HomeMy Public PortalAbout6123 IVAR AVE_Building__ i' WORKERS'COMPENSATION DECLARATION
I hereby-affirm that I have a certificate of consent to self _ D O M O O D O nn
ET
insure,, or a certificate,of,Workers'Compenstion Insurance,-or ' U U L �L�UU E O-LI V -F(0,� D �LI V L1
a cer'ified copy thereof (Sec. 3800,1ab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY 1
Policy-No.-Company
F_] Certified copy is'hereby.furnished. - FQR`APPLICANT TO FILL IN-' BUILDING
, r ADDRESS
'Certified copy is filed with the county building"inspec- % BUILDING
Tion department.. ADDRESS LOCALITY
NEAREST
Date Ap"plicani CITY• r,-r` ZIP , CROSS SL
NO. OF e
CERTIFICATE.OF EXEMPTION FROM WORKERS' DG '
L S. AS SSOR
COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BpQ PAGE PARCEL
(This section need not be completed if the permit is for one E ZONE MAP ��
hundred dollars($100)or less:_)_ TRACT BLOCK LOT NO. NO. >
r ` TEL. SPECIAL
I certify that in,'ihe performance,of the work for which this. OWNER W NO. �': lJ:- CONDITIONS O
pe issued,.I shall not employ any person in any manner STR GROUP TYPE FIRE SED BY y
ADDRESS"
so as tO'become's U.bject to the Workers'Compensation Laws. -
i
' ON
Date'' ° Applicant ( CITY v " dip ` STATISTICAL CL•A KATION APT. CONDO. V
LU
Exem tion, ou should become making-this'.Certificate of
ARCHITECT,OR t TEL
NOTICE TO APPLICANT: ,If, after g' ENGINEER NO. CLASS NO, DWELL. UNITS LU
p y subject to the•:Workers' � - �y
Compensation provisions,of-the Labor Code, you•must forth- `..' ' ADDRESS SEWER MAP with ,comply.with such•provisions or this permit shall be
deemed CONTRACTOR revoked. L' BK. PG, VALIDATION
• "
LICENSED CONTRACTORS DECLARATION
I hereby of that I am licensed under provisions of Chapter 9 ADDRESS NO. VALUATION
(commencing with Section 7000)of Division 3 of the Business and LIC.
Profess ions.Code;.arid my license'is*in full force and effect, CITY _ CLASS
_ SQ. F NO. OF , NO: OF CHECK '
License Number Lic.Class IZE STORIES. FAMILIES . ' ONE
Contractor Date W,
OF WORK �M NEW ❑
❑ I am exempt from the licensing requirements as I,am a ADD ❑
licensed architect or a registered professional engineer ALTER E ,..,❑
FINAL
doing in my 'professional, capacity (Section 7051,' SSL ../� /Z/ REPAIR DATE'
Business and Professions Code). USE OF- Ian(� DEMOL FINAL
EXISTING BLDG. r Y 1G� +
Lic. or Reg..No. Dafe APPLICANT TEL
(PRINT) NO.
By
OWNER-BUILDER'DECLARATION
I hereby affirm that I am'exempt from the Contractor's License
-ADDRESS''- r'J /-/1 r/
Law for to reason "(Section-7031.5, Business and f
jVt,Cocle): PRESENTv
owner.of the,property, .or my employees with P,DIDRESS = �.
wages as their sole compensation,,wiII do the work and t/r
the structure is not intended or offered for sale(Section LOCALITY
7044,B'usiness and Professions Code). MOVING. TEL,
' I, as owner-of,the property,am exclusively contracting CONTRACTOR=. NO. •-with licensed contractors to construct the project(Sec ADDR
tion 7044;•Business and Professions Code): --
REQUIRED TOTAL SETBACK FROM EXIST: a l 6'27 A
"CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE. WIDTH
I hereby affirm that there is a construction lending'agency for " FRONT' #'•o o'o.o o "
the performance of the work for which this permit is issued Pd L.
(Sec. 3097,:Civ. C.).. SIDE
2 o
�.:3 ICO 0.
Lender's Name0
a m
:°`° a 3l G,'0
P.C. Fee$ - Permit Fee ,.
Lendec's:Address 8Q'8'" O
w I certify-that l have read dais application and state that the Issuance Fee
above information is correct I-agree to comply.with all County. nvestigation Fee �
ordinances'and'State`laws relatin to. building construction, rV'
.9 9 - Total Fee'
and hereby authorize,representatives of this County to enter
cupon the abov -me 'on p perty for inspection purposes.
a ` � �• �� SEE REVERSE FOR EXPLANATORY LANGUAGE t
Signature of-Applicant or Agent Dote - - -
Job o J� Permit District No.............................
-} BUILDING SET BACK LINE
�.... .."........ Date Lsuedl
l 1 ""' " ; I agree to locate this building not less than....».•feet
JobAddress. .`. .. ........ ............................ from ._............ .��...�"...�... .........................................'..tine of
�e.. '
Locality....... .�i.2.1 F'.�.. j .. .......................... ' . ,J'`�G,r^^�........-,................. nor less than....... ............ft.. .{. from the............................................line of......... ..........................
... ....
Nearest Crosa St !C�..1 .�.. -�........................ ........................
an provided by Ordinance No.........................................................
APPLICATION FOR PERMIT dediention In Tract No.........x............................ ."
County a Angeles /� /j
BUILDING � record J�ok............. pagal......,..,'bta aFR_leeorda of L. A. Co
j3 l,f j 1�l3 '
✓ aW R Of1~AUI'HORII ED AGENT
THE BUILDING BUREAU OF THE REGIONAL PL,IVNIN_G COMMISSION
COUNTY OFA L(YS ANGELES
LOT NO. �1 A SPECIFICATIONS
BLK. NO. FOUNDATION EXTERIOR PIERS
TRACT _ MATERIAL
TOP
THICKNESS BOTTOM
--)IZE Of LOT '
SIZE OI qV LOING
\/
U � I ` .+ 1/ 1 1 NT. ABOVE GRADE
C9
STORIES 1 NO, OF FAIIILI !'
DEPTH 1N GROUND
I
FIRE DISTRICT SUPERSTRUCTURE
� ,
TYPE I JI III IV X SIZE O. C. SPAN
USE Lv _ CL Y1 t) 'z_ 1 R. W. PLATES
W NAME11
Q 1� GIRDERS
Z ADDRESS
CITY '� T
JOISTS-CEILING
NAME
G W I BEARING WALLS
1! ADDRESS
Z /
Iry CITY TEL. PARTITIONS
u I
c
< LICENSE NO. �\- j ROOF-RAFTERS
t ADDRESS .4A'.
COVERING
CITY TEL,
V
G Wall Roof LICENSE NO.
I
PLANS FILED i
APPLICATION RECD BY f NATURE OF JOB
DATE _
NEW R'Lr7ttR
DESCRIPTION OF WORK
—AD'P T40N MSViNG
42 Z'D
ALTEWATTtm DEJAIOL f O
VALtJ/ ON Fits �
`hereby; ate that the.sbove is correct and all County
9� lnsfl - d State laws e3rgrning building construc-
tion will complied with.
Sign—
OMNpI'OR•AYTHOR1290 AO[NT�
DMMMENT OF BUILDING APPLICATION FOR PERMIT
CO�NTY.OF LOS ANGELES BUILDING ,PLAa
NE !�! ` 2o_OG. ZONE DISTRIC PLAN CHK, rKE PER IT NO.
FILED
RECEIPT No. > •S�
TYPE OR t7-7
BLDG. I 11 111 IV X GROUP7� a r
r DL.TF r AP L. RE EI E Y DAT IffU D
BLDG.SET6ACK LINE
ORD. NO.'`_� 3 -31311,3
1,
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
BUILDING
O � NAME ADDRESS
W Z ADDRESS ' LOCALITY
NEAREST < �J • „}.
U W CITY CROSS ST. • j i�trK,., ,t, ,
C I STATE
< LICENSE NO. TCL. NO. k K SHAME �C�r 1 // "7.t P _
Ir
. .i Z MAIL ✓ '
NAME ADDRESS _ S
< ADDRESS CITY.-�-� 2 rC.� C`' }`FL NO.
Z ' CITY %�`' _ -1S LOT SIZE OP LOT
U I STATE V NO. OF -L CSG ii.
LICENSE NO. TCL. NO. Jo
BLOCK NOW ON LOT
T USE OF BLDG. a
CLASS OF IYORI> TRACT J / NOW ON LOT �t
ESCRII''I'�i�L, OF WORK
NEWI ADDITION DEMOLISH I / W C% /lt4
ALTERATION I I REPAIR I MOVING
USE OF /Jl NO. OF I x'
13 L DG
G. `�tT�� ROOMS
M S
_ _ y
SIZE STORft`S 7�
L� )C / FAIfILti"S I UIZItIiL•1'I ♦\1S V/s/
f 3,
SPECIFICATIONS
FOUNDATION e"
a
EXTERIOPIERS, �f hiT
MATERIAL. - � ( /
THICKNESS--TCP ('p
TNICKNE45____t70TTOM
.�
DEPTH IN GROUND I f '✓ � <
Z
SUPERSTRUCTURE D '
SIZE SPACING SPAN
W. PLATES (SILL) O r
GIRDERS — �
JOIfTa_1<LOOR tc
JOISTf_C£tLINr, �!
BEARING WALLS Y.
PARTITIONS
ROOF RAFTERS FINAL APPROVAL �.
SILL DOLTS
COVERING 3
DAT[ INf►[CTOR'f MSM[ /
WALL ROOT/ t 1 H[RECY ACKNOWLEDGE THAT I HAVE READ THIP
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS GU TING SUI.LDINQ CONSTRUCTION.
VA WATION f FEE s SI ar►NCR co ArrmoRIZED AO[NT
x•11•!1 r r•
Job No. Permit District No... .........
-1 jjj BUILDING SET BACK LINE
Jnq Date Lssucd... . I &Szre* to locate this building not less than...;� f ect
�-';(I -( from 1e...».............. p......................................_line of
Job Address.................................I. . ...... .......................
...........--ft-
..........7 _r. ........ .................. or lees than,..
Locality......�e ......
....................I... from the.............................._.........line of........................._
NearestCross St.6 f.I'\4.!�t.LCAJ......................... ............................................................................
as provided by Ordinance No...........................
dedication In Tract No............................
APPLICATION FOR PERMIT Cou'rity of Los Angeles
recorded In book............. page.......,Maps. JRecords of L A. Co.,
BUILDING
..............
/-OWNER OR AUTHORIZED AGENT
THE BUILDING BUREAU OF THE REGIONAL PLANNING COMMISSION
COUNTY OF, LOS ANGELES
Lor No.
SPECIFICATIONS
BLK. NO. 1 FO DATION EXTERIOR PIERS
TRACT MATERIAL
TOP
THICKNESS BOTTOM
SIZE OF LOT SIZE OF NO
PIT. ABOVE GRADE
';'. 7 1.1y; . 7t
i� j _ , ( k:� 'y * 1
STORIES NO.OF FAMILIES BLDG, ZONE: DEPTH IN GROUND
FIRE DISTRICT SUPERSTRUCTURE
TYrE 1 .11 fit rY x SITE O. C. SPAN
USE <'-w, R. W. PLATES
w NAME
GIRDERS
ADDRESS91 71 k JOISTS-FLOOR
C C
ITY
NAME JOISTS-CEILING
BEARING WALLS
ADDRESS
Z'
1 0 u CITY TEL. PARTITIONS
U
Z
LICENSE NO. ROOF•FtAFTERS
y '�
N A 14 E vI
0
ADDRESS
COVERING
CITY TEL.
0 LICENSE NO, Wall Roof
PLANS FILED
APPLICATION RECD BY ONATURE OF JOB
DATE N EW
& DESCRIPTION OF WORK i
ADDMOV?f1O
A
4 -t
�y 0,
VALUATION) FEE f
I hereby
ate that the above is correct and all County
ordinancex*and State laws governing building construe-
tion will be complied with
Sign................................... ....................................
0WN9R OR AUTHORIZE0 AGENT
Job No. Permit `' .C. District Nc,... .....''..1 ..z....
Z BUILDING SET BACK LINE
aU
..... ........... Date Issuedl.`..� ..`. 4.
1 I arree to locate this b Jdlnr not less thatL—Am.....�. sect
Job Address.... 1.....J.. �.. .. .'�`. froths..._........ .... _... . ,.,'' .. ...»_ . . _.......1[n. of
Locality......l.�rr..�,.�.. .¢». ....i..w...1.� .n.............. ._.....'.. ..5�:.`�I:1a:;�,......N..�.................., noleee••thaa......_..��..��L
-�'rt-- •.�' from the.. .line of..
Nearest Cross St.t. ..��.� ..... ............. .................................... __.: .._........ _., .. _ .
as provided b1
Ordinance No...................... ...................
r dedication In Tract No......................_..
APPLICATION FOR PERMIT ....,_._.�
County of Loa Angeles
BUILDING _ _` �, ' _
.4orded In book......._.... pare.i.ryF^. . bfaps, Records of L. A. Co.
f•' •-"•! ...^,b N[ OR AUTHORIYF.t�AoENT`
THE BUILDING BUREAU OF THE REGIONAL -PLANNING COMMISSION
COUNTY OF LOS ANGELES
LOT NO. �� l t - SPECIFICATIONS
CLK. NO. FOUNDATION EXTERIOR PIERS
TRACT 14 MATERIAL
TOP
THICKNESS BoTTow
SIZE OF LOT SIZE OF BUILDING
r---
HT. ABOVE GRADE
STORMS NO. OF FAMILIES DEPTH IN GROUND
BLDG. ZONE
I I FIRE DISTRICT SUPERSTRUCTURE
TYPE 1 II III IV V) X SIZE O. C. SPAN
USE / r R. W, PLATES 1r+
NAME ���. Y Y� 1 GIRDERS
Z rr�
3 ADDRESS l "
p JOISTS-FLOOR
CITY t TEL.
JOISTS-CEILING
NAME
G K BEARING WALLS
ADDRESS
rZ
U a CITY TEL. PARTITIONS _ e
< ~ LICENSE NO. ROOF-RAFTERS
p NAME
1
ADDRESS 14 { COVERING
CITY TEL.
ID LICENSE NO. VYa11; Roof
PLANS FILED +•� f '
APPLICATION RECD BY NATURE OF JOB
DAT[ L4 NEW RiPMft"
D[SCRIPTICH OF WORK
ADDITT'f3R M OV f N6
r ?.:_Tem-7-1In DEHallalh^•"
VALUATION SO . FES t—I��---
its-+.-.. I hereby state that the above Is correct and all County
- ordinances and Stat"ws governlrg building construc-
tion aril!_be complied with. i
OWN94 OA AVTMORtS[O AGENT
S
COUNTY OF LOS ANGELES - TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS. 9071 LAS TUNAS ALTERATION/REPAIR .
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9702060005
PHONE: (818) 285-0488 EXT:
I
LEGAL ID: NO. OF CONST 'BUILDING ADDRESS:
TR: 5904 LT: 18 SQ. FT STORIES TYPE 6123 IVAR AV
STRUCTURE: 0 VTEMP CA 917801524
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: GARIBALDI
5386-010-060 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY
TENANT: EXIST BLDG USE: RESID USE ZONE: R- ISSUE!) ON: PROCESSED BY: EXPIRES ON:
EXIST OCC GRP: 02/06197 TC 02/06/98
OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL,DATE FINAL CODE:
COWELL MICHAEL R' - 1 1,800 /
32907 BROOKSEED DR o �['
FEES PAID DESCRIP ION OF WORK
FEE DESCRIPTION: QUANTITY UO�M AMOUNT; TEAR OFF ALL ROOFING INSTALL UILT UP HOT MOP
APPLICANT: TEL. N0: {( ��j p�
HAUKOM ROOFING (818) 285-9011- AA BLDG PERMIT ISSUANCES 27.75
AC STRONG MOTION RESIDE 1$00:00-VALE 050 SPECIAL CONDITIONS:
D2 PERMIT W/O EN=HQ� 1800700-VAL 82;20
TOTAL FEES 110'.45-
g
CONTRACTOR: TEL. N0: APPROVALS DATE INSPECTOR SIGNATURE
HAUKOM ROOFING INC. (818) 285-9011- `•)V;• 1 l
6122 N. IVAR LIC. NO — r!,A , _ �L-OCATJON AND SETBACKS
TEMPLE CITY, CA 91780 285-97 SOILS' ENGINEER APPROVAL
ARCHITECT OR ENGINEER: TEL. N0: - i � l/C UAV 's CEJ Ll ,CJ J U��J FOUNDATION/TRENCH FORMS
LIC. NO: 1 i� SLAB/UNDER FLOOR
_j RAISED FLOOR FRAMING
�v
MAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: � UNDERFLOOR INSULATION
15OH261 3 01� C 11
FLOOR, SHEATHING
NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: (2
NO 21 ROOF SHEATHING
SCHOOL WITHIN HAZARDOUS O� \�\ SHEAF, PANELS
AIR QUALITY: 1000 FEET MATERIALS
NO NO NO COB FRAME': INSPECTION
REQUIRED TOTAL SETBACK FROM EXIST FIRE SPRINKLER HANGERS
SET BACK YARD: HWY: PROP,LINE: WIDTH:
FRONT PL- INSULATION/WEATHER STRIP
SIDE PL-
INTE11 OR LATH/DRYWALL
" EXTEPIOR LATH
- RA_TE 1) FLOOR/CELL ASSEM.
r RATE[) WALL ASSEMBLIES
i RATED SHAFTS/OPENINGS
T-BAR CEILINGS
LOT ')RAI AGE
a _
REPORT ID: DPR261 ROUTE TO: BS05O8
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91.780 BL 0508 1307230028
PHONE: (626) 285-0488 EXT:
ILEGAL ID: NO. OF CONST NEW BUILDING ADDRESS:
ITR: 5904 LT: 18 SQ. FT STORIES TYPE OCCUP GROUPI 6123 IVAR AV 1
I ISTRUCTURE: 11;86. 2 V-B " ' R-3 I TEMP CA 917801524`
(ASSESSOR INFORMATION NUMBER: GARAGE k' •220-- ` •:1 V-B U, NEAREST CROSS STREET: 1
15386-010-060 1 OTHER: , _ { ,l.• THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY CAI
(TENANT: JEXIST BLDG USE:u � USE ZONE: f. (ISSUED ON.: PROCESSED BY: 1
EXIST OCC GRP: - 108/28/13 SR
10WNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: IFINAL DATE - FIN BY: - CODE: 1
ILEI, MEI XIAO - 169,520 / f
16123 IVAR AVE
111 !!!
1TEMPLE CITY CA 91780 1 FEES PAID 1 SCF.IPTION .O WORK
1 1.1ST: FLOOR. ADDITION LAUNDRY RM, DINING RM, FAMILY RM, 2 BATHI
I _IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: IRMS, 2ND: FLOOR ADDITION MASTER BEDRM, MASTER BATHRM, 2 BED
;APPLICANT: TEL. NO: i IRMS, 1 BATHRM AND ATTACHED 1 CAR GARAGE
ICHAN, TERENCE (626) 379-4900- IB1 PLANCHECK W/ENERGY 169520.00 VAL 1,637.00 I 1
1560 W MAIN ST #C278 IAA BLDG PERMIT ISSUANCE 27.80 ISPECTAL CONDITIONS:
ALHAMBRA CA 91801 IAB STATE GREEN BLDG FEE 169520.00 VAL 7.00 ICOVENANT RECORDED
I IAC STRONG MOTION RESID 169520.00 VAL 17.00
I _ - -108 CERTIF OF OCCUPANCY 101.40 (APPROVALS DATE INSPECTOR SIGNATURE
IGUANG JIN LIN (626) 672-8360- 1 TOTAL FEES 3,716.10
1522 W WINNIE WAY LIC. NO I ILOCATION AND SETBACKS
1ARCADIA CA 91007 688406 1
1 I - 1SOILS ENGINEER APPROVAL
1 1
ARCHITECT OR ENGINEER: TEL. NO: IFOU:?DATION/TRENCH FORMS
ILANTRIK DEVELOPMENT LLC (626) 379-4900-, I
1560 W MAIN STREET C278LIC. NO: ° ISLAB/UNDER FLOOR
ALHAMBRA CA 91801 688406
* RAISED FLOOR FRAMING
12 AO
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMF: ( IUNDF=:FLOOR INSULATION 1
1 3 00I (1ST LEVEL FLOOR SHEATH
INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS:
1 0 NO 21 12ND LEVEL FLOOR SHEATH
SCHOOL WITHIN HAZARDOUS ROOF SHEATHING
1
1AIR QUALITY: 1000 FEET - MATERIALS _
NO NO NO FIRE` DEPT. FRAME INSPECTI 1
BLDG DEPT. FRAME INSPECT
1 1 ,_. _ - •. " -•' SHEAF PANELS
1 -
!INSULATION/WEATHER STRIP(
I �
• INTERIOR LATH/DRYWALL 1
I
1 1 EXTERIOR LATH
_ •1 LOT DRAINAGE
1 1 1 1
SMOP.E DETECTION DEVICES
1 I (FIRE DEPARTMENT APPROVAL( 1 1
I* ADDITIONAL DATA ON FILE
1
_ (REPORT ID: DPR261 ROUTE TO: BS0508