HomeMy Public PortalAbout8802 LONGDEN AVE_Building__ ' tl
COMPENSATION DECLARATIONthat I �(
insure, c r a certificate off Workers'have
Compensation a certificate ofconsent Insuran of A PIP��O U LI P O IJ M V . FOR O U L D N G P E L3M T .
or a certified copy thereof (Seca 3800, Lab. C.)
COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. - - Company
Certified copy is-hereby furnished.. FOR APPLICANT TO FILL IN BUILDING J�
ADDRESS
Certified copy is filed with the county building inspec- BUILDINGQ
tion department: ADDRESS p� LIIA
tt
Date Applicant CITY TI ` (,', ZIP LOCALITY
CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. NEAREST
-,'COMPENSATION INSURANCE SIZE.OF LOT NOW ON LOT CROSS ST.
ASSESSOR
(This section need not be completed if the permit is for one TRACT BLOCK LOT NO.' MAP BOOK PAGE PARCEL
hundred dollars($100)or less.)
`, TEL. USE�NE, MAP
-I certify that in the performance of the work for which thisOWNER NO. NO.
permit is issued, I shall not employ an rson i ' y manner SPECIAL
ADDRESS p �Z.. L O CONDITIONS
so as to become subject to the Work o ation Laws --�• U
Date Applicant CITY 1 �l ZIP fly�V �.
NOTICE TO APPLICANT:.If, after ma ing' this.Certificate o ARCHITECT OR L DISTRICT GROUP TYPE FIRE PROCESSED BY O
ENGINEER NO. R CONST. ZONE H
Exemption, you should become subject to the-Workers' �7 y U
Compensation.provisions of the Labor Code, you must forth- ADDRESS (J JLLJ
with comply with such provisions or this.permit,shall be TEL, ' STATISTICAL CLASSIFICATION APT. CONDO. N
CL
deemed revoked. CONTRACTOR NO. ll Z
LICENSED CONTRACTORS DECLARATION LIC: CLASS NO. 1— DWELL. UNITS
I hereby affirm that I am licensed under provisions of ChapterSt ADDRESS NO. SEWER MAP
(commencing with Section 700016f Division 3 of the Business and LIC. /
Professions Code,:an'd my license is in full force and effect. CITY CLASS BK. PG. VALIDATION
SQ. FT. NO.OF NO. OF CHECK
License Number' Lic.Class SIZE STORIES FAMILIES ONE
n NEW VALUATION
DESCRIPTION OF WORK 00 O J
Contractor Date7— ADD $
.
am exempt under Sec.
_ ALTER O
B.&P.C. for this reason S I�� ,' REPAIR $
USE OF 8 3 9 3
Date:
EXISTING BLDG. DEMOL'❑ # i 0f1
Signature APPLICANT TEL. FINAL
g PRINT NO. —3.�. ;� -,649..88
OWNER-BUILDER DECLARATION DATE CJ
I hereby affirm that.1 am exempt from the Contractor's License oo i o 4 9,.8 8 6'
Law for the following reason (Section 7031.5, Business and ADDRESS FI
Professions Code):' PRESENT _ ;J 1.1 9 m$7
BUILDING.
I, as owner of the property, or my employees with ADDRESS
wages as`their sole compensation,will do the work and
the structure is not intended or offered for sale(Section LOCALITY
7044, Business and Professions Code). MOVING TEL. D i'
I, as owner of the property, am exclusively contracting CONTRACTOR NO.
with licensed contractors to construct the project (Sec- ADDRESS
.tion,7044, Business and Professions Code).
REQUIRED TOTAL SETBACK FROM
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE' WIDTH
I hereby affirm that there is a construction lending agency for FRONT
the performance of the work for which this permit is issued P.L.
(Sec. 3097, Civ. C..). SIDE
PI L.
Lender's Name 2 LDMA Ref. q
Z P.C. Fee$ Permit Fee ) D
Lender's Address
I-certify that I have read this-application and state that the Issuance Fee LV (/- LDMA P/C N
o above information is correct. I agree to comply with all County Investigation Fee
°o ordinances and State laws relating to building construction, g . .
R and hereby authorize representatives of this County to enter Total Fee Al LDMA Perm. q i.
M
upon a bo ve- n Toned property or inspection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Applicant or Agent �Do—tey--
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 1112120035
PHONE: (626) 285-0488 EXT:
(LEGAL ID: I NO. OF CONST
BUILDING ADDRESS:8802 LONGDEN A
ITR: 5904 LT: 1 UN: .002 I SQ. FT STORIES TYPE I 1
(STRUCTURE: 18 V-B I S
ASSESSOR INFORMATION NUMBER: I TEMP CA_917
I I NEAREST CROSSSS STREET: MUSCATEL
15386-010-001 1 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY, Cl
TENANT: (EXIST BLDG USE: RESID USE ZONE: R-1 (ISSUED ON: PROCESSED BY: 1
I (EXIST OCC GRP: 112/12/11 SR I
I I 1 i
TOWNER: TEL. N0: IBLDGS. NOW ON LOT: VALUATION: (FINAL D E FIN BY: CODE: T
IFINDLAY, DEBRA (626) 614-8418- 1 7,950
18802 LONGDEN AV I I ' /
ITEMP 917801501 - 1 - FEES PAID 1 CRI TION F WORK
ITEAR OFF AND REROOF WITH CO POSITION SHINGLES
I IFEEDESCRIPTION: QUANTITY: UOM: AMOUNT: (
(APPLICANT: TEL. NO: I I I
ISAME AS OWNER - 1AA BLDG PERMIT ISSUANCE 27.80 1_ I'
I IAB STATE GREEN BLDG FEE 7950.00 VAL 1.00 ISPECIAL CONDITIONS: 1
I 1AC STRONG MOTION RESID 7950.00 VAL 0.80 1 1
I ID2 PERMIT W/O EN-HC 7950.00 VAL 183.40 1 1
I _IFR INV WORK W/O PERMIT 257.00 DOL 257.00 1 1
ICONTRACTOR: TEL. NO: I TOTAL FEES 470.00 (APPROVALS DATE INSPECTOR SIGNATURE 1
ISAME AS OWNER - I I-
I
_I LIC. NO ILOCATION AND SETBACKS
I I I
I ISOILS ENGINEER APPROVAL I
1 I I I I I
1ARCHITECT OR ENGINEER: TEL. NO: IFOUN.DATION/TRENCH FORMS I I' I
I - I
LIC. NO: (SLAB/UNDER FLOOR
1 1 IRAISED FLOOR FRAMING I I I
I I I
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:j (UNDERFLOOR INSULATION I
I153H261 3 Go II'
._I IFLOOR SHEATHING 1 -
INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: 1 I 1.
0 NO 21 1 (ROOF SHEATHING
SCHOOL WITHIN HAZARDOUS 1 ISHEP-R PANELS I
(AIR QUALITY: 1000 FEET MATERIALS I - I 1
NO NO NO IFRAD'!E INSPECTION
I I I
I 1 IFIRE SPRINKLER HANGERS I 1
I I I
I I (INSULATION/WEATHER STRIPI I I
I I (INTERIOR LATH/DRYWALL I 1 1
I I I
I (EXTERIOR LATH 1 T
I I I
I I IRATED FLOOR/CEIL ASSEM.
I I I I I I
I 1 IRATED WALL ASSEMBLIES
I I I
1 i (RATED SHAFTS/OPENINGS
I IT-BAR CEILINGS I I 1
I I I
I I
ILOT DRAINAGE I
I I
1 I I I I I
IREPORT ID: DPR261 ROUTE TO: BS0508
I I I I I I