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Home My Public Portal About10318 KEY WEST ST_Building__ WORKERS'COMPENSATION DECLARATION n; "sure, reb>" affirm that I.have a certificate consent to self APPLICATION FOR BUILDING PERMIT ' isure, ora certificate of Workers' Compensation Insurance, � , or a certified copy thereof (Sec. 3800, Lab. C.) ` COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified co is hereby furnished. BUILDING �^ copy v FOR APP.LICANT,T0 FILL IN-., ADDRESS Certified copy is filed with the county building inspec- BUILDING' tion department. ADDRESS Date Applicant CITY E/1/7 ' L/f ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' - NO. OF BLDGS. ® ' NEAREST . COMPENSATION INSURANCE SIZE OF LOT �ZO 41> NOW ON LOT CROSS ST. (This section need notbe completed if the permit is for.one - � �-� ASSESSOR hundred dollars ($100)or less.) TRAC BLOCK LOT NO. MAP BOOK PAGE PARCEL ,e v N� .Cy' USE ZONE FN ' s7� OWNER pY I certify that,in the performance of the work.for which this // a permit is issued, I shall not employ any person in any manner ADDRESS�� // �E IAL so'as to become subject to the Workers'Compensation Laws. DITIONS O U CITY ZIP ;.16:. 94 Date' Applicant ARCHITECT OR TEL. O DISTRICT GROUP TYPE FIRE PRO SSED B NOTICE TO APPLICANT: If, after making this Certificate of By- Exemption, NO. CONST.' ZONE Exemption, you should become subject to the Workers' .� Compensation provisions of the Labor Code, you must forth- ADDRESS t -/1 — with comply with such provisions or this permit shall be -- deemed revoked. CONTRA "Ley jj(/E��f/}�Q �� STATISTICAL CLASSIFICATION APT. CONDO. LICENSED CONTRACTORS DECLARATION LIC. CLASS NO._DWELL. UNITS — I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS N �� (commencing with Section 7000)of Division 3 of the Business and LIC SEWER MAP Professions Code, and my license is in full force and effect. CITY CLASS BK PG VALIDATION SQ. FT. NO.OF NO. OF CHECK License Number Lic.Class SIZE STORIES FAMILIES ONE VALUATION DESCRIPTION OF WORK NEW �a Contractor Date ADD I am exempt under Sec. `�� / ALTER , 2 1 6 3 A . B.&P.C. for this reasonREPAIR Q S ¢} ° 0.010 2 3 USE OF '' Date: DEMOL EXISTING BLDG. 2 ° 6 1 �,'1 Signature APPLICA TEL. ` FINAL PRtO / /y NO 6.� OWNER-BUILDER DECLARATION _ DATE s 1 hereby affirm that I am exempt from the Contractor's License � �4' FINA t U•o 1 G Law for the following reason (Section 7031.5, Business and ADDRESS Professions Code): - PRESENT- -BY•� - 0L 84 BUILDING I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL: I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). �, \ 1264,-2 A REQUIRED ..TOTAL SETBACK.FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH # o o,-0 0:2 3 I 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 Q'. w P.L. Q Lender's Name - ° ° 6 1-Q �'c=i !` m aa -74 LDMA Ref:<# t\ \. ', Ooh \1*k \ - - P.C. Fee$ - /V Permit Fee -. .. :.r�. .: 1 ;:4 '0�.. �`, a.` :� 8�- Lender's Address / /� J o N - certify that.I have read this application-and state that the l (l r( (l Issuance Fee ��D LDMA P/C# ' {fV' o •p a above information is correct. I agree to comply with all County Investigation Fee 14D Qo- o pp ordinances and State laws relating to building construction, Total Fee �i� LDMA Perm. # ODO Iv o U and hereby authorize representatives of this County to enter' U" Cri —,D upon the above-mentioned property for inspection purposes. a CH . Q SEE REVERSE FOR EXPLANATORY LANGUAGE COUNTY OF LOS ANGELES TEMPLE CITY # 0508 = BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9808280012 PHONE: (818) 285-0488 EXT-r ` LEGAL ID: NO. OF CONST BUILDING ADDRESS: TR: 36735 LT: 8 SQ. FT STORIES TYPE 10318 KEY WEST ST STRUCTURE: 0 VN TEMP CA 917803476 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 8585-018-072 THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY, C TENANT: EXIST BLDG USE: RESID USE ZONE: R-1 ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 08/28/98 VG 08/28/99 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FI L BY: ODE: RYKER, BETH (626) 448-6304- 5,500 10318 KEY WEST ST L2 TEMP 917803476 FEES PAID DESCRIPTION OF ORK ENLARGE SHOWER STALL AND INSTALL 3 P C DOORS FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. N0: S & N CONSTRUCTION (626) 792-2020- AA BLDG PERMIT ISSUANCE 27.75 P. 0. BOX 93194 AC STRONG MOTION RESID _5500.00 VAL 0.55 SPECIAL CONDITIONS: PASADENA, CA 91109 AX BUILDING REV.-lEW77FEE 54.70 D2 PERMIT W/Q EN=HC �` 5500 00 VAL 149.40 —TOTAL FEES," 232.40 CONTRACTOR: TEL. N0: APPROVALS DATE INSPECTOR SIGNATURE S & N CONSTRUCTION (626) 792-2020- /� � �� P. 0. BOX 93194 LIC. NO �' �� d '�. �� LOCATION AND SETBACKS PASADENA, CA 91109 6845416 %i�/ :"r• SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. N0: FOUNDATION/TRENCH FORMS I ` LIC. NO: �, —;^I I .,\I;I�,i, SLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: �` �'�: � � �� UNDERFLOOR INSULATION 147-273 3 01 ' FLOOR SHEATHING NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: -_ NO 21 ROOF SHEATHING SCHOOL WITHIN HAZARDOUS m < >,;'F�.� � / SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO NO /� � ,�, � /�� FRAME INSPECTION REQUIRED TOTAL SETBACK FROM EXIST �� QFIRE SPRINKLER HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- \\`=_"q=�e �" ^�� INSULATION/WEATHER STRIP SIDE PL- -- =- INTERIOR LATH/DRYWALL r EXTERIOR LATH RATED FLOOR/CEIL ASSEM. RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS LOT DRAINAGE 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 0610090007 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: TR: 36735 LT: 8 SQ. FT STORIES TYPE 10318 KEY WEST ST STRUCTURE: 3400 VN TEMP CA 917803476 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: HALIFAX 8585-018-072 THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY, C TENANT: EXIST BLDG USE: RESID USE ZONE: R-1 ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 10/09/06 JK 10/04/07 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: A? DATE FINAL B_ Y: i' CODE: HONG DUCK C;JUNG S (818) 401-2402- 11,000 `/ / �\Q��/ 10318 KEY WEST ST TEMP 917803476 FEES PAID - DESCRI TION OF WORK TAKE ALL TILE OFF HOUSE REPLACE WITH NEW 30 LB FELT PAPER FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: AND 30 YR. COMPOSITION APPLICANT: TEL. NO: I WOODRUFF (323) 913-4190- �AA BLDG PERMIT ISSUANCE 27.75 2929 KNOX AVE AC STRONG MOTION RESID 11000.00 VAL 1.10 . SPECIAL CONDITIONS: LOS ANGELES 90039 D2 PERMIT W/O EN-HC 11000.00 VAL 233.40 TOTAL FEES 262.25 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE J & J ROOFING (323) 913-4190- 2929 KNOX AVE LIC. NO LOCATION AND SETBACKS LOS ANGELES, CA 90039 761462 C39 SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS LIC. NO: SLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION 147H273 3 01 _ FLOOR SHEATHING NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: _ 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/CEIL ASSEM. RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508