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HomeMy Public PortalAbout5634 LOMA AVE_Building__ 76A638A CE #803 3-69 APPLICATION FOR BU I LDI NG PERMIT COUNTY OF LOS ANGELES BUILDING / DEPARTMENT OF COUNTY ENGINEER ADDRESS 3 ~ AQ BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUP'T OF BUILDING NEAREST - CROSS ST. R APPLICANT TO FILL IN olsTjJCT N GRO P/�/1p/J TYPE�J�[J�p�y�_T. P -ESSE (PRINT OR TYPE ONLY) N.. .y. �L [A7DDRESS STATISTICAL CCLkSSIIIFICATION SEWER MAP CLASS NO. C:il -DWE.LL.UNITS r BK PG BLOCKUSE ZONE MAP • - NO. '"�� _ TRACT . -CONDITIONS. . SIZE OF LOT �?j. NONO W OF ON LOT BLDGS. - - USE OF EXISTING BLDG. BLDG. SETBACK FROM TEL. ^ FRONT PROP. LINE OF - - ` . (STREET) OWNER N0• ��_ ✓ TYPE OF EXISTING SETBACK HIGHWAY •+ YARD = TOTAL ADDRESS. �L � HIGHWAY WIDTH FROM C.L. + _ CITY ARCHITECT TEL. BLDG.SETBACK FROM - (STREET) ENGINEER - N0. SIDE PROP. LINE OF - TYPE OF EXISTING - SETBACK HIGHWAY + YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C.L.' TEL. + CONTRACTOR NO: ADDRESS NO CORNER CUTOFF YES ❑ NO ❑ C C LIC. L CITY CLASS SEER VERSE SIDE„FOR SPECIAL APPA VALS' CONSTRUCTION LENDER7 C NAME AND BRANCH .•Z /e Mh'-&. LL LL ADDRESS - �• t/ SQ. FT. NO. OF NO. OF Z SIZE STORIES FAMILIES NEW El USE OF ..� f - ADD ❑ STRUURE A ALTER ❑, (//CTC” REPAIR ❑ . SIGNATURE OF DEMOL ❑ - APPLICANT C VALUATION $ APPROVALS DATE y INSPE .W. St A RE P.C. PMT. FOUNDATIONFORMS, TERIIA SN / d [-'V FEE $ FEE $ HEREBY ACKNOWLEDGE THAT I HAVE READ THIS -APPLICATION FRAME: FIRE STOPS, . BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUC- TION ONSTRUC- GAS VENT DUCTS TION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I _ WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE LATH, INT. OF THE STATE OF CALIFORNIA IN RELATING T WORKMEN'S COM PENSATI INSURANO LATH, EXT. SIGNATURE HOUSE NUMBER CORRECT, PERMITTEE _ AND POSTED ADDRESS . FINAL • ,�J JOHN F. LEWIS, PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH . PERMIT VALIDATION CK. M..O. ASH { r� 3 5 5 7 N 2 1 a .G 0 DEPARTMENT OF BUILDINrws.A�TDa_5AFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELESBUILDIN I Wk J._FOX, CHIEF ENGINEER •- FOR APPLICANT TO FILL INH FOR OFFICE USE ONLY.. DISTR`I,CTT NO: /PLAN CK .NO: 1�•PrERyMIIT'NO.- BUILDING . ADDRES , � T, GJ rI L1616� S RE IVED Y DATE OF-APPL• DATE ISSUED •LOCALITY. NEAREST • - �G}r�� ®, /�� /` '�a ^'d i.. . CROSS ST. BUILDING // .Q� ADDRESSk� OWNER G • y( c� MAIL r LOCALITY -,�'^f•. '.. ADDRESS ® ��p .G,� .N � NEAREST CROSS-ST. •CITY NO. 6 ""7 Q FIRE NO. OF TY G U,P ARCHITECT OR - TEL. ZONE I PLANS I - I ENGINEER NO. BLDG. 'SETBACK LINE - , t , ADDRESS -� `APPROVED - l TEL. BY DATE ... 'CONTRACTOR.. NO -. ZUSE ONE "`r� APPROVED.. .,' +..••DATE -ADDRESS ° - • ' •- .gHOUSE NUMBERING LEGAL LOT NO. BLOCK MAP-NUMBER •i'�' —FIELD CHECK BY DESCRIPTION ,I I. , �wr�J _ - - 'TRACT' Y -NO. ASSIGNED BY✓�'- `oATF NO. OF BLDGS. 7CORRECTIONS, -- ' SIZE OF LOT .� Q:/`YY l I�NOW ON LOT/jj_&—v—L - SS ., nr_f BtT..t'. - USB OF � - - - NO. OF EXISTING BLDG. I,FAMILIES DESCRIPTION OF WORK h� NEW I I ALTERATION I I-ADDITION I - 60./ ./_ O. .. REPAIR I I DEMOLITION i SO. FT. - - .NO. OF, , - !'T1_ ' '°l�.'fAr��!13; 9n/r� .A �+'�41tNr.1113;ta '•O SIZE "90,Q' - - ROOMS 'y STORIES p S ` nG EXT. WALL '• ROOF COVERING ,a—� I COVERING�� •�' gpa/®G B� ,d�.it ?°"t5� .Co.��.0.'1��tl t'/i✓�i. USE OF STRUCTURE AJJ' - ' i 11 5 .e.Q i ',�`-:��.. ✓esr TI' ..e. T i�/.f/.a,a e. a col f 4)L£L. =d ;APPROVALS INSPECTOR'S SIGNATURE DATE - 1 HEREBY ACKNOWLEDGE THAT 1 HAVEREAD THIS AP FOUNDATION: LOCATION PLICATION AND STATE THAT THE INFORMATION GIVEN IS FORMS,(MATERIALS..: -, � My, X11 LST I`Y 'L :CORRECT.. - .. _ - I AGREE TO COMPLY. WITH THE 'CORRECTIONS LISTED- *FRAME: FIRE STOPS, HEREON AND WITH ALL COUNTY ORDINANCES AND STATE BRACING; BOLTS • / �,,,,1:.— - LAWS REGULATING'B ILDING CONSTRUCTION.; FURNACE:LOCATION, G SIGNATURE OFA GAS VENT, DUCTS .—2r 7. PERMITTER ♦ fff 111J LATH, INT.. Lk+a' ,/ ✓. .. ADDRESS / ? tJ 6t. ILS e ) ,✓ i..C/ 1 . LATH, EXT. - AUTHORIZED AGT. PLASTER, INT. © D AS38A:• 888 10-80 _ FEE $ 'PLASTER,'. O _ EXT. VALUATION FEE.. $. �G e�'®► FINAL ��s�GL`'.• WORKERS' COMPENSATION DECLARATION hereby affirm that I havecertificate 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 El Certified co s hereby furnished. BUILDING Py Y FOR APPLICANT TO FILL IN ADDRESS Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS ` f Date Applicant CITY T •,•'r _ Z • LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF 4LDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS SL (This section need not be completed if the permit is for one ASSESSOR } hundred dollars ($100)or less.) TRACT BLOCK LOT NO. MAP BOOK I PAGE PARCEL d OWNER NO. USE ZONE MAP 0 1 certify that in the performance of the work for which this NO. permit is issued, I shall not employ any person in any manner } SPECIAL J so as to become subject to the Workers'Compensation laws. ADDRESS CONDITIONS _J `i LL CITY ZIP } Date Applicant -' ARCHITECT OR TEL. NOTICE TO APPLICANT: If, after making this Certificate of DISTRICT GROUP TYPE FIRE PROCESSED BY Q Exemption, you should become subject to the Workers' ENGINEER NO. CONST. ZONE O Compensation provisions of the Labor Code, you must forth- ADDRESS '' d with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT CONDO. deemed revoked. CONTRACTOR NO. 1 Lil LICENSED CONTRACTORS DECLARATION LIC, CLASS NO. DWELL. UNITS— I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. (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 CLASS BK PG VALIDATION SQ. FT. NO. OF NO. OF CHECK License NumberLic.Class �-%f SIZE ISTORIES FAMILIES ONE VALUATION I �' ,t + DESCRIPTION OF WORK NEW ❑ Contractor Date ❑ $ ADD �,. F-1 , I am exempt under Sec. ��`�••s ALTER B.BP.C. for this reason REPAIR ❑ $ Date: USE OF ❑ EXISTING BLDG. ',- DEMOL Signature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION (PRINT) ��,; �J U IN ' DATE I hereby affirm that I am exempt from the Contractor's License Low for the following reason (Section 7031.5, Business and ADDRESS L FINAL Professions Code): PRE EN By BUILDING I, as owner of the property, or my employees with ADDRESS . wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY poll. o s s t , 7044, Business and Professions Code). MOVING TEL. I, as owner of the property, am exclusively contracting CONTRACTOR NO. -�,• with licensed contractors to construct the project (Sec- r ADDRESS tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK FROM CONSTRUCTION LENDING AGENCY SET BACK YARD HWY 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. # P . Fee$ Permit Fee poolLender's Address 3 $ 1 certify that I have read this application and state that the Issuance Fee LDMA P/C# 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. # o and hereby authorize representatives of this County to enter m upon the above-mentioned property for inspection purposes. a `) .z--•, �* SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant:or Agent Date ,. WORKERS COMPENSATION DECLARATION y APPLI A°fl I!I` + O IJhLDI�VG PERMIT .E .n I h reby-cfGir,m^that I Have a certificate of.'consent to self ' insure; ar a ce'riificafe of Worker r Com ensat?on Insurance, -or a cert fled copy.thereof (Seca 3800, Lab: C ) COUNTY OF LOS ANGELES BUILDING`'AND`SAFETY Policy No Company BUILDING �/ D Certified copy is.hereby furnished: FOR APPLICANT-TO`FILL IN ADDRESS %3 rCertified copy is filed with;the county building inspec' BUILDING y .,tion deportment;':; ADDRESS56�348 �;', LOCALITY` :. � L _.GI T NEAREST f /+ Date:, Applicant' CITY - l' IF. ® CROSS ST. CERTIF.ICATE.OF,EXEMPTION FROM WORKERS' `� ASSESSORS t• N OF LDG ,,fi�.-.gg COMPENSATION INSURANCE MAP BOOK �,J SIZE OF LOT'- Q NO O B LOT, PAGE PARCEL /a ' (This section need not be completed if the permit-is,for,one 2 \` �f USE ONE' MAP , hundred dollars.{$100)or less.) OT NO. —LTELNO SPECIAL.. TRACT BLOC 1 ceriif that in.The performance of:f e ork..for which this OWNER(? '� �/ f N GROUCONP y p DISTRICT P TYPE FIRE PRO ED BY O: permit is•issued, I shall not employ a-y win, y'manner �"�� Z so gs'to become-subject,to ihe:Wbr r pe ation Laws. ' ADDRESS S Clay S a— CONST. „ ZONE. U' �r� CITY +(� ZIP �i C® O_ Date" Applicant' V NOTICE-"TO APPLICANT:*'If, after making:this Certificate of ARCHITECT OR ` TEL STATISTICAL CLASSIFICATION ENGINEER `�C�' NO '•'" TCLASS NO:LAS TIODWELL.°UNITS LU Exemption,,you. should become- subject to, the'Workers' SIFICA APT. CON Compensation provisions of the Labor Code,'-you must forth- ADDRESS - SEWER MAP y with comply with: such provisions or this permit shall.be. r TELQQ s deemed revoked. ' •. T . J NO.-7 .'LZZS BK: PG, Z VALIDATION LICENSED CONTRACTORS DECLARATION',` IC. n L I hereby affirm;that I am licensed under provisions of Chapter 9 ADDRESS Z &ZHilw. PL NO. VAL ATION ' (commencing with Section 7000)of Division 3 of,the Business and s p LIC. Professions Code, and my,license:is in full force and effect.. CITY /fir It19 � ,'S' CLASS $ License Number' l�c.'Class SQ. FT.' NO OF V NO. OF 0 CHECK SIZE ® STORIES / FAMILIES ONE NEW ❑ $ , Contractor. Date DESCRIPTION OF WORK ❑ [,am exempt under Sec. FINAL Q .ADD-- _❑ $.&P.C: for this ceason . . .. . - �ltr� ®8 ALTER- ❑ - ❑ DATE REPAIR Date DEM ❑ USE OF FIN �• EXISTING BLDG: yy�� By Si0oture yB,. c,>r - ,. APPLICANT - TEL. OWNER-BUILDER DECLARATION PRINT) NO. h hereby affirm that I am exempt from the Contractor's License, C./ A���� `_ z 6 1. 2 J� A Law for the.following reason (Section 7031.5,.business.and ADDRESS. , Professions Code): n. PRESENT as owner of the property or_:niy}employees with ADDRESS , ) ° Lj 0 wages as their sole compensation,Will do the work and' J ,_-r' kADDRE y * !_ the str'u'cture is not.intended or offered for sale(Section. ; 7044, Business and Professions Code) TEL. ° ° 8 - CTOR NO.. 7. as,owner of the property am exclusively contracting - �J 8 t ,. :1 .2.1 7; `8 6 with licensed contractors to construct the-project(Sec tion 7044; Business.and-Professions Code).` RED, - TOTAL SETBACK,FROM EXIST.. CONSTRUCTION LENDING AGENCY. CK YARD HWY PROP. LINE'" WIDTH I hereby affirm;that there is:a-construction lending;agency for T the performance of the work for:which this permit is issued ; (Sec 3097 Civ.'C ) " k m t ame -76• ,$ Permit Fee - Lender' ddress `>� e �;• 1 cer y that I have read this application and state that the, r y f Jssuance'Eee ¢. abo e i orm tion is come t:I ogree'to<comply with,all County,, Investigation.Fee $ or ino ces a d State law •relating to building construction; k u a d ereby' uthorize r resentgtives o this County to enter Total Fee 3 � . u the ab v enti n d property,fo inspection purposes. - ` /+ � � SEE REVERSE FOR EXPLANATORY LANGUAGE fL� Sig aturerofApplicantorAgent Date :' t COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS DEMOLITION BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0309020003 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: TR: 16134 LT: 19 SQ. FT STORIES TYPE 5634 LOMA AV STRUCTURE: 320 TEMP CA 917802450 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: BIDWELL 5387-019-015 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: RESID USE ZONE: ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 10/21/03 JK 10/15/04 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE: AHN; PETER - 0 5634 LOMA STREET JJ TEMPLE CITY 91780 FEES PAID DESCRIPTION OF WORK DEMO EXISTING GARAGE FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. N0: KEVIN C YANG (626) 672-5098- AA BLDG PERMIT ISSUANCE 27.75 9138 OLEMA ST 02 DEMOLITION INSPECTN 163.50 SPECIAL CONDITIONS: TEMPLE CITY 91780 TOTAL FEES 191.25 \. C � CONTRACTOR: TEL. NO: �/�,� APPROVALS DATE INSPECTOR SIGNATURE KEVIN CHIA-JEN YANG (626) 286-2096- 9138 OLEMA ST LIC. NO PEDESTRIAN P OTECT10N TEMPLE CITY , CA 91780 807384 HIC SEWER DISCONNECTION ARCHITECT OR ENGINEER: TEL. N0: �1�� ABANDON PRIVATE DISPOSAL UND STRUCT LIC. NO: I ! I' ��1'll;� �1y\iy}11 ANDESOILDRECOMPACTREMOVAL ION MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: n nFID 11,01 NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT C- ---- ------------------- Jt NO 23 SCHOOL WITHIN HAZARDOUS Z7 AIR QUALITY: 1000 FEET MATERIALS �\ $=*, T,P 1 ') NO NO NO eP'119C:� * ADDITIONAL DATA ON FILE REPORT ID: DPR261 ROUTE TO: SSO508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD/ALT/REP BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0309020002 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST NEW BUILDING ADDRESS: TR: 16134 LT: 19 SQ. FT STORIES TYPE OCCUP GROUP 5634 LOMA AV STRUCTURE: 423 1 VN R3 TEMP CA 917802450 ASSESSOR INFORMATION NUMBER: GARAGE: 400' 1 VN U1 NEAREST CROSS STREET: BIDWELL 5387-019-015 OTHER: THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: USE ZONE: ISSUED ON: PROCESSED BY: EXPIRE ON: EXIST OCC GRP: 10/21/03 JK 10/15/04 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE: AHN; PETER 40,000 5634 LOMA STREET �— TEMPLE CITY 91780 FEES PAID DESCRIPTION OF WORK ADD MASTERBD, BATHRM, DINING RM, & ATTACHED 2CAR GARAGE FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. NO: KEVIN C YANG (626) 672-5098- AA BLDG PERMIT ISSUANCE 27.75 9138 OLEMA ST AC STRONG MOTION RESID 40000.00 VAL 4.00 SPECIAL CONDITIONS: TEMPLE CITY 91780 81 PLANCHECK,W/ENERGY_ -140000.00 VAL 623.82 B2 PERM I.T--W/`ENERGY——'--- -'FEES 40000..00 VAL 733.92 TOTAL CONTRACTOR: TEL. NO: ��� " 1,384.49 6 �` APPROVALS DATE INSPECTOR SIGNATURE KEVIN CHIA-JEN YANG (626) 286-2096- ��r 9138 OLEMA ST LIC. NO ,/ LOCATION AND SETBACKS TEMPLE CITY CA 91780 807384 HIC * \ SOILS ENGINEER APPROVAL vL / ARCHITECT OR ENGINEER: TEL. NO: / �- yr \\\ FOUNDATION/TRENCH FORMS LIC. NOl SLAB/UNDER FLOOR 111 �-- f111�111�1 1.�i,i / RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: i II J (� r UNDERFLOOR INSULATION 3 U X01 LDLI 1��V`�I V� /L� L L� ��J '1 ST LEVEL FLOOR SHEATH NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS:---- -------------- ___ 1 NO 21 — ND LEVEL FLOOR SHEATH SCHOOL WITHIN HAZARDOUS �, ROOF SHEATHING AIR QUALITY: 1000 FEET MATERIALS , NO NO NO ins FIRE DEPT. FRAME INSPECT. / �l � REQUIRED TOTAL SETBACK FROM EXIST BLDG DEPT. FRAME INSPECT SET BACK YARD: HWY: PROP LINE: WIDTH: e�'�a FRONT PL d� G4y0����g�1s / SHEAR PANELS SIDE PL- INSULATION/WEATHER STRIP INTERIOR LATH/DRYWALL lf�/l�',j EXTERIOR LATH LOT DRAINAGE SMOKE DETECTION DEVIC S FIRE DEPARTMENT APPROVAL * ADDITIONAL DATA ON FILE REPORT ID: DPR261 ROUTE TO: BS0508 1