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Home My Public Portal About10523 KEY WEST ST_Building__ APKICATION FOR BUILDING PERMIT COUNTY'OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION , FOR APPLICANT TO FILL,IN, BUILDING ADDRESS I hereby affirm that I have a certificate of consent to self Insure, BUI I_NGp9DRFs or a certificate of Workers' Compensation Insurance,or a certified �P copy thereof(S c 38/00, ib C) C � ZIP 1790 LOCALITY Policy No y �� CQmpa SIZE OF LOT NO OF BLDGS NOW ON LOT ❑ Certified copy Is hereby furnished NEAREST CROSS ST r lop, A Certified copy Is filed with the county building Inspection TR C7 n /g+{,OCK LOT NO ♦� / �CJ l� � USE'ZONE MAP NO department � DatQ q-1i 3 Applicant VIA ASSE�R,C , PAGE P R L CSvJC`hJ SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS; ° R rlfl TEL NO YES No COMPENSATION INSURANCE WITHIN 1000 FT OF SCHOOL? (This section need not be completed If the permit Is for one hundred ADDnRE �� DISTRICT GROUP TYPE CONST FIRE ZONE PROCESeeASED BY. dollars ($100) or less) -CITY /J Z / �� I certify that In the performance of the work for which this permit at" /1.�1 ,►" �,. � �✓l ��g'� Is Issued, I shall not employ any person in any manner so as to ARCHITECT AR ENGINEER I TEL NO (/ become subject to the Workers'Compensation Laws STATISTICAL CLAS IFICATION APT CONDO Date Applicant ' ADDRESS CLASS NO 4,2 1 DWELL UNITS NOTICE TO APPLICANT If, after making this Certificate Of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become Subject to the Workers CO TOR TEL SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith Z— FRONT comply with such provisions or this permit shall be deemed revoked A jESQ ` L NO P L (� SIDE LICENSED CONTRACTORS DECLARATION CI YLIC LAS P L I hereby affirm that I am licensed underprovislons of Chapter 9 e- SEWER MAP (commencing with Section 7000)of Division 3 of the Business and Q,FjT SE NO OF STORIES NO OF FAMILIES Professions Code, n mylillce se Is in full force an effect NEW BK PG a License NuLIC Class _ 3 / DESCRIPTION OF WORK ADD E] VALUATION pool. Q Contractor to ALTER ❑ $�� ` U ❑ I am exempt under Sec CA.Y6 REPAIR El $ 0 �� l BBPC for this reason DEMOL ❑ U Cl "5 LDMA P/C# W Date USE OF EXI TING BLDG URM El 1 Signature APP T(PRIN TEL NO "LDMA Perm# Z v El 1, as owner of the property, or my employees with wages as 1, OZ their sole compensation, will do the work and the structure Is AD RE /n,, not Intended or offered for sale (Section 7044, Business and �7�t Q0� 0. , FINAL D TE Q ;'I�;}} T Ire 1?o�?I� Pro feSSIonS Code) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL- 1 I i E 1- ❑ 1, as owner Of the property, am exclusive) contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE J P P Y. Y g AMOUNTS SPECIFI ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY licensed contractors to construct the project (Section 7044, ves El No /'�� t I-I T AL 1-17 - 90 Business and Professions Code) Lr q [,( WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING C HLL r 11/n 7 LI OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR ^ GUIDELINES CHANGE .130 1 hereby affirm that there Is a construction lending agency for YES ElNO a the performance of the work for which this permit Is Issued(Sec IHAVE READ THE HAZARDOUS MATE RLALS INFORMATION GUIDE AND THE SCAQMD PERMITTING 3097,CIV C) CHECKUST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE -f/ a TITLE 2 CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS 1 li f I-fit Sid 1 cjJ 1`7 j_ Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD o Lender's Address '5 1 I;N 2: -I O OWNER OR AGENT o I certify that I have read thl Ppllcation and state under,penalty •p PC FEE PERMIT FEE _ of perjury that the a e mf matron is correct I agree to comply with all county Inanpe and State laws relating to building construction, here thorize representatives of this County ISSUANCE FEE / co he ab - ntl d property for Inspection purposes (O J a INVESTIGATION FEE TOTAL FEE / O ' S911—of ApoL—«Ape Date ' 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 0209270032 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ANMS: TR: 11290 LT: 13 BL: C SQ. FT STORIES TYPE 10523 KEY WEST ST STRUCTURE: VN TEMP CA 917803463 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 8585-023-023 THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY EXPIRESTENANT: EXIST BLDG USE: RESID USE ZONE: R-1 I-SSUED ON: PROCESSED BY: ON: EXIST OCC GRP: 09/27/02 JK 03/26/03 OWNER: TEL. BLDGS. NOW ON LOT: VALUATION: F A A FINAL-BY: CODE: MARCELLUS JULIA (626) 279-9866- 300 v� 10523 KEY WEST ST TEMP 917803463 FEES PAID CRIPTION OFK ADD CLOSET (49SF) WITHIN FAMILY RM FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APP . SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RESID___- 300.00 VAL 0.50 SPECIAL CONDITIONS: D2 PERMIT W/O-EN=HC-- - 300.00 VAL 43.65 } ��T�a F�� 71.90 CONTRACTOR: L. : \ �� wV�� APP 0 A S DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO LO SOILS NGI ER APPROVAL ARCHITECT '/ �r ��;-- �� -moi FSO R NC FORMS / f!{f I LIC. NO' !�— --[ - 1 ( -�� STAB/UNDER FLOOR L MAP NO• SEWER MAP BOOK• PAGE: R ONE• CMT.- + U R F OOR INSULATION X 3 01 FLOOR SHEATHING NO. OF FAMILIES: EL : APT/COND: STAT EUMF — -- - —— - - - - - - NO 21 �� - -" % - SHEATHING SCHOOL WITHIN HAZARDOUSSHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO NO �� J� `- '" :/� E NS S REQUIRED ROM EXIsT-- FIRE SPRINKLERHANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- SU IO W ATH R STRIP SIDE PL- INTSRIOR LATH/DRYWALL _ EXTERIOR LATH RATED L ASSEM. RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508 1 I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD/ALT/REP BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0411090052 PHONE: (626) 285-0488 EXT: LEGALADDRESS: TR: 11290 LT: 13 BL: C SQ. FT STORIES TYPE OCCUP GROUP 10523 KEY WEST ST STRUCTURE: 480 1 VN R3 TEMP CA 917803463 ASSESSOR0 GARAGE: NEAREST CROSS STREET: DOREEN 8585-023-023 OTHER: 334 1 VN R3 THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY, C TE ST BLDG S E 20NE: ISSUED B E . EXIST OCC GRP: 11/15/04 JK 11/10/05 OWNER: TEL. 0: BL GS. NOW ON LOT: VALUATI DATE FINAL B COD PASTOR, MANUEL (626) 482-1382- 53,100 10523 KEY WEST ST 2 TEMP 917803463 S PAI SCR 0 1-STORY ADDITION LIVING/DINING ROOM 480 SF. & KITCHEN FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: REMODELING 334 SF. TEL. . SAME AS OWNER - B1 PLANCHECK W/ENERGY 53100.00 VAL 785.82 AA BLDG PERMIT ISSUANCE 27.75 SPECIAL CONDITIONS: AC STRONG MOTION RESID 53100.00 VAL 5.31 B2 PERMIT W/ENERGY 53100.00 VAL 924.50 TOTAL FEES 1,743.38 CONTRACTOR: TEL. N0: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - LIC. NO LOCATION AND SETBACKS SOILS ENGINEER APPROVAL ARCHITECTFOUNDATION/TRENCH CHEN, CHARLES (626) 454-9555- 1517 S. 8TH ST. LIC. NO: SLAB/UNDER FLOOR ALHAMBRA, CA 91803 C 019359 FLOORRAISED NG P NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMUNDERFLOOR INSULATION 3 01 FAMILIES:NO. OF I AP /CON CLASS: SHEATHIST LEVEL FLOOR NO 21 2ND LEVEL FLOORSHEATH SCHOOLAROOF SHEATHING AIR QUALITY: 1000 FEET MATERIALS NO NO NO FIRE DEPT. FRAME INSPECTREQUIRED TOTAL SETBACK EXIST DEPT. FRAME INSPEC SET BACK YARD: HWY: PROP LINE: ROM WIDTH: LD FRONT PL- SHEAR PANELS SIDE PL- R STRIPWv(� L)I lllu ^� INTERIOR LATH/DRYWALL EXTERIOR LOT DRAINAGE SMOKE DETECTIONS FIRE DEPARTMENT APPROVA REPORT ID: DPR261 ROUTE TO: BS0508