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Home My Public Portal About6460 LIVIA AVE_Building__ APPUCAMON,FOR BULONG PERNT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING/AD Ess - DI G D E �� I hereby affirm that I have a•certificate of consent to BUILSS !/�self Insure, fA vC or'a certificate of Workers' Compensation Insurance,or a certified copy thereof(Sec 3800,Lab C) � 1 !� C /C./� � l 7 V LOCALITY Policy No Company SIZE OF LO NO OF BLDGS NOW ON LOT ElCertified copy is hereby furnished f NEAREST CROSS ST ❑ Certified copy 1s filed with the county budding Inspection TRACTLOCK LOT NO - department USE ZONE MAP NO Date Applicant ASSESSOR P BOOK PAGE PARCEL 1 3 SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER / TEL NO COMPENSATION INSURANCE 1 [.-( J � WITHIN 1000 FT OF SCHOOL'? YES NO (This section need not be completed If the permit Is for one hundred ADDRESS _ DISTRICT GROUP TYPE CONST FIRE ZONE PROCESSED BY dollars ($100)or less) (� CIT ZIP I certify that In the performance of the work for which this permit ,I;;, 7�Q Is Issued, I shall not employ any person In any manner so as to ARCHITECT O NGINEER TEL NO become subject to the'Workers'Compensation Laws STATISTICAL CLASSIFICATION APT CONDO Date Applicant- ADDRESS CLASS NO 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 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 P L LICENSED CONTRACTORS DECLARATIONSIDE CITY 'LIC 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 SQ FT ZE No OF STORIES NO OF FAMIUES " Professions Code,and my license Is in full force and effect NEW ❑ BK PG D 0_ 1 DESCRIPTION OF WORK ADD ❑ VALUATION Q License Number Llc Class �y Contractor Date l�Llf • - 6 ALTER ❑ $ Z 6r� U ❑ cc .1 am exempt,under Sec REPAIR ❑ $ ; ', 1 DEMOL ❑ U B&P C for this reason o 'GIJ�� LDMA P/C# W - Date USE O EXISTING BLDG 61666-e ,Jf O e URM 1:1 - � Signature APPLICA T(PRINT. 141 1. 1 ��"GL NO LDMA Perm# - Z I, as owner of the property, or my employees with wagesas Z weir sole compensation, will do the work and the structure Is AD SS O �Ct not Intended or offered for sale (Section 7044, Business and FINAL DATE a -'S 3 !=' Professions Code) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL i ❑ I, as owner Of theproperty, am exclusive) contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE Q Y g AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDES FINAL BY t•' E licensed contractors to construct the project (Section 7044, Business VES 1:1 No Eland Professions Code) WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUAUTY MANAGEMENT DISTRICT(SCAOMD)SEE PERMnl1NG CHECKLIST FOR 2 1 T EME GUIDEUNES 1 1 _ I hereby affirm that there Is a construction lending agency for YES❑ NO❑ - ' 4 5 w the performance of the work for which this permit Is issued(Sec S f I()� - ® ate"— IHAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING _ 3097, CIV C) CHECKLIST I UNDERSTAND MV REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, i?1 w 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 SCAQMD tf CL Lender's Address '_•2"Iii�E'�� ,4 OJJNER OR AGENT O o I certify that I have read this application and state under penalty o - PC FEE C PERMIT FEE of perjury that the above nformation Is correct I agree to comply . !'_f 'l!_fj[�+I ;` '`'4 N with all county ordinz C s and State laws relating to building constructlo and hereby authorize rep sentaUv s of this Count ISSUANCE FEE - y to e u the o e- entione ro rty f , ection purpo s INVESTIGATION FEE TOTAL FEE of Aoohwn« m ae 7 SEE REVERSE FOR EXPLANATORY LANGUAGE 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 0005020003 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CO BUILDING ADDRESS: TR: 12504 LT: 15 SQ. FT STORIES TYPE 6460 LIVIA AV STRUCTURE: 0 VN TEMP CA 917801329 ASSESSOR INFORMATION NUM NEAREST CROSS STREET: LONGDEN 5382-018-003 THOMAS PAGE: 596 GRID: H1 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: RESID USE ZONE: R-1 ISSUED ON: PROCESSED EXPIRES ON: EXIST OCC GRP: 05/02/00 UT 10/29/00 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL CODE: LOK;HARRY (626) 288-3501- 1 15,000 IJ 6460 LIVIA AVL -� TEMP 917801329 FEES PAID DES TION OF WORK KITCHEN AND BATHROOM REMODELI rG FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. SAME AS OWNER AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION�RESID�15000.00 VAL 1.50 SPECIAL CONDITIONS: D2 PERMIT W/O.EN.HC-X5000.00 VAL 300.60 GLES TOIA FEES 329.85 CONTRACTOR: TEL. NO: ®63 ( �� APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER e, LIC. NO LOCATION AND SETBACKS SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS LIC. N 1111111 SLAB/UNDER FLOOR LOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMF: n (� UNDERFLOOR INSULATION U 153H265 3 t Tf 9 L1J V �C Q�� FLOOW-SREATHING OF FAMILIES: DWELLING UNITS: APT/CO L S: NO 2V 0 ROOF SHEATHING SCHOOL WITHIN HAZARDOUS 0 . SHE PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO NO ® ®y FRAME INSPECTION REQUIRED TOTAL CK FROM EXIS �/8% �Q� FIR SPRINKLER HA R SET A El FRONTPL YARD: HWY: PROP LINE: WIDTH: %L. �erv'�� INSULATION/WEATHER STRIP SIDE PL- INTERIOR LATH/DRYWALL EXTERIOR LATH RATED FLOOR/CEIL ASSE . RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508 d COUNTY.OF LOS ANGELES TEMPLE CITY # 0508 - - BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS 6 ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0004070006 PHONE: (626) 285-0488 EXT: - LEGAL ID: NO. OF CONST BU [DIN ADDRESS: TR: 12504 LT: 15 SQ. FT STORIES TYPE 6460 LIVIA AV STRUCTURE: 0 VN TEMP CA 917801329 ASSESSORR A ON NUMBER: NEAREST CROSS STREET: LONGDEN 5382-018-003 THOMAS PAGE: 596 GRID: H1 LOCALITY: TEMPLE CITY TENANT: EXIS BL G USE: RE I USE ZONE: R ISSUED ON: PROCESS BY: EXPIRES ON: EXIST OCC GRP: 04/07/00 UT 10/04/00 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY ODE: LOK•HARRY (626) 288-3501- 1 1,900 6465 LIVIA AV TEMP 917801329 FES PAID DE CRIPTION OF WORK CHANGE OUT OF EXISTING WINDOWS (13) FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. NO: SAME AS OWNER AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RESID 1900.00 VAL 0.50 SPECIAL CONDITIONS: D2 PERMIT W/O�EN:.HC-X1900.00 VAL 82.20 C$ELESTO?®FEES 110.45 CONTRACTOR: TEL. NO: 9 �/�,,� APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO LOCATION W-SETBACKS SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TE . NO: d/ FOUNDATION/TR N FORMS LIC. N 1111111 SLAB/UNDER FLOOR RAISED FLOOR NG MAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE: cmp,: UBL n /]��/J UNDERFLOOR INSULATION 153H265 3 01� WORKS){l1�-•US ItJI�� FLOOR SHEATHING NO. OF FAMILIES: DWELLING UNIT /COND: STAT CLA NO 21V� .' F ROOF SHEATHING X -7.1 SCHOOL WIT HAZARDOUS \ _ +, SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS CJ NO NO NO A ® ®� FRAME IKSPECT N SETBACKREQUIRED TOTAL FROM SET BACK YARD: HWY: PROP LINE: WIDTH: 4810 u w1OQ� RE SPRINKLER HANGERS FRONT PL- C `�erVICe-T%ja� INSULATION/WEATHER STRIP SIDE PL- INTERIOR LA H/DR ALL EXTERIOR LATH RATED LOOR/CEIL A SEM. RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS LOT DRAINAME REPORT ID: DPR261 ROUTE TO: BS0508