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HomeMy Public PortalAbout9128 LONGDEN AVE_Building__ ,A P PL i CAT 0 O N F r0� COUNTY _OF LOS ANGELES >� DEPARTMENT•OF.COUNTY ENGINEER O U B LD 0 N G PERMIT . BUILDING AND SAFETY-DIVISION' BUILDING ' FOR APPLICANT TO FILL IN ADDRESS O (�Q iv_ Gf�-�•��% ' _ BUILDING '�• - ' ADDRESS 7,c- ] rT �/ LOCALITY ` S T CITY ^ /L, 1_ {„�1T •ZIP ///a/� CROSS ST 4- NO OF BLOGS - - - 'ASSESSOR SIZE OF LO,/ i-, -,C &,#NOW ON 'LOT MAP BOOK PAGE PARCEL /� DISTRICT GROUP TYPE FIRE CESSED BY TRACT61Q~ •A� BLOCK p/C4_/� LOT NOpY/• CONST. . ZONF OWNER STATISTICAL CLASSIFICA/TION EWER_MAP ADDRESS I�'�.�OI✓Fr-�CN /r--r+•' -CLASS NOI-�,DWELL UNITS 'BK PG,, _ USE-ZONEF A T P CITY / (v- -ZIP / �V - O a �•. - - :. _ ARCHITECT OR TEL - PECIAL _ ENGINEER NO �'�,- ONDITIONS - ADDRESS ROAD DEPARTMENT APPROVAL,REQUIRED, YES. NO❑ CONTRACTOR TEL. BLDG SETBACK FROM •• N 0. LIC. FRONTPROP LINEOF (STREET), ' _ 'ADDRESS - - _ NO, HIGH AY } YARD = TOTAL SETBACK FROM TYPE-OF EXISTING ' LIC - FRONT PROP LINE HIGHWAY WIDTH CITY -, .. _-. .. CLASS _ _ CONSTRUCTION'LENDER } NAME AND BRANCH - _ _ BLDG,S ACK FROM, - a CD ADDRESS CITY SIDE PROP, (STREET) . V SO FT NO OF NO. OF,, CHECK HIGHWAY } • YARD = TO L E BACK FR YPE,OF, EXISTING 'SIZE STORIES FAMILIES ONE - SIDE PROP LINE HWAY WIDTH DESCRIP ION OF WORK - NEW_ ❑ } •a- C7 ADD - ❑ CORNER CUTOFF YES ❑ NO ❑•ALTER Z ` IN OPEN SPACE YES ❑ NO ❑ - - REPA IF� ' USE,OF - IN'COAS,TAL'PERMIT ZONE YES ❑ NO ❑ EXISTING-BLDG "' EMOL ❑ APPLICANT TEL (PRINT) - - NO. BY (SIGNATURE) I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT'AND AGREE TO COMPLY - WIT HALL ORDINANCES AND LAWS REGULATING BUILDING CON- STR UC TION I CERTIFY -THAT IN DOING-THE WORK-AUTHORIZED - - - •• -� HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF•THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COMPENSA ANCE SIGNATURE OF FINAL BY i PERMITTEE •� /� DATE /�' / -7zo , ,t ADDRESS - TEL - CITY' ._.. NO P.C. Fee$ Permit Fee Q Issuance Fee VALUATION$ ,o /U vU 5 _ ./ Total Fee , PLAN CHECK`VALIDATION CK =Iw O CASH o :.i 1'' PERMIT VALIDATION CK MO CASH 15.0 0,,& • . 76A638A CB:*8038 12/78 - - - - - ---- AISPLECATQ®N FOR BUflL®ONG PERMOT FOR APPLILANT TO FILL-IN (Print or type only) . I a COUNTY OF LOS ANGELES BUILDING ADDRESS o A/ 677A.) Iq v ' DEPARTMENT OF COUNTY ENGINEER CITYi ZIP C� 7 4f O BUILDING AND SAFETY DIVISION NO OF BLDGS BUILDING SIZE OF LOT X I 0 0 NOW ON LOT ADDRESS ADDRESS TRACT�� . BLOCK Alf OT/NU ' li LOCALITY OWNER 11 LN- e_& V Pv *4f TEL, / FOREST• 14Wg ROSS ST ADDRESSMAP BOOK PAGE PARCEL L DISTRICT GROUP TYPE FIRE ESSED BY -CITY 7r— ZIP'. C) 7 O U r_. CONS ZONE ARCHITECT OR TELli 6.1 ENGINEER NO STATISTICAL CLASSIFICATION SEWER AP ADDRESS TEL CLASS NODWELL UNITS BK� PG - _ CONTRACTOR' NO USE ZONE No LIC ADDRESS NO ( SPECI LIC CONDITIONS CITY CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ CONSTRUCTION LENDER NAME AND BRANCH BLDG SETBACK FROM FRONT OP LINE OF (STREET) -ADDRESS CITY TOTAL SETBACK FROM TYPE OF EXISTING HIGH AY + YARD SQ FT z -� NO OF NO OF CHECK - - "FRONT PROP LINE HIGHWAY WIDTH SIZE STORIES FAMILIES ONE } CL DESCRIPTION OF WORK NEW ❑ + O �( BLDG SETBACK cl� 4 ADD SIDE PROP LINE OF (STREET) O ALTER ❑ TOTAL SETBACK FROM I PE OF EXISTING w HIGHWAY + _YARD = SIDE PROP LINE JHIGWAY WIDTH N USE OF' REPAIR ❑ Z EXISTING BLDG DEMOL ❑ + APPLICANT TEL CORNER CUTOFF YES ❑ NO ❑ (PRINT) NO IN OPEN SPACE YES ❑ NO ❑ BY(SIGNATURE( - -- -Q- IN COASTAL PERMIT ZONE YES N ❑ O ❑ VALUATION.p 0 6 . �28" " ©�;� T /ate" �� �--• -- I HEREBY ACKNO EDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION I CERTIFY THAT•IN DOING THE -' WORK AUTHORIZED HEREBY I WILLNOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STAT LIFO IN RELATING TO WORKMEN S COM ' PENSATION INSURANCE SIGNATURE OF �..,� PERMITTEE ADDRESS ej FINAN '7 TEL DATE /3 `/ 7 BY CITY -NO PC- MAKE CHECKS PAYABLE TO FEE $ FET HARVEY T.BRANDT,COUNTY ENGINEER `J PLAN CHECK VALIDATION CK ' M O CASH PERMIT VALIDATION cK? M o GASH _ - 1 9 1 c APA 7 1 D 6 2.2 5 ,hjd ®s 76A 638A CE 6803 3 75 APPUCAT�QN. FOR BULMNG" P,ERN'T COUNTY OF'LOS'ANGELES _�w BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATI.ON' -�FOR`dPPLICANT,TO.tiLLJN.�• :j,• r`, BUILDING ADDRESS- i I hereby affirm that I have a certificate of consent,to self Insure, BUI ING ADDRESS "- or a certificate of,Workers' Compensation Insurance, or a certified / 29 Copy thereof(Sec 3800, Lab C) ~ CITY• `ZIP - �='�- . / LOCALITY Policy No Company SIZE OF T - NO.OF BLDGS NO ON LOT - ❑'Certified copy is hereby furnished l NEAREST CROSS ST El Certified copy is filed with the county budding Inspection TRACT BLOCK LOT'N�fO department - ` •• USE ZONE MAP NO ASSESSOR AP BOOK PAGE PARCEL Date Applicant - 'SPECIAL CONDITIONS' CERTIFICATE OF EXEMPTION FROM.WORKERS' OWN R TEL NO COMPENSATION INSURANCE WITHIN 1000 FT OF SCHOOL'S YES NO This section be' completed not becom feted if the permit is for one'hundred ADDRESS ` ( P P � �c.J ✓`;- - DISTRICT GROUP TY�P CONST IFIRE ZONE PROCE " dollars($100) t fess) ®� �► "� 1+ C�ITY- I certify that In the performance of the work for which this permit ZIP Is Issued, I shall not employ,any person in any manner so as to become subject t0 the Workers'Compensation Laws - ARCHITECT ENGINEER 1 TEL NO _ , STATISTICAL CLASSIFICATION - APT- CO Do Date Applicant ADDRESS - CLASS NO DWELL UNITS NOTICE TO APPLICANT If, after•making this Certificate :of ° REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers, CONTRACTOR - - - TEL NO SET BACK YARD HWY PROP LINE WIDTH Compensation-provisions-of-the Labor Code, you must forthwith comply with such,provislons or this permit shall be deemed revoked FRONT PY - P ADDRESS LIC NO P L_ _ LICENSED CONTRACTORS DECLARATION SIDE LIC CLASS P L I hereby affirm that I am licensed underprovisions of Chapter_9 SEWER MAP (commencing with Section 7000)of Division 3 of'the Business"and SQ FT E NO F STORIES NO OF FAMILIES Professions Code,'and my license's in full force and effect NEW ❑ BK PG a _r • License Number Lic Class DESCRIPTION OF WOR qpp ❑ VALUATIONAC Contractor Date ' ALTER o ElI am exempt under Sec REPAIR B&PC for this reason DEMOL ❑ DMA P/C# Date USE OF EXISTING BLDG URM ❑ r _ Signature APPLICANT(PRINT) TEL NO-- _LDMA Perm# 3303 1 158.85 z 1, as'owner of the property, or my employges'wdh'wages as Z, 1 ITEMS G their sole compensation, will,do the work and the structure is ADDRESS not intended or offered for sale (Section 7044, Business and FINAL DATE' G T11r� ��� 85 Professions Code) WILL THE APPUCANT'OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL - •Iep¢ oe OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE J t.Q j.!{1■(�.1 ` ❑ 1, as,owner of the property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE?, FINAL BY 7 �A�' licesed contractors to construct the project (Section 7044, ves❑ No❑ `Itt�1� ■OO Business and Professions Code) ' WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING - r OCCUPANT REQUIRE A„PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH• ' CONSTRUCTION LENDING AGENCY COAST AIR QUAUTY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKUST FORGUInf1 I hereby affirm that there is a construction lending agency for YES 11- DWO-0001 12/18/95 VES 11- NO❑ N the performance of the work for which this permit is Issued(Sec '�pc.L r'53 rn I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING 38!% 1 PM - 4 3097, CIV C) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, r` TITLE 2,CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNWG HAZARDOUS Lenders Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD o 'Lender's'Address O OWNER OR AGENT + I o I certify that I have read this application and state under penalty of perjury that the above Information Is correct I agree to comply PC FEE PERMIT-FEE - $ wl nces and St s relating to budding a constru er repreatives of this County ISSUANCE FEE �7 h ' 0 -4 n er upon t on erty for mspectio po V - 12 INVESTIGATION FEE TOTAL FEE �® - of Agent e17- D SEE REVERSE FOR EXPLANATORY LANGUAGE t � s r .WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self n O ^O p U��O�n�G P E R nn�T insure„ or a certificate of Workers' Compensation Insurance, L/�.11l A LI V IJ IJULIIIU or a certified copy thereof (Sec 3800, Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No " CompanyAI ElCertified copy is hereby furnished w `a FOR APPLICA ••TO FILL IN BUILDING ADDRESS, �oZ� ❑ Certified copy is filed with the'county building inspec- BUILDING '7 - tion debartment ADDRESS Date Applicant, CITY ZIP LOCALITY „NO OF BLDGS NEAREST CERTIFICATE OF EXEMPTION•FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS S7 COMPENSATION INSURANCE ASSESSOR (This section need not be cop)eted if the permit is for,one TRLOT N ACT' BLOCK, O T MAP_ BOOK. PAGE PARCEL hundred dollars ($1m00)"or less ) TEL WNER r./ iv NO yG USE ZONE• . MA certify that,in the performance ofthe work'for which this NOy permit is issued, I shall not employ a-ny.person,in any manner ADDRESS�/� c /G-- I SPECIAL CONDITIONS CL so as to become subject to the Wo e at aw O CITY i� D ��ZIP /�.� / U Date - Appii ARCHITECT OR TEL 'DISTRICT GROUP TYPE FIRE• P SSED BY O NOTICE TO APPLI ANT If, malting t is C icate of ENGINEER NO CONST Z � Exemption, ,you should become sublect-to a .Workers' 3 _ ` w Compensation provisions of the Labor Code, you must forth- ADD a with comply-.with such provisions or this permit shall be TEL STATISTICAL CLASSIFICATION APT CONDO N Z deemed revoked � CONTRACTOR - NO , �- LICENSED CONTRACTORS DECLARATIONS LIC CLASS NO DWELL,UNITS I hereby affirm that,I-am licensed under provisions of Chapter 9 , ADDRESS NO LIC SEWER MAP (commencing with Section 7000 )ofi Division 3 of the Business , and Professions Code,and my license is in full force and effect CITY CLASS BK VALIDATION SQ FT NO OF NO OF CHECK License Number Lic Class SIZE STORIES FAMILIES ONE s t VALUATION ,^Jt `. ` • � - . G• DESCRIPTIO WORK NEW ElContractorDate � - `ADD El _ - • ❑I'am exempt under Sec ALTER .❑` ,teB&P C for tk is reasont t_ USE OF REPAIR ❑ $ : Date ?`_ EXISTING BLDG DEMOL ❑ Signature APPLICANT- TEL FINAL OWNER-BUILDER DECLARATION (PRINT) NO 6 DATE,l�., n n I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031 5, Business and ADDRESS. FINAL _ Professions Code) N• PRESENT By I, as owner of the property, or my employees with BUDDING '[' �•�°a , wages as their sole compensation,will do The work-and _ the structure is not intended or offered for sale(Section LOCALITY D i` Q' 3%;07 4 9.3_ 7044, Business and Professions Code.) MOVING TEL {t TT �f ❑ 1, as owner of the property, am exclusively contracting CONTRACTOR NO 1 1 It lam= ,`with licensed contractors to construct the project (Sec- ADDRESS TOTAL�)NL ® �1 tion 7044, Business and Professions Code )' / r v REQUIRED TOTAL SETBACK FROML�,' EXIST (L•; CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP LINE WIDTH t 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 CHANGE- (Sec 3097, Civ C ). SIDE PL Lender's NameI )!i!!j—i 4I X111 -/?ti Sty LDMA Ref•#• L PC Fee$ Permit Fee -Lender's Address ; ^ 168 1 AN 11 2.'5 a 1 certify'that I have read This application and state that the Issuance Fee LDMA P/C# 8 above information is correct I agree to comply with all County Investigation Fee ordinances and State laws relating,to building construction, Total Fee, �C� LDMA Perm # Q and her 111tho a re nt of this County to enter u tie IIb�� o op or inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Atco r Agent Date COUNTY OF `tOS ANGELES TEMPLE CITY �� ~ # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT- TEMPLE CITY CA BL 0508 9710210056 PHONE: (818) 285-0488 EXT: LEGAL ID: . OF CONST . TR: 5904 LT: 241 SQ. FT STORIES TYPE 9128 LONGDEN AV STRUCTURE: 0 VN TEMP CA 917801603 AM'S90IFTN FORMAT ION NUMBER: NEAREST CROSS STREET: 5384-009-015 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY TENANT: USE ZONE: R-1 ISSUED PROCESSED BY: EX EXIST OCC GRP: 10/21/97 UT /21/98 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY' CODE: RAMIREZ CRUZ R;ESTELA 1 1,500 /� 9128 LONGDEN AV U Z-6 TEMP 917801603 FEES PAIDDESCRIPTION OF WORK INSTALL FIREPLACE IN EXISTING L KING ROOM FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: . SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RESID 1500.00 VAL 0.50 SPECIAL CONDITIONS: D2 PERMIT �u6 HC. --1500.00 VAL 82.20 ���TO�TA�L _F,EES 110.45 CON RAC OR: TEL. NO: (��®p APPROVALS DAT INSPECTOR SIGNA, URE SAME AS OWNER - /J�e LIC. NO � �j,TLOCATION AND SETBACKS SOILS ENGINE R A PROVAL ARCHITECT R GINEER: TEL. NO: ® 0 T N/TRENCH FOR S LIC. NO: SLAB/UNDER FLOOR tttt:� RAISED FLOOR FRAMING 1153H265 SEWER MAP BOOK: PAGE: FIRE ZONE: CMO1 PF (�B L C �I�II� l KS UNDERFLOOR INSULATION v �11� FLOOR SHEATHING 0 G UNITS: APT/COND: STAT CLASS: NO 21 ` O pItco ROOF SHEATHING SCHOOL WITHIN DO 0 SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS ( 0 NO NO NO Q FRAME INSPECTION ] REQUIRED TOTAL S "O� IR L ERS l SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- INSULATION/WEATHER STRIP SIDE PL- l� IO LAT DRY EXTERIOR LATH b RATED FLOOW7EETU7AT9EW.— RATEDWALL ASSEMBLIES RATED SHAFTS/OPENINGS T-B R CEILINGS LOT DRAINAff— REPORT ID: DPR261 ROUTE TO: BS0508