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Home My Public Portal About10350 KEY WEST ST_Building__ WORKERS'COMPENSATION DECLARATION hereby dffirmthat I havecertificate of,consent to self A P p"L j,CATI O N F O_ R BUILDING_ PERMIT- ,insure, or a certificate of Workers; •� kers' Compensation Insurance, _ or a certified copy thereof(Sec. 3800, Lab.'C.) J COUNTY OF LOS ANGELES BUILgRI A D SAFETY Policy No. . Company Certified co is hereby furnished. BUILDING copy Y FDDRE FOR APPLICANT TO FILL IN ADDRESSCertified copy is filed withthe county building inspec- � �tion department. Z�Date Applicant �" L ZIP LOCALITYCERTIFICATE OF EXEMPTION FROM.WORKERS' NO. OF-BLDGS. NEAREST COMPENSATION INSURANCE NOW ON LOT CROSS ST. (This section need not be completed if the permit is for one J�f� ASSESSOR hundred dollars ($100)or less,) BLOCK LOT NO. MAP BOOK PAGE PARCEL {/�/�/ �j�g� USE ZONE MAPI certify that in The performance of.the work for which thish cab NO. Qpermit is issued, I shall not employ any person in any manner sSPECIAL so as to become subject to the Workers'Compensation Laws. �� L�s/`�/� +` ` CONDITIONSO Date Applicant � / ZIP �f 99 NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT-OR TEL. DISTRICT GROUP TYPE FIRE PRO SSED'BY 0 Exemption, you should become subject to'the 'Workers' ENGINEER NO. CONST. ZONE Compensation provisions of the Labor Code, you must forth- � 4 3 3 CL ADDRESS with comply with such provisions or this permit shall be // r 4h deemed revoked. COI�i �I^✓/�� /T7 L - / /2� STATISTICAL CLASSIFICATION APT. CONDO. LICENSED CONTRACTORS DECLARATION CCC!!! L Gs✓�f�t� CLASS NO. t' DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESSomw (commencing with Section 7000),9f Division 3 of the Business and LIC. SEWER MAP Profess ions-Codei and my license is in full force and effect. CITY CLASS BK "� VALIDATION SQ. FT NO. OF _ NO. OF CHECK License Number Lic.Class SIZE/3� STORIES FAMILIES ONE VALUATION DESCRIPTION OF WORKNEW ❑Contractor Date - ADD ❑ E C�� pill.:,. i�G � iJG�si I am exempt under Sec. i > - -• [E::]ALTER B.BP.C. for this reason REPAIR ❑ $ "C°-2 1 6.8 A Date: USE OF EXISTING BLDG. DEMOL ❑ 'J. o o to 0 23 Signature APPLIC�,MT j _ TEL. FINAL OWNER-BUILDER DECLARATION '�"""`_ ""� N DAT Z a C7 1 �, 1 O I hereby affirm that I am exempt from the Contractor's License • Law for the following reason (Section 7031.5, Business and ADDRESS �� FIN c o 6 1 Q, 1 Q "Professions Code): PRESENT B '1 ❑ BUILDING ♦ Ora 2 1 -84 I, as owner of the property, or my employees with ADDRESS 0•,�• '' 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. ' ❑ CONTRACTOR NO. _ y5 I, as owner of the property, am exclusively contracting ti 4 ti ,,.w, _1 •� . with licensed contractors to construct the project (Sec- ADDRESS - - • tion 7044, Business and Professions Code). , '•( 2 2(� 3.7 A REQUIRED TOTAL SETBACK FROM EXIST. ,t CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I herebyaffirm that there is a construction lending agency for o,0 0 a 2 3 9 9 Y FRONT _ , d' the performance of the work for which-this permit is issued P.L. i (Sec. 3097, Civ. C.). SIDE L'� '.I% a 6 1 0, 1 0 P.L. i ' Lender's Name _ :! o - 61 0. 1 D o /� s� 7 LDMA Ref-# t, o : i� a �, -- - - -- P.C. Fee$ - - C9/;/V- Permit•Fee - - ..a -..p a Q 8-8 5- - Lender's Address _ > —7 0 N I certify that.l have read this.application and state that the Issuance Fee LDMRP/C.# F\)W-00- < above information is correct. I agree to comply with all County Investigation Fee ` -' Q0.00 0^v1 ordinances and State laws relating to building construction, _. Total Fee LDMA Perm. # PVIV a0 v and hereby authorize representatives of this County to enter < upon the above-mentioned property for inspection purposes. HC < o SEE REVERSE FOR EXPLANATORY LANGUAGE • Signature of Applicant or Agent Date - - - - - - - - - -- - 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 0612010015 PHONE (626) 285-0488 EXT LEGAL ID: NO. OF CONST BUILDING ADDRESS TR 36735 LT 13 SQ FT STORIES TYPE 10350 KEY WEST ST STRUCTURE VN TEMP CA 917803476 ASSESSOR INFORMATION NUMBER• NEAREST CROSS STREET 8585-018-077 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: 12/01/06 JK 11/26/07 OWNER TEL NO• BLDGS. NOW ON LOT• VALUATION. FINAL DATE / FI BY• CODE: OSOLLO LUIS M,ESTHER (626) 350-1655- 3,600 10350 KEY WEST ST TEMP 917803476 FEES PAID DESCRIPTION OF WORK CHANGING OUT 6 WINDOWS LIKE FOR LIKE FEE DESCRIPTION: QUANTITY UOM AMOUNT APPLICANT TEL NO: CHAD CUNNINGHAM - AA BLDG PERMIT ISSUANCE 27 75 AC STRONG MOTION RESID 3600 00 VAL 0 50 SPECIAL CONDITIONS D2 PERMIT W/O EN-HC 3600 00 VAL 115 80 TOTAL FEES 144 05 CONTRACTOR TEL. NO. APPROVALS DATE INSPECTOR SIGNATURE GALKOS CONSTRUCTION, INC (714) 373-8545- 15261 CONNECTOR LN LIC NO LOCATION AND SETBACKS HUNTINGTON BEACH CA 92049 492715 B 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- I 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 v 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 1205210088 PHONE: (626) 285-0488 EXT ILEGAL ID NO OF CONST I BUILDING ADDRESS ITR 36735 LT. 13 SQ FT STORIES TYPE 10350 KEY WEST ST 1 I ISTRUCTURE V-B TEMP CA 917803476 1 (ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET I 18585-018-077 THOMAS PAGE 597 GRID C4 LOCALITY TEMPLE CITY, Cl I I I I ITENANT _ 1EXIST BLDG USE RESID USE ZONE R-1 JISSUED ON PROCESSED BY 1 I IEXIST OCC GRP. 107/05/12 SR 1 (OWNER TEL NO IBLDGS NOW ON LOT VALUATION IFTNALDATE FINAL BY CODE 1OSOLLO LUIS M,ESTHER - 1 - 14,900 110350 KEY WEST ST I 1 4 1 ITEMP 917803476 I FEES PAID ID SCOL RIP ON OF WORK 1 1 I IP V • SOLAR 1 I IFEE DESCRIPTION QUANTITY UOM AMOUNT 1 1 JAPPLICANT TEL NO I I I ISHELDON, CHEYNE (562) 371-4947- ID7 ADDNL PLANCHECK FEE 1 00 HOU 109 40 1 I 12020 DEL AMO BLVD JAA BLDG PERMIT ISSUANCE 27 80 ISPECIAL CONDITIONS I JAB STATE GREEN BLDG FEE 14900 00 VAL 1 00 1 I JAC STRONG MOTION RESID 14900 00 VAL 1 50 1 1 1 IP2 INSPCT RES PV <10KW 138 00 ICONTRACTOR TEL NO I TOTAL FEES 277 70 JAPPROVALS .DATE INSPECTOR SIGNATURE 1 ISUNGATE ENERGY SOLUTIONS (858) 457-4500- I 1_ 1 16335 FERRIS SQUARE LIC NO i I-LOCATION AND SETBACKS I 1 ISAN DIEGO CA 92121 790709 B II 1 J ISOILS ENGINEER APPROVAL I 1 (ARCHITECT OR ENGINEER TEL NO 1 - IFOUNDATION/TRENCH FORMS I I LIC- NO (SLAB'/UNDER FLOOR I I I 1RAISED FLOOR FRAMING I I I IMAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP:1 JUNDERFLOOR INSULATION I I I 1147H273 3 001 1 1 1 1 I - I IFLOO:< SHEATHING I 1 I- INO OF FAMILIES DWELLING UNITS APT/COND STAT CLASS I 1 - 1 I 1 0 NO 21 1 IROOF SHEATHING I I I 1 SCHOOL'WITHIN HAZARDOUS 1 ISHEAR PANELS I I 1 1AIR QUALITY 1000 FEET MATERIALS I I I I NO NO NO 1 JFRAME INSPECTION I I I IFIRE SPRINKLER HANGERS 1 I I I I 1 IINSULATION/WEATHER STRIPI I I 1 1 11NTERIOR LATH/DRYWALL 1 I 1 I I I I 1 1EXTERIOR LATH 1 I 1 I I I IRATED FLOOR/CEIL ASSEM. 1 1 I IRATED WALL ASSEMBLIES I 1 I I I I 1 IRATED SHAFTS/OPENINGS I I I 1 1 IT-BAR CEILINGS I 1 1 1 JLOT DRAINAGE 1 1 1 1 IREPORT ID. DPR261 ROUTE TO BS0508 1 '