HomeMy Public PortalAbout5719 LOMA AVE_Building__ I. t / '. ;ADD EIS9 -
�`� I'; APPLICATION e� Locnu rY -T C _
..- � CROBB BT. -
- NG: AND SAFETY
DIVISION OFIIBUof06 ty.miginee! DISTRICT NO ' ' " "'RECEIPT NO. PERMIT NO.*Department of Qo g .., .� g09 � �'
An plea
WM. J. FOX. COUNTY EN6INEER GROUP, DATE RECEIVED DATE ISSUED
{ CASSAW D. GRIFFIN, ,BUP•T OF.'BUILDING
FOR APPLICANT TO FILL IN TYPE CONST. ECEIVED BY �I'SSUE13Y
OWNER MAP -T . STATEr � -
' MAIL. /��! .NUMBER 2QOCo HWY �P/NO ".
ADDRESS
USEZONS 'SPECIAL _ i.
TEL �7 e� CONDITIONS `
I CITY �.V Csq�f '
ARCHITECT CF TEL: `7cJ®
ENGINEERT2! Y.�J;Z,GI NO.° /f) -
�}/� �/ �J . "BUILDING YARD HWY STREET NAME " _ EXIST. z
A DRESSY V, / :v' l y �f�F' SETBACK WIDTH
.._,._ .., � . FRONT �}� Le;
... TEL P.L oCV - GO
CONTRACTOR
. _ P.L_
A DRESS
DATECORRECTIONS INSPECTOR
BUILDING' L�� � � '� - '^'
ADORESS
._ LOT NO. - BLOCK ® r-
TRACT i.Z�2 977
SIZE OF LOT J�,�/ T /7 ► .�I NDWOON'LOTB.
USE OF
- 'EXISTIN -BLDG.
DESCRIPTION OF WORK :L�'AI.�..1 .A
p A V.P[ ��'
NEW ✓ ADD -.ALTER REPAIR DEMOLISH - - - Z
SO.FT. yy� NO. OF-!- / NO.OF F
SIZE � STORIES - ,/ FAMILIES-. /�, /'1 -
USE OFSTRUCTURE S r .- 1.�-•','..n7u,6i tS+ C.dG6.F'P_V,6A-C
/ /�
_
(!5w,=,___-. .�L14 hJWJA3L/J_ yA_L .:.rQ" `7-c O
e x)Zl 7_'lm"
4e 4
.. N D.OF .. ..!/I/
EMPLOYEES
1. HERESY,ACKNOWLEDGE THAT.-I -HAVE READ•TH19 AP
PLICATION AND STATE THAT THE INFORMATION _GIVEN 19 APPROVALS .IkBPECTORl&SIGNATURE I DATE.f '.
CORRECT.
I AGREETa COMPLY WITH ALL_COUNTY ORD.INANCES'r FOUNDATION: LOCATION .a. ,r, ,
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FORMS,MATERIALS ,
FRAME: FIRE STOPS,
SIGNATURE OF. BRACING:BOLTS --
PERMITTEE FURNACE: LOCATION.
- ®�y GAS VENT,DUCTS t� -
ADDRESS ,/4 •J_..C� F lst3d ..�' Yl.�^t :, 1� •'4!.s„„ . . ., - "47
-
LATH, INT. .Il J..
-AUTHORIZED, AST.. -
00 ,.�. LATH, -EXT.
$ �--�, r!c P.,C..>a- .A ...f�Y-.' - HOUSE NUMBER COR-
-� _J n OO FEE - 1'Y �T ;' RECT AND POSTED
LUON Z." _ .. o-1
I �o�-�.' �' FEE , O FI,WAL P /
-VAATI �
76AS39A DBS 3 4-54 -
,i
WORKERS COMPENSATION DECLARATION
-
i:I hereb affirm:thor I hove-:a certificate',of consent to�self '. -� - `
J Y ITM1 .F IJILI _ t.
_ .PER w"
insure; or•-a,certificate-ofWorkers'.Compensation:Insurdnce,, v•-
o`r'a certifred ¢oPy thereof (Sec. 3800;:Lab. C,);.,.' '
IT
COUNTY OF�LOS ANGELES BUILDING'AND,SAFETY.,``
r' Policy.No. Com"pang. <� [/ C/
Certrfiedcopy'is hereby'furnished=~ „ FOR`APPLICANT TO FILL 1N'
+"Gertified',¢o ADDRESS i��/
is`'filed with;th°e.co,unt buildin ins spec
PY. r Y" 9 P, . t BUILDING
BUILDING
tion` epariment ,: ADDRESS ,+
„r•Date, '/: G' Apphcont 1L i CITY_ ` C? ZIP LOCALITY•.
CERTIFICATE.;OF:EXEMPTION'FROM'WORKERS' -
NO.;OF BLDGS.;'., NEAREST'
INSURA.NCE SIZE'OF LOT, ,eNOW LOT• CROSS,ST.
(This section need not,be complet'd if the permit isASSESSOR
'for one =
hundred dollars ($100)drJess } :
% :TRACT' BLOCK („ LOT NO MAP BOOK PAGE PARCEL
k OWNER .`c p LL/'�L/ NOTEL -�,3OJ=:. USE.ZONE MAP t
'I certify'thot iiJhe- performance,of the'work forwhich•t.is _
perm itis'issued,;l shall not employjany person in any manner, SPECIAL t.:.
LJD/2 Q S CONDlTlONS
so.as to-become.sutiject to,the�Workers'Compensation Laws ADDRESS U;
`Date Applicant.' A
a, CITY cS ZIP
T - PPI ANT:Pf..after'
'making.this Certificate of ARCHITECT OR". TEL. - DISTRICT GROUP (TYPE FIRE PROCESSED'BY O
NOTICEO.A . L C , - 9 ENGINEER. _ NO. CONST. NE Vt
Exemption,-,you- should become• subject to the,.Workers
Compensation provi3ions'of the Labor,Code, you m`ust;'forth- gDDRESS. w V W�
with,comply with such,provisions or this,'permit shall be ::.
TEL STATISTICAL CLASSIFICATIONS, APT.. CONDO fn
deem'ed:revoked
CONTRACTOR f I/ NO. ,:: -
-LICENSED-CONTRACTORS DECLARATION,- LIC. CLASS NO: DWELL'UNt75
.
I hereby'affi`rm that I am'Iicensecl•.under,provisions of Chapter 9 ADDRESS Y C A! NO
(commencing with Se'ct+on 7i*,of Dtvision'3 of'the'Business and LIC. _
SEWER MAP./
Professions Code, and'my hcen"se is m fuljl force and effect CITY 'CLASS _ �: VALIDATION
BK.
Q. ET. NO'OF NO.OF {HECK;_
Lic Class ^ - RIES L
License Number SIZE STORIES.' FAMILIES ONE..
VALUATION .
' / ` DESCRIPTION OF WORK O CA NEW i_� ✓^ -:
Contractor 2 Dgfe ADD $ S
❑ '
I am exempt under Sec. �/ �7L
' t i
;• .� ANTER
B.BP.C:•for.this reason = if L zLl' Ma2� REPAIR"
o'.' USE'OF 4�p�-� ya 8f)�^Cot"'t jJ
Date EXISTING BLDG. DEMOL
a a
+ Sr nature i:. ti_ : ." NT FINAL
- y APPLICA TEL'.
g - " PRINT) !'/- NO. 6041 `.
OWNER--BUICDER DECLARATION F
<c.L hereby affirm that,Lam'exemptfroin the Contractor's License ' ^ %, •' t
ADDRESS ; VV'/}C e DAT L
E
Law for the following'reason (Section 7031.5, Business and ' FIN
Professions Code). PRESENT By, r,
as,owner of the property or my-employees:with ADDRESS
❑ <
wages as their sole compensatwn''will do;tlie work and ,.
'the structure'is not intended or offered fo"r sale(Sect`on LOCALITY ' i
7044; Business.and'Professions'Code) MOVING TEL,
I, as owner cf;the property, am exclusively contracting CONTRACTOR
NO.. �. t
� '.;withdicensed.controctors to construct the project (Sec °
tion-7044, Business and Professions Code):^';: ADDRESS
m
?_ REQUIRED, TOTAL SETBACK FIRM
CONSTRUCTION LENDING AGENCY SET,BACK , . YARD HWY PROP. LINE`? WIDTH j +
I hereby,dffjrm that there.isa construction l"ending agency for a FRONT
" the
performance.of the"work for which•this p,e'rmit is issued P:L .
(Sec :_3097 Civ. C ) SIDE
P:L. i
Lender's Name ;
P.C.r.Fee$ .. - .PermiI e
m CDMA-Ref #
Lend'er's Address Q O
. t
g I certify..thor l,'have.regd this'appIication and.state`that the ;., Issuance Fee CDMA P/C# -
'' above information is,correct. I agree f0 comply with.all Count - - - - �• - - -- -
PY Y Investigation.Fee a -
o•. ordinances and State Gws'relating•to,building Construction ,, "'..Total Fee- s;; -CDMA Perm # -
and,hereby authoriie'represeritatives`of this County to enter
m: upon the above-mentioned property for inspection.purpose's -
Qr,- ice" SEE REVERSE-FOR EXPLANATORY LANGUAGEr'
o v
„Signature of Applic Agent
- a
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 917801 - BL 0508,1205150033
"PHONE.: (626) `285'0488 EXT: '
- LEGAL ID: - -- - - - - '` .NO.,OF CONST NEW BUILDING ADDRESS-
ITR:
DDRESS:ITR: 12977 LT: "5I
. .. SC2.".RT STORIES TYPE OCCUP*GROUP 5.719 LOMA,AV ..
_ (STRUCTURE: 352 1 V_B R-3 TEMP CA'9.17802453 -
JASSESSOR�.INFORMATION NUMBER GARAGE: - ;NEAREST CROSS STREET: BIDWELL
15387022-005 - - "OTHER: 45 1 V-B U - THOMAS .PAGEi 596 GRID: H3 LOCALITY: TEMPLE CITY, 'CI
TENANT: IEXIST BLDG USE: USE ZONE:.` ,TISSUED ON: PROCESSED'BY:
(EXIST OCC GRP: 105/16/12 SR
DOWNER: TEL. NO? IBLDGS- NOW ON LOT: - - VALUATION: -IFINAL DATE FINAL BY: CODE: .
57 JENNY (6261, 5.62-2000- - - - 29,020
15719 LOMA AV T I
ITEMP 917802453_ - FEES PAID 1155ESCRIPTION OF WORK - �
J INTERIOR"REMODELING KITCHEN '2 BATHROOMS AND CLOSET AND ENTRY
_IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:-COVERED PORCH
TAPPLICANT: - TEL. NO: �• - -
IYU, ANDY (626.) 458-8111- ••IB1 PLANCHECK W/ENERGY 29020.00 VAL ,502.20 1" _
111946 FAIRVIEW ST - IAA.•BLDG PERMIT ISSUANCE 27.80 ISPECIAL,CONDITIONS:
TEL MONTE CA 91732 'JAB STATE GREEN BLDG FEE 29020:.00 VAL 22.00. 1
IAC STRONG MOTION RESID 29020-00 VAL 2.90- T
- - JB2 PERMIT W/ENERGY 29020.0O VAL 590.70 'I _ .�-
ICONTRACTOR: - - - TEL. NO: - I TOTAL FEES 1,125.60 ;JAPPROVALS - DATE INSPECTOR SIGNATURE
JXU, JENNY G (626) 592-2000-_ .'- - -
15719 LOMA`-AVE . LIC. NO - - - LOCATION AND SETBACKS
ITEM PLE-CITY, CA 91780 - - _ NONE - - •'.
T T ISOILS ENGINEER APPROVAL
ARCHITECT OR ENGINEER: TEL. NO: - - .(FOUNDATION/TRENCH FORMS
1 LIC. NO; JSLAR/UNDER FLOOR" J
RAISED FLOOR FRAMING
.' MAP NO:.�SEWER MAP. BOOK: PAGE:' FIRE� ZONE: CMP.:. (UNDERFLOOR INSULATION I
3 001
T - DIST LEVEL -FLOOR-SHEATH .. _
INC." OF FAMILIES: DWELLINGUNITS: APT/COND: STAT CLASS: - L_•-' �' _ �
0 NO 2, 12ND.LEVEL FLOOR SHEATH .T
SCHOOL WITHIN HAZARDOUS IROOF SHEATHING
-FAIR QUALITY: 1000 FEET MATERIALS - - - • _
1
NO, NO NO (FIRE DEPT. FRAME INSPECT)
-i - BLDG DEPT... FRAME INSPECT( ,-
. I SHEAR PANELS
J INSULATION/WEATHER STRIP(
JINTERIOR.LATH/DRYWALL . i..
. I "• .; EXTERIOR LATH -
I I I
I 1 �LOTS DRAINAGE
I I I
- I - JSMOKE DETECTION DEVICES.1. I
FIRE DEPARTMENT APPROVAL ... -
I - I •. I- I I - I
- .. �.REPORT ID; DPR261 .-ROUTE TO:
" -COUNTY-OF LOS-ANGELES -TEMPLE CITY "' - # 0508 • BUILDING PERMIT -DEPARTMENT-OF PUBLIC. WORKS 9701 LAS TUNAS - RESIDENTIAL ADD
BUILDING AND SAFETY / -LAND DEVELOPMENT TEMPLE CITY CA 91780 -' - BL 0508 0605120044 _
- - PHONE: (626) .•285-0488 EXT:'
LEGAL YD: - - - NO. OF CONST NEW BUILDING ADDRESS:-
'TR: 12977 LT: 5 - - SQ:_.FT. STORIES TYPE OCCUR GROUP 5719 LOMA AV -
_ STRUCTURE: 66,: - `1 VN' R3 TEMP-CA.9.17802453
ASSESSOR INFORMATION NUMBER:. GARAGE:- NEAREST CROSS STREET: -
5387-022-005 OTHER- THOMAS PAGE: 596-- GRID: H3, LOCALITY: TEMPLE. CITY, "C
TENANT('--- - - ' "• EXIST`BLDG USE - 'USE-ZONE: '. ISSUED ON: PROCESSED BY: EXPIRES ON: -
EXIST OCC-GRP:: - 08/23/06 - JK 08/18/07
.OWNER: TEL. NO: - BLDGS. NOW ON:LOT: - VALUATION: FINAL. DATE FINAL-BY-- - - --- - CODE:
L,. WONG - (626) 287-3567- 8,.000 /1 Z �i �, - /LJ• -
5719 LOMA AV - 1
TEMP 917802453• - .FEES PAID - DESCRIPTION OF WORK ,
ENLARGE THE EXISTING DINING ROOM 66 S.F. -
' FEE-DESCRIPTION: QUANTITY: UOM: AMOUNT
APPLICANT:' - • TEL. NO: -
.GEORGE HSU ' (626) 552-1655- B1 PLANCHECK W/ENERGY 8000.00 VAL 171.11 -
908 CONCORD AVE - AA BLDG.PERMIT- ISSUANCE 27.75 SPECIAL CONDITIONS-: -
MONTEBELLO CA 90640 AC STRONG MOTION RESID 8000..00 VAL 0.80 -
B2 PERMIT W/ENERGY 8000.00 VAL 201.30 _
TOTAL-FEES 400.96
CONTRACTOR: TEL.. NO: - - APPROVALS DATE. INSPECTOR SIGNATURE -
L.-WONG - (626) 287,73567- •
5719 LOMA AVENUE LIC. NO LOCATION AND SETBACKS -
TEMPLE CITY, CA 91780 NONE -
_ SOILS ENGINEER APPROVAL
ARCHITECT OR ENGINEER:_ TEL. NO: - - - FOUNDATION/TRENCH FORMS
LIC. N0: I_ .• SLAB/UNDER FLOOR
_ - - - RAISED FLOOR FRAMING
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE- - CMP:'I - UNDERFLOOR INSULATION u
w - 3 O1j
1ST LEVEL FLOOR SHEATH
NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS:NO - 21 - - .2ND LEVEL FLOOR SHEATH
SCHOOL WITHIN HAZARDOUS - - - ROOF SHEATHING - - - - -
AIR QUALITY: 1000-FEET. -` .MATERIALS
NO NO NO .- - FIRE DEPT.
FRAME INSPECT -
- •'I - ..
REQUIRED - TOTAL SETBACK FROM EXIST 'i - BLDG DEPT. FRAME INSPECT
SET BACK YARD: HWY: PROP LINE: WIDTH:
FRONT PL- - _ SHEAR -PANELS - - -
SIDE PL- - -
--- - INSULATION/WEATHER STRIP.
.INTERIOR LATH/DRYWALL. - -
l EXTERIOR.LATH
'.,, ,• y LOT DPAINAGE
SMOKE.DETECTION DEVICES" - -
_
FIRE DEPARTMENT APPROVAL -
- - (REPORT ID:. DPR261 ROUTE TO:•�BS0508 -