HomeMy Public PortalAbout10225 LA ROSA DR_Building__ 76A538A CEi8035-65 APPLICATION'. FOR BUILD N� G PERMIJ
COUNTY OF LOS ANGELES BUILDING j r
DEPARTMENT OF COUNTY ENGINEER ADOREss
BUILDING AND SAFETY DIVISION OCALI T
`w JOHN A. LAMBIE. COUNTY ENGINEER NEAREST - ,L
COLEMAN W. JENKINS,SUP'T OF BUILDING CROSS ST. /)
DIST CTN ,GROUP 'TYPE PROCESS BY
FOR APPLICANT TO FILL IN U- CONST. J
BUILDING (� / STATISTICAL ASSIFICATION SEWER MAP
ADDRESS �OS�,J �y d,S(j �(�. CLASS NO. DWELL UNITS BK /: PGz//
LOT NO. BLOCK USE ZO1�MAPv�TRACT 35 ! R-1SPECIAL
AL
C1
SIZE OF LOT JO K/yr NOOWOONeLOT Z
USE OF LSA srJ /AQ /
EXISTING T BLOC. SETBACK FROM
TEL // FRONT PROP. LINE OF (9T RE Et)
OWNER C O �
f"t NO. JJ TYPE OF E%ISTING SETB4CK HIOHWAY + YARD = TOTAL
ADDRESS O,f.y.S MIGHWgT WIDTH FROlMC.L.
CITY !/h /� �/,/ - 6D, . +
A RC HITEC OR TEl LDG. SETBACK FROM
ENGINEER '� NO. SIDE P ROP. LINEOF (STREET)
TYPE OF EXISTING' SETBACK HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM 0.L.
CONTRACTOR e ,o- NO +
LIC O
ADDRESS �O.S S. S LV OSr/ NO CORNER CUTOFF YES NO V
�.
cITYJ L�� - SEE REVERSE SIDE FOR SPECIAL APPROVALS 0'
DESCRIPTION OF WORK
NEW ADO I! ALTER REPAIR DEMOLISH
SO.FT. o NO. OF 'NO. OF b
SIZE 7 Q STORIES / FAMILIES
USE OF
STRUCTURE SC Cn /4
SIGNATURE OF -
APPLICANT '
VALUATION$ 4LO
APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. PMT. FOUNDATION, LOCATION _,
FEE ^j FEES AME, FIESTOPS,MATERIALSFRAME, FIRE FIRE STOPS, I
HEREBY THAT
THE
LABOVE THAT CORRECT
READ THIS APPLICATION BRACING BOLTS 2-ZO'dr
ANO STATE ACKNOWLEDGE
THE ABOVE IS CORRECT AND AGREE E COMPLY FURNACE: LOCATION
WITH ALL COUNTY TI.H. INCES AND STATE LAWS REGULATING GAS VENT. DUCTS `
AUTHORIZED
CONSTRUCTION. i CERTIFY EMPLOY
A N DOING THE WORK
TIONO F EO HEREBT 1 WILL NOT EMPLOY ANY PERSON IN RVIOLAELAT LATH. INT. AAn�J
TION OF THE LABOR COOS OF THE STATE OF CALIFORNIA RELAT-
IG ATURKMEN'S COMP ANC Ii
LATH. ENT. J
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE
ORPERMITTEE T RECT AND POSTED
ADDRESS 16SFINAL
JOHN F. LEWIS. PRINCIPAL ST AL ENGINE
PLAN CHECK VALIDATION CK. M.D. CASH PERMIT VALIDATIOr CASH
( 6 'S`5 12 OCT18 1 D 8.00~
Ar ;' _
A ROAD' DEPT. , PERMIT IS REQUIRED
FOP,.AN'Y ldAfERIAL.S-ORAGE OR-VVORI\`. .
PONE LK lU el" RIGHT OF.WAY.
7;Ae3a =Eg•e •e• APPLICATION FOR BUILDING 'PERMIT 1"
COUNTY'OF LOS ANGELES BUILDING. ' •�J O� C564-1 / _
• DEPARTMENT OF COUNTY ENGINADDRESS GL iEER
BUILDING AND SAFETY DMoSION. LOCALITY ' ( �2
+JOHN A. LAM SIE:COUNTYENGINEER NEAREST ...
- -CASSATT D. GRIFFIN SUPT OF BUILDING CROSS ST. , -
DISTRI O. GROUP TYPE PROCESSED BY
FOR APPLICANT TO FILL IN CONST. --
BUILDING - / //JJ _ STATISTICAL CLASS I FI CATION _ -SEWER MAP
ADDRESS ,/O Z2S /� "e} ISO r� - - BK '/PGGl
CLASS.NO.��JDWELL. UNIT � L .'T 4',9
LOT NO. •J BLOCK MAPNUMBER CP- HWSTANO'YES O�
TRACT .S l/ .• ' - USE ZONE ''SPECIAL. -
NO. OFBLDGS.';2_. .CONDITIONS
SIZE OF'LOT O � �� d NOW ON LOT /• _
USE'OF, _ -
EXISTING BLDG. /� LJI BUILD - EXIST. `
SETBACK WARD HWY �.'STREET NAME
WIDTH'
AzAW NER / - C_ / G� C., FRONT' . > !.p
MAIL
ADDRESS %L� / �SH SIDE ,
TEL P.L. -
clTr - f' No :. INSPECTION RECORD.' - -
ARCHITECT OR - TEL.
ENGINEER NO.
ADDRESS
-
CONTRACTOR 'TEL.
NO. -
ADDRESS• - -
DESCRIPTION OF WORK . e
NEW ALTER REPAIR DEMOLISH - -
SO. NO. OF - -
SIZE d- STORIES FAMILIES ,
USEOF
STRUCTURE
STRURE CQ_,11/ -
O e,
SIGNATURE OF
APPLICANT ' -
(� 'APPROVALS DATE - .INSPECTOR'S SIGNATURE '
ADDRESS / �/ FOUNDATION: LOCATION -
n �
FORMS. MATERIALS
VAL NATION $ �L�} I FRAME: FIRE STOPS ` U ` Y -
BRACING, BOLTS 1 l
P.C. PMT. FURNACE:'LOCATION, —
FEE $ I FEE $
s GAS VENT,-DUCTS-
."
ENT,-DUCTS'." I HEREBY'ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH. INT.
PLICATION AND STATE TH T THE ABOVE IS CORRECT AND
AGREE TO COMPLY WIT L COUNTY OR ANCES AND % - -
STATE. LAWS- REGULA G B DING STRUCTION. LATH, EXT. u
SIGNATURE OF .l ( HOUSE NUMBER COR _ -
I PERMITTE -u� RECT AND POSTED /
ADDRESS FINAL - . I - - `I � `'
CLYDE N. DIRLAM, PRINCIPAL STRU RAL.ENGINEER
PLAN:CHECS VALIDATION CK.'` M.o: .GA9R PERMIT VALIDATION : K m.0. CASH '•
'L. GO 5-II'•5 MAY 10 .1 A -- , 3.00. V
. A ROAD DEPT, F- frliT, ��3 Rxv
FOR ANY AAATE.-,!AL STG..-tAGF q�
`DONE IN THE ROAq R.iGKiQF
7A„aACx#...... APPLICATION FOR `BUILDING PERMIT 1:
1 COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ' ADDRESS Off' �y GoS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST / -
CASSATT D. GRIFFIN; SUPT OF BU110ING CROSS ST: C /7
DISTR19T NO. GROUP TYPE �y PR CESSED'BY J
FOR APPLICANT TO FILL. IN consT.
BUILDINGy STATISTICAL CLASSIFICATION _ _ SEWER MAP
ADDRESS O I -S �'�J' OS CLASS.NO.LDWELL.UNITS_O I �� Pzdz '
LOT NO. BLOCK MAP �T O �O STATE* YES NO
NUMBER O� HWY.
TRACT J-,3 USE ZONE SPECIAL I
NO.OF BLDGS. //,� CONDITIONS
SIZE OF LOT �o y /6'a NOW ON LOT
USE OF '
EXISTING BLDG. / O/ �/ G' BUILDING EXIST.
OWNER 1 G- S SFRONT,
wY(A'R�D. HWY 'STREET NAME ,744-- ,.
MAIL P.L. _
ADDRESS SIDE
TEL. P:L
CITY �� �' No.67 <//9 INSPECTION RECORD
ARCHITECT OW TEL. _
ENGINEER NO. _!o_G cv/�V
ADDRESS =� �T
TEL. -!7-� > r !'K 1�'l l 7- /t 7_Q / U - r:.,� V
CONTRACTOR _ / NO. �� Lr„
AODRESS SG / L�
DESCRIPTION OF WORK
NEW AD ALTER REPAIR DEMOLISH
SO. FT.. NO. OF NO. OF '
SIZE 3�T.O ' STORIES FAMILIES .
-USE OF _
STRUCTURE
SIGNATURE OF
APPLICANT -
_ /+ APPROVALS OTATE INSPECTOR'S SIGNATURE '
ADDRESS o�-s'S�. O✓�% C /G C'� FOUNDATION:
LOCATION
VALUATION S��a FRAME: FIRE STOPS, 6
BRACING,BOLTS,
FURNACE: LOCATION _ y
P.C. PMT .GAS VENT,.DUCTS
FEE S I FEE.
PHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH. INT.
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND _
AGREE TO COMPLY WITH,ALL-CIO0UNTY ORDINANCES AND
STATE LAWS REG T N B LD1 CONSTRUCTION. - LATH,EXT: I_' /•
SIGNATURE OF O-/7� HOUSE NUMBER COR-
PERMITTE RECT AND POSTED
ADDRESS Q9:�� sZ=goS G' FINAL. ' //- I+ti - - 7--�,
' - CLYDE N. DIRLAM, PRINCIPAL ST CT'RAL ENGINEER
PLAN CHECK{ VALIDATION CK. M.O. CASH PERMIT VALIDATION mo. CASH'
1�tJ:7. 3 0 9 AR ] _ 1 ,A 1 2.0 0 K®,
DEPARTMENT OF BUILDING AND SAFETY ! APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES B ® ® I e ® I N G
WM. J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN' FOR OFFICE USE ONLY
BUILDING {�+ ,I //n� DISTRICT NO. PLL/A/NI CK.NO. PERMIT NO.
ADD REBS I L /`tom/VC�� J•Y //'[-- �/ / V / /' - l�
LOCALITY RECEIIVVVEED BY /DATE OF APPL. DATE IBSSUED
NEAREST a wxfMOBS IT.
BUILD
NG r
OWNER - I / ADDRESS L- / l i Z,4 /VD y��✓/Z
MAIL _ LOCALITY /
ADDRESS _ NEA
REBT
CITY
� L CROB96T.
o.
FIRE O.OF- TYPE GROUP
ARCHITECT OR TEN
L ZONE PLANE 2� l7 /
ENGINEER NO.
BLOS. ^ ORD.NO.
ADDRESS �'^✓�" SETBACK LINE, fns / ��� ` GC r7 LI
APPROVED
TEL.
CONTRACTOR BY ~ DATE
UBE APPROVED,
ADDRESS ZONE /-/ BY DATE
LEGAL I CORRECTIONS
DESCRIPTION LOTNO. BLOCK
TRACT
BIZE OF LOT 2!d- I NOWW UN NOLOT //LDBB.AZ.�
_ ON �A. (/
EXISTING BLDG. FAM".-_
USE bF � cs NO.
ROOMS
DESCRIPTION OF WORK
NEW ALTERATION ADDITION
O
A
. REPAIR MOVING DEMOLISH 1 p
SNO or e
SIZE FT. / nifl ROOMS STORIES. ( >
A V
F
WALL ROOF .� f�1f�A�C
COVERING I COVERING /vim v r
USE NEW !
BUILDIDI NG
�!Q /
V �
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS ..APPROVALS -
APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION INSPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS ��
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
FRAME: FIRE STOPS,
SIGNATURE OF BRACING,BDLTS
PERMITTEE LATH.INT.:
AUTHORIZED AOT LATH.EXT.:
oe9-3 MM SETB 1-48 $ P.C.® PLASTER. INT.
FEE v/ VI/ PLASTER,EXT.
VALUATION •' V FEE ��l _ V FINAL d �/ T
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDI AOgRESS
BUILDING ADDRESS
1 hereby affirm that I have a certificate of consent to self insure,
or a certificate of Workers'Compensation Insurance,or a certified CITY ZIP
/ O
copy thereof(Sec.3800,Lab.C.) 'T LOCALITY
Policy No. Company A
SIZE OF LOT ,. ` J r NO.OF�BLD .NOW ON LOT -
❑ Certified copy is hereby furnished. x J NEAREST CR .
❑ Certified copy Is filed With the county building InspectionTRACT / BLOCK LOT NO.
department- USE ZONE MAP NO.
Date Applicant ASSESSOR P O PAOGEO PARUOELB
J SPECIAL CONDITIONS
CERTIFICATE OF EXEMPTION FROM WORKERS' YES NO
OWNER ' TEL O.
COMPENSATION INSURANCE ,*X� ���'� ��� WITHIN 1000 FT OF SCHOOL?
ADDRESS A
(This section need not be completetl if the permit is for one hundred /��2 S f�� Pe S'/I DISTRICT' - GROUP TYPE ST.' FIRE ZONE POC D BY n
(Thisdollarss($100)or less.) - �'(y�///
I certify that in the performance of the work for which this permit CI_J/ -^ IP / O /��
is issued, I shall not em to an l� 1 1'L
p y y pers0 any an OBS t0 ARCHITECT OR ENGINEER TEL.NO.
become subject to the ZrkeB'Com Sa n Q NL: ems_ STATISTICAL I KATION ONDO
Date Applicant ADDRESS CLASS NO. DWELL UNITS
NOTICE TO APPLICANT: If, after' making this Certificate Of CONTRACTOR TEL.NO. REQUIRED TOTAL SETBA KFROM EXIST
Exemption, you should become subject to.the Workers' _ �, SBACK YARD HWY PROP LINE WIDTH
Compensation provisions s the Labor Code, you must forthwith LFRONIT
comply with such provisions or.this permit shall be deemed revoked. ADDRESS -- LIC.NO.LICENSED CONTRACTORS DECLARATION clTv LIC. o
U
I hereby affirm that I am licensed under provisions of Chapter B - SEWER MAP
(commencing With Section 7000)Of Division 3 0}the Business and 50 FT. NO. STORES NO.O FAMILIES
Professions Code,and my license is in full force and effect. '''v �� NEW ❑ BK PG U
DESCRIPTION WORK ,
License Number Lia Class � Gd -r B.V ADDDoe ❑ $ TI w
Contractor
Date ALTER 4❑w Z
�`" �C 15 INC REPAIR ly1
❑ I am exempt antler Sec.
B.BP.C.for this reason DEMOL ❑
USE OF EXISTING BLDG. LDMA P/C x
Date: OY�E URM' 0
Signature APPLICANT TEL.Plg.
C1lLOMA Penn 11 — Z �'I�� O,','_`.
I, as owner of the property, or my employees with wages as
.their sole compensation, will do the work and the structure is ADDRESS - F 1 ITEN
D
not intended or offered for sale (Section 7044, Business and FINAL TE/� TOTAL m +�
Professions Code.) MLLTNEAPPLICANTORF REaU1LDINGCCCUPANTHANDLEAHXtAR BIMTERIAL
OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EOUAL TO OR GREATER THAN J C I" 93.63
❑ I, as,Owner of the property, em exclusively contracting with THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDES . IFl B 1 I u11� •'�E K
licensed contractors to construct the project.(Section 7044, YES❑ No (r v.;flf�{'�(]E
Business and Professions Code.) ,
WILL THE INTENDED WE OF THE BUILDING BY THE APXICANT OR FUTURE BUILDING -
OCCUMNT REOUIREA PERMIT FORCONSTRUCTIONOR MODIFICATION FROM THESOUTH ' q,�,:
ICONSTRUCTIONLENDING AGENCY COAST AIR OUAUTY MANAGEMENT DISTRICT SCAOMD)WE PERMITTING CHECKLISTr'Ir1 r, /_rFOR GUIDELINE ( fl-ADLIQO—JLILI}• 'S, 7/00I hereby aRlari thatthere is a construction lending agency forTEs❑ No 1 'l } I LI,I 7-12{_
the performance CIv. of the WOfk for Which this permit is issued(SBC. 1 HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD 1 I 225:- 1 A i �-li
3D87,Ci IV.ri.). PERMITTING CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES
Lender's Name COUNTYCODETITLEPpJ1APTER 2tOSELT10 MAWTHR000HZ21.MaCONCERNING
HAZARDOLAy'MATERI.�L'k CEPoRT ANOF G=AINING A PERMIT FROM THE SCAOMD. I
Lender's Address
o oANw DR r,Mo.T
o I certity that I have read this application and state that the above .1
information is correct. I agree to comply with all county P.C.FEE PERMIT FEE
ordinances and State laws relating to building construction,and D
hereby aulh0fj. y req/esentativW Of this County to enter Upon ISSUANCE E �1
. .the above- 4IT'6 ro dy r Inspection purposes.
INVESTIGATION FEE TOTAL FEE
� spawn anlvp.a m
- SEE REVERSE FOR EXPLANATORY LAN PAGE,
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 0703200016
PHONE: (626) 285-0488 EXT: -
ILEGAL ID: NO. OF CONST BUILDING ADDRESS:-
ITR: 13531 LT: 4 SQ. FT STORIES TYPE 10225 LA'ROSA DR•
STRUCTURE: VN TEMP CA 917803307
ASSESSOR INFORMATION NUMBER: '. NEAREST CROSS STREET:
18585-006-004 THOMAS PAGE: 597 GRID: B4 LOCALITY: -TEMPLE CITY, Cl
TENANT: IEXIST BLDG USE: RESID USE ZONE: R-1 IISSUED ON: PROCESSED BY: EXPIRES ON:
IEXIST OCC GRP: 103/20/07 JK 03/14/08
(OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: I FINALEIPVEFINA CODE:
IROGERS DALE F;RUTH M (626) 444-6117- I' - -. - 6,230 ( Fly
110225 LA ROSA DR - IP-�" 1:4
ITEMP 917803307 FEES PAID (DESCRIPTION OF WORK
WINDOW REPLACEMENT 11 WINDOWS
IEEE DESCRIPTION: QUANTITY: UOM: AMOUNT: (
(APPLICANT: TEL, NO I I
BRANSON SASH 6 DOOR (626)' 334-9318- IAA BLDG PERMIT ISSUANCE 27:75 1 - 1
116343 ARROW HWY IAC STRONG MOTION RESID 6230.00 VAI 0.62 SPECIAL_ CONDITIONS: -
1RWINDALE, CA.91706 - ID2 PERMIT W/0 EN-HC 6230.00 VAI, 166.20
TOTAL FEES 194.57
CONTRACTOR: TEL. NO: .(APPROVALS DATE INSPECTOR SIGNATURE
BRANSON SASH L DOOR (626) 334-9318-
I1643 ARROW"HWY LIC. NO (LOCA^_ION AND SETBACKS
IRWINDALE, CA 91706 577107 B
- ISOILS ENGINEER APPROVAL
ARCHITECT OR ENGINEER: TEL N0: FOUNUAT ION/TRENCH FORMS
LIC. NO: (SLAB:/UNDER FLOOR
RAISED FLOOR FRAMING
(MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:l UNDERFLOOR INSULATION
1147H273 3 O11 -
(FLOOR SHEATHING
N0. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: 1 -
NO 21 IROOF,.SHEATHING
SCHOOL WITHIN HAZARDOUS (SHEAR PANELS
AIRQUALITY: 1000'FEET MATERIALS I NO NO NO FRAME INSPECTION
REQUIRED TOTAL SETBACK FROM EXIST - (FIRE SPRINKLER HANGERS
ISET BACK YARD: HWY: PROP LINE: WIDTH:
IFRONT PL- (INSULATION/WEATHER STRIPI
SIDE PL- 1 11
(INTERIOR LATH/DRYWALL -
EXTE:3IOR LATH
RATED FLOOR/CEIL ASSEM.
• .. RATED WALL ASSEMBLIES
(RATED SHAFTS/OPENINGS
I I IT-BAR CEILINGS. I I I
I
ILOT DRAINAGE I I
REPORT ID: DPR261 ROUTE TO: BS0508
1 I i I I I