HomeMy Public PortalAbout5216 KAUFFMAN AVE_Building__ 7ewe9eA CH#803 a-ee- APPLICATION -FO' R''BUIL DING- PERM-IT �.
COUNTY OF, LOS ANGELES- - :BUILDING
DEPARTMENT OF'COUNTY ENGINEER ADDRESS
BUILDING AND-SAFETY DIVISION LOCALITY
JOHN A.L'AMBIE.COUNTY ENGINEER- NEAREST
CASSATT D.GRIFFIN
S. OF BUILDING ` CROSS ST.
_ DISTRICT O. OUP- TYPE' - - OCESSED Y
FOR APPLICANT'=TO FILL IN o o . I CONST.,
`
BUILDING - -l° STATISTICAL CLASSIFICATION SEWERAMAIP ,
ADDRESS (7 /y %F.��/7'Ji¢� �� l BK • 'PG'
_' ; BLOCK CLASS. NO�LDWELL. UNITS�I " ,•
LOT NO.••- MAP qli. ` STATE
NUMBER D !•.` HWY.' YES
•TRACT ` :�V �o',�' - ' -: U E ZONE SPECIAL,'
NO:OF BLDGS.. I: I CONDITIONS
SI-ZE OF.LOT-�, /I �a-y I NOW ON:LOT �Z
USE OF
EXISTING -DG - �s• - �� BUILDING - EXIST.' r
YARD ' HWY STREET NAME
SETBACK WIDTH'
OWNER �G !/Lc, `2.' _ FRONT• h '/ .
MAIL y " P.L. f�(�
ADDRESS -�0� �!%^ - %�9A //• G •SIDE:.
CITY F�7 Y •� i TEL'NO. T f. �! "P.L. - ••
AR ITECT O + TE_L/ 7 INSPECTION RECORD
'ENGINEER •� �/�/79/�S '-/ .."f/• NDN- /�� fr A -
ADDRESS
.. - •TEL. _ !/
CONTRACTOR,. / •d0 O.i�J�'^ - - ' ,• ,
`DESCRIPTION OF- WORK G J
NEW-AADD. ALTER r REPAIR DEMOLISH '4�y
SO.•FT:%.
-NO:OF - NO.OF •��• ., r -
SIZE 'lJ i[ ;�� STORIES- - FAMILIES
USE OF STRUCTURE l -� �,:
SIGNATURE
/ APPROVAL'S
AP-PLICANT ATE INSPECTORIS SIGNATURE
ADDRES _ .� �� .FOUNDATION: LOCATION �-
FORMS.MATERIALS _ /�S
$' P.,C.r S FRAME.-FIRE STOPS., � �f
FEE. BRACING• BOLTS
VAL"DATION• '(9 t� FURNACE: LOCATION: . `
FEE,' GAS VENT.DUCTS.
t, I HEREBY ACKNOWLEDGE THAT I HAVE,READ THIS AP- LgTH,INT.
PLICATION'AND STATE THAT THE ABOVE,IS CORRECT AND''.
AGREE TO'COMPLY LL COUNTY ORPbqlNae AND u
STATE 'LAWS' RligULATIpisuiLDINUCTION. LATH,EXT.
SIGNATURE OF HOUSE NUMBER COR=`
PERMITTE RECT AND POSTED"'
4'ADDREss FINAL t~ y 7e
CLYDE N. DIRLAM: PRINCIPAL STRUCTURAL ENGINEER-. -
CHECK VALIDATIOII'' cK M.O.'• CASH o. PERMIT VALIDATION CK. M.O. CASH
2'A", 3, Ems =-2. 2 3. n' 33:00 M
- . 2, VA.�ELB 1.. �' ' . OF
moo' 2 x 1:2::Q}0
„,APPLICATI0N.,F0R'. COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
B U I L D I N G PERMIT BUILDING AND SAFETY DIVISION
BUILDING
FOR APPLICANT TO'FILL IN ADDRESS _2
BUILDING - -
ADDRESS LOCALITY (.
NEAREST
CITY e-1'7- ZIP 7 CROSS ST.
.OF SLOGS. ASSESSOR
SIZE OF LOT y rC. OW ON-LOT ! MAP BOOK -- PAGE PARCEL
f DISTRICT) 1,GROUPITYPE FIRE PRO ED BY
TRACT/�G � BLOCK LOT NO-2-5-
O 2-� CONS •ZONE
u TEL.
OWNER //E QW NO: STATISTICAL CLASSIFICATION -
r���• S WER MAP
•ADDRESS CLASS NO�DWELL•UNITS � BK .PG
USE NE MAP Ce-_
CITY r1F ZIP U _ O•
ARCHITECT OR EL.' P) G PECIAL
,ENGINEER NO, Z+ CONDITIONS - -
ADDRESS RO DEPARTMENT APPROVAL REQUIRED •YES❑ NO ❑
CONTRACTOR EL. BLDG.SE CK FROM
TO FRONT PRO 1 NE OF (STREET)
LIC.
,ADDRESS NO. HIGHWAY + V _ TOTA L7 SETBACK FROM TYPE OF EXISTING
LIC. FRONT PROP. LINE HIGHWAY WIDTH
CITY CLASS _
CONSTRUCTION LENDER +
�.
NAME AND BRANCH BLDG.SETBACK FROM O
ADDRESS CITY SIDE PROP. LINEOF (STREET) G>
SQ. FT. NO. OF NO. OF CHECK HIGHWAY + YARD = TOTAL SETS K FROM TYPE OF EXISTING 9=
SIZE STORIES FAMILIES ONE SIDE PROP. L E HIGHWAY WIDTH
Ej
DESCRIP-TION OF WORK NEW ❑ + a
C/7
Z
ADD ❑ CORNER CUTOFF YES ❑ . NO
LTER
�� 2 I EPAIR IN
OPEN SPACE YES ❑ NO ❑
//''�� ❑
USE OF EMOL ❑ IN COASTAL•PERMIT ZONE YES E] No
: ❑
EXISTING' BLDG
APPLICANT TEL t” ••
(PRINT) �,.� �J �� - O. -113
_ -
t
BY (SIGNATURE) - -
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- '
STRUCTION. 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 '
WORKMEN'S COMPENSATION INSURANCE. -- -
SIGNATURE OF FINAL 7� BY
PERMITTEE DATE
ADDRESS
�J
TEL P.C. Fee$ ' Permit Fee
CITY,�G NO.
.Issuance Fee
VALUATION$ Od / - - - -
Total Fee �
PLAN CHECK VALIDATION' CK M o CASH PERMIT VALIDATION CK M o CASH
,26 1. 0, 1 -5.0 0 n
76AG38A CE#80313 12/75
V
TEMPLE CITE
7EA68l.CE#8032/eo A'PPL_ICATION FOR BUILDING PERMIT
COUNTY OF'LOS- ANGELES'•': BuiLDING
ADDREss •216 No: Kauffman�-St -
.DEPARTMENT OF.C•OUNTY.'ENGMMR
BUILDING AND SAFETY -DMSION LOCALiTir Tem 1e C't
'JOHN A. LAMME, COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST. . ..
DISTRICT'NO • G UP --P ESSED-BY
FOR'APPLICANT TO FILL IN hT PE:
/L- O - - CONST.'
BUILDING
STATISTICAL-CLA_SSIFICAT.ION -SF ER,MAP
ADDRESS - CLASS.NO. WELL.'UNITS �+_
K - PG
LOT NO. BLOCK MAP. ' STATE.
YES O
NUMBER - i HWY.
TRACT USEZONE SPECIAL v '
NO.OFBLDGS. CONDITIONS-
SIZE OF LOT' - '•I NOW ON LOT /'/�
USE OF• 7 �- -
EXISTING`BLDG. House BUILDING - .EXIST:
YARD -HWY - - STREET ME
' -•TE SETBACK: WIDTH
,OWNER B'. = TZ 661 - FRONT
P.L. - o _
ADDRESS 5216 No-.' Kauffman St. Tem: Cit SIDE
A P.,L.
ENGINEER NO. '
/ i .a ,.��1giSpECTIOr�N�R,E�C�ORDf�,,'/�_' .
TE . -C„i""�� .�1tl„E`.-�rF/'v*+'f/�'•_/I.�C' ".J''tfY(
CONTRACTORPatib Const. Co. No`SY•22 r - - pp
ADDRESS .,. . _`: f '• 'C' e4�rt.=- A--
s f
DESCRIPTION OF WORKNEW REPEMOLI- �aZlz'
SQ.,F..T. , ADD ALTER NO.OFAIR DNO''.OFSH .)�/4'Z 4 —4 X"
SIZE Z �b 'STORIES FAMILIES fpy ,yL . /� �j/ tn
SUSE OF
TRUCTURE O'FiCL-4c s^YA LfY.�L�
.SIGNATURE "•~ ►' - - .. - ., + _ - -
APPLICAN �h�i� '� -
VALUATION$ 2 200.00 ;
;'APPROVALS ,DATE• -INSPECTOR'S SIGNATURE -
FEE ,��' FEE •$ Q FOUNDATION:-LOCATION " ) O�r� t� r
FORMS, MATERIALS fB'�,7 ,p� jrrt f
FRAME: FIRE STOPS. �,,f'
1;'1EREbY ACKNOWLEDGE THAT I HAVE READ THIS AP- -BRACING,.BOLTS'
-PLICATION AND STATE THAT THE ABOVE IS CORRECT AND FURNACE: LOCATION,' 1
AGREE TO COMPLY WITH'ALL COUNTY ORDINANCES AND GAS VENT'DUCTS QIP`
STATE LAWS REGULATING BUILDING CONSTRUCTION.
1 CERTI_F,Y:.TIfAT- LATH-
-IN DOING THE 'WORK AUTkORIZED 1
WILL NOT'EMPLOY ANY PERSON IN VIOLATION-OF THE,
WORKMEN'S MPENSATION LAWS OF, LIF NIA. LATH,EXT.
SIGNATURE HOUSE NUMBER COR-
PER] ITTE �� �6 • RECT AND POSTED
ADDRESS J a"- -�adena, FINAL
CLYDE N. DIRLAM, PR9NCIPAL STRUC RAL ENGINEER'
PLAN CHECK VALIDATION' CK m.o.
CASH PERMIT VALIDATION cK M.o;;' cnsH
y WORKERS' COMPENSATION DECLARATION
•-t
hereby+Sffirm tftcf I Have a certificate of consif nt to s f
ins:�, or a certificate of Workers' Compensation Insurance, � AP P L �T,I O N F O R' B U I L D I N G,`.-fERM_1T
Por a certified copy thereof (Sec.'.3800,'Lab. C.)" } ;
I . *: C ^ )WY'OF-LOS ANGELES ; ' BUILDING AND-SAFETY ' ;
t• ,
Policy No. ;.' 'Company
❑ Certified copy.is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS
❑ , Certified copy is filed with the county,building inspec- BUILDING -
tion department. ADDRESS 2 x �,
Date Applicant CITY" TP 6 G . -, ZIP q/700,
•SQ LOCALITY' „�C.� r LCar -
NO OF BLDGS.1 .•.-• NEARE
CERTIFICATE OF EXEMPTION FROM WORKERS"' SIZE OF LOT b `� 2rc'.NOW ON LOT' CROSS ST.ST
COMPENSATION INSURANCE ASSESSOR
(This section need not be completed if-the permit is for one TRCT ABLOCK LOT�NO, MAP BOOK "� `,' PAGE PARCEL
hundred dollars($100) or less.)' TEL. USE ZONE MAP
b OWNER- O G O NO ^Z NO. 71
I certify that,in th*e performance of the work fair which this _
permit is issued, I shall not employ•any person in any manner ADDRESS' _ s' CQ (�Q SPECIAL'
CONDITIONS
so as to become 'subject to the Workers' Compensation LawsO
CITY. ZIP' O '
Date Applicant " = ARCHITECT OR ''11^^� / TEL. g( DISTRICT GROUP TYPE FIRE PROCESSED BY Q '
NOTICE,-TO.APPLICANL 4f,".after making this Certificate of ENGINEER H. l�If•tlV' NO L CONST,
ONST Z E F—
Exemption, you.,should- become,:sublect to the',Workers' //L�/ tl' ��}�i /� ,q / U
Compensation provisions of the,Labor Code; you must forth- ADDRESS ,. •^� E.- ALLEY,9L,: 67vi� G (IO-, /C ✓ � (J �,, LG�i�LtL:-d� '�'
,with comply with such •provis)ons or-this permit-shall be TEL, STATISTICAL CLASSIFICATION% ,. APT CONDO N
deemed revoked., _ CONTRACTOR
1 t
Z
LIC. S,•,} o-iC55 NO DWEL'�:'UNITS''
LICENSED.CONTRACTORS DECLARATION, -'. ADDRESS NO
hereby offiim that,l am licensed under provisions of Chopter.9'
(commencing with Section 7000)of Division 3 of the Business LIC "
CITY CLASS ° _ Y;V •
and Professions Code,and my license is'in full force and effect. BK pG'• -1- s.. � AUDATIOIN:li i
SO FT NO OF
NO OF CHECK - — ;
License Number Licr Class
SIZE'-- STORIES FAMILIES ONE t '
• VALUATION, TOTAL { 1195'08
Contractor Date 'DESCRIPTION OF WORK NEW ❑ ✓,;; n_
❑ 1195.0u
Z-Srto rZvoMAOoino�U. ADD' CHECK :,,,,
I am exempt under Sec. , ALTER.' ,
B.&P.C. for this reason ZKEP7/ZM'� T ./t `� �, s.___ �._ .:-- - (• •
REPAIR
Date:^� USE OF
EXISTING BLDG.• �j s DEMOL .
Signature APPLICANT TEL - :FINAL' 0000�l�Nll i,.,7w1� �e�Ti
OWNER-BUILDER DECLARATION' (PRINT) u- NO. DATE �- 5�3�t1 1 AI G.:0
I hereby affirm that I am exempt from the Contractor's License
Law'for"the following_reason.(Section 7031'.5, Business and ADDRESS ��� E u,E �l -• FINAL,
P, rgfessions Code): PRESENT - �- - By '.r i
1V��1 BUILDING ' Z V k
I, as owner of the property, or-my,employees with ADDRESS t
wages as their,sole compensation,will do the.work cind - r" 4 a':
the structure is riot intended or offered'for sale(Section• LOCALITY- T"
70",
x'� p'�
7044, Business•and Professions Code.) MOVING TEL.
❑ I, as owner of the property, am exclusively contracting
CONTRACTOR NO
- _• .with licensed contractors to construct the protect (Sec-- - -T-'`' - '• • 't ,����
ADDRESS
tion 7044,'Business and-Professions Code.)- `� ��,.: ,.�; '� .• �y°�'!'i_,t[.�.,,.,.,L.• �'.,,`ti,-., ;.� ,
REQUIRED TOTAL SETBACK FROM EXIST'' = AE1 Ci?
CONSTRUCTION LENDING AGENCY, SETBACK YARD. HVVY -A, ,,PROP. LINE ', WIDTH �
I hereby affirm that-there is a construction lending agency for FRONT i' ✓ r r;t xi;lG'ia`• _ ,f,3 i
th'e performance of the work fo'r which this permit is issued P L
(Sec. 3097,,Civ. C:). SIDE.. �' 1
Lender's Name tr b(.1 ,
- r LDMA Ref 1 ).loi-I)�Ir 4 i;
�.y�y /7 . 33 - , ,,,,
P.C. Fee$ Permit Fee ti i I
Lendera Address '
o I certify that I-have read this application and state that the Issuance Fee•- LDMA P/C#
8 above information is correct I agree to comply with all County Investigation Fee [! +•
R ordinances and State 16ws relating to building.construction, I Total Fee d a LDMA Perm #,'-
a and h by outhoriz P�afirtysf-this Count to neer
upon a above-m ' ne inspe io Pur 5ses'.
2 SEE_REVERSE.FOR EXPLANATORY LANGUAGE•
Signature'of Applicant or g nt Date
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD/ALT/REP
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1011090007
PHONE: (626) 285-0488 EXT
(LEGAL ID: NO. OF CONST NEW
TR: 15683 LT: 25 I, BUILDING ADDRESS I
I 1 SQ. FT STORIES TYPE OCCUP GROUPI 5216 KAUFFMAN AV I
I (STRUCTURE: 0 1 V-B R-3 I TEMP CA 917803947 I
(ASSESSOR INFORMATION NUMBER: I GARAGE: NEAREST CROSS STREET: 1
18589-010-025 I OTHER:- THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY, Cl
ITENANT:. (EXIST BLDG USE: USE ZONE: (ISSUED ON: PROCESSED BY: 1
I (EXIST OCC GRP: 101/26/11 SR 1
I I I I
(OWNER: TEL. NO: JBLDGS. NOW ON LOT: VALUATION: (FINAL DATE FINAL BY: CODE: I
ISOOHOO, JEFF (626) 674-1001-' 1 10,000
15216 KAUFFMAN AV II
ITEMP 917803947 1 ' ' FEES PAID I' SCRIPT I F WORK ' I
I 1 1PHOTOVOLTAIC SOLAR SYSTEM I
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 I
JAPPLICANT: TEL. NO: I I I
ICURTIS, JUSTIN (714) 373-8545- ID7 ADDNL PLANCHECK FEE 1.00 HOU 109.40 1 I
115261 CONNECTOR LN - 1AA BLDG PERMIT ISSUANCE 27.80 (SPECIAL CONDITIONS: I
IHUNTINGTON BEACH JAB STATE GREEN BLDG FEE 10000.00 VAL 1.00 I I
1 ID2 PERMIT W/O EN-HC 10000.00 VAL 109.40 J
1 ID7 ADDNL PLANCHECK FEE 2.00 HOU 218.80 1
(CONTRACTOR: TEL. NO: I TOTAL FEES 466.40 (APPROVALS DATE INSPECTOR SIGNATURE 1
IGALKOS CONSTRUCTION INC. (714) 373-8545- I 1 -
115261 CONNECTOR LANE LIC. NO I ILOCATION AND SETBACKS J J
1HUNTINGTON BEACH CA 92649 492715BC17 I J J
I (SOILS ENGINEER APPROVAL 1 1
I I I I I
JARCHITECT OR ENGINEER: TEL. NO: I IFOUNDATION/TRENCH FORMS I I
1 LIC. NO: I ISLAB/UNDER FLOOR I I I
I I I I
I (RAISED FLOOR FRAMING I J I
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: � • ' '(UNDERFLOOR INSULATIONI
I I I
3 OOi 11ST LEVEL FLOOR SHEATH 1 I I
INC. OF FAMILIES- DWELLING UNITS: APT/COND: STAT CLASS: I I I I I
NO 21 12ND LEVEL FLOOR SHEATH I I I
1 SCHOOL WITHIN- HAZARDOUS 1 IROOF SHEATHING I I I
(AIR QUALITY: 1000 FEET MATERIALS 1 I 1 1 I
I NO NO NO I IFIRE DEPT. FRAME INSPECTI I I
I 1BLDG DEPT. FRAME INSPECTI I I
1 1 11 I
(SHEAR PANELS
1 I I 11 1
1 I JINSULATION/WEATHER STRIPI I I
I (INTERIOR LATH/DRYWALL
I I I
1 1EXTERIOR LATH 1
I I I
1 ILOT DRAINAGE 1
I I I
1 (SMOKE DETECTION DEVICES I
I 1 IFIRE DEPARTMENT APPROVALI I I
I I I I I I
1 IREPORT ID: DPR261 ROUTE TO: BS0508
I I I I I I