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HomeMy Public PortalAbout6129 IVAR AVE_Building__ -, pp • .. �p.'�y 78A@eeA CE 1fe09 70-@8,.. APPLICATION FO Y 1 ��l�n®'H�lei �➢m LL iI.Y.Y LL�!-'.: / + .,�. �' . COUNBUILDING TY OF LOS ANGELES -- �� DEPARTMENT OF COUNTY ENGINEER ADDRESS r ` BUILDING AND_SAFETY. DIVISION" LOCALITY ✓, JOHN'A. LAMBIE, COUNTY ENGINEER NEAREST • z - 'C.4SSATT`D. GRIFFIN,�SuPT OF BUILDING _CROSS ST. - x DISTRIC O. LROU TYPE_ . P. S D)BY FOR APPLICANT AO FILL IN coNsr _ BUILDING^ - " I I SEWER-MAP l STATISTICAL CLA SPF CATION.• C.ci L. u�S ADDRESS , _ _CLASS NO.�.PLDWELL.UNITS LOT NO. J _�O. oT BLOCK "MAP STATE - .'NIJMBER _ -H�yY., , YES i O TRACT _ :© USE ZON ,SpEC1AL , - © ,\ _I 'I NO:OF:BLDGSCONDITIONS,. .. C ZED FLOT NOW ON LOT USE OF —. EXISTING H G. BUILDING. '' - EXIST.- UILDI KHWY •"STREET NAME'- OWNEF,RONTr ,. MAIL- - , P..L. WID w- ADDRESS_ 'SIDE*.< - ' .TEL: .� - CITY N0: l INSPECTIQN:RECORD ARCH I?ECT- - TEL. . ENGINEER NO - /o- sip's A_DDRESS.-. .�•-• - - - e,. TEL. 4.GL bl:ci4T�.ts CONTRACT g 5'1 e9!�Mr!�..J AA.9'�:.NaT��-7y-/� A'DDRES �1. -.! ,DESCRIPTION OF'WORK , '. NEW "HADD ALTER REPAIR DEMOLISH SQ.FT. . NO.OF •..'.,-NO.OF SIZE - ..STORIES - FAMILIES USE OF STR CTUR - - SIGNATURE OF:,.. APPLICANT - .;: - -• 'APPROVAL-5=j - DATE'' "INSPECTOR'S SIGNATURE '• ADDRESS .FelUNDATION:LOCATION . . FiORMS,:MATERIALS3 VALUATION. -. - I, .FF:AME:•FIRE'STOPS, - -"` EiRACiNG,BOLTS _ P.C. - PMT: s� SCJ FLi.RN;4CE:-LOCATION. FEE $ I FEE $� "`� I "GAS.VENT,DUCTS /�� .: I HEREBY ACKNOWLEDGE.THAT 1 HAVE-READ THIS AP- -LATH.INT.- 'AGREE NT PLICATION•AND�STATE THAT-THE ABOVE IS CORRECT AND _ '- 'AGREE-TO COMP - WI.TH;ALL.COUN ORDINANCES AND - WERMIT TATE LAWS R G LATIN BUIL PG CON CTION. LATH,EXT.:77 IGNATURE OF.- HOUSE NUMBER COR- " .. "'A TEE 'e -F'.ECTANDPOSTEDL. - FI4VAL .. ...• .., .. - .. . .,CL CK: W:0;''. cwsH . YDE N. DIRLAM,PRINCIPAL STRUCTUR1AL- cwAkif s 'ER ; PLANCHECS VALIDATION' PERMIT VALIDATION z u 3 all, 'Ir 16 �A 21.0 0 pip pp '' flfl Temple City 76A638A-CE#8031.-67 •� PPLIC�a� ION F®RBUI•IL DING PERMIT- COUNTY OF:LOS ANGELES BUILDING DEPARTMENT. OF.COUNTY ENGINEER ADD RESS. 612 No,• Ivar °BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE.,COUNTY ENGINEERNEAREST' 1 - COLEMAN W.J;ENKA NS,SUP'r oFBuILDING - CROSS ST. -.� /71i�'�'' a, .,s OISTRICS. NO GR_9 Y-J �' T.YPE - P O`.ES D B_Y FOR-APPLICANT T0:FILL IN r"' CONST. BUILDING • - " STA-T.ISTICCAL C,LA DiFICATION SEWER MAP. - ` ADDRESSTvAr + BK 1 P G'. C LASS'`NO. WELL UNITS. - .8 LOT NO. .BLOCK USE ZONE MAP" 'NOS TRACT v - SPECIAL No OF OF BLOBS. CONDITIONS - SIZE OF LCT;' - NOW ON LOT - - .USE OF - .. EXISTING I BLDG. SETBACK FROM TEL FRONT PROP.-LINE OR - (STREET) . .OWNER GG qqS4id0. -TYPE OF EXISTING SETBACK. HIGHWAY +- YARD = TOTAL_ •ADDRESSVIY� NO `IVa'r - HIGHWAY WIDTH FROM C.L. ' CLTY +' • BLDG. SETBACK FROM ARCHITECT- R - T.EL.' - ENGINEER NO. SIDE PROP. LINE OF .(STREET). - .. - ' TYPE.OF EXISTING SETBACK HIGHWAY + 'YARD = TOTAL ADDRESS - Y, HIGHWAY WIDTH' FROM C.L. - CONTRACTORH-,' L.O; Randolria88- 0 0 - + . COR.NER CUTOFF - YES NOa ' LIG. .. . ' . CL ADDRESS - NO, C LIC -CITY SEE REVERSE SIDE FOR SPECIAL APPROVALS DESCRIPTION'OF W.ORK'. 'a .. LL a Yv V NEW ADD. - _.ALTER. '%REPAIR d DEMOLISH SQ.FT. - ,. NO. OF....,..- , - N0.'0F SIZE STORIES FAMILIES ,USE OF'- STRUCTURE •G. AP j SIGNATURE-OF - •APPLICANT -• _ - - VALUATION$ ZOO q: .00 ' + APPROVALS -.DATE INSPEGTOR'SSIBNATURE P C PMT. FOUNDATION; LOCATION - FEE$ FEE'$ -6 vOO' FORMS, MATERIALS` - - FRAME, FIRE-STOPS,- 1 HEREBY ACKNOWLEDGE THAT 1�HAVE READ THIS APPLICATION BRACING BOLTS 'AND STATE THAT THE%ABOVE IS_CORRECT,ANO '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 1 WILL NOT_EMPLOY AN RSON IN VIOLA'.. LATH. INT: TION OF THE-LABOR CoD- OF.THE TATE. C IFOR 1A RELAT. ING TO-WORKMEN'S COMP 710 .I SUR CE.'. LATH. EXT: .SIGNATURE-•CLF PERMITTEE HOUSE NUMBER COR- - - 7 RECT•A.ND POSTED ADDRESS-129 F.., Val1QV Blvd;. &;,G,. FiNAL -JOHN F. LEWIS. PRINCIPAL ST TURAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH. PERMIT VALIDATION CK. M.D CASH , a c DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PER3ILT T i, A . COUNTY OF LOS ANGELES BUILDING WM. J. FOX. CHIEF ENGINEER PLAND BLDG. ��\\ f INS DISTRICT No. PLAN CHK. Fe¢ PERMIT NO FILED ��OETO I ZONE /'•1 ZONE __� RECEIPT No. TYPL OF Tr BLDG. 1 11 III I X„-GROUP. _�•! DATL OF APPL. RtCE1V¢D BY DATZ IV9U110 —5� LIN ORO. No. 7'� G APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY g ofBUILDING NAME ADDRESS tl ZIADbR[88 LOCALITY. �,(R��.•}! d�1 �y . NRAREVT U d CITY . CROSS ST. STATE I 4 LIC[N81L NO. I Y MAIL + - IHAMS _tet •_ ADDRESS �3r >/(C �{;--t�`'�Z...t.• . 'i :LCITY /�/ ' . /IJSUII STATE Q E LOT►" 612E OP:LOT J L U tlU NO. OP OLOG13 LICENSE NO. Tat. No. QLOCl: NOW ON LUT USE OF BLDG. — - .0 TRACT NOW ON LOT CLASS OF WORK Jtl P DESCRIPTION OF WORK y NEW ADDITIONI'I DEMOLISH_i ,/•, i 1 ALTERATIONI REPAIR _MOVING I UBE OF NO. OR BLDG. L'u <, `^. l Q.7 ROOM9 S LOG. OF/� I BTORICS No. OF J -1 FAMILIES R ; • a I [ b ' SPECIFICATIONS Or I r 1 " f FOUNDATION - MATERIAL �,,t,, J. �/+ EXTERIOR PIQRO ` •+ cry�^�- THICKNE9fl_TOP f TICKNEDII_BOTTOM 4'4.. ,�^,( —�� H d DEPTH IN GROUND z SUPERSTRUCTURE 1- SIZE SPACING SPAN O _R. W. PLATEB ISILLO-V ` GIRDERS _•^ _ - i•; JOIST'S—FLOOR JOtIST4'I—C¢FLING 2,141 _ HEARING WALLS _ ( - ROOF RAFTERS. ..�r ^_ FINAL APPROVAL. GILL BOLTV �f COVERING DATE INUP¢GTOR'o PAMIR J T WALL �'� /" ROOF X11'1 1 HEREBY ACKNOWLEDGE. THAT 1 HAVE READ TMA ' APPLICATION AND STATIC THAT THE ABOVE IS CORRECT }: AND AGR[I[ TO COMPLY WITH ALL COUNTY OFOINAAM-ZZ P.C. FEE S AND BTATQ LAWS REG VLATING.43UILDING,C GTRUCTvm. o® SIGNL.VAL ATI F 0WHII OR AU oll+:eD oelrT D0�9 d-JO 2tIM .. v::;l t DEPART31ENT OF BUILDING APPL%CATION FOR PERMrr COUNTY OF LOS ANGELES BUILDING PLAND BLDG, plpE LAN NK, fCQ O. PILED 20N¢ 20N¢ RRCQIPT'No, �{ TYPE OF - / 1 J /(J QLOO. 1 11 UL ►V (d -$ I QROUPP SLOG.$€TOACDATA P A.VI/PEt. R¢CE YE D DA ID}c/7�J!?� APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY 6 BUILDING D NAME - 11+1...'a - ADDREOfl y!!_ZI ADDR¢00 LOCALITY tl N¢ARE igtd ` I "7,r. T_ CRO0 DT T � '- C -UTATQ ' < I LICENSE NO. TEL. NO. Q NAM¢ I ¢ I 6t IMAILADDF A DDR[99 � CITY � ( �� � ` E _ TEL 'NO.(1 r I !• Z CITY J 6 I LOT 812q OF LOT. } ��� 0 U L CENSE "aCLASS OF WORK No. G 8' "Q��..\ NO. OF BLOOD. 14 BLOCIT ! J NOW ON LOT O U6¢ OP DLOO, NEW I ADDITION DEM OLt6N TRACTNOW ON LOT I �-` ,— AESCRIIION OF ALTERATION REPAIR MOVIN® - -j^/•� fyj�•� ` U9E OP NO.OP y �'1 .Y�•>� "^vim-9. -� •t��--�l� _ BLDG. ROOMfl 1 A Alza OF \1 I aroitiza /d.No. OF SMO / f �' PAMIL E SPECIFIC IONS ' FOUNDATIONCORRECTIONS EXTHRIOM- I PIERS ' MATERIAL THICKNESS—TOP THICKNEBD_BOTTOM DEPTH IN QRRU D SUPERSTRUCTURE Il a1ZE ACItY i;-a / R. W. PI.ATE9 (DILL)j 1 GIRDERS ! L I F 1 J010TS_FLOOR - JOIDTa_CQILING _ SEARING WALLS _ - g 1' PARTITIONS Q ROOP RAFTBR0 __09 -- �L nvc 8 1- - –I COVERING WALL POOP 1 HEREBY ACKNOWLEDGE THAT I NAV¢ READ THIO - APPLICATION AND STATE THAT THE ABOVE IB CORRECT AND-AOP.EE TO COMPLY WITH ALL.COUNTY ORDINANCES ` AND 0TATQ LAWS REGULATING BV ILDI40 C076TRUCTION. SIGN�!!•tiJ- %i-+ �`• � ..�'d-'�L!, OWN[R OR AUTHC*12.�_, Aa[M'r FINAL APPROVAL ;P.C.RAE S VALUATION $ _ Bo•a o•oo q\tfdRKERS' COMPENSATION DECLARATION rl hereby affirm that I have a certificate-of consent to selfp O: O r7 D O nn insure, or a certificate,of Workers"Compensation Insurance, A CAT. O- or a certified'copy thereof (Sec, 3800, Lab. C.) f COUNTY OF LOS=.ANGELES . -BUILDING AND SAFETY Policy No. Company BUILDING ❑ Certrfied copy;is hereby furnished. "_FOR APPLICANT TO FILL IN' . ADDRESS`��� ,v C ❑ Certified copy is filed with the county building inspec- BUILDING ^: tion department. t ADDRESS Y� Date Applicant CITY '\� �Ll?.. Cr� R IN C ZIP ITOD LOCALITY NO._OF BLDGS:' NEAREST- CERTIFICATE OF EXEMPTION FROWORKERS' :; SIZE OF'LOT"A NOW ON LOT 'COMPENSATION INSURANCE'A CROSS ST., {Thisaection need not be•complefed if tK' permit i"s for'one TRACY BLOCK LOT NO. B'� MAP.BOOK PAGE' PARCEL V ASSESSO hundred dollars,($1,00) or-less ) .ey TEL. �, L .. ` USE ZONE'. 'MAP OWNER ® NO. O �1, NO. �� I certify That"irt.the performance of the,work for which this r(� / SRECIAI } permit:is issued, I shall not employ any per son pin any manner ADDRESS ' .�. �.. .�,V a'C� :.: Ir> , . CONDITIONS .so as to become subject to the•Workers' Com ensation Laws. O CITY ZIP : `�d�✓ U .. Date ARCHITECT OR TEL DISTRICT GROUP TYPE FIRE PROCESSED BY, NOTICE TO APPLICANT: If, after making::this Certificate of ENGINEER NO. CONST r ONE F_ ' Eke t] you should become ,subject io the" Workers` _ u Compensation provisions of:The•Labor.Code,-you,must forth ADDRESS a. 4 with,_comply•with such provisions or this permit, shall .be TEL.` STATISTICAL CLASSIFICATION APT. CONDO. N 'deemed revoked. CONTRACTOR NO. M _ Z "t LIC. CLASS NO. '�� DWELL".UNITS LICENSED CONTRACTORS DECLARATION. I hereby affirm that I am licensed under provisions of ChapTer9 ADDRESS • NO. LIC. SEWER MAP (commencing with Section 7000)of Division 3 of the Business : and Professions Code; and,my license is in.fuh force and effect. CITY CLASS _BK. PG. f� VALIDATION' SQ FT, -NO..OF NO. OF CHECK License Number LIC' class SIZE ;,' STORIES FAMILIES „ ONE :. _ - - VALUATION Contiactor Date RIP TION OF WORK" NEW . ❑ ❑I am exempYunder Sec ` ADD- ❑_ $ D L � BAP.C. for this;eason " ALTER, ❑ A' `� Date:' REPAIR USE OF ,_ ❑ $ EXISTING BLDG. "' "- DEMOL Signature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION (PRINT) �ltJ t NO. I hereby affirm:that I am exempt from.the Contractors License _ 9 "DATE q Ci Law or the following reason.(Section 7031.5,_Business and ADDRESS FINAL �2� QcV ssions Code):, PUELDNT. By,- PRESENT y _ • I, as owner of.the property or-;rny employees with' ADDRESS ;wages as.their sole:compensation will do the work and'. the structure is"not intended or offered for LOCALITY_ 7044 •Business and Profess iona'Code.) MOOING _ TEL. ❑ .I, as owner of the-property, am exclusively contracting C NTRACTOR" NO. ' with licensed'contractors.to:con'struct the,project(Sec- - ADDRESS 'tion 7044,'•-Business and Professions•,Code.) REQUIRED TOTAL SETBACK-FROM EXIST. yr - CONSTRUCTION,LENDING.AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending:agency for _ FRONT the perforrnance.of the;work-for which this permit"is`issued P.L.- '• `'" (Sec:3097, Civ. C ) SIDE h _ Lender's'Name } T dr MA , P.C. Fee$ Permit Fee LDRef. #. t _ 3 Lender's.Addres o I certify that I a ead this application and--state that The Issuance Fee LDMA P/C# D 8 above informati n' rrec[;'j agree to comply-with.allsCounty Investigation Fee { " d r 6nces d St a laws relating To building;consiruction,: Total fee e.�" LDMA Perm. #" a and h re y 't or a epresentativ.es of this.County to enter upon t e,ab a ti ned property for'inspecti Ws , SEE REVERSE FOR EXPLANATORY LANGUAGE Sia re o licant'or.A ent .' 9 > WORKERS' COMPENSATION.DECLARATION I hereby affirm that I have a certificate of conseni to self AL/�1 censure,,o�a certificdte of.Workers 'Compensation Insurance, L0 0[ . BOO Q o:M�d � I,C� p�G31�� or a certified copy thereof (Sec` 3800, COUNTY OF LOS ANGELES .BUILDING AND SAFETY Policy Nc,�l21�, � ComBUILDIN pany ❑ Certified copy is hereby furnished.. ADDRESS �g `FO ' R APPLICANT TO_FILL IN D—.' Certified copy�is,filed with The county.building inspec- BUILDING tion-.department.:,' ADDRESS /l`�O%�. CITY•. "'I ,! . ' r� ZIP LOCALITY LS ' Date Apphcanl NO OF B DGS 101, CERTIFICATE OF EXE MPTION'FROM.WOR- RS' SIZE OF LOT NOW ON LOT COMPENSATION INSURANCE NEAREST CROSS ST. .ASSESSOR (This section.need riot-be completed-if.the permit is.for one TRACT^ BLOCK' LOT NO. MAP BOOK. PAGE "PARCEL hundred dollars ($100) or less.)c:,: TEL.. OWNER.. - USE ZONE" ? T I:certify that..,in theaperformance.of. the work for which this SPOEC permit is,issued, (•,shall'not employ any person in ony:mtlnnec ADDRES CL so as to become subject•to the Workers'Compensation Laws., 0 .CITY-' ZIP 6/ 4 IAL CONDITIONS r / Date Applicant " ARCHITECT OR TEL. NOTICE TO APPLICANT( If,- after,makin this Certificate of ENGINEER. TEL. DISTRICT GROUP ,TY.PE ,FIRE PROCESSED$Y g' CONST. i ZONE O Exemption; you 'should_become subject to.the Workers U Compensation provisions of TFie Labor<Code you must ADDRESS ` �, : with comply:with.•such,provisions or this permif hall be TEL. _ STATISTICAL CLASSIFICATION APT: [=CONO.deemedrevoked L CONTRACTOR' NO 3wl'SSS) -�z LICENSED C-ONTRACTORS'DECLARATION I / /��// ADDRESS�v O / �ji Q.. .. LIC. CLASS NO. DWELL: UNITS 1,her that I am licensed under provisions of Chapter'9 NO ::(commencing with Section 7000),of Division 3 of,the Busine"ss SEWER and,Professions Code and my license is in full force'ond,effect ' BK ER -PG. VALIDATION ' S TY NO. OF NO: OE I 'CLASS Q FT: "CHECK. ; License Number lG/ 7/ LiI Of c Class C` 3 RIES - FAMILIES ONE SIZE STORIES { N ,:� VALUATION 4 6^ DESCRIPTION OF WORK NEW ❑ Date ��- - . 9 . Contractor t. c ADD $El f I am exempt under Sec.- ' Af .. B.&P C *forthis reason114 : ALTER OF REPAIR•❑ $ - Date:: E OF -LDG: DEMOL ,Signature APPLICANT L. _ FINAL OWNER-BUILDER DECLARATION. (PRINT) k& Q` ® r P OL �' �J 4 DATE I hereby affirm that I.am'exempt from the Contractors_License ri" taw-for the following reason (Section 7031 5, Business and ADDRESS x FIINAL .Professions.Code), ;',, PRESENT BY. . t • BUILDING'. I, as owner of-the property or my.employees with ADDRESS ' �p T wages as'their sole compensation',will do the work and LOCALITY ItJ t � LT�. .40 5 ' a' A the structure isnot intended or offered far sale(Sec'tion �_-3 6 7044, Business and Professions Code.) MOVING TEL., CONTRACTOR NO. L ❑ I, as owner of the property, am-exclusively.contracting*. - s p, '. ADDRESS .; : •. �:� •tihon7044,, bus nessaand Professions cCode roIect{Sec- I t REQUIRED ,. TOTAL SETBACK FROM 7 EXIST. CONSTRUCTION LEND ING:AGENCY` - SET BACK_ YARD' HW.Y PROP. LINE WIDTH' I hereby affir' that there is a construction lending agency for FRONT the"performance of the work for which this-permit.is issued - (Sec. 3097, Civ. C.): SIDE PA. _ e _ c L'ender's Name v (/ LDMA Ref. # - ' .. P C. Fee$ - Permit Fee- Lender's Address _ ,- D. o I certify that I have read this application and state that the Issuance Fee ' -715 LDMA P/C# • above information is correct. I agree to comply with all County Investigation Fee-, . / 6 ordinan and State I ws relating to building`construction, Total fee m(6✓ LDMA Perm. # Q and reby out iz epr�sentatives of this:County to enter n the ab me Toned property for inspec ion purposge�s. . ,� l '�'O^ `�• SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of App. nt or Date > - WORKERS'COMPaNSATION DECLARATION r I hereby affir,m`,that I have a certificate of'ccnsent tor'self /��\ D D O O insure, or a cO ertificate of Workers' Compensation Insurance, A �U U� [ 13 d D [�C p Q 0 or a certified copy'thereof (Sec. 3800, Lab. C. COUNTY OF.LOS AIYCELES,. • : - BUILDING AND SAFETY Policy No. Company Certified co is hereb furnished. BUILDING copy v' FOR APPLICANT TO FILL IN- ADDRESS" a" Certified copy is filed with the county building inspec- BUILDING 10 tion department. ADDRESS C( - - -V LOCALITY / / NEAREST Date Applicant CITY Ci ( � ZIP CROSS ST. ' CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT A CJ NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed-if the permit-is for one USE ZONE MAP ' hundred dollars ($100)or less.) TRACT BLOCK LOT NO. NO: d TEL. //►� SPECIAL I certify that in the performance of the work for which this OWNER O. =d" CONDITIONS IL permit is issued, I shall not employ any person in any maline // DISTRICT GROUP TYPE FIRE PROCESSED BY 0 so as to become subject to the Workers'Compens fion La ADDRESS (O 7 (/E� Lti� CONST. ZONE U �' Date �t Applicant CITY R lam-` ZIP TEL:` STATISTICAL LASSIFI TION APT. CONDO. 0 NOTICE TO APPLICANT:_If, after making this Certificate of ARCHITECTO u ENGINEER A0 lie— NO: CLASS NO. DWELL. UNITS W Exemption, you should become subject to the Workers' IL Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP_ to with comply with such provisions'or this permit'shall be TEL — deemed revoked. . ' BK. PG, - VALIDATION CONTRACTOR „Q NO. LICENSED CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. VALUATION t (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 D SQ. FT. NO.OF NO. OF CHECK License Number Lic.Class SIZE STORIES FAMILIES ONE Contractor Date. DESCRIPTION OF WORK (C NEW ❑ ❑ I am exempt under Sec. ADD. . ALTER ❑ FINAL T' B.BP.C.'for this reason ❑ DATE REPAIR Date: USE OF FINA EXISTING BLDG. L<V� - DEMOL ❑ B Signature APPLICANT TEL. y {1 LO�1 � OWNER-BUILDER PRINT DECLARATION NO. � r - �4 3(a.,3 A d hereby affirm that I am exempt from the Contractors License n . /^ Law for the,following reason (Section 7031.5, Business and ADDRESS :Z 1�C/C(. __I'll I j---f-(/ Ir?C i D 0 0 0 0 0 1 Professions Code): .- PRESENT BUILDING I, as owner of the property,..or my employees with ADDRESS 2 . - 4 9.88 w es as their sole compensation,will do the work and the structure is not intended or offered forsale(Section LOCALITY o'o 0 4 9 8 8 7044, Business and Professions Code). MOVING TEL. I ❑ CONTRACTOR NO. 0 2 2 1 -84 I, as owner of the property, am exclusively contracting, C - _ _ =v -�� _ with licensed contractors to construct the project (Sec- ADDRESS. -tion'7044, Business and Professions Code). REQUIRED TOTAL.SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY' SETBACK YARD HWY PROP. LINE WIDTH D d hereby 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 •- Lender's Name Lender's Address P.C. Fee$ . Permit Fee I certify that I have read this application and state that the Issuance Fee above information is correct. I agree to comply with.all County Investigation Fee g ordinances and State laws relating to building construction, Total Fee u and hereby authorize represe_ .ves of this County to enter m upon fhe ab mentioned-pr"op fty for inspection purposes. a o SEE REVERSE FOR.EXPLANATORY LANGUAGE • Signature of Applicant or Agent Date ®s 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 91780 BL 0508 1109270047 _ PHONE: (626) 285-0488 EXT: ILEGAL ID: 1 NO. OF CONST NEW BUILDING ADDRESS: 1 ITR: 5904 LT: 18 UN: .002 I SQ. FT STORIES TYPE OCCUP GROUPI 6129 IVAR AV 1 (STRUCTURE: 492 1 V-B R.-3 - I TEMP CA 917801524 (ASSESSOR INFORMATION NUMBER: GARAGE: NEAREST CROSS STREET: GARIBALDI i 15386-010-061 I OTHER:, THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY, Cl (TENANT: (EXIST BLDG USE: USF. ZONE: (ISSUED ON: PROCESSED BY: 1 (EXIST OCC GRP: 112/20/11 SR - 1 (OWNER: - TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: IFz AL DATF. P_T*1*r. nv: CODE: 1 IOLGUIN, JOSEPHINE (626) 255-3467- I 72,930 6129 IVAR AV Imo" JJ I I !l v I ITEMP 917801524 '1 FEES PAID 1DESCRI 5OF WORK - -- 1 INEW REAR ADDITION: FAMILY ROOM, BEDROOM AND BATHROOM 1 I _1FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: IEXTRNSION 1 (APPLICANT: - TEL. NO: 1 IMALDONADO, HELBERT (626) 255-3467- IB1 PLANCHECK W/ENERGY 72930.00 VAL 960.60 I J 1174 W. FOOTHILL 4275 IAA BLDG PERMIT ISSUANCE 27.80 ISPECIAL CONDITIONS: (MONROVIA, CA 91016 IAB STATE GREEN BLDG FEE 72930.00 VAL _ 3.00 J IAC STRONG MOTION RESID 72930.00 VAL 7.30 1 1 JB2 PERMIT W/ENERGY 72930.00 VAL 1,.130.10 1 1 (CONTRACTOR: TEL. NO: IFR INV WORK W/O PERMIT 257.00 DOL • 257,00• IAPPROVALS DATE INSPECTOR SIGNATURE 1 MALDONADO, HELBERT (626) 255-3467- TOTAL FEES 2,'385.80 I J 1174 W. FOOTHILL BLVD. #275 LIC. NO 1 1LOCATION AND SETBACKS J J (MONROVIA, CA 91016 'NONE ISOILS ENGINEER APPROVAL I I 1ARCHITECT OR ENGINEER: - TEL. NO: 1 IFOUNDATION/TRENCH FORMS I 1 LIC. NO: 1 1SLAB/UNDER FLOOR 1 r 1 IRAISED FLOOR FRAMING I J (MAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: - � 1UNDERFLOOR INSULATION 1 3 001 J --I 1ST LEVEL FLOOR SHEATHI INO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: ( 111 1 0 NO 21 - 2NL' LEVEL FLOOR SHEATH J J I 1 SCHOOL WITHIN HAZARDOUS 1 IROOF HEHING ( I I 1 JAIR QUALITY: 1000 FEET MATERIALS I_ 4-(et,�vc C 1 NO NO NO 1 IFIRE DEPT. FRAME NSPECTI I IBLDC DEPT. FRAME INSPECTI ISHEAR PANELS J J J I a l r INSULATION/WEATHERYl' oj- (INTERIOR LATH/DRYWALL U i 1 r I I J I 1EXTERIOR LATH I J I I I IL T DRAINAGE I I I i I J ISMOKE DETECTION DEVICES I I I I -1-1 I ' J IFIRE DEPARTMENT APPROVALI I I 1 I I I I I ;REPORT ID: DPR261 ROUTE TO: BS0508 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 120517000.9 PHONE: (626)285-0488 EXT: ILEGAL ID:, NO. OF CONST BUILDING ADDRESS: _ ITR': 5904 LT: 18 UN: .002 SQ. FT STORIES TYPE 6129 IVAR AV - 1 I (STRUCTURE: V-B I TEMP CA 917801524 1ASSESSOR INFORMATION-NUMBER: I - NEAREST,-CROSS STREET: GARIBALDI 15386-010-061 - - I THOMAS PAGE-: 596 GRID: H2- LOCALITY: TEMPLE CITY, Cl I (TENANT: - IEXIST BLDG USE: RESID USE ZONE: R-1 (ISSUED ON: PROCESSED BY: . - IEXIST OCC GRP: 105/17/12 SR- I I I I (OWNER: - TEL. NO: IBLDGS. NOW ON-LOT: VALUATION: IFj AL DATE FIN* Y: CODE: IOLGUIN, JOSEPHINE (626) 255-3467- - 1 1,000 ., - 16129 IVAR AV TEMP 917801524 - - FEES PAID I-'LeriON OF WORK IREMODEL EXISTING BATHROOM NO NEW FIXTURES: ( . IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( 1 (APPLICANT: TEL. NO: I I I - - I - MALDONADO-, HELBERT (626) 255-3467- - IAA BLDG PERMIT ISSUANCE 27.80 1 1 1174 W. FOOTHILL #275 ' IAB STATE GREEN BLDG FEE 1000.00 VAL 1.60. ISPECIAL CONDITIONS: 1 IMONROVIA, CA 91016 IAC STRONG MOTION RESID 1000.00 VAL 0.50 _ 1 JB2 PERMIT W/ENERGY 1000.00 VAL 71.90 1' - 1 TOTAL FEES 10.1.2o ICONTRACTOR: _ TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE _ MALDONADO, HELBERT - - (626)_255-3467- 1174 W. FOOTHILL BLVD. #27S LIC. NO 1 - - ILOCATION AND SETBACKS IMONROVIA, CA 91016 NONE ISOILS ENGINEER APPROVAL 1 1 (ARCHITECT OR ENGINEER: TEL. NO: I IFOUNDATION/TRENCH FORMS 1 1 1 1 LIC. N0: -1SLAB/UNDER FLOOR RAISED FLOOR FRAMING I IMAP NO: SEWER MAP, BOOK: PAGE: FIRE ZONE: @MP:I 1UNDERFLOOR INSULATION. I 115OH265 3 001 _ 1 I 1 I - I -I FLOOR SHEATHING INO. OF. FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: 1: 0 NO 21 I IROOF SHEATHING 1 SCHOOL WITHIN HAZARDOUS I ISHEAR PANELS -1AIR QUALITY: 1000 FEET MATERIALS 1 NO NO NO I - 1FRAME INSPECTION I I I I I I I - IFIRE SPRINKLER HANGERS I 11NSULATION/WEATHER STRIPI ' - -- 11NTERIOR LATH/DRYWALL ( .. ' I I I I I I 1EXTERIOR LATH IRATED FLOOR/CEIL kSSEM. 1 1 _ RATED WALL ASSEMBLIES - I ' I I I I 1 I . I IRATED SHAFTS/OPENINGS 1 1. I IT-BAR CEILINGS I 1 1 I I I 1 I ILOT DRAINAGE I I I IREPORT ID: DPR261 ROUTE TO: BS0508 I I I I I I