HomeMy Public PortalAbout9921 LA ROSA DR_Building__ tvE}e;5Ae38 �� � �I
cc/803e/Zer Irv' // l C111t3
APPLICATIONcgOR BUIG PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUDDING
_ ADDRESS ,;,t, _ LC,. Q. —iBUILDING /
ADDRESS i LOCALITY
NEAREST
CITY L /T� ZIP �?17YOmss ST.
NO,OF BLDGS �7 ASSESSOR
SIZE OF LOT
(j2uQ�Q / NOW ON LOT C 2_ MAP BOOK PAGE PARCEL
O BLOCK LOT NO. DISTRICT GROUP TYPE FIRE
ZONE P CES BY
TRACT
TEL. yj
OWNERCJLC F L NO
STATISTICAL CLASSIFICATION ER MAP
ADDRESS I S CLASS NO. '� / DWELL.UNITS (iC BK11 6G
CITY (, (j ZIP @
ENGINEER
TEL. 7-C22106VALUATION Y� �
ENGINEER NO.
ADDRESS Ei BLDG.SETBACK FROM
TEL FRONT PRO P.LI NE OF ISTREETI
CONTRACTOR NO. HIGHWAY + YARD _ TOTAL SETBACK FROM TYPE OF E%ISTING
LIC. FRONT PROP.LINE HIGHWAY WIDTH
ADDRESS �� NO.
LIC. +
CITY — CLASS
CONSTRUCTION LENDER BLDG.SETBACK FROM
NAME AND BRANCH SIDE PROP.LINE OF (STREET)
HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING G
ADDRES CITY SIDE PROP.LINE HIGH WAV WIDTH Q'
SQ.Fi. _ NO.OF NO.OF CHECK + = V
SIZE. STORIES FAMILIES ONE ' O
DESCRIPTION OF WORK 17, NEW ❑ P.C. Fee S 166'4 d Permit Fee
ADD % Issuance Fe / N
ALTER ❑ n l
1y REPAIR El - Total Fee / K/
U6wlQ �'ErjK'i¢T D OL EJEXISTING BLDG. Z
APPUCANT ay o -27 9 S 3,A
IPRINTt i.
3 o peeee23
BY ISIGNATUREI _ ~ 2 0 a;e 7,2 O
1 HEREBY ACKNOW DGE THAT I HAVE REA HIS APPLICATION AND STATE / � / mU
THAT THE ABOVE IS CORRECT AND AGREE TO OMPLY WITH ALL ORDINANCES y' /`�•' e (�N.. W O O e e 7.2 O U
AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE S
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF u
1
THE LABOR CODE OF THE STATEOFCALIFORNIA IN RELATING TO WORKMEN'SCOM- p y" 7� Z1.2 6,-7 9G
PENSATION INSURANCE. J
s
SIGNATURE OF
PERMITTEE :97954A
ADDRESS 27A Z 44 AFKJA7 163�0
0
EL
✓ . Z
CITY NO. p 2 - 22300
USE ZONE rSP71ALOP t� 0 / Ge e e 2 2 3 0 0
/ TONDITIONS f r
FINAL
DATE
Tewnsaw Dncq s.aa
APPLICATION FOR BUILDING PERMIT 1
DIVISION OF BUILDING AND SAFETY AO DRESS 6 g, D
Department of County Engineer
County of Los Angeles LOCALITY 1
VIM.J. FOX, COUNTY ENGINEER NEAREST pP
CASSATT D. GRIFFIN. SUPnT OP BUILDING CROSS ST. AJ 1.'-+
DISTRIC NO. GR UP I TYPET 1/ ISE BER K MA PO
FOR APPLICANT TO FILL IN ��
:::777 CONST.
BUILDING 7/ / � ��� o hl NUMAP MBER Q/ HWY YES NO
ADDRESS / C /
6
LOT NO. I+rzf / D F USE ZON SPECIAL
BLOCK CON DITIONB
TRACT 9481. �1 A-
NO. OF SLOGS. BUILDING EXIST.SIZE OF LOT- 5r5 D I NOW ON LOT SETBACK YARD HWY STREET NAME WIDTH
EXISTOINUSE
O BLDG. -r re [ FRONT
_}'' T r1 P. L.
OWNER O / / Cy4 G' SIDE
MAIL /y q qq �/1 P. L.
ADDRESS / % OL-/ �r1. (/V (( i O TRACT DWELL. 1 UNIT
T 5 INDUSTRIAL
I I ^/'- TEL 1 DWELL. 1 UNIT
CITY [ 1 l NO. PUBLIC BLDG.
ARCHITECT OR TEL. 2 DUPLEX 1 UNI 7 DDN., ALT.. ETC.
ENGINEER NO. 3 APT. _UNITS
8 M19CEL.
AD�RppE//SS 4 COMMERCIAL
TRACT i r. 1,ET, (o NO. ), �Sa% INSPECTION RECORD
ADDRESS
a3 _ l I
DESCRIPTIO"F WORK
NEW HADD ALTER REPAIR DEMOLISH
90. FT. NO.OF- NO. OF
SIZE STORIES FAMILIES
USE OF STRUCTURE / --
a �i a o ve �
SIGNATURE OF
APPLICANT APPROVALS
ADDRESS /
D Z2u ( C DATE INSPECTORS SIGNATURE
FOUNDATION: LOCATION
$ ®®Oa P. C. S FORMS. MATERIALS
FEE FRAME: FIRE STOPS.
VALUATIONS
it O 0 BRACING.BOLTS
FEE `'P'® FURNACE: LOCATION,
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GAS VENT, DUCTS
APPLICATION AND STATE SHAT THE AB VE 19 CORRECT
AND AGREE TO COMPLY T_H ALL CO TY,yORDINANCES LATH, INT.
AND STATE LAWS RE ELATING BUI CONSTRUC-
TION. v l/`
LATH.EXT.
SIGNATURE OF ��j HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
I
ADDRESS O FINAL
VVM.J. FOX,COUNTY ENGINEER VALIDATION C. N. DIRLA . CHIE O
MI 9 8-0' JAN 17 1 4.0 O �
`A'APR 22 1954 �yZ
^I�/• 1 ® I w BUILDING
ADO ESS
APPLICATION LOCALI i
DIVISION OF BUILDING AND SAFETY CROSSNEAREST
NEARE BT. �V
Department of County Engineer DISTRICT NO. RECEIPTT NO. PERMIT NO.
County of Los Angeles ��— �Q O Cf
/ 7
WM. J. FOX, COUNTY ENGINEER GROUP DATE RECEIVED ATEISSUED
CA69ATT D. GRIFFIN, Suver of BUILDING ///Z2/5 /� V )•J /l
FOR APPLICANT TO FILL IN TYPE CONST. Zae BY ��BH�uE�o BY
OWNER :�r MAP �O�/ V $TATE YES O
MAIL O� NUMBER (ham HWY
ADDRESS
i U9EZONE SPECIAL
TEL. Q CONDITIONS
,ARCHITECT OR TEL. WD
ENGINEER NO.
BUILDING YARD HWY STREET NAME EXIST-
SETBACK WIDTH
ADDRESS /J
FRONT
TEL P.L.
CONTRACTOR NO.
SIDE
ADDRESS
BUILD
IND A DATE ` ICORRECTIONS INSPECTOR
ADDRESS I'r .T/J�ylr.�/ Nw r• d 'J4W GCLH-.-.�_
LOT NO. S3 ' BLOCK
TRACT •7 O
NO. OF SLOGS. / zy A I /A/ • G hG9 AC
SIZE OF LOT.73'13 2 �y I NOW ON LOT
USE OF F2/L / wTOP•• .rl" /N ISO T'LOAU
EXISTING BLDG. /
�m vT �ietc..
DESCRIPTION OF WORK °x
NEW ADD ALTER REPAIR DEMOLISH Z
BO.FT. NO. OF NO,or T ,G.vs S F.o u✓ -yn r
SIZE STORIES FAMILIES
USE OF STRUCTURE cQ
may— QFC T Qn✓A/ L.J
NO.OF
EMPLOYEES '
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP-
PLICATION AND STATE THAT THE INFORMATION GIVEN IS APPROVALS INSPECTORIS SIGNATURE DATE
CORRECT. - ✓ / /
I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION:MATERIALS.LOCATION
AND STATE L 'V%B/OREGULATING WITH
BUILDING/�/U �CynONS1DINANCE FORMS,MATERIALS
E_C/� r�"> / N`- FRAME:FIRE BTOPH.
SIGNATURE OF 'pJ'{�//p [/ ^� - /BRACING,BOLTS / // .ar /�✓ ��
PERMITTE FGALOCATION,S VENT.DUCTB /
ADDRESS /f) -:�:? `�' ! r
LATH. INT.
AUTHORIZED ACT.
p. LATH, EXT.
$ � /O pOQQ p P.C.IB UGC MOUSE NUMBER COR.
s FEE 2- RECTANDPOSTED / rAw'`� c�
VALVA ON QQD FEE 62 6 FINAL
_
96A63BA DB5 3 12-53 '
APPLICATION FOR BUILDING PERMIT
_ COUNTY OF LOS ANGELES +—` BUILDING AND SAFETY u
WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILG�RF,ss ,%
I hereby affirm that I have.a certificate of consent to self insure,
BUILDING DDRESS / /��d�e<�
or a certificate of Workers' Compensation Insurance,or a certified e ' q
copy thereof(Sec. 3800,Lab.C.) CITY ZIP
O� LOCALITY /
Policy No. Company SIZE OF LO // NO.OF BLDGS.NOW ON LOT
El Certified copy is hereby furnished. GqT//D Z NEAREST CROSS ST. .01
❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO.
department. USE ZONE AMP �
Date Applicant ASSESSO B K PAG PARCEIr
�' �=(J SPECIAL CONDITIONS
CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER ',`f(,,,r` F/y�(,' Lo H TEL No.
C —� _0 6 WITHIN 1000 FL OF SCHOOL? YES No
COMPENSATION INSURANCE v
(This section need not be completed if the permit is for one hundred ADDRES �q
dollars ($100)or less) �- L% / DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED By
CITY ZIP ^ I � �� , /
certify that in the performance of the Work for which this permit t/..N�.l ..� ---
is issued, I Shall not employ any person in any manner so as t0 ARCHITECT OR ENGINE - TEL N .
become subject to the Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT CONDO
Date Applicant ADDRESS CLASS NOI DWELL UNITS
NOTICE TO APPLICANT: If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST
Exemption, you should become subject t0 the Workers' CONTRACTOR '' I ' TEL NO. SET BACK YARD HWV PROP LINE WIDTH
Compensation provisions of the Labor Code, you must forthwith A—"11 (N FRONT
comply with such provisions Or this permit shall be deemed revoked. ADDRESS LIC.NO. P L
LICENSED CONTRACTORS DECLARATIONSIDE
CITY UC.CLASS P L
I hereby affirm that I am licensed underprovisionS of Chapter 9 SEWER MAP
(commencing with Section 7000)Of Division 3 Of the Business and SO.FT.SIZE NO.OF STORIES NO.OF FAMILIES
Professions Code,and my license is in full force and effect. NEW ❑ BK PG , - d
License Number I Class D
GRIP ION OF WOR ADD ❑ VALUATION O
Contractor Date ./ -" ALTER ❑ $ 'POO.00 U
yZLy 70/G 7D/.l#f0/7' REPAIR ❑ $ OF
❑ 1 am exempt under Sec.
B.BP.C.for this reason DEMOL ❑ CDMA PIC# O
W
Date: us snN BLDG. URM ❑ LL
APPLICANT( T) TEL NO. LEVIPerm# 23
Signature Z
I"I I, as owner Of the property, or my employees with wages as O ACCT.-,
their sole compensation, will do the work and the structure is ADDRESS
not intended or Offered for Sale (Section 7044, Business and FINAL DATEA.
G 3303 50.50
Professions Code.) WILL THE APPLICANT OR FUTURE HAZARDOUS
APERIANT HANDLE A HAZARDOUS MATERIAL J
1
❑ 1, as owner of theproperty, am exclusive contracting with ORA MIXTURE COMAIN THE
A HAZARDOUS
MATERIAL EQUAL TO OR GREATER THAN THE
Y g AMOUNTS SPECIFIED ON THE H/SPAWU$MATERNL$INFORMATION GUIDE? FINAL BY �A//////((.��.�� ♦♦
5-
licensed contractors to construct the project (Section 7044, YES NO 2�2•PiJ '
Business and Professions Code.) ' J
WILL THE INTENDED USE MI THE SUIDUNG BY THE MODIFICATION
OR FROM T BUILDING
OCCUPANTOASTIR REQUIRE A PERMIT FOR CONSTRUCTION OTION OR MODIFICATION FROM THE SOUTH
CONSTRUCTION LENDING AGENCY COAST AIR OUAUTV MANAGEMENT DISTRICT ISCAOM01 SEE PERMITTING CHECKLIST FOR ITEMS q
GUIDELINES. � 6 ITEMS
I hereby affirm that there is o construction permit
lending agency for res❑ No❑ 1.11Lbf 2939
tfl2 performance Of tflO Wolk for which thl$pefmlt l5 l$$VEd(Sec. HEAVE READ THE HAZARDOUS MATSTALSINFORMAPON GUIDE AND THE SCAOMD PERMITTING ' A1.11/iL�
3097,Civ.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE 1
TITLE 2.CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20 140 CONCERNING HAZARDOUS
3 Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCA NO �•
a. Lender's Address Cuw`Lrt• •DO
o
.1.CU AcErT
o I certify that I have read this application and state under penalty
of perjury that the above information is correct. I agree t0 comply P.C.FEE ' SjT PERMIT FEE �O—�Q 1 E/21I9S
with all county ordinances and State laws relating to building o'( 92
m Construction, and hereby authorize representatives of this County ISSUANCE FEE ij y 3 0ip{J 17 1 AM E:J7
to enter upon the ve-me need p/{ypeFly for inspection purposes. /O�C�$/ p' J�
INVESTIGATION FEE TOTAL FEE
SEE REVERSE FOR EXPLANATORY LANGUAGE
CORKERS' COMPENSATION DECLARATION
`I sure, or
certificate
I have W Workers'
ome of consent to self APPLICATION FOR BUILDING PERMIT
insure, or a certificate of Workers' Compensation Insurance,
o'a certified_ropy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY
Plicy No. _ Company
Certified co is hereby furnished. FOR APPLICANT TO FILL IN BUILDING
r , copy y ADDRESS
Ll Certified copy is filed with the county building inspec- BUILDING •7 a
tion department. ADDRESS r�
r^
Date -r2 ?:!VAppllcant ITY /y� LE l T ZIP '717&50 LOCALITY G
NO. OF BLDGS. 7 NEAREST
CERTIFICATE OF EXEMPTION F OM WORKERS' SIZE OF LOT S X O NOW ON LOT CROSS ST. 67
COMPENSATION INSURANCE / ASSESSOR p /7
(This section need not be completed if the permit is for one TRACT BLOCK LOT NO.�P MAP BO
0 FXrl
OK ..r / PAGE OC PARCEL
hundred dollars ($100) or less.) TEL Q p USE ZONE MAP'
/L��
OWNER NNO 7
I certify that in the performance of the work for which this ® �//ma�y_�
permit is issued, I shall not employ any person In any manner ADDRESS /`-� / CONDITIONS C:�C'L'C-G d
so as to become subject to the Workers'Compensation Laws. - QQ
' CITY ZIP
Date Applicant ARCHITECT OR 1 TEL may- 0
NOTICE TO APPLICANT: If, after makingthis Certificate of ENGINEER LLC NmZ �0.� DISTRICT GROUP TYPE FIRE PROCESSED BV
CONST. ZONE Q
Exemption, you should become subject to the Workers'
Compensation provisions of the Labor Code, you must forth- ADDRESS ��OF V a
With comply with such provisions or this permit shall be ' TEL STATISTICAL CLASSIFICATION APT. CONDO.
deemed revoked. CONTRACTOR /L LLNO. z
LICENSED CONTRACTORS DECLARATION DC. - CLASS NO. -V1 DWELL. UNITS_
I hereby affirm that I am licensed under provisions of Chapteri? ADDRESS NO.
(commencing with Section 7000)of Division 3 of the Business LIC. SEWER MAP
CITU CLASS VALIDATION
and Professions Code,and my license is in full force and effect. BK. PG.
50. FT. NO. OF FA OF CHECK
License Number �� i Class SfZE STORIES FAMILIES ONE
VALUATION
DESCRIPTION OF WORK NEW ❑ 70 d, aL,p
Contractor .ADD ►
❑ am exempt under Sea ALTER ❑
B.&P.C. for this reason
REPAIR ❑ $
Date: E OF
EXISTING BLDG. DEMrOL ❑
Signature APPLICANTPNT)L71 �� //t J FINAL
OWNER-BUILDER DECLARATION DATE
I hereby affirm that I am exempt from the Contractor's License �sW 1
Law for the following reason (Section 7031.5, Business and ADDRESS /3 r/ FINAL 4 i
ProfQssions Code): PRESENT By �.T -
L�iJf BUILDING
I, as owner of the property, or my employees with ADDRESS
wagesastheir sole compensation,will do the workand
the structure is not intended or offered for sale(Section LOCALITY , 1 T'_j+l:_:
❑ 7044, Business and Professions Code.) MOVING TEL. 43
I,as owner of the property,am exclusively contracting CONTRACTOR NO. (PTAL 243 - 13
with licensed contractors to construct the project (Sec- ADDRESS ! , -" y.-„1,
tion 7044, Business and Professions Code.)
CONSTRUCTION LENDING AGENCY REQUIRED YARD HWV TOTAL-SETBACK FROM EXIST. f�I,lf'R'lI,�
SET BACK PROP. LINE WIDTH il]i_
I hereby affirm that there is a construction lending agency for FRONT - I
the performance of the work for which this permit is issued P.I.
(Sec. 3097, Civ. C.). SIDE
P.L.
1 Lender's Name '
4 -'_ '?
9 �,5 / LDMA Ref. # 71110 1 1-i 1 f'7
P.C. Fee S Permit Fee a+T/
Lender's Address
b I certify that 1 have read this application and state that the Issuance Fee `�'" LDMA P/C R
3 above Information is correct. I agree to comply with all County Investigation Fee /�
Z ordinances and State laws relating to building construction, Total Fee LDMA Perm. #
and hereby authorize repre nt of this County to enter
u above-m tan pr for inspection purposes.
J
SEE REVERSE FOR EXPLANATORY LANGUAGE
ignature of Appli I or Agent Date `
COUNTY-OF'LOS ANGELES TEMPLE CITY "- N 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS - 9701 LAS TUNAS ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0506 0510190059
PHONE: )626) 285-0488 EXT:
LEGAL ID: NO. OF CONST BUILDING ADDRESS:
IS: 9481 LT: 6 UN: .002 SQ. FT STORIES TYPE 9921 LA ROSA DR
STRUCTURE: 3000 VN TEMP CA 917803923
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: AGNES
8589-007-009 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY, C
TENANT: EXIST BLDG USE: REBID USE ZONE: R-1 ISSUED ON: PROCESSED BY: EXPIRES ON:
EXIST OCC GRP: 10/19/05 JK 10/14/06
OWNER: TEL. N0: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE:
LOH WAYNE;RUSSLE;CHUNG-HUNG (626) 285-1716- 6,000
9921 LA ROSA DR }
TEMP 917803923 FEES PAID DESCRIPTIO
TEAR OFF AND RE-ROOF WITH NEW PLYWOOD AND COMPOSITION
FEE DESCRIPTION: QUANTITY: DOM: AMOUNT: SHINGLES
APPLICANT: TEL. NO:
SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75
AC STRONG MOTION REBID 6000.00 VAL 0.60 SPECIAL CONDITIONS:
D2 PERMIT W/0 EN-HC 6000.00 VAL 149.40
TOTAL FEES 177.75
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER -
LIC. NO LOCATION AND SETBACKS
SOILS ENGINEER APPROVAL
ARCHITECT OR ENGINEER: TEL. NO: POUNDATION/TRENCH FORMS
LIC. NO: SLAP/UNDER FLOOR
RAISED FLOOR FRAMING
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION
147H269 3 01
FLOOR SHEATHING
NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS:
NO 21 ROOF SHEATHING c ��
SCHOOL WITHIN HAZARDOUS SHEAR PANELS
AIR QUALITY: 1000 FEET MATERIALS
NO NO NO FRAME INSPECTION
REQUIRED TOTAL SETBACK FROM EXIST FIRE SPRINKLER HANGERS
SET BACK YARD: HWY: PROP LINE: WIDTH:
FRONT PL- INSULATION/WEATHER STRIP
SIDE PL-
INTERIOR LATH DRYWALL
EXTERIOR LATH
RATED FLOOR/CEIL ASSEM.
RATED WALL ASSEMBLIES
RATED SHAFTS/OPENINGS
T-BAR CEILINGS
LOT DRAINAGE
REPORT ID: DPR261 ROUTE TO: BS0508