HomeMy Public PortalAbout5631 LOMA AVE_Building__ DEPARTMENT OF-'BUILPING AND SAFETY APPLICATION FOR PERMIT
COUNTY OF LOS.ANGELES
44.'J. FOX, CHIEF ENGINEER
FOR APPLICANT. TO FILL IN FOR OFFICE USE ONLY
BUILDING DISTRI(CTiNO. PLAN CK. NO. '�7
ADDRESSP/ERMIT,.NyO.
/(e V
R CEIVED BY, ^I DATE OF AP.PL. DATEISSUED.
LOCALITY _ o, 7_.� O
NEAREST*
NEARE3 � y..
CROSS$T, BUILDING �.n. � /1 vLr-
0WNER •a.`. _
.ADDRESS �
S l0 /✓CJ - �'V ,/ 7-
MAIL LOCALITY C/G
ADDRESS NEAREST AL
CROSS ST:
TEL. T / `' �j
CITY P NO. rI �1 "( !i FIRE NO. OF TY' GROUP/�^'
ARCHITECT OR TEL. ZONE �I PLANS Y I I
ENGINEER NO. BLDG.
SETBACK LINE �Yl�' 14C . 'T •7
ADDRES$ - APPROVED
TEL. BY - _DATE
CONTRACTOR - NO. USE J/IAPPROVED -
ZONE "( BY DATE
ADDRESS HOUSE NUMBERING
LEGAL
DESCRIPTION - r �/0-d i
.I LOT NO. I BLOCK MAP NUMBEIa FIELD CHECK BY
TRACT /6 /. _ NO. ASSIGNED BY ATF
SIZE OF LOT 3-0 I NO. OF BLDGS. . A CORRECTIONS
NOW ON LOT ,,.y-1,-
USE OF _ I NO. OF
EXISTING BLDG. FAMILIES
DESCRIPTION OF WORK
NEW I I ALTERATION I I ADDITION I 3�3r/52 .. p
REPAIR DEMOLITION
SO. FT. NO. OF
SIZE �U 6 ROOMS S STORIES ' Z
EXT. WALL ROOF - �G`���•��g� Lr r
COVERING COVERING
USE OF STRUCTURE .
• � STa•o� n rsliv /2.v
s
G�7- s-.�c�oo dve aC F�o�r 7•P�arrt o
A, ; X PPROYALS'e---'
INSPECTOR'S SIGNATURE DATE
1 HEREBY ACKNOWLEDGE THAT I HAVE R9HAFOUNDATION: LOCATION
PLICATION. AND 'STATE THAT THE
IN
FORMS, MATERIALS '
CORRECT.I AGREE TO COMPLY WITH THE CORRECFRAME: FIRESTOPSHEREON AND WITH ALL COUNTY ORDINANCBRACING, BOLTSLAWS REGULATINGBUILDING CONSTRUCTIO
-Q'!JJ/ FURNACE: LOCATION,
SIGNATURE OF GAS VENT, DUCTS
PERMITTEE L ,�
LATH, INT.
ADDRESS /d � :G .E� e.tJ ^Y. , 4✓1 - v
r LATH, EXT. - .3
AUTHORIZED AGT.
y� PLASTER, INT.
76A638A, DBBH 10-80 P. C. $
FEE PLASTER, EXT.
VALUATION $
FEE
��
WORKERS COMPENSATION DECLARATION a- `
f heF`e:by affirm that-4"have'a certificafe of.consent t��,self ® P L I ® �� MO • �UI L D I.N G �E R ,I T
insure; or a certificate of'Workers' Compensation Insurance, /� S""0 Al
or a certified copy theFe'of (S4 -.3800; Lab C.) �-� COUNTY"OF LOS,ANGELES w --'BUILDING'AND SAFETY..
a'
Policy No. Company T _ ,_
BUILDING .
❑' `Certified copy,is,;hereby furnished. :" '; FOR APPLICANT TO FILL,IN, ADDRESS
❑ , Certified copy is filed with The county building inspec
BUILDING
[�
ADDRESS '.:a_' ��
tion,,de
P
e artmnt?' /,6447/,64471:*
OQ
1 11
ZIP
Date APP I i ca nt T �- 0. OF-BLDG
CITY'.: C' LOCALITY-
t �s-
CERTIFICATE OF EXEMPTION:FROM IRS'.". SIZE OF LOT=
OW ON LOT
COMPENsATION:INSORANCE
NEAREST "•
ASSESSOR
CROSS ST..
This section neecd=not.:be•com feted if the ermrt'�is for'.one TRACT '` BLOCK LOT-NO.' '
(i<
( P P - MAP. BOOK PAGE ��- PARCEL
hundred dollars,($100) or less ) TEL
t^�cc
.• ,. ':�• OWNER_:' :; -.. ,NO..a�,J r•.f1, / 3
-USE-ZONE
% I certify that in-the performance,of The work for which this "w.
permit is issued;I shall not ern to an erson an manner. ADDRESS Cil a'
NO ;
P P. Y yP. - y
so.as-to become su jectto the-Wor rs'. : ns,a Laws r O,`
- SPECIAL
7. CITY _ -1, ZIP (70;
rX CONDITIONS
• Date V —� Applicant ARCHITECT OR 1TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY
NOTICE JO APPLICANT:,If, after. makingthis:Certificate of ENGINEER
NO.. CONST ZONE F
Exemption, you, should become •subjec,t to. the,',Workers , ! _ w'
Compensation`proyisions of the Labor Code•'y.,ou must forth- ADDRESS _'' j,,of R J lo' Jji,�e e -r a
with -comply with such provisions orthis permit shall be `.. TEL: _ STATISTICAL.CLASSIFICATION AP.T: CONDO.
CONTRACTOR- NO 0
N
deemed reygkedy.., Z
LICENSED CONTRACTORS•DECLARATION,, ' No' p-�-�!. CLASS NO. DWELL. UNITS
I hereby dffirm�that I am licensed under provisions.of Chapter9 ADDRESS �7� r EeJ r 32. J / p
(commencing with Section-7000)of Division 3 of the Business
CITYS/�U G /.t 'CLASS. �� SEW
and Professions Code ond•my license is in full fore effect BK.
ER pG VALIDATION
/ SQ"FT: NO..OF NO. OF CHECK
Z1 SIZE ' STORIES ( FAMILIES, ONE
v
Class •'
Co act y ,
�r• VALUATION'
License Numb ' Lie ' SCRIPTION OF,WORK` �3u NEW•.
i
❑I,am exempt under Sec.
ADD $ -
//// -
B.&P.C: for,this son . f' C5EL, a
.ALTER ❑
11SE OF
PAIR
RE ❑',
EXISTING BLDG" -�:, 71
DE
MOL'❑
Signature'. ��/� `� FINAL
LICANT Y " TEL.
(PR NT) '.Z.LO/VbA0 NOd
OWNER-BUILDER DECLARATION. a
I hereby,affrm thgt°l am exempT from the Contractor's License DATE
(/ A'
ADDRESS ��•TI ' �/t ". e
Law for the.following ieasoh (Section'.7031'.5,-Busin"ess`and FINAL= _:
Professions Code) PRESENT By
❑ I, as:-owner of the property, .6r'my'employees!with ADDRESS
wages as thetrsole compensation will do.the work and k ,ILDIN
^i rj-':•t
LOCALITY, ��
the structure is not intended or_offered for sale(Section
M' 7044, Business and,Professions-Code ) G a `
. >
❑ - 1> asbwner,of the:property; am„exclusively contracting
MOVIN _ _t •,-. TEL.
NTRACTOR;'` NO
9
with licensed contractors to construct The project (Sec ADDRESS
_ .
tion 7044; Busines's and Professions Code.)>
- `
CONSTRUCTION,LENDING AGENCY SETBACK • YARD ' HWY• TA PROPALINEFRO ``WIDTH
TO M • �
I.
hereby affirm.that tthere'i's ci construction lending agency for FRONT r
the performance cif,.the w6rk for wFiich this permit"is issued
(See:.3097 Gv`C
Lender's Name > - LDMA Ref. # � 5.
m PC Fee$ 76 Permit Fee ✓1:�7A�' -4.`
3 Lender's Address
I'certif'that) have read {his o lication.and state that”the ` Issuance Fee: LD/v1A P%C#
8 above information is correct.I'agree to:comply with-all County Investigation Fee", ��
0 ordinances and State lawa`reldting to building construction, Total,F.ee :A LDMA Perm.
hereby authori a representatives of.this County,to enter
�-
p n ve, e tinned property for inspection purposes
SEE-REVERSE FOR EXPLANATORY LANGUAGE
Signature.of Applicanf w Agent Date
I �
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9805290028
PHONE: (818) 285-0488 EXT: DUPLICATE
LEGAL ID: NO. OF CONST BUILDING ADDRESS:
TR: 16134 LT: 6 SQ. FT STORIES TYPE 5631 LOMA AV
STRUCTURE: 0 VN TEMP CA 917802451
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: DUFFY
5387-022-018 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY
TENANT: EXIST BLDG USE: RESID USE ZONE: R ISSUED ON: PROCESSED BY: EXPIRES ON:
EXIST OCC GRP: 05/29/98 UT 05/29/99
OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FIN L Br: CODE:
WARDELL FRED M;CHARLENE M (818) 285-8930- 1 1,000
5631 LOMA AV l4 `
TEMP 917802451 FEES PAID DESCRIPTION OF WORK
RECOVER WITH 2OYR. GENSTAR TAB COMP SHINGLE-8 SQUARES ONLY
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT-
APPLICANT: TEL. NO:
SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75
AC STRONG MOTION RESID-----1.000.00 VAL 0.50 SPECIAL CONDITIONS:
D2 PERMIT W/0 EN HC-7:—=Z:--1000'-00 VAL 65.25
E LETOTAG FEES 93.50
CONTRACTOR:
TEL. N0: ��� 3�� APPROVALS DATE INSPECTOR SIGNATURE
SAME AOWNER
LIC. NO "r LOCATION AND SETBACKS
'(� a SOILS ENGINEER APPROVAL
ARCHITECT OR ENGINEER: TEL. N0: r �^ \` FOUNDATION/TRENCH FORMS
LIC. N0: _ v litllll Il`y SLAB/UNDER FLOOR
f _r�—
RAISED FLOOR FRAMING
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP ;; 1, _� , // ` UNDERFLOOR INSULATION
147H265 3 0,1 FLOOR SHEATHING
NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS
NO 21 a j / t ROOF SHEATHING
SCHOOL WITHIN HAZARDOUS / (Y u �' �i;" SHEAR PANELS
AIR QUALITY: 1000 FEET MATERIALS
i,
NO • NO NO �;, � �� �,�� � �; d ' � FRAME INSPECTION
REQUIRED TOTAL SETBACK FROM EXIST `�'� �,? � jh'i;;' FIRE SPRINKLER HANGERS
SET BACK YARD: HWY: WIDTH: a
PROP LINE:
FRONT PL INSULATION/WEATHER STRIP
SIDE PL
INTERIOR LATH/DRYWALL
EXTERIOR LATH
RATED FLOOR/CEIL ASSEM.
RATED WALL ASSEMBLIES
RATED SHAFTS/OPENINGS
T-BAR CEILINGS
LOT DRAINAGE
REPORT ID: DPR261 ROUTE TO: BS0508
I