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HomeMy Public PortalAbout10124 LANDSEER ST_Building__ 76•!38.CIE#Box-1.g, APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER 4DDRESS BUILDING AND SAFETY DMSION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST. FOR APPLICANT TO FILL IN DISTDI ICT N GR TYPE R S BY . D CONST. Qi BUILDING', l / STATISTICAL CLASSIFICATION ADDRESS / Q/I�rsP�f VeI.SEWERMAP BK PG • 7 CLASS.NO. D DWELL:UNITS LOT NO. / BLOCK WATERNOT REQUIRED❑ RECEIVED CERTIFICATE TRACT 96,5_2Z MAPHIGHWAY STATE*MAJOR SECOND LOCAL NO.OF BLDGS. NO (CIRCLE) SIZE•OFLOT NOW ON LOT N� USc ZOf1E SPECIAL USE OF - / CONDITIONS' EXISTING BLDG. y+ J TEL OWNER NO. 1' S BUILDING EXIST. e� ,{� ..•�� h SETBACK YARD HWY, STREET NAME WIDTH ADDRESS'86'32`G• �S { (,lH4f� L/�^•r FRONT ARCHITECT OR• - TEL. P. L. ENGINEER NO. I SIDE ' P.L. ADDRESS - TEL INSPECTION RECORD a CONTRACTORJ.Fld !r NO. 7 I ou ADDRESSR�7G^C .L.fFS; .�� yl,, / � • - � DESCRIPTION OF WORK �� ; f' !;' Fi` / ';` o,-. NEW � ALTER . REPAIR DEMOLISH I U •,�' J [� - r - y SQ. FT. NO.OF NO.OF !A r '...�.•yl?. r 1' Z IZE ^1) STORIES FAMILIES USE OF STRUf=RE r- oe /: SIGNATURE OF. ' APPLICANT ° VALUATION ' APPROVALS DATE INSPECTOR' SIGNATURE [ FOUNDATION: LOCATION F E $ nJ FEE $ r— FORMS, MATERIALS FRAME: FIRE STOPS, nn JpJU} •I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS ► l,t ,r �A. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, �` ��- '`"'�/l� WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS- I /A BUILDING CONSTRUCTION. ICERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERS O IN VIOLA- LATH, INT. TI 0N;OF'THE LABOR CODE OF THE STATE OF CALIF NIA RELAT- {{ d I ING TO WORKMEN'S COMPENSATION INSSUUURRANNCCg LATH.EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTEE - RECT AND POSTED ADDRESS LQ FINAL CLYDE N. DIRLAM, PRINCIPAL STR AL ENGINEER PLAN CHECK VALIDATION cK. I.O. CASH PERMIT VALIDATION cK M.c. CASH L o .1 93 SEN '?'72 3 D 2 2 .5f, a: 3../7 4 0 OCT t�o. 1 D 4 5 .0 0 M WORKERS"COMPENSATION DECLARATION or � r. - APPLICATION -FOR BUILIDIIVG PERMIT 1,hereby'affirm that-1 have a certificate ofvconsent to self insure, or a certificate of Workers' Compensation,lnsurdnce, or a certifiE;&copytb'ereof (Sec.3800,'L CI , i C - � :1., .r COUNTY OF LOS ANGELES BUILDING,AND•SAF TY Pol cy N Company:• - - _ - - Certified copy is hereby furnished. FOR APPLIC T T FILL IN BUILDING - ���`l ADDRESS Certified copy is filed'with'the*c �unty butlding'inspec- BUILDING i ;• - { do department. �' ADDRESS , Date' App CITY ZIP G' I t LOCALITY' I,ioi CERTIFICATE OF EXEMPTION FROM WOR RS'. - NO. OF BLDGS NEAREST: ' COMPENSATION'INSURANCE SIZE OF LOT NOW ON LOT I CROSS ST - (This section need>not•be'cornple'ted tf+the permit is'for,one - ASSESSOR hundred dollars ($100)or less..) •, -r. n TRACT BL CK LOT NO 1 MAP-BOOK' T PAGE I PARCEL �� -��,, TEL USE ONE MAP OWNER LuLvk' NO ��. �. I•certrfy•that m ihe_.peiform_ ante of the work for-which'•this NO I} - permit is'is'sued, I`shall':not employ any person in any manner - SPECIAL- -s' PECIAL- so'aa to,become s6bject.to the Workers'-Coinpensation Laws. 'ADDRESS' Q f CONDITIONS d', '0 l\,.LP•s . c Y SJ CITY" ZIP .Z• tag Date Applicant' ^+ NOTICE'TO APPLICANT:`If, diter' making`this'Certificate of ARCHITECT OR TEL. DISTRICT _ GROUP TYPE_ __ - "-'_FIRE •: PR ESSED• t O ENGINEER NO. 13, Exemption; you�t•should become•subject to•the*, Workers' ' CONST ZO E 1 Com ensation Provisions of:the LaborCode,,'ou must.forth- W P P Y ADDRESS . with•comply with such provisions or.this=permit shall-be - - H deemed,,revok_ed:;', ' TEL STATISTICAL CLASSIFICATION ; L APT NDO `' t Z. S CONTRACTOR NO -LICENSED CONTRACTORS DECLARATION ..• =• - LIC / CLASS NODWELL•UNITS I hereby.afftrm that!,am licensed under pr'ovisions'of Chapter 9 ADDRESS t NO� 6 �) L (commencing with Section 7000)of Division-3 of the Business;and• __ - _ _ SEWER MAP Professions Code, and m license'i's,`in full`foicetarid effect LIC.Y - _ y CITY �' CLASS y� t' F' VALIDATION' r-. :,•.,r..� •-. r a•r i BK. PG. 1� SQ FT NO OF NO OF CHECK t License Number Lic.Class-`T SIZE STORIES FAMILIES ONE + i -sv•• VALLI TION _ ,� DES IP ION OF WORK - (� NEW •-❑ -„ 1' Contract; ate ADD ❑ S �i } ❑'I am exerr(tpt under ec. , - - r ALTER~ ❑ .REPAIR USE OF i Date' EXISTING BLDG DEMOL ❑ _ _ r ' Signature APPLICANT• -TEL FINAL" OWNER-BUILDER DECLARATION PRINT NO DAT 1,hereby affirmihat I am exempt from th_e.Contractorfs.License CL Law for the followirig_reason (Section 7031.5, Bustness`'and ADDRESS FIN' t` - ,4" ! o '8}I•,Y;d'•? .Professibns•Code):' PRESE By/ e..e 873BUILDING8 1, as owner of-the pjoperjy, or m em to ees• with ADDRESS - s_. _ wages as'tlietr sole compensation,will do the work and the structure is not intended or-offered for-sole(Section LOCALITY ! 7044; Business and Professions Code). MOVING' " -TEL. = -_ 0,1L.2 2,-8 7.' t CONTRACTOR' NO ❑ ' I; as owner of the property, am exclusively contracting - wtth'licensed contractors to construct the project (Sec- DRESS hon 7044, Business and Professions Code). :_,REQUIRED -TOTAL SETBACK _ - - CONSTRUCTION LENDING AGENCY SETBACK YARD HWY PROP LINE WIDTH: I hereby affirm that the're'ts a constructhom,lendmg agency for - FRONT -the performance of--the work for-which this permit is issued - . '-"P L - - - - (Sec. 3097, Cry C.)^ SIDE -_ � -' -- - PA e. Lender,'s Name LDMA Ref # •k �..• .. P C-Fee-$ w._ _ -' Permiff6e �• _,.. _ _ - - _ - i^ r Lender's Address > = _I.certify-that-I.have.read this application and state that.the _- ._. Issuance•Fee• - LbMA•P/C-# above information is correct. I agree to comply with all County Investg5tron Fee g ordinan gs and State laws relattng.to building construction, _ - - - Total-Fee -LDMA-Perm.-# u and eby author representatives of this Count to enter r - T y up e a m tione�property for inspectio purposes. a -ff SEE REVERSE FOR EXPLANATORY LANGUAGE _ a -. ^Sign urof pplicant•or,Agent - .• - - •..°Date'-•_ 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 1108160062 PHONE: (626) 285-0488 EXT- ILEGAL ID: I NO. OF CONST I BUILDING ADDRESS: ITR- 26522 LT: 17 I SQ. FT STORIES TYPE 10124 LANDSEER ST I (STRUCTURE: 25 V-B I TEMP CA 917803340 1 (ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: 1 18585-003-031 I I THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY, Cl I I I I ITENANT: IEXIST BLDG USE: RESID USE ZONE: R-1 IISSUFD ON: PROCESSED BY: I 1EXIST OCC GRP: 108/16/11 SR I I I I I 1OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: IF TE FIN BY. CODE: 1 ILAI, ROLAND (323) 268-1368- 1 8,800 1 1237 SEGOVIA AV I I ISGAB 917752945 1 FEES PAID JDAtCRIPTION OF WORK I IT/O EXISTING ROOFING MATERIAL, INSTALL OSB.PLYWOOD & MONIERLI 1 IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: IIFE 'ISLE DARALITE SHAKE SMOKEY #3958, 5.8i,,IPSFT ICC #1647 1 (APPLICANT• TEL. NO: I IHOUSF & GARAGE I ISUNSHINE ROOFING (909) 598-8988- IAA BLDG PERMIT ISSUANCE 27.80 I IAB STATE GREEN BLDG FEE 8800 00 VAL 1.00 ISPECIAL CONDITIONS: I IAC STRONG MOTION RESID 8800.00 VAL 0.90 I ID2 PERMIT W/O EN-HC 8800.00 VAL 200.30 1 I I 1 TOTAL FEES 230.00 1 1 (CONTRACTOR: TEL. NO: I 1APPRGVALS DATE INSPECTOR SIGNATURE 1 ISUNSHINE ROOFING INC. (626) 581-7688- 1 1 1516 N DIAMOND BAR BLVD #183 LIC. NO 1 (LOCATION AND SETBACKS .I (DIAMOND BAR, CA 91765 755126 C39 I I I 1 1 ISOILS ENGINEER APPROVAL I I I I I I 1ARCHITECT OR ENGINEER: TEL. NO: I IFOUNDATION/TRENCH FORMS I I I LIC NO: I !SLAB/UNDER FLOOR I I I I I I I I IRAISED FLOOR FRAMING 1 I I IMAP NO: SEWER MAP BOOK. PAGE: FIRE ZONE:" CMP I 1UNDERFLOOR INSULATION I I 1147H273 3 001 1 11 1 I I IFLOOR SHEATHING I INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I 0 NO 21 1 (ROOF SHEATHINGI I I I 1 Yb SCHOOL WITHIN HAZARDOUS 1 ISHEAR PANELS I I I 1AIR QUALITY. 1000 FEET MATERIALS I I I I I 1 NO NO NO 1 (FRAME: INSPECTION I I I I I I I I I IFIRE SPRINKLER HANGERS I I I I I I I I 1 (INSULATION/WEATHER STRIPI I I I 11 I I I 11NTERIOR LATH/DRYWALL 1 I I I I I I I I IEXTERIOR LATH I I I I 11 1 IRATED FLOOR/CEIL ASSEM. I I I I I I I I IRATED WALL ASSEMBLIES I I I I I I 1 I R-ATED SHAFTS/OPENINGS 1 I I I I I I IT-BAR CEILINGS 1 I I I I I I ILOT DRAINAGE I I I I I I I IREPORT ID: DPR261 ROUTE TO: BS0508 I I I