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Home My Public Portal About10511 KEY WEST ST_Building__ WORKERS'COMPENSATION DECLARATION n hereby affirm that I havecertificate of cnt,to serf - A P P L I CAT I O N� F O R BUILDING PERMIT JI�I insure, or a certificate of Workers' Compensationion Insurance, or a certified copy thereof (Sec 3800, Lab,C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company Certified copy is hereby furnished BUILDING FOR APPLICANT TO F LL IN ADDRESS f7.J Certified copy is filed with the county building inspec- BUILDINGr "� �^ /y tion department ADDRESS / V � '. LOCALITY-15 r 1 r 01 rf NEAREST Date Applicant CITY 8 ZIP v CROSS STAX - CERTIFICATE OF EXEMPTION FROM WORKERS' PO OF BL S ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one USE ZONE MAP' hundred dollars ($100)or less ) TRACT Bl. K A LOT NjOl�1(�f H �( NO SPECIAL I certify that in the performance of the work for which this OWNER NO/TrJ 7j ,G -` CONDITIONS d permit is issued,`I shall not employ any person in any nner _ DISTRICT GROUP TYPE FIRE /ROVED BY O so as to become subject to the Worke s'Comp do aws ADDRESS + CONST -ZO U OC c Il Date Applicant CITY ^ ZIP STATISTICAL CIA SIFICATION APT NDO O rr NO CE TO APPLI T If, after making t i Certificate of ENGINEERARCHITET OR NLO' V Exemption, you should become subject the Workers' CLASS NO DWELL UNITS LU Compensation provisions of the Labor Code, you must forth- tail ADDRESS - - SEWER MAP with comply with such provisions or this permit shall be Z deemed revoked CONTRACTOR Np BK PG, VALIDATION LICENSED CONTRACTORS DECLARATION LIC I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS s NO VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC Professions Code, and my license is in full force and effect CITY CLASS $ tJL J ► SQ FT NO OF NO OF CHECK License Number Lic Class " SIZE STORIES FAMILIES ONE DESCRIPTION OF WORK NEW ❑ $ Contractor Date _ ADD ❑ I am exempt under Sec ALTER FINAL B 8P C for this reason REPAIR ❑ DATE USE OF ❑ 7 Date EXISTING BLDG DEMOL BNA APPLICANT TEL Y Signature PRINT NO ' OWNER-B D CLARAT10N , I hereby affirm thof I am exempt from the Contractor's License Law for the following reason (Section 7031 5, Business and ADDRESS Professions Code) 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 fOCALITY 9 2'7 9, VA 7044, Business and Professions Code) MOVING TEL I, as owner of the property, am exclusively contracting CONTRACTOR NO o 0,0 0 0 with licensed contractors to construct the protect (Se1 t ,c- ADDRESS tion 7044, Business and Professions Code) 2to,0 4 9,,8 8 REQUIRED TOTAL SETBACK FROM EXIST CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP LIN WIDTH o 0 o g I hereby affirm that there is a construction tending agency-for FRONT , �17i7`,�' _— '4 the performance of the work for which this permit is issued P L (Sec 3097, Civ C ) SIDE FO P L a Lender's Name Lender's Address P C Fee$ Permit Fee I certify that I have read this application and state that the Issuance Fee iJ above information is correct I agree to comply with'all County Investigation Fee ordinances and State tow relating to building construction, Total Fee d and hereby authorize re r sentatives of thi aunty to enter upon a above- ntio d property f m coon to o �g SEE REVERSE FOR EXPLANATORY LANGUAGE SignaTu of Applicant or Agent Dae COUNTY OF LOS kiGELES TEMPLE CITY ?f 0508 BUILDING s' z. ;-JT DEPARTMENT OF PUBt.IC WOFKS701 LAS TUNAS RESIDENTIAL ADL,ALT'REP BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 04G5190020 PHONE: (626) 285-04ia, LEGAL 1D _ NO. OF C0,1ST- NEW —BL?DING ADDRESS: TR: 11290 LT: 12 BL: C SQ. FT STORIES TYPE OCCUP GROUP 10511 KEY WEST ST j STRUCT`Q ': 1144 1 VN R3 TEMP CA 917803463 1 ASSESSOR INFORMATION NUMBER: GARAGE: 40 1 VNI U1 NEAREST CROSS STREET: 8585-023.1,551 0?H R: 5i 1 VN U1 THOMAS PAGE: 597 GRI:: C4 LOCALITY: TEMPLE C,-,Y, Cl TENANT: - EXIST BLDG USE: ;ISE ZONE: ISSUED 014: PROCESSED BY, EXPIRES ON: EXIST o�,C GRP: 09/;M4 JK 09/23/05 OWNER: IEL. NO: BLDGS. OOT IN LOT: '- VALUATION: itF FINAL 6Y._ -^ CODE: CHEN HWAI S,AL TSC'N C (`109) 932-9259- 122,500 ^l .-�� 1803 LAKEWOOD AVE. UPLAND, CA 91784. --- FEES PIATD DE aC :PTION OF WORK -� ADD F;ALYRi ,2BDRMS,2BATHS,NEW KTCH,LMDRY,CONVRT EXIST KTOHN FEE DESCRIPTION: QUANTITY: UCM: AMOUNT: TO D9ING,EXNDT LVNGRM,DEMO GAR&BLD NEI.J GAR,ADD FONT POR., APPLICANT- TE:_. NO: � A H ACCORD GROUP INC. (626) 308-9983- B1 PLr',NT'HECK '.:;ENERGY 122500.00 VAL 1,346.96 821 S. GARFIELD AVE AA BLDG PERM, ISSUANCE 27.75 SYkt:lr L CONDITIONS: ALHAMBRA, CA 91801 AC STRONG MOTION RESID 122500.00 VAL 12.25 � B2 PERMIT W/ENERGY 12259 .0u AL 1,584.66 TOTAL 'ES ',971.62 __ CCNTRr; TE._. N0: kir: :'.'AL` jN-P:CiOR SIGNAT;.::':' - A H ACCORD GROUP INC. (626) 308-9983- ' 821 S. GA%FIELD `,VE., :202 LIC. NO LE7C "i i—ON ANE~ETBACKS � -I ALHAN.3-RA, GA 915.01 757675 C16 Ic,TLS ENGINEER APPROVAL �I i .�-='=__-- --- �E�• ---..-.T;:._•n. � I.i�. - - �,;3:^'rcCNCIi FORMS � �--�-n--__.._ _-__.----___. 5559 At'.i ST iii ii0: 1✓c:. !� � SAN !;'B :EL, C A 671176SA 2.-.J FLOOR FRAMING MAP NQ:�;=i�JER i•iAP BLOT'.: PAGE: 7,?RE 7GN�: CMP: UfD'cGFI_UJR ?P:SiJLAI'ION � 3 01 �W—FLEWEL FLOOR SHEATH NO. OF FAMILIES: DWELLING UNITS: APTiCOND. STAT CLASS: NO 21 ? D LEVEL FLOOR SHEATH SCHOOL WITHIN HAZARDOUS ROOF SHEATHING — - AIR QUALITY: 1000 FEET MATERIALS _ NO NO NO FI.RE DEPT. FRAME INSPECTI REQUIRED TOTAL SETBACK FROM EXIST ( BLDG 'DEPT. FRAME INSPE l _j I' SET BACK YARD: HWY: PROP LINE: WIDTH: GJ FRONT PL-- SHEAR PANELS v I SIDE PL- INSULATION/WEATHER STRI , _ - INMR TOR LATH/DRYWALL -' c 1111 EXTERIOR _ATH LUT DRAINAGE i St?55,Y.E7DETECTION DEVICES -�� FIRE DEPARTMENT APPROVAL REPORT ID: OPR261 ROUTE TO: BS0508 �I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS NEW RESIDENTIAL BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0501250058 PHONE: (626) 285-0488 EXT: LEGAL ID: 0. OF CONST NEW BUILDING TR: 11290 LT: 12 BL: C SQ. FT STORIES TYPE OCCUP GROUP 10511 KEY WEST ST STRUCTURE: 815 - - 1 _-- VN - - - - R3 --- • .,;_.�;TEMP_ _CA-917803463;-,--:_-'- _ -- S S GARAGE: }' _ NEAREST-CROSS STREET:_'_ 8585-023-051 OTHER: THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY, C TENANT: USE ZONE: RI ISSUED ON: PROCESSED B . 01/27/05 JK 01/22/06 TEL. N0: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: . CHEN HWAI S;ALISON C (909) 932-9259- 67,482 .s 1803 LAKEWOOD AVE. UPLAND, CA 91784 E DESCR I P ION OF WORK DEMO EXISTING LIVING AREA AND REBUILD SAME SIZE HOUSE 1962SF FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: SEE ALSO BUILDING PERMIT 405190020 L. 0: SAME AS OWNER - B1 PLANCHECK W/ENERGY 67482.00 VAL 915.41 AA BLDG PERMIT ISSUANCE 27.75 SPECIAL CONDITIONS: AC STRONG MOTION RESID 67482.00 VAL 6.75 B2 PERMIT W/ENERGY 67482.00 VAL 1,076.96 TOTAL FEES 2,026.87 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - LIC. NO LOCATION SOILS ENGINEER APPROVAL ARCHITECT OR E C FORMS KO DAVID (626) 286-1867- 5569 EARLE ST LIC. N0: SLAB/UNDER FLOOR SAN GABRIEL, CA 6711768A P 0: SEWER MAP BOOK: PAGE: FIRE ZONE: ERF- UNDERFLOOR INSULATION XX 3 01 1ST LEVEL / 0 C NO 00 2ND LEVEL FLOOR SHEATH SCHOOL WITHIN HAZARDOUS ROOF SHEATHING AIR QUALITY: 1000 FEET MATERIALS NO NO NO FIRE DEPT. F SETBACKREQUIRED TOTAL SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- SHEAR PANELSC f-�• SIDE PL- INSULATION/WEATHER L- S A ER STRI _ I OR LATH/DRYWALL may, LOT DRAINAGE SMOKE DETECTION DEVICE§'_ FIRE DEPARTMENT PPR 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 0501270039 PHONE: (626) 285-0488 EXT: ADDRESS:LEGAL ID: NO. OF CONST BUILDING TR: 11290 LT: 12 BL: C SQ. FT STORIES TYPE 10511 KEY WEST ST STRUCTURE: VN - TEMP CA 917803463 ASSESSOR INFORMATION NUMBER: - NEAREST CROSS STREET: LOWER AZUSA 8585-023-051 THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY, C TENANT: EXIST BLDG USE ZONE: R-1 ISSUED S P . EXIST OCC GRP: 01/27/05 JK 01/22/06 OWNER: TEL. N0: BLDGS. NOW ON LO LUATIOL FINAL BY: CODE: 2 CHEN HWAI S;ALISON C (909) 932-9259- 257 G/ 1803 LAKEWOOD AVE. UPLAND, CA 91784 FEES PAID SCRIPT INVESTIGATION FEE WORKING WITHOUT PERMIT. FEE DESCRIPTION: ' - QUANTITY: UOM: T: APPLICANT: TEL. 0: - SAME AS OWNER - FR INV WORK W/0 PERMIT 257.00 DOL 257.00 TOTAL FEES 257. SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO LOCATION ANDSETBACKS SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS K0, DAVID (626) 286-1867- 5559 EARLE ST LIC. NO: SLAB/UNDER R SAN GABRIEL, CA 671176BA RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAG E ONE: UNDERFLOOR INS LA 0 XX 3 01 FLOOR SHEATHING NO. OF F NG UNITS: APT709FE-�CLUg'-7- NO 21 ROOF SHEATHING SCHOOL WITHIN --WARMUg-AIR QUALITY: 1000 FEET MATERIALS S LS NO NO NO FRAME INSPECTION REQUIRED TOTAL SETBACK FROM I FIRE SPRINKLEW-MMERT- SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- INSULATION/WEATHER STRTF SIDE PL- R LATH/DRYgAUE- EXTERIOR LATH RATED FLOOR/CEIL MTN. RATED WALLASSEMBLI RATED F S GS T-BAR CEILINGS LOT-DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508