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Home My Public Portal About9607, 9607 1/2 LAS TUNAS DR_Building__ r APPLICATION FOR BUILDING PERMIT L� COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS BUILDING ADDRESS I hereby affirm that I have a certificate of consent to self insure, 9,607 % Las Tun a s or a certificate of Workers'Compensation Insurance,or a certified CTY ZIP copy thereof(Sec.380,Lab.CJTEMPLE CITY 91780 LOCALI Policy NOR WC' (11 9 6 0 6 S CompanJ T I GHLANDS T NS .SIZE OF LOT NO.OF BLDGS.NOW ON LOT NEAREST CROSS ST. rtified copy is hereby furnished. ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. USE ZONE MAP NO. Date 7 f 31/9 0pplicant R.A. KETTENHOFEN ASSESSOR 0 1 BOOK PAGE PARCEL 8 S 8 7-019- 018 SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL.NO. COMPENSATION INSURANCE A.W. DRI ER 286-1147 WITHIN 1000 FT.OF SCHOOL? YES No ADDRESS (This section need not be completed if the permit is for one hundred s ame DISTRICT GROUP TYPE CONST.' FIRE ZONEOCESSED Y dollars($100)or less.) CITY 9,3 31 I certify that in the performance of the work for which this permit Jt `JII`s/� J]'} is issued, I Shall not employ any person in any manner so as to ARCHITECT OR ENGINEER TEL NO. become subject to the Workers'Compensation Laws. 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 — FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL LICENSED CONTRACTORS DECLARATION CITY LIC.CLASS SIDE a ARCADIA, CA, B1 PL � I hereby affirm that I am licensed under provisions of Chapter 9 SO.FT SIZE NO.OF STORES NO. FAMILIES SEWER MAP C3 (commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. I NEW ❑ BK PG , CD W License Number 2 S 7 9�76 Lic.Class R� DESCRIPTIORK� ADD ❑ VALUATION � Contractcy,F T TF T�TTI(11~1 TAT Pfic._ 7/31/90 ALTER ❑ Z_ ❑ I am exempt under Sec. REPAIR B.&P.C.for this reason DEMOL ❑ LDMA P/C# Date: USE OF EXISTING BLDG. URM ❑ Signature APPLICANT(PRIND TEL.NO. LDMA Perm# E] 1, CONSTRUCTI. 445-5560 I, as owner of the property, or my employees with wages as p I^• �^ s their sole compensation, will do the work and the structure is ADDRESS F 1y�.1 1 •'T not intended or offered for sale (Section 7044, Business andame FINAL D Q p L-_I : Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL — OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN J i -rpm, ❑ I, as owner of the property, am exclusively contracting with THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FII • � �'I� licensed contractors to construct the project (Section 7044, YES❑ NO❑ I '3" 00 Business and Professions Code.) I ( � 5_e� WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING 'ii OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CHECK 1 L a 1!L CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES. =' I- 1 hereby affirm that there is a construction lending agency for YES 1:1 NO El1 ANS` the performance of the work for which this permit is issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD 3097,CIV.C.). PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES y .. m COUNTY CODE,TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING 11(�(�I�-1�4��;�. '�`_, Tf�j_i Lender's Name HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. Lenders Address 2)169 1 AN -1:Y: 0 OWNER OR AGENT 0 1 certify that I have read this application and state that the above P.C.FEE PERMIT FEE information is correct. I agree to comply with all county O ordinances and State laws relating building construction,and o hereby authorize representati s this County to enter upon ISSUANCE FEE th bove ro a ction purposes. 4 INVESTIGATION FEE TOTAL FEE m sq�mn a Apgkml p o.m SEE REVERSE FOR EXPLANATORY LANGUAGE COUNTY OF LOS 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 9712160047 PHONE: (818) 285-0488 EXT: LEGAL ID• NO. OF CONST IBUILDINGADDRESS: TR: 6561 LT: 184 SQ. FT STORIES TYPE ,9607 1/2 LAS TUNAS DR STRUCTURE: 0 VN TEMP CA 917802109 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 8587-019-018 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: COMME USE ZONE: C-2 ISSUED ON: PROCESSED BY: EXPIRES ON: MIKE'S TAILOR SHOP EXIST OCC GRP: 12/16/97 UT 12/16/98 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL Y CODE: DRIVER ALBERT W TR DRIVER FAMILY TR (818) 355-3831- 1 250 40 HACIENDA DR ARCD 910062346 FEES PAID DESCRIPTION OF WORK PARTITION WALL FOR TAILOR SHOP ./ FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. NO: SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75 AE STRONG MOTION—OTHER= _, 250.00 VAL 0.50 SPECIAL CONDITIONS: D2 PERMIT W/0=EN-HC- x-250:00 VAL 43.50 - C�,t ETOTA L FEES 71.75 CONTRACTOR: TEL. NO: /��`� � �� APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO ❑ .� �❑ LOCATION AND SETBACKS j� � ❑ �F,ti�� SOILS ENGINEER APPROVAL ARCHITECT--OR NGINEER: TEL. N0: 1/ / �/�' ❑\ FOUNDATION/TRENCH FORMS LIC. 140, -�- j ii�j 11 i11� �� SLAB/UNDER FLOOR '' --- - -- -- - -- - -- ----- RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:, '�I❑ ; � �� I1��;�❑�Oi�� ji UNDERFLOOR INSULATION 150H269 3 OG- � Li❑❑ 1 �` 7 ❑l J ❑��1� 1�!;�i�t� FLOOR SHEATHING NO. OF S: DWELLING UNITS: A T 0 D: STAT CUA — — =-- NO 22 •� 0 1P � � e �� ROOF SHEATHING SCHOOL WITHIN HA ARDOUS 1 + lih p4+ SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS -- NO NO NO ❑ ❑E / FRAME INSPECTION REQUIRED TOTAL SETBACK ROM EXIST �u�ao• ❑ ��d� / FIRE SPRINKLER HANGER SET BACK• YARD: HWY: PROP LINE: WIDTH: FRONT PL- �\`Lzyv5cv�,� '/ INSULATION/WEATHER STRIP SIDE PL- -`--'--�� IN ERIOR LAT /DRYWALL EXTERIOR LATH RATED FLOOR/CEIL ASSEM. RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS OT DRAINAGE REPORT ID:. DPR261 ROUTE TO: BS0508