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Home My Public Portal About9410 LIVE OAK AVE_Building__ 76A838A CE#803 8-63 APPLICATION FOR BUILDING P RMIT 'LL COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS �lvv ` BUILDING AND SAFETY DIVISION LOCALITY2, JOHN A. LAMBIE, COUNTY'ENGINEER NEAREST n WILLIAM A JENSEN, SUPT OF BUILDING CROSS ST DISTR CT NO "TYPE PROCESi ABY FBD R APPLICANT TO FILL IN CONST / - STATISTICAL CL4SSIF.ICATION SEW�R MAP ° BK $� ' r, �O� ' D�,j� CLASS ,NO DWELL UNITS 5 � WATER NOT REQUIRED RECEIVEDCERTIFICATEHIGHWAYNO OF SLOGS NO (CIRCLE) STATE MAJOR SECOND OCALNOW ON LOT SPECIAL DUSE ZONE CONDITIONSDG �j TEL / L OWNER � }� NO BUILDING - XIST ..j. F SETBACK YARD HWY STREET NAME WIDTH ADDRESS ") r' .+ 'FRONT O/ - 1 ARCHITECT OR 6200 ENGINEER NO FIDE ADDRESS /441 ` ,1 �.�'-/w• �y- p T,E / /G/l' CONTRACTOR _ _ NO - Z G - ADDRESS . w- / fee DESCRIPTION WORK ` ` �►� * ' Lua NEW ADD ALTER REPAIR DEMOLISH n6.� e'T - F N Z tsoFr NO OF NO OF SIZE STORIES .21 FAMILIES - �l USE OF _ r_ - STRUCTURE__ SIGNURE'OF APPLICANT r ' VALUATION $ Q J APPROVALS RDATE INSPECTORA S SIGNTURE FPC 3 EE $ � FPMT EE $ S� FOUNDATION LOCATION I' - FORMS MATERIALS FRAME FIRE STOPS, t J s - 1 HEREBY ACKNOWLEDGE THAT 1 HAVE,READ THIS APPLICATION BRACING BOLTS h abs AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION LIaFF K( Y�+�� WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS ( tt BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK Q w AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH INT TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT. ING TO WORKMEN S COMPENSATION INSURANCE LATH EXT /p� �s�r_ / PERMITTEE OF / 1` HRECT AND POSTEDOUSE NUMBER O/2 2-A ✓7�rd."A' d ADDRESS • FINAL " '' /A hb� JOHN F LEWIS PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION/') M� CASH PERMIT VALIDATION — M O CASH 6 3 �illY 1 2 3 D � J 3 7.". 5 7;^'''• /9'-5°7 8 ,tea 1 1 D 7 4.5 0, 76A6'3-BA Ctlt*.38-64 APPLICATION FOR BUILDIN PERMIT, COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER- ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST _ COLEMAN W JENKINSSUP'T OF BUILDING CROSS ST jfjI D NPI- G 'T-Y PE FOR APPLICANT TO FILL IN CONST. BUILDING STATISTICAL C SIFICATION SEWER MAPA ADDRESS lo •�, -' BK PG CLASS-NO- DWELL UNITS LOT NOBLOCK USE ZONE MAP �'1l 119MoK� ® LO , - NO. I TRACT SS/Oi�-) E;k.),4C,e��' SPECIAL - NO OF SLOGS. CONDITION SIZE OF LOT NOW ON LOT / I USE'OF NG BLDG, mpl= AS41 BLDG. SETBACK FROM ' _ TEL FRONT PROP. LINE OF (STREET) OWNER NO TYPE-OF-- EXISTING I SETBACK HIGHWAY YARD = TOTAL ADDRESSIn HIGHWAY WIDTH I FM C L. _ - CITY - 0,111-5-0 -- _ . + ARCHITECT TEL. BLDG SETBACK FROM ENGINEER �NO Za S BIDE PROP LINE OF - (STREET) TYPE OF 'EXISTING SETBACK -` HIGHWAY' +"' YARD - TOTAL ADDRESS HIGHWAY WIDTH FROM C L d �> O / TEL }- + _ V CONTRACTOR NO ADDRESS L j Z CORNER CUTOFF YES E-1NOE] 0 H Y LIQ -.3. SEE REVERSE SIDE FOR SPECIAL APPROVALS W DESCRIPTION OF WORK Z NEW ADD ALTER REPAIR DEMOLISH SQ,FT. -SNO. OF NO OF SIZE Oo ' / /�• STORIES FAMILIES USE OF STRUCTURE i 61 s SIGNATURE OF APPLICANT VALUATION$ O\ -T /�-� APPROVALS DATE,INSPECTOR'S8IGNATURE LOC FEE$ FEE$ / (/ V FOUNDAFORMS I MPMT- TONATERIA LSON FRAME, FIRE , I, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTSTOPS7 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 TION OF THE L CODE OF THE STATE OF CALIFORNIA RELAT. ING TO WORKM S MPENSATI ON V NSU RANCE LATH -EXT , f SIGNATURE Of �\ HOUSE NUMBER COR- I PERMITTEE RE AND POSTED V ' ADDRESS � � IF I N A L • JOHN F LEWIS PRINCIPAL STRUCTURAL ENGI SER ' PLAN CHECK VALIDATION CK M o CASH PERMIT VALIDATION CK M O CASH : LuJ08 3 8 2 IEB 8 1 D. 4.00N APPLICATION F R BUILDING PERMIT / COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION _ FOR APPLICANT TO FILL IN BUILDIN ADDRESS I•hereby affirm that I have a certificate of consent to self Insure, BUILDING ADDRESS or a certificate of Workers',Compensation Insurance,.or a certified 9410 LIVE OAK AVE. - copy thereof (Sec 3800, Lab C) CITY ZIP TEMPLE CITY, CA 91780 LOCALITY Policy No • 1046140 'Company STATE FUND SIZE OF LOT NO OF BLDGS NOW ON LOT ❑ Certified copy Is hereby furnished NEAREST CROSS-ST TRACT BLOCK LOT NO OMertified copy Is filed with the county building Inspection USE ZONE MAP NO ' department . Date 11-1-9,1ppllcant RANDOL,ROOFING ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL NO • COMPENSATION INSURANCE ' DARRELL WSEVENEY 287-9149 WITHIN 1000 FT OF SCHOOL? ' ves No (This section need not be completed If the permit Is for one hundred ADDRESS DISTRICT GROUP T ECO T FIRE NE dollars ($100)or less) 9 140 E. LIVE OAK AVE. p ZONE PROCESSED BY I certify that in the performance of the work for which this permit CITY ITEMPLE CITY CA ZIP 91780 �'n0 —3 ✓ GLl�� Is Issued, I shall not employ any person In any manner,so as to become subject to the Workers'COmpensation'Laws ARCHITECT OR ENGINEER• TEL NO STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO C>1 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 ' RANDOL ROOFING 288-4040 FRONT comply with such provisions ol permit shall be deemed revoked ADDRESS LIC NO P L 529 E.• VALLEY BLVD". 451937 SIDE LICENSED CONTRACTORS DECLARATION CITY - 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 SO FT SIZE-°- NO OF STORIES NO OF FAMILIES Professions Code,and my license is in full force and effect NEW El 8( PG ® a License Number 451937 ' LIC Class C-39. DESCRIPTION OF WORKADD E] VALUATION Q Contractor RANDOL ROOFINgate 1-31-94 , 0 D WITH ALTER ❑ $ 6,000.00 0= 30—YEAR CLASS A FIBERGLAS REPAIR ED El am exempt under Sec $ F_ B&PC for this reason SHINGLES. TEAR OFF 1 LAYER OF DEMOL' ❑ LDMA P/C# W Date USE OF EXISTING BLDG URM El } SFD SHAKE. Signature APPLICANT(PRINT) TEL NO I LDMA Perm# ��i tC T o H - Z ❑ I, as owner of the property, or my employees with wages as RANDOL ROOFING 288-4040 -- -^nn3' their sole compensation, will do the work and the structure Is ADDRESS O -30 �.J'f e 75 not Intended or offered for sale (Section 7044, Business and 529 E. VALLEY SAN GABRIEL - 91776 FINAL DATE a 1 ITEM' PfOfeSSlOnS Code) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL r0—�3•r �� y �I'��si� + - 164 •135 OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER.THAN THE / Q S %_F ❑ 1,.as owner of the property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDES } FINAL BY 3 licensed contractors to construct the project (Section 7044, i. EC*(! 1i4o Business and Professions Code) YES El No Elr WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING _�_ 1.�� 3� e •• OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH, CONSTRUCTION LENDING AGENCY COAST NEAIR UAUTY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR I herebyaffirm that,there Is a construction lending agency for k 9 g Y YES❑ NO❑' a1 II�1=—I H_jjI JrJ i N, the performance of the work for which this permit Is Issued(Sec I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING 3097;CIV C), _ CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS-ANGELES COUNTY CODE, t V 0 179 1 AN;�•I a J= TITLE 2 CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD — - , h+ o Lender's Address O ,ONNER OR AGENT , o I certify,that I have read this application and state under penalty O of perjury that the above information Is correct I agree t0 comply PC FEE PERMIT FEE 139.20 o with all county ordinances and State laws relating to b Iding co construction, and h y author re sentatives of his ounty ISSUANCE FEE to ent u on th endo r erty for Insp ctl es 25.69 INVESTIGATION FEE TOTAL FEE 164.85 Sgnelw o + AV, SEE REVERSE FOR EXPLANATORY LANGUAGE