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HomeMy Public PortalAbout9720 LIVE OAK AVE_Building__ I qN Cil 0j? 7-�zz "il CITY OF TEMPLE CI R t! 71A699A Cl#e09.9-e0 APPLICATION FOR BUILDING PE MI T Z:"() COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALI JOHN A. LAMBIE, COUNTY ENGINEER NEAREST � WILLIAM A. JENSEN SUF'T OF BUILDING CROSS ST. -G DISTRICT O. GRO P TypE PR ESSED BY FOR APPLICANT TO FILL IN y CONST, BUILDING _ r � - STATISTICAL CLASSIFICATION SEWER MAP ADDRESS : i"7 Live el: P G CLASS. NODWELL. UNITS 0I / LOT NO. BLOCK MAP - STATE (NO)NUMBE H Q TRACT '!i. _.0Y? 'J:L , _ 1 NO USE ZONE SPECIAL SUMNO.OF BLDGS. L a11- CONDITION t SIZE OF LOT I NOW ON LOT 41 v USE OF EXISTING BLDG _• W "Yf? iiiJc:? Zr" BUILDING EXIST. `r+� YARD HWY STREET NAME TEL 7SETBACK W DTH OWNER,2T'_L T,• OOT'e NO _ iJ27, FRONT n.-n - �z: t. P. L. 21- ADDRESS` -}� •-•c�.��z`"�T�", s rl-L __ SIDE ARCHITECT OR ,AOI-e TEL. P.L.. ENGINEER No. INSPECTION RECORD ADDRESS >_a u CONTRACTOR�-%ELI i� :i L_i <i .;0 13,�:ITE . TE.Ltiro in 7%' ADDRESS f I__: -�'• l.,iz.` i� .u.i�ii3i. O DESCRIPTION OF WORK W CL U) NEW,_- ADD ALTER REPAIR DEMOLISH Z SQ. FT. NO.OF NO.OF SIZE '8 STORIES -- FAMILIES-- USE OF c::Y a7e 'o r STRUCTURE - - SIGNATU APPLIC li VALUATION S APPROVALS DATE INSPECTOR'S SIGNATURE =T, ,�__G FOUNDATION: LOCATION F E S FE _ FORMS, MATERIALS FRAME: FIRE STOPS, IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS BUILDING CONSTRUCTION. I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED I SHALL NOT LATH, INT. EMPLOYANY PERSON IN ANY MANNER 50 AS TO BECOME SUBUECT TO THE WORKMEN'S COMPENSATION LAWS OF CALIFORNIA. _ LATH,EXT. SIGNATU HOUSE NUMBER COR- PERMITTE RECT AND POSTED ADDRESS FINAL CLYDE N. DIRLAM, PRINCIPAL ST RAL ENGINEER PIAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O, CASH I ,o l 4 f L-) ., in DEPARTMENT COUNTY OF LOS ANGELES Lo AFETY c WM. J. FOX, CHIEF ENGINEER i� APPLICATION FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY 'J DISTRICT N0. PLAN CK. OR REc:No. •-ray FERMI NO.. BUILDING ADDRESS 97Z` 61i' 71 I / Aa 17 LOCALITY Test p�alT!d�C RECEIVED BY DATE OFAPPL. DATE I ED NEAREST /6O'.Q�A' �� r v�• CRO896T. (`� /U f'P Il BUILDING ADDRESS` r /� �. G✓ `p CL, OWNER •MAILLOCALITY 2{/77 -,0- G�rT ADDRESS �� ��'��G���1 NEAREST TEL CROSS ST. d -G r! NO. FIRE NO. DF TYPE I GROUP` y--� ARCHITECT OR TEL -7`/"'ZONE PLANS �� ENGINEER NO. BLDG. r ORD. NO. SETBACK LINEK! ' ADDRESS USE APPROVED ' CONTRACTOR TEL ZONE �� BY 6DATE HOUSE NUMBERING ADDRESS JA2,j MAP NUMBER W a NO. ASSIGNED BY LEGAL CORRECTIONS DESCRIPTION LOT NO.6eZ BLOCK TRACT &1 Z —/SO - NO. OF SLOGS. SIZE OF LOT ��( QQs��+nrl NOW ON LOT ' USE OFC .7J��(L hY�+� I NO. OF - EXIST IN BLDG. FAMIL1E9 8! DESCRIPTION OF WORK NEW ALTERATION ADDITION D REPAIR DEMOLITION r Sq.FT. NOS/ NO.Or D SIZESIZE ® ROOMSQ STORIESQ STORIES EXT.WALLROOF n COVERING COVERING J USE OF STRUCTURE INSPECTION FOR APPROVALS OCCUPANCYAS INSPECTOR'S SIGNATURE DATE FOUNDATION, LOCATION FORMS, MATERIALS 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP1-le v - PLICATION AND STATE THAT THE INFORMATION GIVEN IS FRAME: FIRESTOPS, CORRECT. BRACING, BOLTS I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES I FURNACE: LOCATION, AND STATE LAWS REGULATING BUILDING ONSTRUCTION. GAS VENT, DUCTS SIGNATURE OF - LATH, INT. -PERMITTEE • ADDRESS LATH. EXT. AUTHORIZED AOT. PLASTER, INT. PLASTER, EXT. P.C.4, CDR- FEE HOUSE NUMBER COR- (//J P.ECT AND POSTED VALUATION FEE FINAL 7GA638A DSS 3 7-51 V f 70A686A DIBS•7 12.54 APPLICATION ..F®•R: BUIL® NG PERMIT j DIVISION OF BUILDING AND SAFETY ADDRSS EQ7 ? 2-- 4 Department of County Engineer �d County Of Los Angeles - LOCALITY 7 vA WM.J. FOX, COUNTY ENGINEER CASSATT D. GRIFFIN, SUPT OF BUILDING NEAREST /���/ !•� CROSS ST.- (,_-,J` G7 • DISTRICT NO. GROUP TYPE SEWER MAP, FOR APPLICANT TO FILL IN _E_ BK. PG CONST. BUILDING.- sy ` � J' y� ADDRESS / Z Z LJ.Ii� ©A-�C NUMAPMBER v p�,V HWY YES NO. LOT NO: 2c::: �� �� - BLOCK USE ZONE SPECIAL _ = _ ,��{,,^� -- CONDITIONS - - TRACT !YKZ? ���-��D - - - �('''° NO OF BLDGS. SIZE OF LOT Iva /1� G I NOW ON LOT BUILDING YARD HWY .STREET NAME - EXIST USE OF - - SETBACK WIDTH" EXISTING BLDG i FRONT I/ . _ P L �pQ(J IL OWNER SIDEMAIL P L: ADDRESS 2 7 2 2 If 6 4_& —� TEL. 1, 'DWELL I UNIT 5- INDUSTRIAL C�ITT�YM/�LJr� %7 �NO 2 DUPLEX-- UNIT 6 PUBLIC BLDG ARCHITECT OR - TEL. ENGINEER - NO S APT UNITS ' 7 ADDN ,ALT., ETC.- ADDRESS - `4 COMMERCIAL 8 MISCEL. l CONTRACTO _ ``'r^wo�` INSPECTION RECORD ADDRESS_ /►' - /['FFGII'-iV/,A"�V `- s __ DESCRIPTION OF WORK NEW ADD 1— ALTER REPAIR. DEMOLISH - SQ FT a � IZ � NO OF / NO OF E a� SSTORIES ,/ FAMIL�I}ES USE OF 4/7 SIGNATURE SIGNATURE APPLICANT �`'F••�,+"7 -APPROVALS ADDRESS DATE INSPECTOR'S SIGNATURE - _ FOUNDATION: LOCATION �• - ©_�. - P.C. $., - , FORMS, MATERIALS al 1315 _ r., a�,�--__•��� - ,©� FEE- _ FRAME- FIRE STOPS, pp VALUATION S 00 i BRACING, BOLTS - FEE ' 'FURNACE LOCATION. GAS VENT, DUCTS 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS 6 - APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH, INT. AND STATE LAWS REGULATING' BUILDING CONSTRUC- TION. LATH, EXT. Y U SIGNATURE OF HOUSE NUMBER COR- PRECT AND POSTED ADDRESS FINAL A A�, 1I, 0 Wit. J. FOX. CouN'rr--EKGIN6sR VALIDATIOIa BY '�fi 9�'© fE8�1.g I 8,1GO a� DEPUTY "' DEPUTY-- BY .. _ BY ® DEPUTY DEPUTY APPUCAT N FOR,, M-LMNO P[RNT COU14TY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDw D RESS I hereby affirm that I,have a certificate of consent to self Insure, BUILDING ADDR s L �,✓_e 0/.Qor a certificate of Workers' Compensation Insurance,or a certified copy there f c 3800,jab_C) " CITY ! .Q' ✓ I. I. ZIP _ LOCALITY Policy No �� � �- Company SIZE OF LOT NO OF BIL DGS NOW ON LOT ' ❑'Certified copy is hereby furnished NEAREST CROSS ST Certified copy IS filed with the county,buil ection TRACT' BLOCK LOT NO depdJyt[n t USE'ZONE MAP NO Date ` / �A�plicant ASSESSOR MAP BOOK PAGE 'PARCEL ' SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION.FROM WORKERS'• OWNER / m TEL NO COMPENSATION INSURANCE v �'� v WITHIN 1000 FT OF SCHOOLS YES No ADDRESS �y ' (This section need n completed if the permit is for one hundred / 7 Z V ��r� O % DISTRICT GROUP TYPE CONST, FIRE ZONE PROCESSED BY dollars($100)or less) ' CITY ZIP I certify that•in,the performance'o work for which this permit ter,,,,° � is issued, I shall not employ any person any manner so as to _ become subject to the Workers'Co. enSaBho aws NGINEER T L NO p SZ STATISTICAL•CLASSIFICATION APT CONDO, u.v • Date Applicant• - - ADDRESS n CLASS NODWELL UNITS ' NOTICE TO APPLICANT If, after makingthis Certificate of s Z �� i� ��� REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should: become Subject t0 the Workers' CONTRACTOR / TEL N _ SET BACK YARD- HWY• PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith <—_4 -- ! 's 772 / Z S FRONT comply with such provisions or this permit shall be deemed revoked ADDRESS - LIC NO PL LICENSED CONTRACTORS DECLARATION -7S���� SIDE CITY ,�J��I LIC CLASS �P I_ - 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 an ffe t NEW ❑ BK' PG License Number S S 9 S` Lic Class ' DE CRIPTION OF WORK WORK ADD ❑ VALU 6N c a D _ - O G l sv�ffS,M1� '� , ct {'voJ 1 f ccvt,E{ ' oV;�'��� J ��� U Contracto 3 Date' _ ,ALTER r❑ /i a t— fc>( REPAIR $ 0 ❑ I am exempt nder Sec ' 88PC forthi reason DEMOL 'E1 U LDMA P/C# Date" USE OF EXISTING BLDGy������`� URM ❑ ii Signature APPLICANyL�(PRINTy," �� TEL NO LDMA Perm# x3107 � °�i1 Z ❑ I,•as owner of the p erty, or my•employees with,wages as : . �` Z—� � 7o 7 /Z?S Z their sole compensatio 'will do the•wofk•and the structure Is ADDRESS �h f�1 0 } not Intended or offered r sale (Section 7044, Business and U �i FINAL DATE Q r - $ 'PrOfeSSIOr1S Code) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL �•� ZZ �'�3. `� _ Hr'•"!'�°g ' p OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE J -� - �-�-., ❑ l,.aS caner of the propert am exclusively contracting with AMOUNTS SPECIFIE ON THE HAZARDOUS MATERIALS INFORMATION GUIDES Q r�-} license contractors to cons ct the project (Section 7044, �'P FINAL BY r > J.1V t , _ t:L°_i Business d Professions Code YES❑ ry i �r ��� WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE,BUILDING .. "�"-'' COAST OCCUPANT QUQAUTY MANAGEE A IMENOT DSOTRICTi(SCAOMD)SEE PCTION OR ERMITTING FROM KUSTOFOR ��•--°---° t� CON RUTH CTION LEN G AGENCY TOTAL r; � F GUIDELINES - - hereby affirm that ere is,a construction+lending agency for YES El N !HEL•�i L'aa 11J the performance of the ork for which this permit is issued(Sec HAVE READ THE HAZARDOUS MATERIAJG NF ON GUIDE AND THE SCAQMDPERMITTING y 3097,CIV`C) - - CHECKLIST UNDERSTAND MY RE RE UNDER THE LOS ANGELES COUNTY CODE, .��E w1 ° 1 i� TTTLE 2 CHAPTER 2 2 GTI 2 HROUGH 2 20 140 CONCERNING HAZARDOUS ' _ , 3 Lender's Name - MATERIALS REP A A PERMIT FROM THE SCAOMD („{fir}3C • OL Lender's Address ' O OWNER OR AGENT " o I certify that'I have read this apph\epresen tate under penalty o P C FEE PERMIT FEE - - d of perjury that the above Informati I agree to comply /� 0000-000i 1 I444 N with, all county ordinance an elating to building 1 �'{ t,/y"�_ , �, construction, and hereb t eS Of thl COUnty ISSUANCE FEE 9:5tf 1 AN 9:20 � to enter up0 b pspectio urpo s ' % INVESTIGATION FEE TOTAL FEE � srerew,e a M �a � •�� � � r , SEE REVERSE FOR EXPLANATORY LANGUAGE WORKERS'COMPENSATION DECLARATION F - `� .^" "'- - _ + i•k?1 ___ insurebor a certif carte of Workers' Compensation I have at i;er!ificate of elnsuran ent to, lf ap_pd C Q _�_Ol h FOR , o�M 0 dD0 GAJ a pE G3G�iv or a certifted'copy thereof (Sec 3800, Lab C ), i - -,- YI ' - PC9,75585 Repubic Iride'Tnnit - COUNTY OF LOS,ANGELES BUILDING-AND SAFETY �•, Poltcy,No Company P Y _ _ _ _ __ _ ` Certified copy,is hereby furnished' 1-. ^•` t BUILDING' nn nni ' _ _ ; -FOR-APPLICANT TO FILL IN ADDRESS Certified copy is filed-with the county building'in'spec- BUILDING , ,., tion deportment � - " :, •' u ADDRE559720 Live Oak A4 Date 7-16-86 ':o;ppl cantRANDOL' ROOFINGS CITY Tem le it ZIP 1775 LOCALITY G CERTIFICATE OF-EXEMPTION FROM'WORKERS' •"'; " ' - ' ' '"•"•NO-„OF-BLDGS---„- - NEAREST - 'COMPENSATION INSURANCE n• SIZE OF LOT $. ' NOW ON LOT CROSS ST rt - (This section need'notbe completed if the permit is for',one - - - ^- - - ASSESSOR, ~ TRAC - '1%` PAGE. -hundred dollars ($100)or,less ) .r .- '. T BLOCK LOT NO ' MAP BOOK PARCEL _ _TEL - OWNER Nick VanOlst• NO 285=1679 USE� I- NE i I certify that m the perforrnance of the,work for,wFiich,this' MAP NO >• issued, I shall not employ any person in any manner',•__ _ _ SPECIAL-', so as to become subject to-the Woikers'Compensation Laws ADDRESS 2 i e` CONDITIONS'--i «_. 1 0 _ CIT-Y . •w_Temple'.City.'._. -ZIP .9.1775- r -_ - U Date ' ]=1 6886 'Applcani RANT)OT, :RQQETNG __{_- ARCHITECT OR TEL DISTRICT_ GROUP TYPE-, _ FIRE PR SSED.BY- O NOTICE'TO APPLICANT ;If, after making this'Certifcote of ENGINEER-_ _ NO t' F- Exerniption, .you'`shouldrbecome subject-to'the Workers'{ - (�r CONST i E V Compensation provisions,of',the`Labor Code, you must forth- - ADDRESS ' - - 5'” - - - d with•cornply•witK,such provisions or.this permit-shall be - -- - - - Y y deemed revoked TEL STATISTICAL CLASSIFICATION APT ONDO `• ' CONTRACTOR NO 288-4040 - LICENSED CONTRACTORS DECLARATION -, - -- --- LIC CLASS NO 2+ DWELL( UNITS ' I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESSNO 45 (commenting with Section 760b),of Division 3 of iFie Business and ,. ,- _ _ _. , _ LIC • - - - SEWER MAP Professions Code, and my'Itcense is,in_full force and effect CITY CLASS C-3 t3K ' ' �r "" "VALIDATION NO OF - __ NO_OF CHECK I Lcense Number 45193'7 Lc Class'C=39t't SIZE. STORIES FAMILIES ONE VALUATION _ Contractor ]jOI;�Qf1FTN( Dafe 7'-1 6=`86 - DESCRIPTION OF WORK-,- RE-roof h011Se NEW - ❑ V - -{ ADD ❑ $ 2,147.00 D ❑ I am exempt under Sec With fiber las--shin les - - - - - > ALTER B&P C for this reason _ REPAIR-- -$_ '_ _ - 1 Date , USE OF - t EXISTING BLDG SFD. ' ' DEMOL ❑ `r.- --' �� ---- •� " APPLICANT ,� , TEL Signature (PRINT) RANDOL' ROOFING No 288-4040 FINALr ? �'5 1 2 A OWNER-BUILDER DECLARATION DATE ,,-G I hereby affirm that I am exempt from the Contractor's License Law for the following'reason (Section 7031 5, Business and, ADDRESS F - z.eclC.C�/ #'0 0 0 oxo' "Prrofessions Code) .. _ T - REE r ' - _ -- .- 4- BUILDING / 5 9."2 5''' ], as owner of the property, or my employees with ADDRESS_^ wages as their sole compensation,will do the work and o e o'S 9 2 5-v the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code)' - MOVING - "' - `- TEL- r 7 2 5 m ❑ I, as owner of theproperty, am-exclusive) contracting CONTRACTOR NO -0 8 6•,•, Y 9 ' with-licensed-contractors to construct the project'(Sec- _ ' "' """ - ' "'- -� " - - -,"•^-`- - - - -- _ < ADDRESS tion 7044, Business and Professions Code) - '- '• f � in. _REQUIRED TOTAL SETBACK-FR _ _ CONSTRUCTION LENDING AGENCY SET BACK YARD - HWY PROP LINE WIDTH_ " I hereby affirm that there is a construction lending agency for FRONT r the performance of the work for which-this-permit-is issued P17- (Sec L(Sec 3097, Civ C ) SIDE , Lender's Name p L - - - - • •-- _ _' - - .r _ - LDMA Ref # _ . - P C'Fee$ - - -- _._, ..... Permit Fee"__,- 7Y- - - - - -- - - --•- t.w .._ _ , Lender's Address t I certify that j-have-read this application and,state-that the - _ _ _.,_ Issuance Fee- - LDMA-P/C# a above information is correct I agree to comply with all County Investigation Fee g ordinances and State jaws relating to building construction, Total Fee - 59'.25 CDMA Perm # -' t d and hereby authorize representatives of this County to enter upon the b�v/e-mentioned property for inspection purposes i �2-1(0-8 SEE REVERSE FOR EXPLANATORY LANGUAGE •- '-Signature•of Applicant or Agent " " Date -- _ ._._ _. _-_ ._. _ _. -- -----