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Home My Public Portal About9230 LIVE OAK AVE_Building__ WORKERS'COMPENSATION DECLARATION Asureboraafcertif cafirm tharte of Workers' Comtpensation eInsurance, APPLICATION FOR BUILDING PERMIT or a certified copy thereof (Sec. 3800, L b. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnishe FOR APPLIC NT TO FILL IN BUILDING ADDRESS Certified copy is filed with the county building inspec- BUILDING o* Tion department. ADDRESS Date Applicant CIT ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLD EAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT T NCROSS ST. (This section need not be completed if the permit is for one ASSESSOR hundred dollars ($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL / TEL.,.7 USE Z�JE MAP I certify that in the performance of the work for which this OWNER N K NO. 7— permit is issued, I shall not employ any person in any manner ADDRESS SPECIAL so as to become subject to the Workers'Compensation Laws. CONDITIONS O U Date Applicant CITY ZIP ln: NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. DISTRICT GROUP OPE FIRE N ZONE PROCE SED BY O EER NO. ENGIN Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forth- ADDRESS .(J 'A W with comply with such provisions or this permit shall be fL deemed revoked. CONTRACTOR . NTEL.O. ej STATISTICAL CLATFIGATION APT. DO. N � / LICENSED CONTRACTORS DECLARATION e (LIC,.. CLASS NO. DWELL. UNITS Z I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS �� (commencing with Section 7000)of Division 3 of the Business andr LIC. SEWER MAP Professions Code, and my license is in full force and effect. CITY CLASS BK PG. VALIDATION C/, C SQ. FT. / ONO. OF NO.OF CHECK License Number y� 0 J Lic.Class_ SIZE (�G !STORIES FAMILIES _ ONE / NEW VALUATION Contractor - at DESCRIPTION OF WORK $ � f p ADD V v Poll.❑ 1 am exempt unler Sec. 'vt� ��`A n�� ALTER B.BP.C. for this reason er REPAIR ❑ $ Dote: USE OF17 U EXISTING BL �� DEMO ❑ Signature APPLICANT /- TEL. /1� FINAL OWNER-BUILDER DECLARATION PRINT (/f.CX� NO. �� DATE A2I I hereby affirm that I am.exempt from the Contractor's License 7 4 2:0 A Law for the following reason (Section 7031.5, Business and ADDRESS FINAL f Professions Code): PRESENT By i *f o o ❑ BUILDING 1, as owner of the property, or my employees with ADDRESS o7,07-87 wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. ❑ I, as owner of the property, am exclusively contracting CONTRACTOR O. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY REQUIRED YARD HWY TOTAL SETBACK FROM SET BACK PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name LDMA Ref. # m P.C. Fee$ Permit Fee 7� Lender's Address �ry I certify that I have read this application and state that the Issuance Fee O (/ LDMA P/C# o above information is correct. I agree to comply with all County Investigation Fee 0 ordinances and State laws relating to building construction, Total Fee LDMA Perm. # and hereby ou orize representatives of this County to enter upon the bo mentioned property for inspecti n purposes. a M=-24? SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date WORKERS' COMPENSATION DECLARATION hereby affirm that I have certificate of consent to self APPLICATION FOR BUILDING PERMIT insure, or a certificate of Workers' Compensation Insurance, �' .� or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS C BUILDING ❑ Certified copy is filed with the county building inspec- BUILDING r- tion department. ADDRESS �_14Y ZIP d Date Applicant CITYLOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NONO: OF BLDGS. NEAREST COMPENSATION INSURANCE W ON LOT CROSS ST.ASSESSOR (This section need not be completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL hundred dollars ($100) or less.) I�R(/ C� T a��9ys USE ZONE MAP �f _ OWNER NO. I1 7 �al" 1 certify.that in the performance of the work for which this 'n permit is issued, l shall not employ any person in any manner ADDRESS I/ ej U/2 Q/yy� / SPECIAL a so as to become subject to the Workers' Compensation Laws. /�_ CONDITIONS O CITY L/ ZIP ? U Date Applicant ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY O NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. CONST. ZONE (— Exemption, you should become subject- to the Workers' ,gyp U Compensation provisions of the Labor Code, you must forth- ADDRESS J' c ,3 (� 115� C�GGu a. with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. CONDO. N deemed revoked. CONTRACTOR NO. Z LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. a DWELL. UNITS — I hereby affirm that l am licensed under provisions of Chapter 9 ADDRESS NO. (commencing with Section 7000)of Division 3 of the Business LIC. SEWER MAP and Professions Code,and my license is in full force and effect. CITY CLASS BK PG � VALIDATION SQ. FT. NO. OF NO. OF CHECK License Number Lic. Class SIZE I STORIES FAMILIES ONE VALUATION Contractor Date DESCRIPTION OF WORK NEW ❑ $ Elam exempt under Sec. a. v ADD ALTER ❑ , B.&P.C. for this reason REPAIR ❑ $ Date: USE OF EXISTING BLDG. DEMOL F-1 Signature APPLICANT D FINAL (PRINT).!;*v ad a U �R(SeT� e f, y OWNER-BUILDER DECLARATION /� DATE T I hereby affirm that I am exempt from the Contractor's License ADDRESS / (/ e' Law for the following reason (Section 7031.5, Business and V e 7 FINAL Rrofessions Code): PRESENT By i BUILDING p 'n MA 1, as owner of the property, or my employees with ADDRESS i Z 3 "e V�Z G � �Jg / h a, wages as their sole compensation,will do the work andu qA (/ the structure is not intended or offered for sale(Section LOCALITY •C • G 1 7 � I 7044, Business and Professions Code.) MOVING TEL. 7 ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. �1)• 3 with licensed contractors to construct the project (Sec- ADDRESS 0!7 7, tion 7044, Business and Professions Code.) CONSTRUCTION LENDING AGENCY nDO REQUIRED YARD HWY TOTAL SETBACK FROM EXIST. G SET BACK PROP. LINE WIDTH ` I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name. m 1 .z LDMA Ref. # P.C. Fee $ Permit Fee 3 Lender's Address poll 1 certify that I have read this application and state that the Issuance Fee C d LDMA P/C# above information is correct. I agree to comply with all County Investigation Fee r 8 ordinances and State laws relating to building construction, Total Fee e LDMA Perm. # a and hereby authorize representatives of this County to enter upon above-mentio ed pro rty for inspection purposes. a 71 SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applican or Agent Date COUNTY OF LOS ANGELES Ei-iPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 L,%S TUNAS ALTERATION/REP'"TF BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 040727000> PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: TR: 7485 LT: 5 SQ. �-T STORIES. TYPE 9230 LIVE OAK AV _ STRUCTURE: 1772 VN TEMP CA 917802425 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: ENCINITAS ; 8588-001-006 THO?1.AS PAG=E: 596 GRID: J3 LOCALITY: TEMPLE CITY, C' TENANT: EXIST BLDG USP:'RESID USE ZO` - R-3 ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 07/27/04 JK 07/22/05 OWNER: TEL. N7: BLDGS. NOW U' LOT 9—T•_JATFIW FIAT-F FI L BY. � CCDE: BRISENO GUADALUPE A TR (626) 285-9459- 900 9230 LIVE OAK AV ,TEMP 917802425 �— FEES PAIS DESCRIPI" Ot: OF WORK T/0 AND REROOF OVER THE EXISTING W_Tii COMPOSITION SHINGLES FEE DESCRIPTION: QUANTITY: UOA?. AMOUNT: APPLICANT: TEL. Pi_0 SAME AS OWNER AA BLDG PERM'T ISSUANCE 27.75 AC STRONG MOTION REBID 900.00 VAL 0.50 SPECIAL.. CONDITIONS: {i D2 PERMIT W10 Ell-HC 900.00 VAL 65.40 TOTAL FEES 93.65 CONTRACTOR: TEL. NO: APPROVALS DATE - IFS'.."Ei:TOR SIGNATURE 'I SAME AS OWNER j L I C. NO LOCATION F17A --UACKS SOILS ENGINEER APPRGVAI_ � I—— --- �fiRCHITECT OR ENGINEER: (GL. ':0: .--_�, FSR`O�i±Oe:;TRENCh FORMS LIC_ NO: ! SLAv:u ER FLOOR _ i- 1 � RAISwD ?OO- FRI�MINu� I �! MAP NO: SEWER MAP BOOK: PAGE: FTRE ZONE: CP1P: UNDERFLuOR INS—UL i''i Iy XX 3 03 lil FL-00-6— NO. LOG?NO. OF FAMILIES: DWELLING UNITS: RPT/CONDI STwT%LASS j NO 21 ROOF S:iEA7H I`r.'is SCHOOL WITHIN HAZARDOUS SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO P90 FRAME ;T' ECTICN . REQUIRED TOTAL SETBACK FROM LXIST FIRE SPRINKLER HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: �- FRONT PL- INSULAT?ON/tcA.IHER STRIP !! SIDE PL- INTERIOR EA—UH.-/DRYWALL EXTERIOR RATED F1.��JR/C -I i. ASSEM. �� -I RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508 �— 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 1110100014 PHONE: (626) 285-0488 EXT: ILEGAL ID: NO. OF CONST BUILDING ADDRESS: I ITR: 7485 LT: 5 SQ. FT STORIES TYPE 9230 LIVE OAK AV I (STRUCTURE: 200 V-B TEMP CA 917802425 (ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: ENCINITA 18588-001-006 I THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, Cl I I I I (TENANT: IEXIST BLDG USE: GARAG USE ZONE: R-1 (ISSUED ON: PROCESSED BY: IEXIST OCC GRP: 110/10/11 SR 1 I ! I I (OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: IFINAL TE . FINAL BY: CODE: 1 IANAYA, EDWARD (626) 590-9513- 1 800 1 /Lf 19230 LIVE OAK AV 1 l (TEMP 917802425 1 FEES PAID 1DE RTPtI6P Z59 WORK 1 I I INEW GARAGE ROOF REMOVE OLD R OF AND INSTALL TORCH DOWN OR 1 I _IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ISHIN;?LES 1 (APPLICANT: TEL. NO: I I (SAME AS OWNER - IAA BLDG PERMIT ISSUANCE 27.80 1 I AB STATE GREEN BLDG FEE 800.00 VAL 1.00 ISPECIAL CONDITIONS: 1 I IAC STRONG MOTION RESID 800.00 VAL 0.50 I ` I (D2 PERMIT W/O EN-HC 800.00 VAL 65.40 I I TOTAL FEES 94.70 I ' (CONTRACTOR: TEL- NO: I APPROVALS DATE INSPECTOR SIGNATURE (SAME AS OWNER - I I I LIC. NO I (LOCATION AND SETBACKS I I I I I I I ISOILS ENGINEER APPROVAL I I I I I (ARCHITECT OR ENGINEER: TEL. NO: IFOUNLATION/TRENCH FORMS I 1 LTC. NO: 1 ISLAB/UNDER FLOOR I I I I I I (RAISED FLOOR FRAMING I I I I I I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: ( (UNDERFLOOR INSULATION I I 1147H265 3 001 I I FLOO'; SHEATHING INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I 1 0 NO 21 1 . IROOF SHEATHING � ul`4}78 Ott l 0 V1 1 SCHOOL WITHIN HAZARDOUS ISHEAR PANELS I I� 1AIR QUALITY: 1000 FEET MATERIALS i 1 NO NO NO 1FRAME INSPECTION I I I I I I I (FIRE SPRINKLER HANGERS 1 INSULATION/WEATHER STRIPI 11 IINTEP.IOR LATH/DRYWALL I I (EXTERIOR LATH I ! I I I I IRATED FLOOR/CEIL ASSEM. RATE.6 WALL ASSEMBLIES I I I I I I RATED SHAFTS/OPENINGS I j T-BAF CEILINGS ILOT DRAINAGE . _ IREPORT ID: DPR261 ROUTE TO: BS0508 40