The URL can be used to link to this page

Home My Public Portal About10212 LA ROSA DR_Building__ s,a. E�ao APPLICATION FOR. BUILDING PERMIT 1 COUNTY OF LOS ANGELES ABU ILDING DDRESS 10212-E. La Rosa St. , DEPARTMENT OF COUNTY ENGINEER Temple Cit BUILDING AND SAFETY DIVISION LOCALITY P y JOHN A.LAMBIE,COUNTY ENGINEER NEAREST 'CASSATT O.GRIFFIN.SUPT GF BUILDING CROSS ST. _ DIST: GROUP TYPE - E FOR A�PgPLICANT TO FILL IN Ift4j CONST:BUILDING I. ADDRESS .10212 E. - SEWERMAP'� ♦I_, La Rosa St.) STATISTI CA SSIFICATION I' BK ((�� CLASS. NO. WELL. UNITS 'LOT NO. 1" .BLOCK MAP ..STATE NU MBERZn� HWY. TRACT 1531 USEZONE SPECIAL NO.OF SLOGS. ((( CONDITIONS SIZE OF LOT NOW ON LOT 1 � r USEOFMuseEC ara e - . ` II GBLDG. BUILDINGYT EXIST. SETBACK ARDHWY STREET NAME ' WIDTH . OWNER Jack C . 'Hill FRONT.MAIL ADDRESS 10212 E. La Rosa St. P L. 6V . SIDE , cITY TemDle City NO 'ARCHITECT OR TEL.. - INSPECTIONRECORD - ENGINEER ST.ANDART)'PIAN NO. - (e ADDRESS�.�,,yy..yy�� Ep CONTRAaCtlaOny Bros• , inC NW-32a -�' '.•�- - . - ADDRr$6871 Firestone lvd.,- -So G L:_ • _ _ DESCRIPTION OF WORK G ' ? r Lei' f. j IJ— cl, NEW X. ADD' ALTER REPAIR DEMOLISH SO.FT. NO.OF NO.OF SIZEuu,, e - STORIES FAMILIES - usE,OlTaLcUR9Wlm 001 Std plan ,683 SIGNATUREO APPROVALS APPLICANT F�1 - ,. ADDRESS �. 1 it stn FOUNDATION: LOCATION Ol. , S' a 1 DATE INSPECTOR'S SIGNATURE FORMS. MATERIALS - $ P.C. E FRAME: FIRE STOPS. 2500.00 FEE BRACING. BOLTS VALUATIONS FURNACE: LOCATION. FEE _ GAS VENT.DUCTS I HEREBY ACKNOWLEDGE THAT I HA AD THIS AP- LATH.INT. PLICATION ANO AT MAT THE ABOV 1 CORRECT ANO AGREE TO CO Lld AH, U T O INANC SAND STATE LAWS R G C N�CTION. .LATH. E%T. SIGNATU RE HOUSE NUMBER COR- - PERMIT RECT AND POSTED . ADDRESS" FINAL CLYDE N. DIRLAM. PRINCIPAL ST RAL EN (NEER PLAN CHECK VAIJDATIOZ PERMT VALIDATION crc. M.o. cwsH L AC0 6' 2 6 4 RAY 13 2 3 A,. 3.0 O LACo 6 2 6 5 P AY.1 3 . ,i .A 1 2.0:0. :x`.. . T � I APPLICATION FOR BUILDING PERMIT q - COUNTY OF LOS ANGELES `S BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN - -_ BUILORNG ADDRESS � /� r BU FOR By � .� DA � • 7 hereby affirm that I have a certificate of consent to self insure, ('QZ IzI W 1,• �S - I`' or a certificate of Workers'Compensation Insurance,or a Certified CI - , G ZIP `•� copy thereof(Sec.3804 Lab.C.) W. /..r - LOCALITY Policy NO. Company SIZE OF LOT, _ NO.OF SLOGS.NOW ON LOT I C1 Certified copy is hereby furnished., Q'x Iv 2 NEAREST CROSS ST. I El c0 is filed with the coun buildin ins Ion TRACT • BLOCK LOT NO. PV tY 9 PeCt USE ZONE MAP NO. department. ASSESSORMAPBOOK� , .17 H � _73 - PAGE PARCEL DBIB Applicant as I¢ 0 I SPECIAL CONDITIONS OWNER ' w TEL. CERTIFICATEEXEMPTION FROM WORKERS' T/V MK WITHIN 1000 FT.OF SCHOOL? YES NO COMPENSATION INSURANCE ADDRESS (This section need not be completed if the permit is for one hundred 10V2, ta XOS& ST DISTRICT GROUP TYPE CyN . FIRE ZONE OCESSED B dollars($100),or less.) CITY IV' ` � .Zip - //��(y� I certify that in the performance of the work for which this pemlit ✓r/ J•U/� j j �- Is issued, I shall not employ any person in any manner s0 as t0 AR ITECTOR EN INEER '�s��— TEL.NO. L/ l become-subject to the Workers Compensation Laws. 'l$'LiSo 1' STATISTICAL CLASSIFICATION APT rONDrJ Date "Z I- 'Applicant A RESS - Y O CLASS NO.�L DWELL UNITS - NOTICE TO APPLICANT: If, after ma Ing this Certificate Of U e, 61AAMfAD A4 TT 41 RECURRED = TOTAL SETBACK FROM EXIST CONTRACTOR TEL NO. Exemption, you should become subject to the Workers' ��,,��.,��,r..��/�� 'SETBACK ' � YARD HWY PROP LINE' WIDTH Compensation provisions of the Labor Code, you must forthwith VWT-N I FRONT comply with such provisions or this permit shall be deemed revoked.- ADDRESS LIC.NO. PL LICENSED CONTRACTORS DECLARATION CITY CLASS SIOE Y PL - a O U I hereby affirm that I licensed under provisions of Chapter 9 SEWER MAP (Commencing with Section 7000)Of Division 3 Of the Business and 1 SO'FT' E A - NO.OF STORES NO.OF FAMILIES 33 (.iJ^74`Iv't!Io � S TD ❑ Profession?Code,and my license is in full force and effect. I I NEW BK PG U DES ION OF WORK VALUATION () , 1 1TEM: M.I License Number Lic.Class Z ADD a 3 Contractor - Date ALTER E3TOTAL ,34t5-® 40. ZS � REPAIR ❑ CHECK- 34`.41 ❑ lam exempt under Sec. .A BARC.for this reason MA+14 UNC DEMOL ❑ LDMA Pic« CHANGE - .Gu Date: USE OF EXISTING BLDG. •� ' ' D '-ORM: ❑ - -1 Signature APPLICANT(PRINT) TA� TEL N�o._SO,Lf LDMAPeanp _ 13000–UI�u1 3. �6/'7I) I, as owner of the property, or my employees with wages as 1/F Z / - p n-( I. �: their sole compensation, will do the work and the structure is ADDRESS Q p FINAL LATE Q itQJ' 1 AM 1Cl:1., - not intended or offered for Sale (Section 7044, Business and _ ,y/ PFO}BSSIOnS Code.)' , WILLTHE XP UCANTOR FUTURE BUILDING OCCUPANT HANDLE AHAZARDOUS MATERIAL —�• — r I. - J ❑ I, as owner of the property. y g OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN , Q '� p p rty, am BXCIUSIVDI contracting with THE AMOUNTS SPECIFIED ON THE HAZAROOIIS MATERIALS INFORMATION GUIDE? FINAL 6 I icensed Contractors to construct the project.(Section 7044, YES❑ NO 1:1 Business and Professions Code.) WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING _ OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATLON FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST , FORGUIDEUNIES. 1 hereby affirm that there is a construction lending agency for, YES❑ NO❑ the performance of the work for which this permit is issued(Sec. t.) CD. r'? ^�=t 4t -.I> rt I HAVE READ THE HAZARDq)S"TERIALS INFORMATION GUIDE AND THE SCAQMD .,G Q Z, ]'_ • , - EYJ ' 3097,CIV.C.). -PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES _J [� � COUNTY CODE,TRLE Z CHAPTER 2.A SECTIONS 2.A.Im THROUGH ZWA1 CONCERNING Lender's Name HAZAADOUSMATERIALS REPORTING AND FOR OBTAINING A PERMIT FROMTHE SCAOMD. Lenders Address oANm oaADM.r _ ^ M o' I certify that I have read this application and state that the above P.C.FEE 0 PERMIT FEE ✓�A I-+ information is correct I agree to comply with all county ordinances and State laws relating to building construction,and F hereby authorize presentativ of this County t0 enter upon ISSUANCE FEE .� e abo e-me art spection purposes. /�' 3 j P tr n .2'_ p INVESTIGATION FEE TOTAL FEE .ID \ f•.I �`� E.I DO— A114 -4rI �I CI 11, 1 ' SEE REVERSE FOR EXPLANATORY LANGUAGE• �'—R '— .. ' '-•' 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 0401090023 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST U D G ADDRESS: TR: 13531 LT: 16 SQ: FT STORIES TYPE - - 10212 LA ROSA DR - -- STRUCTURE: 140 VN TEMP CA 917803306 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: GLICKMAN 8585-014-007 -- THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY, C TENANT: BLDG USE: S 0 SE 0 E: R- S ED 0 0 S ED BY: EXPIRES ON: EXIST OCC GRP: 01/09/04 VG 01/03/05 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE: MA TONY;JENNY L (626) 579-4920- 4,000 /2? p(� 10212 LA ROSA DR TEMP 917803306 ES PAID DD SCP.I�� WO LEGALIZE EXISTING STORAGE BUILT WITHOUT PERMIT - 140 S.F. FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: PP ICAN TEL. NO: SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION REBID 4000.00 VAL 0.50 SPECIAL CONDITIONS: D2 PERMIT W/O EN-HC 4000.00 VAL 115.80 TOTAL FEES 144.05 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - LIC. NO LOCATION AND SETBACKS SOIL' 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 XX 3 01 FLOOR SHEATHING NG NO. OF FAMILIES: DWELLING NI S: APT/CONDI STAT CLASS: NO 21 ROOF SHEATHING SCHOOL WI HIN HAZARDOUS SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME INSPECTION REQUIRED TOTAL SETBACK RO EXIST I E SPRINKLER ANGE 5 SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- INSULATION/WEATHER STRIP SIDE PL- INTERIOR L- N E IOR LATH/DRYWALL EXTERIOR LATH RATED LOOR/CEI SS -M RATED WALL ASSEMBLIES RATED SHAF S/OP N NG T-BAR L ILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508