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Home My Public Portal About10039 LA ROSA DR_Building__ 7�ePrR- ,eAe,. Cett�s,a APPLICATION FOR BUILDING PERMIT 1 - COUNTY OF LOS ANGELES LB .GADO DEPARTMENT OF COUNTY-ENGINEER sBUILDING AND SAFETY DIVISION ITYJOHN A. LAMBIE, COUNTY ENGINEER ST CASSATT D. GRIFFIN, SUPT OF BUILDIM. IT. DISTRICT NO. GROUP TYPE ROCESSED B FOR APPLICANT TO FILL IN _ CONST. BUILDING _ _STATISTICALC SSIFICATION SE RM ADDRESS OO Q;7 A K - PG•` CLASS.NO�DWELL.UNMAP ITS / LOT NO. BLOCK NUMBER HWY. YES NO TRACT j 08" 1 U EZONE _ SPECIAL �J }— / CONDITIONS - SIZEOFLOT IDO Z O I N&VON LOTS oac USE OF EXISTING BLDG. BUILDING OWNYARD HWY STREETNAME EXIST. SETBACK WIDTH MAILER GY R U 6 F FRONT,- ADDRESS '3 J� L -5 SIDE P.L. cITY - t" NO. INSPECTION RECORD ARCHITECTOR TEL. ENGINEER NO. ADDRESS I d '' /I TEL. ,l r l CONTRACTOR H O N Y Q LOS NO. ppL. cL -ar h ADDRESS863.6 LL DESCRIPTION OF WORK NEW VADD ALTER REPAIR DEMOLISH SO.FT. NO.OF NO.OF E OFSIZE yy�� STORIES FAMILIES US STRUCTUREf/W F L L I'N G, 14 N T G' SIGNATURE C APPLICANT A ROVALS DATE INSPECTOR'S SIGNATURE ADDRESS FOUNDATION:LOCATION VALUATION$ O—Y FORMS,MATERIALS FBFtAC'I STOPS. P.C. LP 00I PMT. FURNACE: LOCATION. I ��, FEE $ I D FEE $3 GAS VENT,DUCTS 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH.INT. /� �' !'NYK• _ ll(/ PLICATION AND STATE THAT THE ABOVE IS CORRECT AND ) AGREE TOC PLY WITH ALL COUNTY ORDI CES D �d�! STATE lA REGULATING BU L N CO N.♦ ATH,EX . SIGNATU S MEER COR- r, PERMITT ND POSTED ADDRESS AMIFINAL CLYDE N. DIRLAM, PRINCIPAL STWGTURAL ENGINEER PLAN CHECK VALIDATI N <K. M.O. CASH PERMIT VALIDATION cK M.O. CASH (�I�408 OCT 162 3 A 18.00A � 6 3 5 7 � `7 2 2 1 A 3`6'y'.>0'0 /r WORKERS' COMPENSATION DECLARATION hereby affirm that havecertificate of consent to self APPLICATION FOR BUILDING._ PERMIT _ insure, or a certificate of Workers' CompensationtionInsurance, - or�Certified (Sec. 3800,-Lob. C-�.) y 1\ - r� Pomponl> 71f f!= FIXE COUNTY OF LOS ANGELES - BUILDING AND SAFETY. s \ BUILDING . . reby furors d. FOR APPLICANT TO WILL IN ADDREss .3 , /A rz6i ❑ Certified copy is filed with t county b ding ins c- BUILDING - - tion department ADDRESS V)Kr ((�� .Date ,Applic t > - _ CITY'A k — llg NO. OFZIP e / LOCALITY is CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT - - NOW ON LOT NEAREST CROSS ST. COMPENSATION INSURANCE: _ _ ASSESSOR (This section need not be completed if the permit is for one ' TRACT K LOT NO. MAP BOOK PAGE PARCEL hundred dollars ($100) or less.) TEL USE ZONE - MAP . OWNER - NO.c'/7 c r to ' ,I certify that in the performance of the work for which this Q SPECIAL - - Y permit is issued, I shall not employ any person in any manner ADDRESS ,1 CONDITIONS a so as to become subject to the Workers' Compensation Laws. O - CITY- D N ZIP Date - Applicant - ARCHITECT OR TEL. - NOTICE TO APPLICANT: If, after makingthis-Certificate of ENGINEER NO. DISTRICT GROUP TYPE FIRE PROCESSED BY CONST. ZONE Exemption, you should become subject to the Workers' - _.! „ / U Compensation provisions of the Labor Code, you must.forth- . . ADDRESS �O J C _::5 with comply with such-provisions or.this permit shall be '. pp TEL. STATISTICAL CLASSIFICATION APT. CONDO. Z deemed revoked. CONTRACTOR /1IPPJ4JO NO. t LICENSED CONTRACTORS DECLARATIONLIC. n CUSS NO. �'� DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRES ' '6e&16 NO. y / (commencing with.Section 7000)of Division'3 of the'Business LIC. /r SEWER MAP and Professions ad aryl li ' ase is in full force Mand ct CITY CLASS(� BK./— PG.//-P VALIDATION (� SQ. FT. NO. OF NO:OF CHECK License Number Lic. Class SIZE STORIE FAMILIES ONE VALUATION �� Contracto - / pate Y DESCRIPTION OF WORK EW ❑ El am exempt under Sec. A' i 6fi-F ADD LJ 9 loop.AVER ❑ 8.8P.C. for this reason .J REPAIR ❑ f ' Date: USE OF - - EXISTING BLDG. DEMOL ❑ Signature APPLICAN TEL' �' FINAL OWNER-BUILDER DECLARATION (PRINT NO. I hereby off irm that I.am exempt from the Contractor's License _ DATE Law for the following reason (Section 7031.5, Business and ADDRESS/ � ri FINAL ' - Professions Code): PRESENT BY BUILDING - '•+�' a ❑ I, as owner of the property, or my employees with ADDRESS •1, wages as their sole compensation,will do.the work and LOCALITY the structure is not intended or offered for sale(Section --- 7044, Business and Professions Code.) - MOVING _ _ TEL. _ ❑ ,i 1, as owner of the.property, am exclusively contracting CONTRACTOR NO. - 1 _I_!h with licensed contractors to construct the project Sec- - -. - ' 1` f . i P ( ADDRESS - I,�v Atc'_�'. r�l-_' tion 7044, Business and Professions Code.) . - -REQUIREDTOTA .YARD L SETBACK FROM EXIST. HWV Gsi r'% i CONSTRUCTION LENDING AGENCY -SET BACK PROP.LINE WIDTH - r' hereby affirm that there is a construction lending agency for FRONT �I:?j=�C ,f in the performance of the' 'Work for which this permit is issued P.L. '- - - - - - - (Sec. 3097, Civ. C.). _ SIDE . P,I. Lender's Name, -I!-. 47 LDMA Ref. N P.G. Fee$ Permit Fee Lender's Address 1_iq� 1 ( ;';yi; I certify t at I have read this application and state that the Issuance Fee 1:1.; 8 above In ormatian is correct. I agree to comply with all County Investigation Fee d ordi Crites and State ws rel to-building construction, Total Fee s LDMA Perm. M m .and h r by outyoripp�cpl.�entativ of this County to enter upo t ea vene pr rty br inspection f oses. SEEREVERSE FOR EXPLANATORY LANGUAGE li<ant or Agent Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 'LAS TUNAS RESIDENTIAL ADD/ALT/REP • BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9806020027 PHONE: (818) 285-0488 EXT: LEGAL ID: NO. OF CONST NEW BUILDING ADDRESS: TR: 10821 LT: 5 BL: A SO. FT STORIES TYPE OCCUP GROUP 10039 LA ROSA DR STRUCTURE: 616 1 VN R3 TEMP CA 917803302 ASSESSOR INFORMATION NUMBER: GARAGE: NEAREST CROSS STREET: BALDWIN 8585-007-044 OTHER: THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: USE ZONE: ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 06/05/98 - UT 06/05/99 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE: FRAGOSO, JESUS (626) 443-1276- 1 45,580 10039 LA ROSA DR. TEMPLE, CITY FEES PAID DESCRIPTION OF W RK EXTEND LIVING RM/DINING RM/NEW MAST BEDROOM (4TH BEDROOM) FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. NO: SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RESID,- ..45580.00 VAL 4.56 SPECIAL CONDITIONS: B1 PLANCHECK _W/ENERGY - -_45580:00 VAL 694.24 B2 PERMIT W/ENERG- EL[545580:00`VAL 816.75 TOTAHEEES 1,543.30 CONTRACTOR: TEL. NO: per•) "�J� APPROVALS DATE INSPECTOR SI TURE SAME AS OWNER - V LIC. NO / �/�7� �� \ LOCATION AND SETBACKS SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. N0: i \ j, \ �'�" FOUNDATION/TRENCH FORMS LIC. N0: _ '�ttlii �+ SLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: ` 'i UNDERFLOOR INSULATION 3 01 ST LEVEL FLOOR SHEATH NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: NO 21 \ -'N 2ND LEVEL FLOOR SHEATH SCHOOL WI-THIN HAZARDOUS - ROOF SHEATHING AIR QUALITY: 1000 FEET MATERIALS NO NO -' NO _ - ' / �� .O`/ FIRE DEPT. FRAME INSPECT REQUIRED TOTAL SETBACK FROM EXIST i. _ .i h/ BLDG DEPT. FRAME INSPECT SET BACK YARD: HWY: PROP LINE: WIDTH: �r_ � • FRONT PL- SHEAR V"" ` SHEAR PANELS SIDE PL- INSULATION/WEATHER STRIP INTERIOR LAT HjDRYWALL ] 7� EXTERIOR LATH LOT DRAINAGE SMOKE DETECTION DEVICES FIRE DEPARTMENT APPROVAL REPORT ID; DPR261 ROUTE TO: BS0508