HomeMy Public PortalAbout6420 LOMA AVE_Building__ Fes'
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APPLICATION FOR' BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN
BUILDING
Z Q , L O A4 1 (2,
BUILDING
ADDRESS 64ZQ .
2401"'q LOCALITYZr Cl T1
_ NEAREST
CITY 715M^iE CJ/ ZIP / I7GlCJ CROSS ST.
ASSESSOR
SIZE OF LOT �o,X/zO+ NO.NOW ON LOT + MAP BOOK PAGE PARCEL
- _ / DISTRICT GROUP TYPE FIRE PROCESSED BY
TRACT 9 J BLOCK ~3B L, LOT NCO.. 0/6 a CONST./ ZONE
OWNER � TEL 7®<6 5'.O'p T -lI
STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS Zr 4� /4J0�1�1/�J 7 CLASS NO. DWELL.UNITS_j BK ZRG .
CITY ���r L �i ZIP 9f/4fO tlC
ARCHITECT OR TEL. �+
ENGINEER NO. VALUATION $ j 6 J O
ADDRESS BLDG.SETBACK FROM
//++ TEL. FRONT PROP.LINE OF (STREET)
CONTRACTOR t5%1-0 ALPIiv Rap NO. 2 7 r 937 HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING
ADDRESSt UC
L _a NO. FRONT PROP.LINE HIGHWAY WIDTH
i- LIC. (p0027 +
a� _
CITY 1Z!L .OfjT CLASS BLDG.SETBACK FROM
CONSTRUCTION LENDER SIDE PROP.LINE OF (STREET)
NAME AND BRANCH
HIGHWAY + YARD = TOTAL SETBACK FROM I TYPE OF 1EXISTING �
ADDRESS CITY SIDE PROP.LINE IHIGHWAY1 WIDTH
SQ.FT. NO.OF NO.OF CHECK + _
SIZE STORIES FAMILIES ONE
72-
DESCRIPTION
ZoDESCRIPTION OF WORK /7-/0/--** p� NEW ❑ P.C. Fee$ Permit Fee
6.6 7b ADD FI Issuance Fee 700pv
ALTER gCJLti `b
"L,4` ���
REPAIR ❑ Total Fee 7 /
USE OF
EXISTING BLDG. J� /—� �S DEMOL ❑ Z
APPLICANT TEL L"j C
(PRINT) �O ��Z NO.2p/014 Q ;2066 1, A
D
0 0 0 0 0 1
BY(SIGNATURE)
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE U 2 0 o79,00-
THA
79,OOTHAT THE ABOVE ISCORRECT AND AGREE'TO COMPLY WITH ALL ORDINANCES u+
WORK AUTHORIZED AND LAWS REGULATIH HEREBY IDING WILLL NOTEMPLOYANY PERSONTRUCTION.I CERTIFYHINT VIOLAA IONIN DOINGTHE OF U O O O 7 9,O O�,7
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN"S COM- ,,¢� z I
PENSATION INSURANCE. lI 5 ' G06-78
SIGNATURE OF
PERMITTEE
ADDRESS dtk
/ z
TEL. 0-9 1 �\
CITY ' NO. ~
Q
USE ZONE ,MAP
NO. >
7 Zm SPECIAL 6.!
CONDITIONS: X
FINAL / BY
oc
DATE ^Z^1
. • . .. -;'TEMP LCITY , �
76A638A CE 4803 2-63 APPLICATION FOR BUILDING PERMIT _
COUNTY OF.LOS'ANGELES BUILDING
DEPARTMENT-OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
r'
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
WILLIAM A JENSEN, SUP T OF BUILDING CROSS ST
DISTRICT NO GROUP TYPE j MESSED BY
FOR,APPLICANT TO FILL IN J CONST
BUILDING _ STATISTICAL CLASSIFICATION `Y S WEIR MAP
ADDRESS - - BK PG
CLASS NO DWELL UNITS �" a /
LOT NO _ BLOCK WATER
CERTIFICATE NOT REQUIRED RECEIVED
TRACT �p MAP f HIGHWAY STATE MAJOR SECOND OCANO OF
SIZE OF LOT SX' Z NOW ON LOT NO �/ (CIRCLE)
r
USE ONE SPECIAL
USE OF /+ (P CONDITIONS
EXISTING BLDG W c (!-EL¢ l�FI G
OWNER , NO BUILDING EXIST
_ 7- SETBACK YARD HWY REET NAME WIDTH
ADDRESS jp �Q (� II.0 C// FRONT
ARCHITECT OR TEL P L �•
LNE
EER - NO - SIDE +I
� P L1 /0
ESS O
TELACTOR �E NOSSOF WORK _42 hA
ADD ALTER REPAIR DEMOLISH NO OFNO OF _�� - STORIES FAMILIES / QFdA9itlTURE �1Z Q TURE OFICANT � 7—e5*.,
.,, � ;{'�xTION $ < I' I*.=L....�d�"/Avg �
fff` /APPROVALS #DATE INSPECTR 5'
OSIGN6TUFA
PC PMT
FOUNDATION LOCATION �/ /`
FEE $ - ��– FEE Z FORMS MATERIALS / /G
FRAME FIRE STOPS
I HEREBY ACKNOWLEDGE'THAT I HAVE READ THIS APPLICATION !BRACING BOLTS
AND STATE THAT'THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK '/� /
'-!AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH INT n� �:�/'�tl/
TION OF THE LABOR CODE OF THE,STATE OF'
C LIFO NIA RELAT-
ING TO WORKMEN 5 SAT! IN UR NCE
LATH EXT
SIGNATURE:OFHOUSE NUMBER COR-
PERMITTEE 44 RECT AND POSTED '�� JWS
ADDRESS (.-�.] FINAL
JOHN F LEWIS PRINCIPALS URAL ENGINEER
PLAN CHECK VALIDATION CK M O CASH _ PERMIT VALIDATIO CK M O CASH
:1 3. 91- JUL16 1 •0 2 2.00-
76AS36A DDS-3 9.68
APPLICATION FOR BUILDING PERMIT , 1
DIVISION OF BUILDING ASAFETY BUILDING
ND /� l t
ADDRESS (® N (�'y0'K-Q Q 4-P - -
Deportment of County Engineer
1. 'C.Altp of Los Angeles LOCALITY NO.
WM.J. FOX, COUNTY ENGINEER NEAREST }.
CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST. — O M r f O
DIST NO. GRQUP I TYPE 8E BER-/M�APPG ;
FOR APPLICANT TO FILL IN a CONST /— '7 -
-•BUILDING,/�/ MAP
ADDRESS y% 2® i dN(Q �[ UQ NUMBER ` V Q HWY STATE YES O
LOT NO. S BLOCK USE ZONE SPECIAL
- Z�j CONDITIONS
'/
TRACT `l J7 GNO. OF -7 t _
SIZE OF LOT (,�' X 12.� I NOW ON LOT B� f ABACNG K- YARD HWY STREET NAME :�jpT.Hr
USE OF �.:� FRONT
EXISTING BLDG. YY^ �{P` [ P. L.
OWNER 1 ', ,+A� 4Mbc / SP.L. -IV ✓ O _
MAIL L I Z c -�-/- 16 ui Q ✓ 4 y-C O TRACT DWELL. 1 UNIT ADDRESS n Y -736 _ 5 INDUSTRIAL
CITY {0411e CI NO. � 1 DWELL. 1 UNIT 6 PUBLIC BLDG.
ARCHITECT OR TEL. 2 DUPLEX 1 UNIT
ENGINEER NO. - 3 APT. UNITS ADDN.
' _ - MISCEL.- - -
ADDRES9 e - - 4 'COMMERCIAL
CONTRACTOR NO.' INSPECTION RECORD
ADDRESS - 3.16 a 4114th rr.�►°'T,, �-
DESCRIPTION OF WORK .
NEW K
�t ADD ALTER REPAIR DEMOLISH
IO,�,�
8 73 - STORIES FAMIOLIESINO
ZE � l
USE OF STRUCTU EE7L;D QO66�
- - 5 Iry � -
• �S d `;7'11/?'-,Alrh.
SIGNATURE OF v
APPLICANT -`' APPROVALS
,ADDRESS G y�-O iJ, `.Q w1-e tv v c. - DATE INSPECTOR'S SIGNATURE
FFORMS?MATERIIALSION: ION f- / I
O� FEE FRAME: FIRE STOPS. �`` ,,�.j.. !v`/��IIG ,f
VALUATION _ ffi BRACING.BOLTS
FEE FURNACE: LOCATION,
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS ' GAS^VENT.DUCTS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH. INT. -
AND STATE LAWS REGULATING BUILDING CONSTRUC _
TION. LATH. EXT.
SIGNATURE OF y/ HOUSE NUMBER COR-
PERMITTEE
OR-PERMITTEEES= 0CF44 RECT AND POSTED
ADDRESS t.l' Q ��( --FINALCS a(1'
WM.J.FOX.COUNTY ENGINEER , VALIDATION C.•N.,DIRLAM.CHIEF BLDG. INSPECTOR
a �_,s 1.
A. .MAR 8- 2.0':Q
.fit y
APPUCATION Fnn�l� [HERMIT
COUNTY OF LOS ANGELES'— t BUILDING A D SAFETY
FOR APPLICAN TO FILL IN • '••`, GfroDR�S
WORKER'S COMPENSATION DECLARATION � � •'• �- � ' BUILDIN
I hereby.affirm that I have a certificate of consent-to self Insure, BUI DI DSS
1 •'
or a certificate of Workers',Compensation Insurance„or a certified
copy thereof Sec 380_ Lab C) ' ZIP
/ �/, '• 1 LOCALITY �!
POIICy NO COrnpany� SIZE OF LO NO OF BLDGS NOW ON LOT
6ertlfled copy Is hereby furnished % NEA S p� \
ElCertrfie copy Is•fled with the county b 'Iding Inspection, TRACT BLOCK LOT NO
depart USE NE MAP NO
(� k/hASSESSOR MAP BOOK - PAGE- PARCEL
Date v ppllc t
„ SPECIAL CONDITIONS
•OWNER _TEL NO— -*- ` /
CERTI KATE OF EXEMPTION FROM WORKERS i 7 - -
COMPENSATION INSURANCE I WITHIN 1000 FT of SCHOOL?. °YES `No t ?,
(This section need not be completed If the permit Is for one hundred
($�00) or less) ADORES•.,O `
_ �( DISTRICT GROUP TY CONST FIRE ZONE PROCESSED BY'
dollars, , - • ' . p
- - ZIP
I certify that in the performance of,the work for which this permit, fi p
Is Issued'I shall not employ any person In any manner so as to 0 „ '
become subject-to " A CHITECT R ENGINEER TEL N0
1t•to thCompensation”Laws STATISTICAL CLASSIFICATION APT CONDO
Date Applicant -ADDRESS - - CLASS NO DWELL UNITS 1 `�-
NOTICE TO APPLICANT If, after, making this Certificate of. - REQUIRED TOTAL SETBACK FROM 'EXIST. t
Exemptions.you - should_,become+.subject t0 -the Workers' C AC SET BACKi YARD HWY,- ' PROP LINE WIDTH
Compensation provisions of'the Labor Code,-.you must forthwith �� FRONT
comply;with:such provisions or-this permit shall be deemed revoked A ESq LIC N 6 PL
LICENSED CONTRACTORS DECLARATION , d C7 SIDE
1 CITY ' B / LIC�C SS PL
I hereby affirm that I,am licensed underproyisions of,Chapter 9 �• %'� �� SEWER MAP
(commencing with Section 7000)of Division 3 of the Business and SQ FT SIZE .NO OF STORIES NO'OFAMIL,11S
Professions Code � my Ic n s m full force a eff ct NEW VA PG a
DE TION OF WO VALUATION
License Number �LIc Class' �� / .Y ADD ❑ $ -
Contracto Date ALTER ❑ cc
❑ I amexempt under Sec REPAIR ❑
B&PC for-this reason DEMOL ❑ V
_ LDMA P/G# W
'• - '"' Date SE OF EXISTING BLDG ' ' URM- ❑ '� a -1 n'
Signaturet a ; Z
APPLICANT(PRINT) _ TEL NO _ - LDMA„Perm#” _ACCT°a_ tt ,
El 1,as owner of the property, or my employees with-wages as ,0 3303
their sole compensation, will do the work and the structure Is,'., ADDRESS
not Intended or offered for sale (Section.7044, Business.and _ FINAL DATE Q 1 ITEMS
Professions-Code - WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A,HAZARDOUS MATERIAL '
FINAL BY
65
El as owner of the property, am exclusively•contracting with OR-A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE �TOTAL :1 o
AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE'S C
licensed contractors to construct.the project (Section 7044, (�J�(('��1R/I 175°fw
YES El NO❑- - - ��ACK
Business and ProfessYions Code)
` WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING /'{�/�1,IL'C00
OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH, _ _ , _ 4f11'7NGE °
CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR
GUIDELINES '
I hereby affirm that there is a construction lending agency for _ YES El -No El
the performance Of the work for which this,permit IS Issued(Sec I HAVE READ ((((
THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING _ ?p36 ow
3097, CIV C) _ • CHECKLIST`I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE aaa:::lIVJJJJJVVV _
_ TITLE 2 CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS '
3 Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD
o Lender's Address
' p OWNER OR AGENT . -
0 1 certify that I have read this application and state under penalty
o ' PC-FEE PERMIT.FEE
of perjury that the above Information Is correct I agree to comply
with all county or Inances`and State laws relating to bulldl g D
constr�uo,� ereb horde.representatives of
s Cc ty ISSUANCE FEE 3 p
ove ntione property for Inspe� pur ses
- INVESTIGATION FEE TOTAL FEE
m (O
!/ SEE REVERSE FOR EXPLANATORY LANGUAGE
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 1211080009
PHONE (626) 285-0488 EXT
ILEGAL ID I NO. OF CONST I BUILDING ADDRESS I
ITR: 14396 LT 38 I SQ FT STORIES TYPE 1 6420 LOMA AV _
ISTRUCTURE V-B I TEMP CA 917801331 I
(ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET FORTSON
15382-016-018 1 I THOMAS PAGE 596 GRID H1 LOCALITY TEMPLE CITY CAI
ITENANT _ (EXIST BLDG USE RESID USE ZONE R-1 (ISSUED ON - PROCESSED BY -
(EXIST OCC GRP 111/06/12 SR
(OWNER TEL NO IBLDGS- NOW ON LOT VALUATION IFINAL D TE FINAL BY CODE 1
ICHEN JONATHAN C,BONNIE W (626) 287-3362- 1 3,500
16420 LOMA AV I
ITEMP 917801331 FEES PAID D S IPTI N OF WORK
I ICHANGE OUT 11 WINDOWS AND 1 SLIDER DOOR (NO GRIDS)
I IFEE DESCRIPTION- QUANTITY UOM AMOUNT
(APPLICANT TEL NO I
ISAME AS OWNER - IAA BLDG PERMIT ISSUANCE 27 80 I I
I SAB STATE GREEN BLDG FEE .3500 00 VAL 1 00 ISPECIAL CONDITIONS I
IAC STRONG MOTION RESID 3500 00 VAL 0 50 I I
IAX BUILDING REVIEW FEE- 54 70 I I
ID2 PERMIT W/O EN-HC 3500 00 VAL 115 80 I
(CONTRACTOR TEL NO I TOTAL FEES 199 80 (APPROVALS DATE INSPECTOR SIGNATURE
ISAME AS OWNER - - - I-
I LIC NO 1 - ILOCA,'ION AND SETBACKS I
I I I II I
I ISOILS ENGINEER APPROVAL I I
(ARCHITECT OR ENGINEER TEL NO IFOUNDATION/TRENCH FORMS I I
LIC NO 1SLAB/UNDER FLOOR - 1 -
:2
I I (RAISED FLOOR FRAMING
IMAP NO- SEWER MAP BOOK PAGE FIRE ZONE CMP I (UNDERFLOOR INSULATION I I
I153H265 - 3 OP I I
_i IFLOOR SHEATHING I I
INO- OF FAMILIES DWELLING UNITS APT/COND STAT CLASS'
I 0 NO 21 IROOF SHEATHING 1 1
SCHOOL WITHIN HAZARDOUS - ISHEAR PANELS
1AIR QUALITY 1000 FEET MATERIALS I
NO NO NO IFRAME INSPECTION I I
1FIRE'SPRINKLER HANGERS I I
- (INSULATION/WEATHER STRIPI
IINTERIOR LATH/DRYWALL
1EXTERIOR LATH I I
IRATED FLOOR/CEIL ASSEM I I
I IRATED WALL ASSEMBLIES I I
I I IRATED SHAFTS/OPENINGS
I I IT-BAR CEILINGS
I I ILOT DRAINAGE 1 1
IREPORT ID. DPR261 ROUTE TO BSO508
I