Loading...
HomeMy Public PortalAbout9122 LAS TUNAS DR_Building__ APPLICATION FOR BUILDING PERMIT COUNTY OF LU5 ANGtLESBUILDING.AND SAFETY WORKER'S.COMPENSATION DECLARATION FOR APPLICANT TO FILL IN �BUILDING ADDRESS I hereby affirm that I have a certificate of consent to self insure, BUILfDING ADDRESS YY O� a or.a certificate of Workers' Compensation Insurance,,or a certified 41laa-'A G' UNS -fQNAs copyt.hereof.(Sec.3800,.La6„C.)• CITY LMVLr �'i i ZIP�I (� LOCALITY Policy'No. ;Company, SIZE OF LOT NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. - _ .NEAREST CROSS ST ❑ BLOCK Certified copy is filed with,the county building inspection' TRACT - ` LOT�t NO. (' department.. - J" s ,.!VI S��- P 6 ,USE.ZONE MAP NO. . Date Applicant - ASSESSOR MAP'BOOK' 'PAGE PARCEL ' j' SPECIAL CONDITIONS 'c. W OWNER - " t TEL NrO/. - CERTIFICATE OF EXEMPTION FROM WORKERS'• RrND 1�1 ONG " 3l0 ! a-wO3 w WITHIN 1000 FT.OF SCHOOL? YES NO COMPENSATION INSURANCE ADDRESS - p pp*� ("This section need not be'com ,p pleted if,.theermit is for one hundred Y� �)'T�1-ata 7 P TAICT GROUP TYPE CONST. FIRE PROCESSED BY dollars($100)'Or,less.)' 1Ili'I+ofZONE Sf I certify that in,the performance of the work for which this permit, CIUR'W l�l� ZIP 06ijo Is issued, I shall not employ,any person,in any manner,so aS t0. ARCHITECT OR ENGINEER .TEL NO. bECOme.subject to the,Workers'`Compensation Laws. � , � - STATISTICAL CLAS>SI ICATION APT' CONDO Date- Applicant ADDRESS_ - - - - '.CLASS NO.I DWELL UNITS NOTICE TO APPLICANT If,•after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption; you should 'become `subject' to the. Workers' CONTRACTOR TEL NO: SET BACK YARD HWY PROP LINE WIDTH .'Compensation provisions of the 'Labor Code, you must forthwith' FRONT comply with such provisions or.this permit shall be deemed revoked'.. ADDRESS. LIC.NO. PL', . LICENSED CONTRACTORS DECLARATION ,SIDE CITY LIC.CLASS 'P Li 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 NEW ❑ BK PG d Professions Code,and,my,license is in full force and effect License Number LiG.Class D SCRIPTION OF WORK- ADD ❑ VALUATION V Contractor Date 's �FF P—XIS 1.106 p ©0 ALTER .J DD OC W ESi 100 'REPAIR C11 ❑ I•am.exempt under Sec. 22 $ V B.&P.C.for this reason f�� W EEN titNi'TS DEMOL ❑ LDMA P/C# a . .Date: .,' .. USE OF EXISTING BLDG., .. URM ❑ - } .N Z Signature' APPLICANT.(PRINT) TEL NO. LDMA Perm# F _ 17Q.1, as owner of the property,:or my,employees with wages as 0 L ?their sole compensation, will do the work and the structure is ADDRESS -FI not-intended or'offered for sale (Section 7044, Business and NAL DATE ~ 'i JI z• "Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS-MATERIAL /�•-��:�� •J - •.j i =`_+- tli OR A MIXTURE CONTAINING A-HAZARDOUS MATERIAL EQUAL TO OR GREATER.THAN THE ❑ I, as owner'of the property, am exclusively. contracting WITH AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY,,//1 € j �F licensed contractors..to construct the project (Section 7044, YES❑ NO❑ 1 J� 1 1�,_ 6_��l'0 Business and Professions Code.) 3' - .. WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING V'IR' OCCUPANT,REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY - COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR GUIDELINES:' - 1 hereby affirm that there is a construction lending agency for. YES❑ No❑ N the performance of the Work for Which this permit Is issued(Sec. IHAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMDPERMITTING 1 ttt 3097,CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS i' - Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. AN 41:• o Lender's Address O - OWNER OR AGENT .•.•. o I certify that I have-read this application'and state under penalty O of perjury that the above information is correct..I agree to comply. P.C.FEE PERMIT FEE N with all county ordinances 'and State laws relating to building �p CO -construction, and hereby authorize representatives of this County - - ISSUANCE FEE Lam/ - to.en r upon t e above- oned property for insp do pur oses. ✓ D Co. INVESTIGATION FEE' TOTAL FEE J Qna( O OI ADDi ant a Agent Da�' fj `� SEE REVERSE FOR EXPLANATORY LANGUAGE COUNTY OF LOS ANGELES TEMPLE CITY ' .` # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS - SIGN BUILDING AND SAFETY /.LAND DEVELOPMENT TEMPLE CITY CA 91780 - - BL 0508 0609260074 PHONE: (626) 285-0488 EXT: LEGAL ID: NUMBER OF SIGNS: 1 BUILDING ADDRESS: - TR: 5905 LT: 58 BL: .001 SIGN DESCRIPTION.: CHANNEL LETTERS SIGNS 9122 LAS TUNAS DR TEMP CA 917801903 \ ASSESSOR INFORMATION NUMBER: - NEAREST CROSS STREET: 5387-023-035 THOMAS PAGE,: 596 GRID: H3 _ ,-LOCALITY: TEMPLE CITY, C TENANT:. EXIST BLDG USE: ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP:. 09/26/06 JK 09/21/07 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FI�T$ ATE FINAL B� Y: CODE: HUY, QUACH � (626) 512-4000- - 2,800 �/�/ 1016 E. ASTHILLS DR. WEST COVINA CA 91791 FEES PAID DESCRIPTION OF WORK - CHANNEL LETTERS SIGN ' FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. NO: ARTIST SIGNS & ART SERVICE CORP. (626) 288-6872- AA BLDG PERMIT ISSUANCE 27.75 8919 E. GARVEY AVE AX BUILDING REVIEW FEE 54.70 SPECIAL CONDITIONS: ROSEMEAD, CA 91770 D2 PERMIT W/O EN-HC. 2800.00 VAL 99.00 , TOTAL FEES 181.45 CONTRACTOR: - TEL. NO: - APPROVALS DATE INSPECTOR SIGNATURE ARTIST SIGNS AND ART SERV CO. (626) 288-6872- '+ 8919 E GARVEY AVE #C3 LIC. NO - _ _ LOCATION AND SETBACKS- - ROSEMEAD CA 91770 811413 C45 SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: - TEL. NO: - FOUNDATION/TRENCH FORMS LIC. NO: SUPPORT STRUCTURE MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 00 NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: NO 20 SCHOOL WITHIN HAZARDOUS - - AIR QUALITY: 1000 FEET MATERIALS NO NO NO - - REPORT ID: DPR261 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS TENANT IMPROVEMENT .BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA .91780 BL 0508 0911030037 PHONE: (626) 285-0488 EXT: ILEGAL ID: 1 NO. OF CONST NEW 1 - BUILDING ADDRESS: ITR: 5905 - IT: 58 'BL:- .001 I SQ. FT STORIES TYPE OCCUP GROUPI 9122 LAS TUNAS DR - I (STRUCTURE: 0' 1 V-B B I TEMP CA 917801903 1 ' (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: LOMA I 15387-023-035 1 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY, Cl ITENANT: (EXIST BLDG USE: COMME USE ZONE: IISSUED ON: PROCESSED BY: - - I I (EXIST OCC GRP: B 112/22/09 _ SR I (OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: IFINAL DATE FINAL BY: CODE: 1 ICHAN,. VIVIAN (626) 664-3312- I 8,000 I 19122 LAS TUNAS DR (TEMP 917801903 I FEES PAID 11JESCRIPTION OF WORK 1 1T.I. ADD (3) OFFICE ROOM W/NEW 9'-0' HIGH GLASS PARTITION 1 IFEE DESCRIPTION: QUANTITY: UOM:_ AMOUNT: IWALL &RECOVER THE (E) OPENING & PROVIDE A NEW SLIDING DOOR 1 (APPLICANT: TEL. NO: I - I IYUM (626) 410-3113- 1A1 PLANCHECK W/EN-HC 5000.00 VAL 129.62 1 I 1260 E: GARVEY AVE - 1AA BLDG PERMIT ISSUANCE 27.75 ISPECIAL CONDITIONS: I IMONTEREY PARK 91755 IAB STATE GREEN BLDG FEE 8000.00 VAL 1.00 1 I I 1AE STRONG MOTION OTHER 8000.00 VAL 1.68 1 I IA2 PERMIT W/ENERGY-HC 8000.00 VAL 210.45 1 I , ICONTRACTOR: TEL. NO: IFS INV WORK W/O PERMIT 257.00 DOL 257.00 "1 APPROVALS DATE INSPECTOR SIGNATURE_ I IMINEN CONSTRUCTION INC. (626) 705-0651- TOTAL FEES 627.50 1 I I 1621 N. BUSHNELL AVENUE LIC. NO 1 'JLOCATION AND SETBACKS IALHAMBRA, CA 91801 - 900971 B I I_j I I I 1 ISOILS ENGINEER APPROVAL 1ARCHITECT OR ENGINEER: TEL. NO: 1 '.IFOUNDATION/TRENCH FORMS I I I 1KWOK, TERENCE (323) 410-3113- SLAB/UNDER FLOOR I 1 1260 E GARVEY AVE.. LIC. NO: I - 1 I.MONTEREY PARK, CA 91755 C24796 I I I 'IRAISED FLOOR.FRAMING 1 1 I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: I (UNDERFLOOR INSULATION I I 3 041 IFLOOR SHEATHING 1NO. OF FAMILIES: DWELLING UNITS:.APT/GOND: STAT CLASS: 1 (� ..,, „I 1 NO 22 1 IROOF SHEATHING I I 1 SCHOOL WITHIN HAZARDOUS I ISHEAR PANELS I I I (AIR QUALITY: 1000 FEET MATERIALS 1 I I NO NO NO j IFRAME INSPECTION 1 I . IFIRE SPRINKLER HANGERS I IINSULATION/WEATHER STRIPI I I I G I (INTERIOR LATH/DRYWALL 1 1 I (EXTERIOR LATH I i. IRATED FLOOR/CEIL ASSEM. I I I 1 I IRATED WALL ASSEMBLIES I I IRATED SHAFTS/OPENINGS 1 1 I 1 IT-BAR CEILINGS I -I I ILOT DRAINAGE I 1 I I I I I I 1 1 IREPORT ID: DPR261 ROUTE TO: ES0508 1 I 1 I 0.