The URL can be used to link to this page

Home My Public Portal About5702 KAUFFMAN AVE_Building__ 76 A638 CE4803 B-63 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING r DEPARTMENT OF COUNTY ENGINEER ADDRESS !J Q BUILDING AND SAFETY DIVISION LOCALITY O_ JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN, SUPT OF BUILDING - CROSS ST. DISTkZFCT N GR TYPE- PROCES Ely FOR APPLICANT TO FILL IN JL, coNsr.' BUILDINGSTATISTICAL C�FICATION W R MAP w ADDRESS ;2., CLASS. NO DWELL UNITS • LOT NO �� • B OCK WATER NOT REQUIRED RECEIVED ❑ CERTIFICATE: TRACT J NO ,FI OQ- - HIGHWAY STATE MAJOR SECON LOCAL OF SLOGS. O� (CIRCLE) SIZE OF LOT �� OW )N LOT USE ZON SPECIAL USE OF CONDITIO EXISTING BLDG. q � E L. OWNER NO. BUI DING EXIST. S BACK YARD HWY STREET NAME WIDTH ADDRESS '� FRONT O / ARCHITECT OR TEL P. L ' ENGINEER NO SIDE P L Ste/ ADDRESS d CONTRALTO /I s'.--�' �/f� I_ _ r•I"y' V ADDRESS G .r'yr i� � �+•IsV C.tiY/.Cb�L• //16vu77�:.Cd^'Y.f 0 DESCRIPTION OF WOVw EW ADD ALTER REPAIR. DEMOLISH X,.y��s/,/+/ i +.=rid✓/ . `Y.Gd'� ��o' FT NO.OF NO OF .J�GCt -4•�� ^ �?`Z SIZE STORIES FAMILIES USE OF STRUCTURE SIGNATURE OF - APPLICANT VALUATION $ 15— , APPROVALS DATE INSPECTOR'S SIGN TURE P C - - PMT c�s7' FOUNDATION LOCATION FEE $ ` FEE � / ''' FORMS. MATERIALS FRAME FIRE STOPS. It'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 PERSO IN IOLA. ------ "�� - TION OF THE LABOR CODE OF THE STATE OF C LIF NI ELAT- LATH. INT. !' ING TO WORKMEN'S COMPEN� IN Q-rA3N• EXT.S'401,v! - AuhA - SIGNATURE O$� HOUSE NUMBER COR- PERMITTE40RECT AND POSTED c • ADDRESS FINAL PLAN CHECK VALIDATION CK. M o:%' CASH JOHN F. LEWIS. PRINCIPAL STRUCTURAL'EN R', PERMIT VALIDATION CK. M.O CASH LACo 7'4 2 0- JAN 11 1 D 1. 1..5 O N APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN (Print or type only) BUILDING 70 z COUNTY OF LOS ANGELES ADDRESS DEPARTMENT OF COUNTY ENGINEER CITY j ZIP BUILDING AND SAFETY DIVISION O.OF BLDGS. BUILDING �{' SIZE OF LOT �Q� NOW ON LOT ADDRESS•,/ TRACT 6/ BLOCK OT�1NLOCA LIT - TEL.2 8(, JV/Z NEAREST OWNER NO. CROSS ST. ASSESSOR ADDRESS MAP BOOK PAGE CEL DISTRICT I GROUP TYPE FIRE PROC SSED BY CONS T,/r' ZONE 1 CITY ZIP ARCHITECT OR TEL. ENGINEER NO. STATISTICAL CLASSIFICATION SEWER MAP ADDRESS ��/ ), V CLASS NO.C.LDWELL.UNITS BK PG CONTRACTOR l�'$k�y W&[i'�TEL `"�0 2 29 U ZONE MAP - t, LIC. J' NO. ADDRESS d 2_q -I= NO.pCJ/O O SPECIAL LIC. CONDITIONS CITY CLASS 3,7 ROAD DEPARTMENT APPROVAL REQUIRED YES NO CONSTRUCTION LENDER NAME AND BRANCH BLDG.SETBACK FROM r FRONT PROP. LINE OF (STREET) a- ADDRESS CITY _ TOTAL SETBACK FROM TYPE OF EXISTING C1 SQ. FT. NO. OF NO. OF CHECK HIGHWAY } YARD — FRONT PROP. LINE HIGHWAY WIDTH SIZE STORIES FAMILIES ONE O + = U DESCRIPTION OF WORK 'NEW ❑ ILLId ADD 'IBLDG.SETBACK FROM (STREET) Z ZQ �- SIDEPROP, LINEOF ALTER ❑ TOTAL SETBACK FROM TYPE OF EXISTING RREPAIR[]o HIGHWAY + YARD = SIDE PROP. LINE HIGHWAY WIDTH USE OF + _ EXISTING BLDG, . DEMOL ❑ ..A PP RI Q_h1 ,;Ja CA NT/hk TEL _ CORNER CUTOFF YES ❑ NO 'BY (SIGNATURE) ' IN OPEN SPACE YES ❑ NO Q; IN COASTAL ZONE YES NO VALUATION s / CATEGORICAL EXEMPTION YES NO I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL AND STATE THAT THE ABOVE IS CORRECT AND.AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE) WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE) HEREBY IWILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COMPE NSAT N INSURANCE. SIGNATURE OF PERMITTEE ADDRESS FINAL r0 ? BYE/�/y TEL. U�/�/✓ /�iG�[—E'//� CITY NO. DATE %JAKE CHECKS P: YABLE 70: FEE $ / FEE HARVEY T. BRANDT, COUNTY ENGINEER 6.0 ,PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT AISIDATION CK. WO. CASH 76A638A CE.9803 12/72 a i 2. 7 2 2'1,3 AUG 1 4 1 D 1 5.000 Q APPLICATION FOR PU DING PERMIT COUNTY OF LOS'ANGELES �� BUILDING AND SAFETY FOR APPLICANT TO FILL IN BUILDIN ADDRESS WORKER'S COMPENSATION DECLARATION � R/� y ' I hereby affirm that I have a certificate of consent to self insure,' ®�BUILDING ADDR SS a� l_"_L' Q Pi ,v,e, or a certificate of Workers' Compensation Insurance,or a certified 'TT ptl copy thereof (Sec.3800,Lab.C.) CITY e�M i - ZIP �� c•� LOCALITY Policy No. Company SIZE OF LOT NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. NEAREST CROSS ST. ❑ Certified copy is filed with the county building inspection TRACT �� BLOCK LOT NO. department. USE ZONE MAP NO. Date Applicant ASSESSOR BOOK PAGE Z PA®E SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' W ER TEL NO COMPENSATION INSURANCE ��'� KI G�G C�SCl LV 0 2 S?._ E WITHIN 1000 FT.OF'SCHOOL? ves No (This section need not be completed if the permit is for one hundred ADDRESS . a C -7®Z kaA.(:T �aY, Av DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED 8Y dollars($100)or less.) Is I certify that in the performance of the work for which this permit CITY-`-� (� ` ZIPG(( � T fi 9 is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensate ARCHITECT OR ENGINEER TEL NO. 1 STATISTICAL CLASSIFICATIONAPT CONDO Date 1 3 e Applicant ADDRESS CLASS NO.. f DWELL UNITS NOTICE TO APPLICANT.' If, after making this Certificate Of REQUIRED TOTAL SETBACK FROM EXIST ' Exemption, you Should become Subject to the Workers' CONTRACTOR TEL NO. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith f FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. P L LICENSED CONTRACTORS DECLARATION SIDE CITY LIC.CLASS PL I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and Q.FT.SIZE NO.OF STORIES NO.OF FAMILIES Professions Code,and my license is in full force and effect. NEW El BK PG V License Number Lic.Class DESCRIPTION OF WORK ADD ❑ VALUATION , I— Contractor Date 1 ar-Kn quay ALTER E-11$ y T bi w } V 5e +0 REPAIR ❑ N ❑ I am exempt under Sec. "� $ Z BAP.C.for this reason L j ry ct CL-+ 1 0 V) DEMOL ❑ LDMA P/C# Date: USE OF EXISTING BLDG. URM ❑ Si ature APPLICANT(PRINT) TEL NO. LDMA Perm# I,:as owner of the property, or my employees with wages as Z N their sole compensation, will do,the work and the structure is ADDRESS �;, not intended or offered for sale (Section 7044, Business and FINAL DATE / C `__),='4 Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL Z'/J J , OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE I, as owner of the property, am exclusively contracting With AMOUNTS,SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY ' licensed contractors to construct the project (Section 7044, ves El NO ( r'_• i 1 Business and Professions Code.) WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR " GUIDEUNE S. 1 hereby affirm that there is a construction lending agency for YES ElNo�j ) €� �z 3� N the performance of the work for which this permit is issued(Sec. — -° °'f-"' � I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING 3097,CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, if �: TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS ^ ' 3 Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. .�,.-I''_•r� -, i o Lender's Address O OWNER OR AGENT o I certify that I have readthis application and state under penalty or PERMIT FEE of fferjury that the above information is correct.I agree to complyP.C.FEE O �J cm with all county ordinances and State laws relating to building construction, an ereby ori a representatives of this County ISSUANCE FEE /' v� ter upon th bo a-n for inspection purp eS. (p o __..._ 11, INVESTIGATION FEE TOTAL FEE/ 6 (/' �✓71 ^ /� gal 1 Dale SEE REVERSE FOR EXPLANATORY LANGUAGE 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 0301290012 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: TR: 6561 LT: 100 SQ. FT STORIES TYPE 5702 KAUFFMAN AV STRUCTURE: VN TEMP CA 917802505 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LIVE OAK 8587-023-026 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: RESID USE ZONE: R-1 ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 01/29/03 JK 01/24/04 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINA BY CODE: KATIE - 4,500 5702 KAUFFMAN AV TEMP 917802505 FEES PAID DESCRIPTION OF WORK FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: T/0 1LAYER OF WOOD;INSTALL PLYWOOD & CLASS A SHINGLES APPLICANT: TEL. NO: TEMPLE CITY CITY ROOFING (909) 946-8767- fAA BLDG PERMIT ISSUANCE 27.75 1216 BEGONIA COURT IAC STRONG MOTION RESID 4500.00 VAL 0.50 SPECIAL CONDITIONS: UPLAND 91784 ID2 PERMIT W/O.EN-HC 4500.00 VAL 132.60 TOTAL FEES 160.85 CONTRACTOR: TEL. NO: I APPROVALS DATE INSPECTOR SIGNATURE TEMPLE CITY ROOFING CO. (909) 608-0622- j 1216 BEGONIA COURT LIC. NO ' LOCATION AND SETBACKS UPLAND, CA 91784 HIC * ' SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. N0: I - _ FOUNDATION/TRENCH FORMS LIC. N0: I - -- SLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:: . UNDERFLOOR INSULATION 150H269 3 01 j N0. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: FLOOR SHEATHING NO 21 , , , ROOF SHEATHING SCHOOL WITHIN HAZARDOUS SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME INSPECTION REQUIRED TOTAL SETBACK FROM EXIST FIRE SPRINKLER HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL INSULATION/WEATHER STRIP SIDE PL- INTERIOR LATH/DRYWALL EXTERIOR LATH RATED FLOOR/C IL ASSEM. RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS i T-BAR CEILINGS * ADDITIONAL DATA ON FILE LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508 I i