HomeMy Public PortalAbout6017 KAUFFMAN AVE_Building__ 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 1409020025
PHONE: (626) 285-0488 EXT:
LEGAL ID: NO. OF CONST BUILDING ADDRESS:
ITR: 6561 LT: 116 UN: .002 SQ. FT STORIES TYPE 6017 KAUFFMAN AV
(STRUCTURE: 17 V-B TEMP CA 917801742 1
ASSESSOR INFORMATION NUMBER:
NEAREST CROSS STREET:
15385-018-010 -THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY CAI
I I
(TENANT: IEXIST BLDG USE: RESID USE ZONE: R-2 (ISSUED ON: PROCESSED BY:
EXIST OCC GRP: 109/02/14 SR
10WNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: IF SAL TE FIN"FIN CODE: 1
1YOUNG CHARLES C;VICTORIA G (626) 616-5252- 1 3 5,900 1 1
16017 KAUFFMAN AV J I 1
ITEMP 917801742 FEES PAID IDES RIPTION OF WORK 1
IREROOF FRONT HOUSE ONLY WITH CLASS "A" 30 YR COMP REMOVE 1
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 11 - LAYER EXISTING COMP
1APPLICANT: TEL. NO: 1 1 1
1COPENHAVER, DAVID (626) 862-8517- IAA BLDG PERMIT ISSUANCE 27.80 1 1
1144 ROUNDUP ROAD JAB STATE GREEN BLDG FEE 5900.00 VAL 1.00 ISPFCIAL CONDITIONS: 1
IGLENDORA CA 91741 JAC STRONG MOTION RESID 5900.00 VAL 0.60 1
1 1D2 PERMIT W/O EN-HC 5900.00 VAL 149.40 1 1
TOTAL FEES 178.80 1
ICONTRACTOR: TEL. NO: I 1APPROVALS DATE INSPECTOR SIGNATURE 1
ISUNRISE ROOFING (626) 914-5410- 1 1 1
1144 ROUNDUP RD. LIC. NO 1LOCATION AND SETBACKS 1 1
1GLENDORA, CA 91741 406419 * 1 1 J 1 1
1 1 ISOILS ENGINEER APPROVAL 1
1ARCHITECT OR ENGINEER: TEL. NO: IFOUNDATION/TRENCH FORMS I I
LIC. NO: 1SLAB/UNDER FLOOR 1 1 1
1 1 IRAISED FLOOR FRAMING 1 1 1
I I I
1MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:1 1UNDERFLOOR INSULATION
1 3 oo I
1 1 1FLOOR SHEATHING 1 I 1
INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: 1 I_ I
1 NO 21 1 IROOF SHEATHING 1 1
1 SCHOOL WITHIN HAZARDOUS ISHEAR PANELS
JAIR QUALITY: 1000 FEET MATERIALS 1 11 1 1
1 NO NO NO 1 1FRAME INSPECTION
1 IFIRE SPRINKLER HANGERS 1 1 1
I I I
1 1 IINSULATION/WEATHER STRIPI I 1
I 1 11NTERIOR LATH/DRYWALL 1 1 1
1 1EXTERIOR LATH 1
I 1 IRATED FLOOR/CEIL ASSEM. 1
RATED WALL ASSEMBLIES 1 1 1
I I I
1 1 1RATED SHAFTS/OPENINGS 1 1 1
I I I
1 1 1T-BAR CEILINGS 1 1 1
1 * ADDITIONAL DATA ON FILE I1 1
1 ILOT DRAINAGE 1 1
1 1REPORT ID: DPR261 ROUTE TO: BS0508
1 I� I
WORKERS' COMPENSATION DECLARATION t L
hereby affirm that I have a certificate of consent to self APPLICATION FOR BUILDING PERMIT
insure,or G` �-rt4icate of Workers' Compensation Insurance, ��.�
or a c;rti4ied copy thereof (Sec. 3800, Lab. C. �. �, h COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy4�,o. M�mpony
BUILDING r r L
❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS
❑ Certified copy is filed with the county building inspec- BUILDING (,20_ r�
tion department. ADDRESS cw�
Date Applicant CITY` •_ \ ZIP LOCALITY e
CERTIFICATE OF EXEMPTION FROM WORKERS' O. OF BLDGS. NEAREST
SIZE OF LOT NOW ON LOT CROSS ST. 0 d
COMPENSATION INSURANCE ASSESSOR _
(This section need not be completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL
hundred dollars ($100) or less.) TEL. USE ZONE MAP �O 1
OWNER 1..L \ NO. NO. GV
I;certify that in the performance of'the work for which this
permit is issued, I shall not employ a erso n manner ADDRESS 1 _ _ SPECIAL d
so as to become subject to the Wo ers' sat Laws. CONDITIONS 0
7� �C>S
CITY 2vv\ �� ZIP n�� V
Date— <k Applicant ARCHITECT OR TEL.
NOTI d TO. APp ICANT: If, after makin is Certificate of ENGINEER NO. DISTRICT; GROUP TYPE ARE PROCESSED BY
9 � i ZONE
CONST. O
f Exemption, you .should become subject to the Workers' I �. U'
Compensation provisions of the Labor Code, you must forth- ADDRESS a
with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. CONDO. Z
CONTRACTOR Z �1 q
deemed revoked: � V\ P�Q4el0. � ��� 1� _
LICENSED CONTRACTORS DECLARATIONLIC. CLASS NO. DWELL. UNITS
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS v�Cw ! NO.c'\ S
LIC. SEWER MAP
• (commencing with Section 7000)of Division 3 of the Business ��
and Professions Code,and my license is in full force and effect. CITY CLASS % BK: PG VALIDATION
41'99 / SQ. FT. NO. OF NO. OF CHECK
License Number c Lic. Class q
SIZE STORIES FAMILIES ONE
VALUATION
Contractor hdtl2v� �Date �5 ` DESCRIPTION OF WORK NEW ❑ $ �c:�
❑ ►am exempt under Sec. ADD
ALTER
B.&P.C. for this reason C REPAIR $
Date: SE OF
TING BLDG. DEMOL ❑
Signature APPLICANT TEL. FINAL
NO.
OWNER-BUILDER DECLARATION (PRINT). DATE. J,.
I her affirm that I am exempt from the Contractor's License
Law for the following reason (Section,7031.5, Business and ADDRESS "FINAL
Professions Code): PRESENT' By `—ib—1
BUILDING
❑ . I, as owner of the property, or my employees with ADDRESS % A(
wages as their sole compensation, ill-do the work and OCP
��F7°4 16.2.
• LOCALITY
the structure is intended or offered for sale(Section VADDRESS
ING TEL. � ` 30 i�+=°���r
704''4, Business and Professions Code.) , �' t {
TRACTOR NO. 1 JTEMS�-,..: _.-_.._
❑ . I, as owner of the.property,.am exclusively contracting , TOTAL -Y
with licensed contractors to construd,the project (Sec- 1OTAL y62. 38
tion 7044, Business and Professions Code.) , v qq LL
QUIRED YARD HWY TOTAL SETBACK FROM EXIST. CHECK 10?°,Sv
CONSTRUCTION LENDING AGENCY. BACK PROP. LINE WIDTH
I hereby affirm that there is a construction lending agency for FRONT -' 1.
the performance of the work for which this permit is'issued P.L.
(Sec. 3097, Civ. C.). SIDE
Lender's Name ` LDMA Ref.# i AMi1°ht,[
P.C.. $ Permit Fee l 4347 t M'I11•J�F
Lender's Address / ►
0 1 certify That I have read this application and state that the Issuance Fee ., LDMA P/C#
above irtiformati4corre agree to comply with all County nvestigation Feeordinances and lating to building construction, Total Fee LDMA Perm. #
a and here a hntotives of this County.to,enter
upon t ab roperty for inspection urpos s.
7-W SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Applicant or Agent Date