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Home My Public Portal About5339 LOMA AVE_Building__ :APPLICATIO�i�I FOR 'BUILDII�hG .PERMIT 'FOR APP-h4Q�NT TO FILL IN (Print or type only) r COUNTY OF LOS ANGELES -Boo EISS DEPARTMENT OF COUNTY ENGINEER CITY z;P BUILDING AND SAFETY, DIVISION NO.OF BLDGS. BUILDING - SIZE OF LOT NOW ON LOT13 ADDRESS TRACT BLOCK LOT NO LOCALITY - - TEL NEAREST OWNER NO. CROSS ST. ' ASSESSOR _ ADDRESS -� MAP BOOKPAGE PARCEL - DISTRICT GROUP TYPE, 1' -FIRE ESSED BY Q CONST. ZON CITY ZI? TEL ✓SO(J -- ARCHITEC OR NO. ' Lz=z A- ENGINEER _ STATISTICAL CLASSIFICATIONSEWE AP "' • ADDRESS - CLASS NO.�DWELL.UNITS .• BK/14 PG6 ' EL._ CONTRACTOR- T -- E ZONE MAP -- - N nn NO. l LIC, J/ SPECIAL ADDRESS - -N O. � • LIC. ICONDITIONS CITY CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NOE]' CONSTRUCTION LENDER NAME AND BRANCH BLDG.SETBACK FROM FR NT PROP.LINE OF - (STREET) CD ADDRESS - CITY - _ TOTAL SETBACK FROM TYPE OF EXISTING U SQ. FT IN -SIZE NO. OF - - CHECK HIG WAY } YARD — HIGHWAY' WIDTH FRONT PROP. LINE -SIZE STORIES FAMILIES ONE DESCRIPTION OF WORK a NEW ❑ U LLJ ADD BLDG.SE K-FROM - - tt� Z SIDE PROP. LI F` (STREET) ALTER ❑ TOTAL SE.T-BA-CK FROM TYPE OF EXISTING Z HIGHWAY } YARD' = SIDE PROP. LINE- ,- HIGHWAY WIDTH REPAIR❑ -EXISUSE OT NG BLDG. . DEMOL ❑ + \ APPLICANT ° L _ CORNER CUTOFF YES ❑- NO ❑� (PRINT) ,Z/ IN OPEN SPACE _ YES ❑ -• - NO ❑ BY_(SIGNA TORE G/ e'. " Q, �y IN COASTAL ZQ,NE - YES ❑ "NO El VALUATIONi'- ��(,/ - - CATEGORICAL EXEMPTION YES❑ - NO'❑- I HEREBY ACKNOW EDGE THAT I HAVE READ THIS APPLICATION. ENVIRONMENTAL AND STATE THAT THE ABOVE 'IS CORRECT AND AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE). WITH' ALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION I CERTIFY THAT :IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE) HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE nn 'LABOR. CODE OF THE STATE OF CALIFORNIA IN RELATING TO 'W ORKMEN'S COMPENSATION INSURA E. Yvv SIGNATURE O ' /vO .'. E PERMITTE e� !1 Z ev ADDRESS Ii) '� ,A - ' TEL. -FINAL _ VAI / BY Ah �!_ CITY NO. DATE 11.11\L CHLCFS PAYA13LL- 10: FEE FEE HARVEY T. BRANDT. .COUNTY ENGINEER PLAN-CHECK VALIDATION cK M o CASH o PERMIT VALID 1ON CK- M 0 % CASH l 7 5. 1!3. �(u 1 1 -2 1 .7 5 N a 76A638A CE9803-12/72 APPL-ICATION FOR BUILDING PERMIT FOR'APPLICANT`T0 FILL IN 'cPrljit or type-on ly) / 6UI LDING _ - COUNTY OF LOS ANGELES ADDRESS DEPARTMENT OF COUNTY ENGINEER' CITY ' zip /� BUILDING AND SAFETY DIVISION, . NO.OF BLOGS. BUILDING SIZE OF LOT ' ' NOW ON LOT - ADDRESS �� TRACT BLOCK' LOT•NO LOCA LIT J ; TEL NEAREST OWNER G - NO.- CROSS,ST �r ' ' ASSESSOR � ' ADDRESS 0 C MAP BOOK PAGE PARCEL l-� - - DISTRICT • GROUP TYPE FIRE RO ESSED BY CITY ZIP ARC TEC OR TELrQ CO ONE i ENGINEER NO. _ STATISTICAL CLASSIFICATION SEWER MAP ADDRESS CLASS N _DWELL UNITS BK PG ,CONTRACTOR i,/ NOL• USE ZONE MAP LIC. NO �Q ADDRESS NO. _ ..I SPECIAL LIC. CONDITIONS CITY CLASS - ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑ CONSTRUCTION LENDER NAME AND BRANCH BLD SETBACK FROM 'r d -'- FRO T PROP LINE OF (STREET) C C: ADDRESS CITY ` SETBACK FROM TYPE OF; EXISTING TOTAL ETBCK F HIG WAY + YARD = d' SO FT NO. OF NO: OF CHECK FRONT PROP LINE HIGHWAY .WIDTH C SIZE STORIES FAMILIES' ONE + DESCRIPTION OF WORK NEW17 '❑ �• ❑ BLDG.S FROM - Z ' ADD SIDEPR0R.'LINE0 (STREET) ALTER ❑ TOTAL SET K_FROM TYPE OF EXISTING HIGHWAY + YARD = REPAIR❑ SIDE PROP. LI HIGHWAY' WIDTH USE OF + EXISTING BLDG.• DEMOL ❑ APPLICANT• TEL CORNY• ER CUTOFF ES ❑ NO (PRINT) NO. t BY (SIGNATURE) IN OPEN SPACE - YES ❑ NO El IN COASTAL ZONE _ YES ❑ NO ❑ VALUATION CATEGORICAL EXEMPTION YES❑ NO ❑ I HEREBY ACKNO LEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL AND, STATE THA-7- TTIE ABOVE IS CORRECT AND AGREE TO COMPLY- - IMPACT- .EXEMPTION DECLARATION SIGNED (DATE) WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- ' STRUCTI ON I CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED - (DATE) HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COMPENSATION INS RANC 'SIGNATURE O C-1 V^7s�l�,d-.S/?F 0 ./��' lI�� F��•''i PERMITTEE e� fes• .cs p p, - �/1 _ ADDRESS - af^ G` �++a CSP, �C e r�,�f� Y "J•✓ TEL - FINAL Y - -- L•. - - - - CITY �r NO. DATER. e MA 1<'F' S PAYABLE TO. FE PM ' HARVEY T. BRANDT. COUNTY ENGINEER FEE $• FE PLAN CHECK VALIDATION CK_ MO CASH a _PERMIT VA L}ATIONcK- M o CASH 76A638A CE9803 7/73 Y_-84-iZ0C 1-7 'D - 6--9' .-9' . ®�O I 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 0503290033 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: TR: 11218 LT: 6 BL: E SQ. FT STORIES TYPE 5339 LOMA AV STRUCTURE: 28 VN TEMP CA 917803002 SS NEAREST CROSS STREET: BROADWAY 5388-007-006 " 'THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY, C TENANT: EXIST BLDG USE: RESID USE ZMETUT SSS . EXIST OCC GRP: 03/29/05 JK 03/24/06 OWNER: BLDG 0 - VAL N L B : CODE: VYAS RAJESH S;HASUMATI R (626) 285-8766- 5,800 5339 LOMA AV 1 4�� _ TEMP 917803002 ION OF T R OFF EXISTING ROOF AND HAUL AWAY, APPLY 11 SQ OF OSB FEE DESCRIPTION: - QUANTITY: UOM: AMOUNT: 1/2" PLYWOOD, INSTALL 30 YEARS COMPOSITION SHINGLES APPLICANT: CRUZ (562) 577-2667- AA BLDG PERMIT ISSUANCE 27.75 15403 S. WHITE AVE AC STRONG MOTION RESID 5800.00 VAL 0.58 SPECIAL CONDITIONS: COMPTON, CA 90221 D2 PERMIT W/O EN-HC 5800.00 VAL 149.40 TOTAL FEES 177.73 CONTRACTOR: . NO: APPROVALS DATE INSPECTOR SIGNATUR_ BEST QUALITY ROOFING (310) 639-4846- 15403 S WHITE AVE LIC. NO LOCATION_ COMPTON CA 90222 765235039 SOILS PP 0 AL ARCHITECT OR ENGINEER: TEL.- NO: ON LIC. NO: SLAB/UNDER F FLOORRAISED P 0: SEWER-NAP BOO GE: FI CMP: UNDERFLOOR SUL TIO 147H265 3 01 FLOOR SHEATHING 0 D: STAT CLT§T-- NO 21 ROOFS EAT J G I L WITHIN HAZARDOUS SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME INSPECTI REQUIRED TOTAL SETBACK FROM EXIST FIRE SPRINKLER HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL-- INSULATION/WEATHER STRIP SIDE PL- I NTS EXTERIOR LATH RATED WALL ASSEMBLIES RATED S Y-RAq CEILINGS LOT-DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508 -WORKERS' COMPENSATION DECLARATION �. !`Ker`;by affirm, that I have a certificate of consent to self D D D� D O Aura, ora certificate of Workers' Compensation Insurance, L1 U �. lrll •. ,ALJ* ®�. LO or a certified copy thereof (Sec. 3800, Lab C-.) COUNT1Y�OF:LO•S,AWGELES' BUILDING AND SAFETY +, PolicyNo. T Company Certified,copy is hereby furnished FOR APPLICANT TO FILL IN ' BUILDING• ADDRESS ElCertified copy is filed with-the courity.`building mspec- BUILDING tion department. n, ADDRESS, Date Applicant CITY; �, f �•. ZIP 0 !/0 LOCALITY NO`OF CERTIFICATE OF EXEMPTION FROM WORKERS' "5`1'" )' I"�� ^I' BLDGS NEAREST \ COMPENSATION INSURANCE SIZE OF!LOT O JC /L'O NOW ON LOT I CROSS S7 (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' • - ` • " - TEL312-6� USE NE MAP , OWNER NO. L/ I certify,that'in the performance of the'work for,which this NO permit is issued, I shall not employ any person in any manner ADDRESS I SPECIAL1' so as to become-subject to the Workers'Compensation Laws. CONDITIONS U; CITY V 1 � 64V f 4 VPAWt5ZIP Date WApplicon ARCHITECT OR TEL. ¢ NOTICE TO APPLICANT: If,'after,mokin th ertificate of DISTRICT GROUP TYPE FIRE PR CESSED BY 0 g ENGINEER �I'r G. r'fK NO _- •/ CONST , ZONE - 1—; Exemption, you 'should become subject t the Workers' ►d/ 1T V Compensation provisions of the Labor Code, you must forth- ADDRESS 00 N YO Ave', /�yL i�- Vr V � LLI with comply with such provisions or this permit shall be 0.9 deemed revokedTEL STATISTICAL CLASSIFICATION APT. NDO (q CONTRACTOR, NO ,/ Z LICENSED CONTRACTORS DECLARATION IC CLASS NO _fes(—DWELL. UNITS I hereby affirm that I am licerised under provisions of Chapter 9 ADDRESS 44 O (commencing with Section 7000)of Division 3 of the Business and LIC SEWER MAP Professions Code, and my license'is in full force and effect CITY /" CLASSLBK �W VALIDATION v0p) SQ FT. NO OF NO OF CHECK License',Number Lic.Class SIZE STORIES / FAMILIES / ONE VALUATION " Contractor" Date �q�N^ DESCRIPTION OF WORK n1W NEW ❑ 2 lZ--Z1 C4+�SF� ADD , $ J D ❑ I am exempt under Sec. � . ALTER Li , .�•• B.BP.C. for this reason ✓eirt �r� ,Aa ho Pyl- S LL « REPAIR ❑ $ Date: USE OF EXISTING BLDG 57",14 4c .1DEMOL E] Signature APPLICANT' C I G /1,u TEL'NO p/��q-7�� FINAL OWNER-BUILDER DECLARATION PRINT G fir) / DATE I hereby affirm that I am exempt from the Contractor's Licenser✓✓�yf � 0;1 a 1..A Law for the following reason.(Section 7031 5, Business and' ADDRESS o� FINAL' Professions Code): - pR By # o 0 0,o m F1 BUILDING � / ),(1 I, as owner of the property, or my employees 33 L��"loyees with ADDRESS m 1 �l „i •41 99.88 C wages as their sole compensation,will do the work and .� the structure is not intended or offered for sale(Section LOCALITY D 1 .,', i ° 1 y ,,�ti''•, . .4 = 7044, Business and Professions Code). MOVING - TEL + ,9 9.$$v ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO '' -- with licensed contractors to construct the project 44 (Sec- ADDRESS tion 70 , Business and Professions Code). REQUIRED- TOTAL SETBACK CONSTRUCTION LENDING AGENCY SET BACK' YARD HWY PROP. LINE WIDTH r - Ihereby affirm that there is a construction lending agency for FRONT •the performance of the work for which,this permit is issued PA i -•1. 1 (Sec 3097, Civ. C.). SIDE Lender's Name { LDMA Ref # C. Lender's Address P.0 Fee E.-- Permit Fee I certify that I have read this application and.state that the Issuance Fee t r ' w 4' r oabove information is correct. I agree to comply with all County Investigation Fee 6_ "' �' '�':� ordinances and State laws relatingto building construction, X 1 o 9 Total Fee r(J. LDMA Perms,# and hereby authorize representatives of this County to enter 1 c. upon above-mentioned property for inspection purposes. 7 l SEE REVERSE FOR EXPLANATORY LANGUAGE `I'f t ' !�• k°1 :� ` Signature of A scant or Agent - t - - *I a ' ;�Z�•ti�`'t,I