HomeMy Public PortalAbout5126 KAUFFMAN AVE_Building__ -76A638A CE4803 I-67 APPLICAT11®N T®R BUILDIN PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS 7
BUILDING AND SAFETY DIVISION LOCALITY _
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS,SUP'T OF BUILDING CROSS ST.
" `IS.T•ICT, 'G OUP TY E �-. P ESSED BY
FOR APPLICANT TO FILL IN l?' CONST.
BUILDING STATISTICAL ALSSIFICATION +SEWER MAP .
ADDRESS 2z _ BK PG
CLASS.NO'. DWEL UNITS
LOT NO. BLOCK USE ZONE MAP
._ NO..
' TRACT SPECIAL �j
s N0. OF SLOGS. �J CONDITIONS
SIZE OF LOT �• NOW ON LOT J -
USE OF + _
G it 11 D 4!5?�'r Coe_ A4 SLOG. SETBACK FROM
TEL.. +-� FRONT PROP. LINE OF (STREET)
OWNER '� / NO. a
EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS
�5 TH FROMC.L.CITY �• �(/� �. � aS!f _ +ARCHITECT OR TEL. BACK FROM .
ENGINEER NO. SIDE PROP. LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS �/ HIGHWAY WIDTH FROM C.L.
CONTRACTOR r• � T OX90-
ADDRESS � '/ CORNER CUTOFF YES NO C
CITY aI( A0-,e B� LIQ SEE REVERSE SIDE FOR SPECIAL APPROVALS
C
DESCRIPTION OF WORK 4
4----A,6
4
NEW ADD -/ 71 42 a
A TER REPAIR DEMOLISH v
z
SC).FT. NO. OF NO. OF
SIZE STORIES FAMILIES
USE OF
STRUCTURE
SIGNATURE OF
°. APPLICANT
VALUATI $ d�/C,/� •OO APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. - PMT. FOUNDATION, LOCATION
FEE$ FEE.$ FORMS, MATERIALS
FRAME, FIRE STOPS
,I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA;ION BRA �l-vir,"-77 -y"TX.U;' -J�
CING BOLTS ! IJ� / (/
ANSTATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS
9UILDI NG CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK //
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA. LATH. INT. -, A h��
.TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT.
TOW ORKMEN' nMPE NSATION INSURANCE.
LATH. EXT.
SIGNATURE O HOUSE NUMBER COR-
PERMITTEE REC AND POSTED I) A
ADDRES Fl NAL
JOHN F. LEWIS. PRINCIPAL ST CT RAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.D CASH
6
r r t��r 2 I /. 5, •C�+`
L� o 7 C] ,t 5 1 _N
'76A638A 6E#803 3-.68_:q 'PL, 0 CAT p AFCr- R B J L�®Q -tl` . PE RW T • ' 1
BOUNTY OF LOS ANGELES BUILDING.
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND.SA'FETY DIVISION . LOCA LI TY.: r
JOHN A. LAMBI'E, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPT OF BUILDING NEARST
GROSSEST.
DISTRICT-NO. ROUP. PE. PR ESSE ,:BY
FOR APPLICANT TO FILL IN
CONST.,'o:, �.
(Print or type only)
r
BUILDING - STA,TISTICAL'CLASSIFICATION. . SEWER MAP/
ADDRESS •CLASS NO. �= --DWELL.UNITS. BK PG J
LOT NO. BLOCK USE ZONE MAP �••� "
.SPECIAL/�"q/�� N O. V.
TRACT. - • ( ( CODITIONS,
NO.OF BLOGS.
SIZE OF LOT. NOW ON LOT '
USE OF - ..
EXISTING BLDG. BLDG.SETBACK FROM
T FRONT PROP,LINE OF (STREET,).
OWNER TYPE OF EXISTING SETBACK HIGHWAY' + YARD = TOTAL
HIGHWAY WIDTH FROM C.L.
A D ESS
+
CITY
ARCHITECT OR TEL: SI DG,SETBA K FROM. (STREET)
SIDE PROP.LINEOI=
ENGINEER - NO. TYPE OF EXISTING' SETBACK HIGHWAY----+.-- ''-YARD = -:TOTAL
ADDRESS. ,/ HIGHWAY WIDTH FROM C.L.
L + _
CONT
ADDREi
C' CORNER CUTOFF YES Q NO =Q U
S79
t - LIG i •.,y . - .�:.
CITY cLASs ? SEE REVERSE SIDE FOR SPECIALryAPPR LS
�� f m.
DESCRIPTION OF WORK uj
11,ee k z
NEW- ADD. ALTER REPAIR DEMOLISH '
SQ. FT. NO. OF NO. OF `
SIZE STORIES FAMILIES
USE OF
STRUCTURE
`.r
SIGNATUREOF `
APPLICANT
VALUATION $. jcir �
APPROVALS ell DATE `I.SpV79R•. -IGNATURE
P.C. PMT. -" 'FOUNDATION: LOCATION
FEE$ + FEE$ , /,�- // FORMS, MATERIALS
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I'HAVE READ THIS APPLICATION BRACING, BOLTS
AND STATE.THAT THE ABOVE IS.CORRECT AND 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�I'WILL NOT EMPLOY ANY PERSON IN VIOLA- - ^�
TION OF TME LABOR CODE OF THE STATE OF CALIFORNIA RELAT. LATH, INTptq� S iAIeA ����"� ®c iT
ING TO WORKMEN'S COMPENSATION INSURANCE, /
LATH, EXTP- OOli r-+�'f�_ i�<7i G/I �;F, iQ/Len/
SIGNATURE OF HOUSE NUMBER`COR
PERMITTEE' O RECT AND POSTED
ADDRESS / //� r �/ I FINAL �5- q-'�,q v;lr" rll
JOHN F. LEWIS. PRINCIPAL STRUCTU AL ENGINEER
PLAN:CHECK VALIDATIO CK. M.O. CASH' PERMIT VALIDATION CK. M.O. CASH
� 2: 0' AW 2 6..'7 5N
.. - 2 •
Lt'�L J 6. 1 2 1' Kt fj 226 1 D 22.50-
,
i
DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES pr{1'�
WM. J. FOX, CHIEF ENGINEER l L�
niNG
FOR`APPLICANT TO FILL IN FOR OFFICE USE ONLY
,�L s� / ,(� DISTRICT NO. (/�,�PLAN CK. NO. �JPERMIIT� NO.
BUILDING ADDRESS .J /�Y. /✓ Ll FG. /v�iQ N / S^� / C9 61
i RECEIVED BY DATE OF APPL. DATE ISSUED
LOCALITY •�af� ,p ✓�� /� f� Q .-
CROSS ST.
' NEAREST
BUILDING
- OWNER
1 " itCa4'� �C ADDRESS �1 /V /� CJ /. / / �J/V
MAIL d ' LOCALITY
ADDRESS' if irti' L - NEAREST
��� TEL Y"C �� CROSS ST.
CITY NO. J FIRENO. OF �J TYPE / / I GROUP-
ARCHITECT ORS p,.,d/� TEL. / .ZONE PLANS
ENGINEER.
IO / (� -
ENGINEER.- I%%�'V _/V��. b NO. BLDG. :�O / J� /T /De
O.
v - .'SETBACK LINE
' ADDRESS - APPROVED -
.TEL:' - BY DATE
CONTRACTOR NO. USE APPROVED
. ZONE A-1 BY .. DATE �.
ADDRESS .HOUSE NUMBERING
LEGAL s DESCRIPTION I LOT NO. BLOCK MAP NUMBER 66 -FIELD CHECK BY
TRACT Q �. NO. ASSIGNED BYE%° DATE
NO. OF BLDGS. CORRECTIONS
SIZE OF LOT 4'6 I NOW ON LOTd""I "
USE.OF - I NO. OF
EXISTING BLDG.: FAMILIES
'Pup
DESCRIPTION OF WORK .
NEW I
[ALTERATION' . ADDITION
REPAIR I `I DEMOLITIONI 'I A._
.. .SQ. FT. ' NO. -OF
SIZE ROOMS STORIES
EXT. WALL ROOFiy - r
COVERING I COVERING y I �cbMB �'✓.LJ 1i"C? �L-ct71'f "�`�o-eL�t�St,�
LSE OF STRUCTURE L.
APPROVALS
INSPECTOR'S SIGNATURE DATE
I HEREBY ACKNOWLEDGE THAT I HAVE - FOUNDATION: LOCATION'
PLICATION AND STATE THAT THE INFORMATFORMS, MATERIALS
CORRECT. ,
L"AGREE TO COMPLY WITH THE CORRECLJNDA
' FRAME: FIRE STOPS,c�` /
HEREON AND WITH ALL COUNTY ORDINANCE BRACING, BOLTS �
_+ LAWS REGULATING BUILDING CONSTRUCTIO
� FURNACE: LOCATION, /% �✓ ��U .
SIGNATURE OF /�j-�;,��,� �' .i¢aGAS.VENT, DUCTS
PERMITTEE('�'tr��p-,/y ✓./
ADDRESSC LATH, INT. 'LATH, EXT. ��AUTHORIZED AGT. /� /� PLASTER, INT. -
76A638A• DOSS 10-80 $ P. C. $ a� pg�y '
® �� `O� 3 FEE' 2 � / PLASTER, EXT.
VALUATION FEE $ ��- FINAL � ,,..
;'J;EPARTMENT OF BUILDINGAND SAFETY APPLICATION FOR PERMIT
a. COUNTY OF LOS ANGELES
WM.'~J. FOX, CHIEF. ENGINEER
FOR APPLICANT TOFILL IN FOR, OFFICE USE ONLY
- 7 DISTRICT NO. PLANCK. NO. .. //PERMIT
NO.BUILDING
�q
ADDRESS �. .. T �S J'
REG VED BY DATE OF APPL. D%TE ISSUED
LOCALITY ✓�'1.<,.Z. � f7F^ �' � `
NEAREST'
Via• �-
CROSS ST. "I„C r7 BUILDING
- .ADDRESS L - 'T
,OWNER. r.
6497
A
MAIL LOCALIT •� �
ADDRESS •,.A , ♦. � i NEAREST U: -
�/�''.. ''.. �'. TCROSS ST.
CITY FIRE - NO. OF `�I-TYPE _ -V
IGROUP
ARCHITECT OR -.TEL. _ ZONE/ PLANS
ENGINEERNO. BLDG. n - �i Q /� ORD. NO.
SETBACK LINE �``I/ /• !.J
ADDRESS` _ APPROVED
TEL. BY
DATE
CONTRACTOR; NO. USE APPROVED -
ZONE BY` - i - DATE
ADDRESS - .. - ,. HOUSENUMBERING
.DESCRIPTIONLOT NO. 'L - I BLOCK - MAP NUMBER �- -FIELD CHECK BY
TRACT �, NO..ASSIGNED'BY SATE
• y No.;oF BiDcs. . CORRECTIONS..
SIZE OF LOT •• \;4 ,,'a•,2� 'I NOW ON LOT, -
c �
USE OF ..-L.NO.-OF
EXISTING BLDG._. FAMILIES -
DESCRIPTION OF WORK.
NEW I I'ALTERATION I 'I ADDITION I f
oi
.I
REPAIR D.I N
_ EMOLITIO - "' •'_
SQ.•FT.' Thr NO. OF - Q
._ SIZE' •(' -ROOMS STORIES - - Z
a
EXT.-WALL FiOOF
COVERING. �,�e-.,. 'I COVERING, r
USE.OF STRUCTURE - - - -
APPROVALS
- . . INSPECTOR'S SIGNATURE.... DATE. '
1 HEREBY ACKNOWLEDGE TI4AT 1 HAVE ,READ ,THIS AP- FOUNDATION: LOCATION
PLICATION AND STATE THAT THE INFORMATION GIVEN IS 'FORMS, MATERIALS� f �,�ryr ,_
COI AGREE YO '.COMPLY WITH THE CORRECTIONS LISTED T -FRAME: FIRESTOPS, �"'Fpt
HEREON AND WITH'ALL COUNTY'ORD]NANCES AND STATE BRACING, BOLTS _ y„s-fC'�s1 /�- -;
LAWS 'REGULATING BUILDING CONSTRUCTION. FURNACE: LOCATION,
SIGNATURE OFT GAS VENT, DUCTS :
PERMITTEE��-4- 19 /�.
LATH. INT.
M1
ADDRESS
LATH, EXT.
OR'4. -
_
AUTHORIZED AGT.
- PLASTER, INT. t/
76A638A• D139810 80, / C. /1
FEE PLASTER, EXT..
/W„ v
$
VALUATION 6yry L/�Z'
FEE FINAL
WORKERS COMPENSATION`DECLARATION
insure, or afcertif cane of Worke srttomtpensat onse of lnsurdncent to se f (/ "Q �.� N O
oro certified copy4thereof'(Sec. 3800 Lab'::-C.) 7
COUNTY OF LOS ANGELES BUILDINC9;,14ND'SAFETV" 4ti
Policy No a Company. BUILDING
_ - -
,Certified4copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS ./�
: .
'Certrfied'copy'is'filed with'the county building inspec- BUILDs�
tion.dep6rtment. ' G/ ,
Date ;:.` A'pliccint'w, CITY li( ZIP. r LOCALITY
'
'CERTIFICATE OF EXEMPTION FROM WORKERS'' NO: OF BLDGS NEAREST
;
_. _
'GOMPENSATION'.INSURANCE SIZE OF LOT' NOW ON LOT ' CR05SSST. S�
(ThCs'sectton need.not be completed if the permil'is"for•.one : TRACT BLOCK F LOT NO PASSESSOR
hundred dollars''$100 or less MA ZBONE MAP' PAGE: PARCEL
�n _
( ) ) TEL.
c , H`y. OWNER NO.
- USE
I certify that to the performance of the work_for which,this J
perrnit.is issued, I shall not employ any person_in any manner __, 71
_ ..
C-�-�- SPECIAL �
so.as to become'.subject•to'the'Workers''Compensation L'dws. ADDRESS'_' _ /` CONDITIONS'. „, l0'
it y ,ti
t y CITY.._ �:. ,." ZIP _
Date" Applicant'.
a ARCHITECT OR TEL: DISTRICT.._, GROUP-.:+TYPE FIDE PRO ESSED.BY
NOTICE TO :APPLICANT:'If; after making this,Certifica'te of ENGINES NO. '
Exemption you should,,become siubject 'tooth"e' Workers' CONST Z NE U
6a1
Compensatton)p ovisions;,of the Labor Code,,you must f$rth-, ADDRESS .S,eVO _ �..
"
with-,,comply.•'with.such,.provisions orc.this•,permit shall,- be -� _
TEL STATISTICAL CLASSIFICATION APT. CO O f'
deemed revoked. `, CONTRACTOR NO +
LICENSED CONTRACTORS DECLARATION:,: - - -- r LIC; a' CLASS NO. DWELL UNITS
2,
I here by;aff_irm that l om licensed under provisions of Chapter 9 ADDRESS NO:
(commencing with-Section`.7000)of Division 3 of the Business and _ LIG F
, .
EWE P
Professions Code, and my license as to full-force and effect CITY• ��' CLASS - "VALID'ATIOId
SEWER
+.. BK.' FIG.
SQ FT.J NO. OF NO._OF CHECK t'
,License.Number Lic:Class
SIZE / STORIES FAMILIES _ ONE +
..,j ,,, .. .< + - Cj
-
', i,r, DESCRIPTION OF"WORK
-NEV -
Contractor Date ADD a S e
❑ I.arri exempt under Sec
0
TER o
B.&P C..for this reason REPAIR #.. e 3 4 5 #
E] $ oo A .
o.
Dater- i(JSE OF ;DEMOL' Q 6 cn 6 J
EXISTING BLDG.
APPLICANT. -. TEL
® ; i b
"Sign'afure FINAL .
PRINT) ' NO. Jr t,S 5
OWNER-BUILDER DECLARATION _ _ DATE-
, .. _,,.. _ - : ... ...,,
I.hereby affirm:That I,,om exempt from,the Contractor's.License'
Law for the following 'reason`•(Section 7031.5, Business and ADDRESS � d ',`'�'
Professions.Code) w.x , x.- PRESENT - gY if
BUILDING
a I, as:owner of the property, or,my employees with ADDRESS _
wages as the-irsole compensation,will doThe work and -1
the structure is not intended or offered for sale(Section
LOCALITY i t1
S
,
7044,`Business and Professions.'Code). MOVING " "' " "'"TEL:
CONTRACTOR NO.
t,'a5 owner of the property,am exclusively contracting, , - -
_....
`with^licensed-contractors to cons{rucYTheproject (Sec- ADDRESS
tion 7044, Business and Professions Code). t
REQUIRED TOTAL SETBACK FROM XIST._ _
CONSTRUCTION LENDING AGENCY"` SET BACK YARD' HWY"' PROP. LINE WIDTH
I'hereby affirm that there is a construction lending agency for ;FRONT }'•1 h `
The,Performdnce;of the work for which-this Perm&is-issued P.L '•. - -'
(Sec. 300, Civ. C.). SIDE
P.L.
Lender's Name
LDMA Ref. #
Perm it�Fee I.;j 143
`Lender's Address P.C. Fee$'
.,I-:certify t at I h e'read-this application and..state.that.the i _ Issuance Fee -- v CDMA P/C#
W above i ormat' is rect.•I agree to comply with all Count estigation Fee'-
a 9 P Y Y Inv
o ordtna ¢des an' Stat aws relating to.building construction, _ j.
,w Total Fee: - -�J L7.'-6
ands A 6y�at`ithar a representatives of this Count to enter t P ' LDMA Perm. #
upo he ove- boned property for inspectio purpo
SEE REVERSE FOR EXPLANATORY LANGUAGE
- •'._.- Signatur of-Applicant or Agent.,,. '.__ :.--- ate •"-- -- - :.,. �....'_ .�_:__. ,.._._-._: .,. - - _ _ -- _ �.00 t
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 1004210033
PHONE: (626) 285-0488 EXT:
(LEGAL ID: I NO. OF CONST I BUILDING ADDRESS:
ITR: 15683 LT: 19 I SQ. FT STORIES TYPE I 5126 KAUFFMAN AV I
I ISTRUCTURE: 1418V-B TEMP CA 917803945.
(ASSESSOR INFORMATION NUMBER:' I I NEAREST CROSS STREET: LA ROSA I
18589-010-019 I THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY, Cl
ITENANT: IEXIST BLDG USE: RESID USE ZONE: R-1 (ISSUED ON: PROCESSED BY: 1
(EXIST OCC GRP: 103/22/11 SR
1OWNER: TEL. NO: JBLDGS. NOW ON LOT: VALUATION: 1FINALAT FINAL BY: CODE: 1.
IBUBALO MIKE;MERCY L (626) 446-2519- 1 141,800 1 I
112 OLD RANCH RD 1 I
(ARCD 910076170 1 FEES PAID DIISCRIPTION OF WORK I
I IRECONSTRUCT ROOF, RECONFIGU E INT LOADBEARING WALLS KITCHEN I
I IFEEDESCRIPTION: QUANTITY: UOM: AMOUNT: IBATHRMS, CLOSETS, ADD POWDER RM, & REPLACE ALL WINDOWS 1
(APPLICANT: TEL. N0: I I1
ISACCOMAN, FRANK (626) 358-3360- ID1 PLANCHECK W/O EN-HC 49630.00 VAL 678.03 1 _ I
1408 HEATHER HEIGHTS IB1 PLANCHECK W/ENERGY 141800.00 VAL 786.18 ISPECIAL CONDITIONS: 1
IMONROVIA, CA JAA BLDG PERMIT ISSUANCE 27.80
AB STATE GREEN BLDG FEE 141800.00 VAL 6.00 ;
1 _IAC 141800.00 VAL 14.20
STRONG MOTION RESID 1 � pdq /FFILV 1
ICONTRACTOR: TEL. NO: JB2 PERMIT W/ENERGY 141800.00 VAL 1,721.00 APPROVALS' DATE INSPECTOR SIGNATURE 1
IBUBALO, MIKE (626) 446-2519- ID7 ADDNL PLANCHECK FEE 8.00 HOU 875.10 1
112 S. OLD RANCH ROAD LIC. NO 1 TOTAL FEES 4,108.31 ILOCATION AND SETBACKS I I'
1ARCADIA, CA 91006 NONE 1. I I
ISOILS ENGINEER APPROVAL I
JARCHITECT OR ENGINEER: TEL. NO: IFOUNDATION/TRENCH FORMS I I I
I _ LIC. NO: SLAB/UNDER FLOOR
JRAISF..D FLOOR FRAMING I I
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: J 1UNDERFLOOR INSULATION 1 I
1147H269 3 OO J / ' \ `[,, f I I
I I ( SW C`/1 V�?� , Y . rlFLOOR SHEATHING 1
INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I U I 1 7 1
J NO 21 1 IIROOF SHEATHING I
J SCHOOL WITHIN HAZARDOUS J ISHEAR PANELS
JAIR QUALITY: 1000 FEET MATERIALS I I
J NO NO NO 1FRAME INSPECTION
I I IFIRE SPRINKLER HANGERS I
I I I I I I
I (INSULATION/WEATHER STRIP(
I I I I
I (INTERIOR LATH/DRYWALL I
I I I I I
I I IEXTERIOR LATH I
I I I I I ( I
I IRATED FLOOR/CEIL ASSEM. 1 I
I I I I I I
1 RATED WALL ASSEMBLIES I I
I I IRATED SHAFTS/OPENINGS I I
I II i
I I IT-BAR CEILINGS I I I
I I I I I I
I ILOT DRAINAGE
I I I I I I
I IREPORT ID: DPR261 ROUTE TO: BS0508 1