ru exclusively contracting 0with44, THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY licensed contractors to construct the project.(Secfion 7044, YES 1:1 NO K ��/✓I�,J�� TUTA,� 245 "fit- Business and Professions Code.) DED WILL THE INTENDED USE UIRE MI THE BUILDING eY THE APPLICANT OR IO FUTURE BUILDING UTH CONSTRUCTION LENDING AGENCY COAST AOCCUPA�IR QUOALIITY MAN GIEMENT DISTRICT LISCAOMDON OR OSEECPERMITTING CHEN MOM CKLIST � � — _1•V '} Y` Ie_�r' FOR GUIDELINES. Y` 1 • ` CLIAhUt 1 hereby affirm that there is a construction lending agency for YES❑ No the performance of the work for which this permit is issued(Sec. ILLTX��\ 3097,Civ.C.). I HAVE READ THE H."DOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING CHECKLIST 1 UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES '{ i COUNTYCOD TITLE , ERR.205£CTIO 2.W.IMIHROUGH2.p WCONCERNING 3 Lender's Name HAZARDOD TErll LSR ORTIN&AND FOR OBTAINING A PERMIT FROM THE SCAOMD. �!ilii�il`;` y Lender's S Address - iJ .�. owNu cdiowr o I certify that I have read this application and state that the above P.C.FEE PERMIT FEE information is correct. I agree to comply with all county .y 7 �G ordinances and Stale laws relating to building construction.and 45a / Q. hereby authorize re resentatives of this County to enter upon ISSUANCE FEE the abo menti a property for inspection purposes. / 3 INVESTIGATION FEE TOTAL FEE SEE REVERSE FOR EXPLANATORY LANGUAGE APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN BUI1 D ADDRESS WORKER'S COMPENSATION DECLARATION BUILDING ADDRESS L7 /�/y By'I/�L 1 hereby affirm that I have a certificate of consent to self insure, or a certificate of Workers'Compensation Insurance,or a certified ` S �� '� copy thereof(Sec.3900,Lab.C.) CITY ZI LOCALITY Policy No. Company SIZE OF LOT - O.OF BLpGS.NOW ON LOT ❑ Certified copy is hereby furnished. '�'���J NEAREST CROSS ST. _ NG ❑ Certified Copy is filed with the County building inspection TRACT BLOCK LOT O. 4!0 GQ�y department. USEZONE MAP NO. �7 DASSESSOR MAP BOOK PAGE PARCEL i� 6 G Date Applicant S- 0/ — / SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL NO. / �A{i COMPENSATION INSURANCE �,V � � �1/� '�I/ r/J �I WITHIN 1000 FT.OF SCHOOL? YES NO ADDRESS _ (This section need not be completed if the permit is for one hundred •r 6 J� DISTRICT - GROUP TYPE CONST.' FIRE ZONE PROCESSED BY dollars($10D)or less.) CITY < .ZIP 22 //' I certify that in the performance of the work for which this permit P� is issued, I shall not employ any person in any manner Bo a$to ARCHITECT OR ENGINEER TEL.NO. C/ become subject to the Workers Compensation Lem. STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO.�DWELL UNITS NOTICE TO APPLICANT: If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, I CONTRACTOR TE -NO. p you Should become subject t0 the Workers' SETBACK YARD HWY PROP LINE WIDTH Compensation provisions s the Labor Cotle, you must forthwith FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS Y. LIC.NO. PL Y LICENSED CONTRACTORS DECLARATION CITY -/9 6LIC.CLASS SIDE PL 0 U I hereby cnthat am licensed under provisions of Chapter 9 SO.FT.SIZE NO.OF STORES NO.OF FAMILIES SEWER MAP (commencing g with Section 7000)of Division 3 of the Business and PG ❑ BK Professions Code,and my license is in full force and effect. N - DES RIPTION OF WORK VALUATIO d License Number Lic.Class L3 �.2 - 11 a(G(/ ADD ❑ /J, e Contractor Date ALTER $ ��' GO ❑ I am exempt under Sec. REPAIR ❑ $ S.&P.C.for this reason DEMOL El LDMA P/CV Date: US OF EXISTING BLDG. .(IRM ❑ j A,f Signature APPLIANT(PRINT) TEL.NO. LDMA Perm# = 4_ ky I, as owner of the property, or my employees with wages as �.Q/ �V O their sole compensation,will do the work and the structure is ADDRESS not intended or offered for sale (Section 7044, Business and FINAL ATE Professions Code.) �.- WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL ' ❑ I, as owner of theproperty, am exclusive) contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN - -q y g THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDER FINAL BY� �///j 7 Tf HL licensed contractors to Construct the project.(Section 7044, vEs❑ No❑ �/ Business and Professions Code.) WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING OCCUPANTREOUINEA PERMITFOR CONSTRUCTION OR MODIFICATION FROM(STHE SOUTH i'� I�{I_ CONSTRUCTION LENDING AGENCY COAST AIR DUALITY MANAGEMENT DISTRICT CAOMD)SEE PERMITTING CHECKLIST :{,Ti L"ME FOR GUIDELINES I hereby an that there is a construction lending agency for YES❑ NO❑ the performance of the work for which this permit is issued(Sac 1 HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD 3_1' tl1` f- y' �! �'='K O 3097,CIV.C.). PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES I !�J '{-(fl'L / 7- 3 Lender's Name COUNIYCOOETITLE2,CHAPTER2.MSECTIOW2.W.IWTHROUGH2.M.I000NCERNING ��- �,i HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMM Lender's Address oANm oA AoO., 0 o' I certify that I have read this application and state that the above P.C.FEE PERMIT FEE C information is correct. I agree to comply with all county a ordinances and State laws relating to building construction,and '/a 5 ' d hereby authorize representatives of this County to enter upon ISSUANCE FEE ? the above-mentio property for inspection purposes. INVESTIGATION FEE TOTAL FEE sq mARYbnIU AAM m.' / bOaf SEE REVERSE FOR EXPLANATORY LANGUAGE WORKERS'COMPENSATION LSECLARATION P qi I hereby affirm that I have G:brtifsate of consefi j1o� self - R�e/�t /rte 2115 insure, or a certificate of Workers' Compensation InsoTance, P■ `ICA ■ ION F® BUILDING PERMIT or a certified copy thereof (Sec. 3800, Lob. C. ~ COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company BUILDING qg s Nei✓LAiv� � Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING qV,o S— ya1V�,41vLJ oX tion department. ADDRESSr 7 D /1 9`1 ' (uYt �'7 LOCALITY /� �y�.' )// Date Applicant CITY / �Z c OlfY ZIP / 17XV CROOSS ST. 6-04 S V N ,s� CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one Z '�•O USE ZONE MAP hundred dollars ($100)or less.) TRAR D BLOCK LOT NO. NO. V Li /^^ pp //Q n 4 TEL _/[//' SPECIAL } I certify that in the performance of the work.for which this OWNER / Iz�00 L�!/ (.�/v NQ Z J/O CONDITIONS G. permit is issued, I shall not employ any person in any manner /1,r]s L/,y`v,� /J/ld if /1!J DISTRICT GROUP TYPE FIRE PROCESSED BY O so as to become subject to the Workers'Compensation Laws. DDRESS [�7fy!/ // !/ L� A11: X/Y\ CONST. ZONE v CITY �L// � C17, ZIP q�rfo str� �- G r�.'t'� 3 0 Dater Applicant STATISTICAL CLASSIFICATIONCO DO. V NOTICE TO APPLICANT: If, after mak6g this Certifi to of ARCHITECT OR TEL. Exemption; you should become subject to the Workers' ENGINEER NO, CLASS NO. '3-1 DWELL. UNITS_ OW. Compensation provisions of the Labor Code, you must forth- ADDRESS A -CONTRACTOR NO. SEWER MAP N with comply with such provisions or this permit shall be ? deemed revoked. TEL BK PG VALIDATION LICENSED CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC. r Professions Cade, and my license is in full force and effect. CITY CLASS $ 's-00" .SV 0 ' $Q. FT. NO.OF NO. OF CHECK License Number Lic.Class SIZE STORIES FAMILIE``S��QQ ONE 4 L �L NEW S Contractor Dote DESCRIPTION OF ORK / ADD . ❑ I am exempt under Sec. ALTER FINAL B.BP.C. for this reason REPAIR DATE Date: USE OF LL r' - FINAL EXISTING BLDG. .�a�--G DEMOL BY Signature APPLICANT L o a " OWNER-BUILDER DECLARATION PRINT NO. I hereby affirm that I am exempt from the Contractor's License J <J Law for the following reason (Section 7031.5, Business and ADDRESS ® (. �•,� ''— O Professions Code): PRESENT - 1, as owner of the property, or m employees with BUILDING P P a YtADDRESS wages ct their sole compensation,will f o the work and LOCALITY the structure isnot intended or offered for sale(Section 7044, Business and Professions Code). MOVING TEL. I R I, as owner of the property, am exclusively contracting CONTRACTOR NO. F with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.I. (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name $ P.C. Fee$ Permil Fee — Lender's Address _ w certify that I have read this application and state that the Issuance Fee above information is correct. I agree to comply withal)County Investigation Fee g ordinances and State laws relating to building construction, Total Fee u and hereby authorize representatives of this County to enter S upon the above-mentioned property for inspection purposes. '�.e Si�omre e Y SEE REVERSE FOR EXPLANATORY LANGUAGE of ppli r or Agent Date ®s 1 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 1301310091 PHONE: (626) 285-0488 EXT: - ILEGAL ID: N0. OF CONST BUILDING ADDRESS: TR: 12830 LT: 8 1 SQ. FT STORIES TYPE 9805 ROWLAND DR _ISTRUCTURE: 1850 V-B TEMP CA 919803233 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: GOLDEN WEST 18589-004-010 THOMAS PAGE: 599 GRID: A4 LOCALITY: TEMPLE CITY CAI TENANT: IEXIST BLDG USE: REBID USE ZONE: R-1 ISSUED ON: PROCESSED BY: EXIST OCC GRP: 101/311/13, SR (OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: (FINAL ATE FINAL BY: CODE: HUYNH, KIEN (626) 916-8248- 1 5,000I 19805 HOWLAND DR I I ITEMP 919803233 FEES PAID IDESCREPTION OF WORK IHOUSE REMOVE EXISTING ROOF CHECK WOOD SHEATING, REPLACE IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT: IWHERE NEEDED APPLY 1 1/2 EDGING, #30 FELT AND 30 YR COMP APPLICANT: TEL. NO: I ISHINGLE NGO, CHINH V (626) 242-0364- AA BLDG PERMIT ISSUANCE 29.80 1333 TOCINI DRIVE IAB STATE GREEN BLDG FEE 5000.00 VAL 1.00 ISPECIAL CONDITIONS: IDUARTE CA 91010 IAC STRONG MOTION RESID 5000.00 VAL 0.50 IDS PERMIT W/O EN-HC 5D00.00 VAL 132-60 TOTAL FEES 161.90 CONTRACTOR: TEL. NO: iAPPROVALS DATE INSPECTOR SIGNATURE , IC I C S CONSTRUCTION CO (626) 242-0364- 1 1333 TOCINO DRIVE LIC. NO LOChTION AND SETBACKS DOARTE CA 91010 748982 ISOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS LIC. NO: SLAB/UNDER FLOOR I I RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMOOI UNDERFLOOR INSULATION 47H269 FLOOR SHEATHING INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: 0 NO 21 -i (ROOF SHEATHING SCHOOL WITHIN HAZARDOUS 1 (SHEAR PANELS AIR QUALITY: 1000 FEET h1ATERIALS NO NO NO FRAME INSPECTION FIRE SPRINKLER HANGERS I I 11NSDLATION/WEATHER STRIPI _ I INTERIOR LATH/DRYWALL (EXTERIOR LATH I RATED FLOOR/CELL ASSEM. RATED WALL ASSEMBLIES I I RATED SHAFTS/OPENINGS I I T-BAR CEILINGS ILOT DRAINAGE REPORT ID: DPR261 ROUTE T0: B50508 COUNTY OF LOS ANGELES TEMPLE CITY k 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BE 0508 1301310072 PHONE: (626) 285-0480 EXT: (LEGAL ID: NO. OF CONST BUILDING ADDRESS: _ ITR: 12830 LT: 8 SQ. FT STORIES TYPE 9805 HOWLAND DR I (STRUCTURE: 1850 V-B TEMP CA 917803233 1ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: GOLDEN WEST 8589-004-010 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY CAI TENANT: IEXIST BLDG USE: REBID USE ZONE: R-1 JISSUED ON: PROCESSED BY: 1 (EXIST OCT GRP: 101/31/13 SR (OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: (FINA;T DATE FINAL^B-Y: CODE: 1HUYNH, KIEN (626) 716-8248- 1,500 19805 HOWLAND HOWLAND DR ITEMS 917803233 FEES PAID IDESCRIPTION OF WORK 1 IDETACHED GARAGE REMOVE EXISTING ROOF, CHECK WOOD SHEATING, IEEE DESCRIPTION: QUANTITY: UOM: AMOUNT: REPLACE WHERE NEEDED, APPLY 1 1/2 EDGING, #30 FELT AND 30 (APPLICANT: TEL. NO: I IYR COMPO SHINGLE 1NGO, CHINH V (626) 242-0364- IAA BLDG PERMIT ISSUANCE 27.60 1 333 TOCINI DRIVE IAB STATE GREEN BLDG FEE 1500.00 VAL 1.00 (SPECIAL CONDITIONS: DUART.E CA 91010 IAC STRONG MOTION RESID 1500.00 VAL 0.50 I 102 PERMIT W/O EN-HC 1500.00 VAL 82.20 1 1TOTAL FEES 111.50 L (CONTRACTOR: TE . NO: (APPROVALS DATE INSPECTOR SIGNATURE IC J C J CONSTRUCTION CO (626) 242-0364- 1333 TOCINO DRIVE LIC. NO (LOCATION AND SETBACKS 1 1 DUARTE CA 91010 748982 SOILS ENGINEER APPROVAL 1 I ARCHITECT OR ENGINEER: TEL. N0: I (FOUNDATION/TRENCH FORMS I I I LIC. NO: SLAB/UNDER FLOOR 1 AAI5ED FLOOR FRAMING (MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 1 IDNDERFLOOR INSOLATION 1147H269 3 00 1 I I IFLOOR SHEATHING 1NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: 0 NO 21 I 1ROOF SHEATHING n III SCHOOL WITHIN HAZARDOUS (SHEAR PANELS 1AIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME INSPECTION I I I (FIRE SPRINKLER HANGERS 1I I I INSULATION/WEATHER STRIP( I I INTERIOR LATH/DRYMNLL I 1 EXTERIOR LATH RATED FLOOR/CEIL ASSEM. 1 1 1RATED WALL ASSEMBLIES IRATED SHAFTS/OPENINGS 1 1 1T-BAR CEILINGS I I I 1 ILOT DRAINAGE I I I IREPORT ID: DPR261 ROUTE TO: BS0508 1 1 1 1 I I I I I