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Home My Public Portal About5725 LOMA AVE_Building__ DIVISION OF BUILDING AND SAFETY ' Department of County Engineer Mu - . County of Los Angeles WM."J. FOX, COUNTY ENGINEER .APPLICATION FOR APPLICANT TO FILL IN FOR OFFICE USE,ONL'YS/j 7 247 DIST NO. PL tl C,CooR�/ D (��PERMIT/ BUILDING6C / ADDRESS RE EIVEDBY T fOFAPPL. DAT ISSUED LOCALITY •, �' � NEAREST CROSS ST. BfJILDING OWNERn1l . MAIL LOCALITY ADDRESS NEAREST _n\. CROSS ST. CITY. lsy+�, ,1'jfi�'-C...c"Jl TEL NO. FIRE r NO.OF TY GROUP ARCHITECTOR TEL ZONE I' PLANS ''• 9L'� ENGINEER NO. BLDG.} SETBACK LINE 2O ADDRESS .. USE )�/• APPROVED O 7 TZONE/.1 BY E �`-•� �,, DATE �i / CONTRACTO N . V - HOUSE NUM VERINO �. ADDRESS ? MAP NUMBER C/C/ y NO. ASSIGNED BY�! LEGALC CO ECTIONS DESCRIPTION I LOT NO. ""f' BLOCK C , TRACTNO. OF BLDG SIZE OF LOT rt `� IN I NOW ON LOT 5 USE OF I NO.OF EXISTING BLDG. .`ter-- FAM ILIEe DESCRIPTION OF WORK NEW ALTERATION ADDITION Z D REPAIR DEMOLITION t- SQ. FT. NO.OF � ( 91ZE 4j ROOMS STORIES t j p� I L k Pt Er EXT.WALL, y � I ROOF COVERING! COVERING � =�3 0• /�, � �/{"(- ZZ USE OF STRUCTURE INSPECTION FOR APPROVALS OCCUPANCY AS •INSPEEECjTO.RIS/-SI�IGfNiATURE DATE FOUNDATION: LOCATION Y"(`fkf�'Litsfl/ �� 'J ' FORMS, MATERIALS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP-; PLICATION AND STATE THAT THE INFORMATION GIVEN IS4 FRAME: FIRE STOPS, { CORRECT. BRACING, BOLTS( I AGREE TO MPLY Y-WITH ALL COUNTY ORDINANJN !, FURNACE: LOCATICEN.� t AND STATE LAWS EOULATINO UILDING CONSTRUCTIOAS VENT. DUCTSs�•e�t:/NSA SIGNATURE OF LATH, INT. e% � PERM17 ADORES I LATH, EXT.. PLA9TERrINT.AUTHORIZED ADT. PLASTER, EXT. FEE S -77 HOUSE NUMBER COR- RECT AND POSTED VALUATION >8� am o FEE FINAL 7GA638A DBS 3 1-67 PLICATI � y IL. _ -: COUNTY OF'LO7�'ANIELES BUILDING AND,SAFETY WORKER'S-COMPENSATION`DECLARATION FOR APPLICANT"TO.FILC.w BUILDING ADbeess ,' ' " " BUILDING ADDRESS-• I hereby affirm`that],have.a certificate of.consent to self Insure, Or a,certificate of.Workers' Compensation Insurance,'or a.certifjed l5 copy thereof'(Sec LOCALIT. 3800,Lab:C.); CITY _ ZIP p Policy No ,; ` Company SIZE OF L NO.OF-BLDGS.NON LOT, . .o _ � t- El Certified copy Is hereby furnished -❑ Cectifled,copy is filed with the'county building inspection , TRACT -- - -- BLOCK .LOT NO:, - is . NEAREST OSS$Tr; department' ZONE., NO. - ' '•-'S ` ASSESSOR MAP BOOK --PAGE PARCEL•_ - G%� USE Date, Applicant SPECIAL'CONDITION - CERTIFICATE OF EXEMPTION FROM WORKERS OWNS rEL No. -- COMPENSATION INSURANCE ' SLau ;WITHIN 1000 FT.OF SCHOOL? YES',` NO ; (This section need not be completed if the permit Is forgone hundred ADDRESS , , DISTRICT, GROUP TYPE CONST: FIREZONE;. PROCESSED BY dollars ($100)or less) . CITY .. ZIP` _ I 011 certify that in the performance of-the work for which this permit, � ►/ 1s issued, I shall not employ any person in any manner so as;to e become subject•to the Workers..Compensation-Laws. ARCHITECT, - - - STATISTICAL CLA S�ICATION APS. CONDO - OR ENGINEER TEL NO. v` _ Date.- Applicant - ADDRESS - -- - CLASS NO. DWELL UNITS NOTICE' TO' APPLICANT.- If,•after -making this -Certificate-of.. REQUIRED SETBACK FROM EXIST. �.- - -' b TOTAL • �exemption, you should become' -subject to. the Workers''- - CONTRACTOR - - TEL-NO., - SET BACK YARD NWY PROP LINE WIDTH Compensation provisions ,of, the Labor Code, you must forthwith .F FRONT " 1comI with such-provisions or this permit.shall be.deemed revoked. ADDRESS'' LIC.NO: SIDE F pY P d LICENSED CONTRACTORS DECLARATION fs 7 CIT �, - .CIC:CLASS 'P L a I hereby affirm that I am licensed underprovlsions'of. Chapter,9 �' �� SEWER MAP s ! ' (Commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF, DRIES NO FAMILIES :- _ _ - °-- Professions Code,and my jicense'is In full force and effect.' ' NEW ❑ BK PG _ s. d E _ i_ rS DESCRIPTIONOF WORK _r. ADD , [�• VALUATION` - - OOTA . License Number LIc Glass - - - / _ �-•.� - Coritractor Date ALTER,' ❑ 6O i El I am exempt under Sec: kA REPAIR ❑ f B.&P.C:for this reason. - .. TDMA P/C:# .. .. ,_ Date. • .USE OF EXISTING BLDG... .. .. URM.: ❑ - - - IL Signature APPLICANT(PRINT) _ - TEL NO. LDMA•.Per_m# U s , �• 'Z ," , - _• t y I; as Owner-of'the property, or my-employees',with wages'.as E ;f their sole compensation,will do.the work and;the.structure..is ADD ESS not intended or.offered for sale(Section 7044, Business and - a� 1' ? . [� FINAL DATE " - Q ff t V p'xi Professions Code.) -, n '` - '`' ILL THE APPLICANT OR FUTURE BUILDING UCCU ANT HANDLE ` AZARDOUS MATERIAL �� — �,-i ., W _ - F ❑ I; as owner- of the propert am, exclusive] contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL T GREATER THAN'THE Y,, Y• 9 AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE licensed contractors to construct the project (Section.7044, YES❑ No❑ 'b {'iL ' -FINAL BY r j Business and Professions Code.) WILL'THE INTENDED USE,OF THE BUIDLING BY THE,APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR:MOD]FICATION FROM THE SOUTH ' CONSTRUCTION LENDING AGENCY. COAST AIR DELI NES QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST'FOR �� ` .,. _ - I hereby affirm that'there is a construction lending agency for YES❑ No❑ N" the performance of the work for which this permit is issued(Sec, I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING s. 3097 Civ.C. " - .<. - .: r CHECKLIST. UNDERSTAND MX REQUIREMENTS UNDER THE.LOS:ANGELES COUNTY'CODE„ - - TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH.220.140 CONCERNING HAZARDOUS - - _ _,f-f �.' .Lender's Name -' MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. - d e p.. Lenders Address - OWNER OR AGENT, s ' o I certify that 1.have read this application and state under penalty y of perjury that the above information is correct.I agree to comply. P.C.FEE -' PERMIT FEE with all county'ordinances and State laws relating to building �j' 56 �� • .0 construction, and herebyauthorize'representatives of this County b• ISSUANCE FEE co - to ent upon the-above-mentio property for inspection rpo �� ( ses. Q % � •'•" ' INVESTIGATION FEE- - TOTAL-FEE -51 a " P'��eant $ '. Date•. .' _ /J��/��J, �,��+/�/✓�� „ .. SEE REVERSE FOR EXPLANATORY LANGUAGE ' COUNTY`OF LOS ANGELES TEMPLE'CITY - # 0506 BUILDING PERMIT DEPARTMENT. OF-PUBLIC WORKS - - 9701 LAS TUNAS RESIDENTIAL ADD/ALT/REP BUILDING: AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0605220004 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST NEW BUILDING ADDRESS: TR: 12977 ,.LT: 4 - - SQ. FT. STORIES TYPE OCCUP�GROUP 5725 LOMA AV- STRUCTURE:. 608 1 VN R3 TEMP CA 917802453 ASSESSOR INFORMATION NUMBER: GARAGE: 526 1 VN U1 NEAREST CROSS STREET: 5387-022-004 " 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: 09/13/06 JK 0.9/08/07 OWNER: TEL. NO: BLDGS. NOW ON. LOT: VALUATION: FI AL DATE FINAL BY: • CODE: THAM, ANN (626) 274-1248- 75,000 5725 LOMA AV � TEMP 917802453 FEES PAID DESCRLPTION OF WORK ADD IST. FLOOR EXTEND DINING ROOM, ADD 1 MASTER BEDROOM,BATH FEE DESCRIPTION: QUANTITY:- UOM: AMOUNT: 608 S.F,- DEMO (E) GARAGE AND BUILD NEW 2 CAR GARAGE 526 S.F. APPLICANT: TEL. NO: LEE (626) 274-1248- B1 PLANCHECK W/ENERGY 75000.00 VAL 980.20 138 E. ALTA ST.. AA BLDG PERMIT ISSUANCE 27.75 SPECIAL CONDITIONS: ARCADIA, CA 9106 AC STRONG MOTION RESID .75000.00 VAL 7.50 B2 PERMIT W/ENERGY 75000.00 VAL 1,153.19 TOTAL FEES 2,168.64 CONTRACTOR: - TEL. NO: - APPROVALS DATE INSPECTOR SIGNATURE ' HY CONSTRUCTION, CO. (626) 221-9698- 919 S. PALM.AVENUE LIC. NO - - LOCATION AND SETBACKS - SAN GABRIEL, CA 91776 680979 B " SOILS ENGINEER APPROVAL ARCHITECT.OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS O' LANTRIK DEVELOPMENT LLC (626) 379-4900- 744 BONITA DRIVE LIC. NO: - SLAB/UNDER FLOOR " SOUTH PASADEN, CA 9130 NONE _ RAISED FLOOR FRAMING - MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION 3 01 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. - - .REQUIRED TOTAL SETBACK FROM EXIST BLDG DEPT. FRAME INSPECT. SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- SHEAR PANELS SIDE PL- INSULATION/WEATHER STRIP INTERIOR LATH/DRYWALL - EXTERIOR. LATH LOTDRAINAGE SMOKE DETECTION DEVICES- - - .FIRE DEPARTMENT APPROVAL REPORT,SD: DPR261 ROUTE TO:- BS0508 1.