HomeMy Public PortalAbout9431 LONGDEN AVE_Building__ .�� 4� 0392 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS ��c A _
I herbby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS 7 n' 1 y� sl LOf V- P -tJ F6 V� 7
or a certificate of Workers'Compensation Insurance,or a certified �3 1 LON(Mr—V ' V Ei ' —r-t MrL� i 7 f - y')I
copy thereof(Sec.
3800,Lab.C.) CITY-�m n Z� ct� ZIP /L/ 7lI 0 LOCALITY
Policy Noi�CL' Compan SIZE PF LOT T NO.OF BLDG&NOW ON LOT
❑ Certified copy is hereby furnished. �-�—�� 0115 NEAREST CROSS ST. t_ ^ r
❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. V[ A-1!
department. '1 J � a USE ZONE MAP NO. 3 j
Date Applicant"T uU c/ C"Jf l�E J►�J F b-� ASSESSOR MAP BOOK PAGE PARCEL
O f — SPECIAL CONDITIONS
CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER EL NO.
COMPENSATION INSURANCE So d, w-' Dje 26GgEs f WITHIN 1000 FT.OF SCHOOL? YES x No
(This section need not be completed if the permit is for one hundred ADDRESS/ jj y �N /7 l /�
-.�f ��t�(f`[ Y � DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY
dollars($100)Or less.) �{
I certify that in the performance of the work for which this permit CITY—[Z:MfL1=6ri zIP L� 5- o G
IS issued, I shall not employ any person in any manner so as t0 ARCHITECT OR ENGINEE TEL NO.
become subject to the Workers'Compensation Laws. I > .�C [STATISTICAL CLASSIFICATION APT CONDO
Qy p 041381
y Z,sUn, Ss0< iNL. S`�6c
Date v Applicant &A w u / 0413 N 1 L P ADDRESS wj (r�P r-w v CLASS NO.� DWELL UNITS
NOTICE TO APPLICANT If, after making this Certificate of t Z� - S'�'v 'r^'v��vL O"-Vp'� 57r C r 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 DECLARATIONcrrY LIC.CLASS PL
SSIDE - - i .Z r
I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP T '=N a
(commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORIES NO.OF FAMILIES j - =TONS C3
Professions Code,and my license is in full force and effect. NEW ❑ BK PG d / , -,- 2 17=
i;.'1^IL. �d 5.P � e �
License Number 1 Lic.Class A DESCRIPTION OF WORK I ADD ): VALUATION
Contractor k4 NU l faf?il�Date al_��J POI +� `� ALTER ❑ s��. r-' fir'`i L EAE'LU
! 7 t.l?'y
/I:fig, ,_.
'j1tL�(: REPAIR ❑ Z
❑ I am exempt under Sec. v —
B.BP.C.for this reason lJt1/( Ei0• ) 01 lIZ J..7.�4 DEMOL ❑ MA P/C*
-'®Date: USE OF EXISTING BLDG. R(_3 URM ❑ fry '
Signature� Q.Z.I./i/L/ X itC132 i A i ii �)'
,`v .,
APPLICANT(PRINT) TEL NO. LDMA Perm#
❑ I,as owner of the property, or my employees with wages as -Z,S '`Y - r e-2 C111ZO _iy; ,•-�
their sole compensation, will do the work and the structure is ADDRESS ' 1 917-1-6-
�
not intended or offered for sale (Section 7044, Business and ,. i S 'W►N C-A , / 1 7 •� FINAL DATE o ?,__!_ fir;; �:;:•
Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL
❑ I, as owner of theproperty, am exclusive) contracting With OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE Q
Y 9 AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL Y < _ �,_n__
licensed contractors to construct the project (Section 7044, i I' s� r r
Business and Professions Code.) YES❑ NO❑ 1 _ ,IZI_ _ �'" -_,-_
WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING
OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH I.f'rs:S-I ,-%i'■
CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT ISOAOMD)SEE PERMITTING CHECKUST FOR _
GUIDELINES "'��31`+t?G n JL,
I hereby affirm that there is a construction lending agency for YES❑ NO❑
the performance Of the Work for which this permit Is Issued(Sec. I HAVE READ THE HAZARDOUS MATERIALSINFORMAMON GUIDE AND THE SCAOMD PERMITTING
3097,CIV.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE,
r TITLE 2.CHAPTER 220 SECTIONS 2 20.100 THROUGH 220.140 CONCERNING HAZARDOUS
Lender's Name �� r L/1,i MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD,
o Lender's Address 9'9 1 �4 u s d N S I_/tii _ ti
CI OWNER OR AGENT
o I certify that I have read this application and state under penalty
o P.C.FEE / PERMIT FEE
0 of perjury that the above information is correct.I agree to comply /
N with all county ordinances and State laws relating to building
construction, and hereby authorize representatives of this County ISSUANCE FEE
Q to enter upon the above/-��ttentioneo.prop rt for inspection purposes. (P Y
INVESTIGATION FEE TOTAL FEE
81mue4u..d AG71een1 a Apeni oaro
SEE REVERSE FOR EXPLANATORY LANGUAGE
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD/ALT/REP
BUILDING AND SAFETY % LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0708220019
PHONE: (626) 285-0488 EXT:
(LEGAL ID: I NO. OF CONST NEW I BUILDING ADDRESS: I
ON FILE I SQ. FT STORIES TYPE OCCUP GROUPI 9431 LONGDEN AV I
ISTRUCTURE: 445 1 VN R3 TEMP CA 917801609 I
(ASSESSOR INFORMATION NUMBER: I GARAGE: 439 1 VN U1 NEAREST CROSS STREET: OAK
15382-020-047 1 OTHER: THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY, Cl
ITENANT: 1EXIST BLDG USE- USE ZONE: (ISSUED ON: PROCESSED BY: EXPIRES ON:
I 1EXIST OCC GRP: 02/13/08 SR 08/11/08 1
(OWNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: IF T FINA Y: CODE: 1
ISUN TZYH DER (626) 292-6979- I 80,000 I � / I
9431 LONGDEN AV (/{�
ITEMP 917801609 FEES PAID IDE CR�IPTIOO OF WORK ki
I I (ADD BEDROOM, BATHROOM & LIVING ROOM AREA 445 S.F. REMOVE 1
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:IDETACHED CAR GARAGE & RELOCATED TO BE ATTACHED 2 CARGARAGE
(APPLICANT: TEL. NO: I I
1Z. SUN & ASSOC. INC. (626) 705-2210- IBI PLANCHECK W/ENERGY 80000.00 VAL 1,026.49 1
18653 GARVEY AVE. IAA BLDG PERMIT ISSUANCE 27.75 ISPECIAL CONDITIONS: 1
IROSfiMEAD CA 91770 AC STRONG 80000.00 VAL 8.00
IB2 PERMIT W/ENERGYTIONESID 80000.00 VAL 1,207.64
TOTAL FEES 2,269.88 1
1CONTRACTOR: TEL. NO: 1 (APPROVALS DATE INSPECTOR SIGNATURE 1
ITZYH-DER SUN (626) 705-2210- 1 I I
ISHANNON S MA LIC. NO 1 ILOCATION AND SETBACKS 1
19431 LONGDEN AVENUE NONE
ITEMPLE CITY, CA 91780 I ISOILS ENGINEER APPROVAL I I I
ARCHITECT OR ENGINEER: TEL. NO: 1 (FOUNDATION/TRENCH FORMS
1Z. SUN AND ASSOCIATES, INC. (626) 705-2210- 1 I Lf
18653 GARVEY AVE #204 LIC. NO: 1 (SLAB/UNDER FLOOR I I I
IROSEMEAD, CA 91770 C19992
IRAISED FLOOR FRAMING
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:l _ (UNDERFLOOR INSULATION3 Oil I I I
I I 11ST LEVEL FLOOR SHEATH I I I
INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: 1 I I I I
NO 21 1 12ND LEVEL FLOOR SHEATH I I I
1 SCHOOL WITHIN HAZARDOUS I - ROOF SHEATHING e. I I
(AIR QUALITY: 1000 FEET MATERIALS 1 I or I I
1 NO NO NO 1FIRE DEPT. FRAME INSPECT I I
IREQUIRED TOTAL SETBACK FROM EXIST I 1BLDG DEPT. FRAME INSPECT( I
ISET BACK YARD: HWY: PROP LINE: WIDTH: 1 I
IFRONT PL- 1 ISHEAR PANELS
I SIDE PL- 1 I I I
I I (INSULATION/WEATHER STRIP 1
1 I 11NTERIOR LATH/DRYWALL 1
1 I EXTERIOR LATH I 1
ILOT DRAINAGE I� I
II (SMOKE DETECTION DEVICES I I I
\ ` IFIRE DEPARTMENT APPROVAL( 1
1 I* ADDITIONAL DATA ON FILEI` I ` / - ))
(REPORT ID: DPR261 ROUTE TO: BS0508 I I 1 1
I
COUNTY OF IAS 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 0804090045
PHONE: (626) 285-0488 EXT:
[LEGAL ID: I NO. OF CONST 1 BUILDING ADDRESS:
[ ON FILE [ SQ. FT STORIES TYPE [ 9431 LONGDEN AV
[ [STRUCTURE: 1556 V-B [ TEMP CA 917801609 [
[ASSESSOR INFORMATION NUMBER: [ NEAREST CROSS STREET: OAK [
15382-020-047 [ [ THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY, Cl
[TENANT: [EXIST BLDG USE: RESID USE ZONE: R-2 TISSUED ON: PROCESSED BY: EXPIRES ON: [
(EXIST OCC GRP: 104/09/08 SR 10/06/08
[OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: JF TE FIN Y: CODE: [
[SUN TZYH DER (626) 292-6979- 1 124,480 [ [
19431 LONGDEN AV I [ I
ITEMP 917801609 1 FEES PAID JDE CRIPTION OF WORK I [
[ I [INTERIOR REMODEL KITCHEN RELOCATION AND OTHER LIVING SPACE [
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:IREMODELING 1556 S.F. J
[APPLICANT: TEL. N0: I I I
JZ. SUN & ASSOC. INC. (626) 705-2210- IAA BLDG PERMIT ISSUANCE 27.75 1 [
18653 GARVEY AVE. IAC STRONG MOTION RESID 124480.00 VAL 12.45 ISPECIAL CONDITIONS: J
ROSEMEAD CA 91770 JB2 PERMIT W/ENERGY 124480.00 VAL 1,599.18 J I
J TOTAL FEES 1,639.38 1 I
(CONTRACTOR: TEL. NO: J JAPPROVALS DATE INSPECTOR SIGNATURE J
JTZYH-DER SUN (626) 705-2210- I 1 I
ISHANNON S MA LIC. NO 1 ILOCATION AND SETBACKS I I I
19431 LONGDEN AVENUE NONE J I J I I
ITEMPLE CITY, CA 91780 J ISOILS ENGINEER APPROVAL I J I
JARCHITECT OR ENGINEER: TEL. NO: 1 JFOUNDATION/TRENCH FORMS I I I
JZ. SUN AND ASSOCIATES, INC. (626) 705-2210- I 1 1 I I
18653 GARVEY AVE #204 LIC. NO: I JSLAB/UNDER FLOOR i J
1ROSEMEAD, CA 91770 C19992
I I RAISED FLOOR FRAMING 1 I
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:J JUNDERFL.00R INSULATION I I I
1154H265 3 011 II I I
I I [FLOOR SHEATHING
INO. OF FAMILIES: DWELLING UNITS. APT/COND: STAT CLASS: J I I I I
1 NO 21 J IROOF SHEATHING
I I
J SCHOOL WITHIN HAZARDOUS J ]SHEAR PANELS I J I
JAIR QUALITY: 1000 FEET MATERIALS I I J J I
J NO NO NO 1 IFRAME INSPECTION J I I
(REQUIRED TOTAL SETBACK FROM EXIST I IFIRE SPRINKLER HANGERS
I I
ISET BACK YARD: HWY: PROP LINE: WIDTH: J I I I I
IFRONT PL- 1 JINSULATION/WEATHER STRIPI I I
I SIDE PL- I J J I I
I I JINTERIOR LATH/DRYWALL J I I
I I JEXTERIOR LATH J
I
I I IRATED FLOOR/CEIL ASSEM. I ] I
I J IRATED WALL ASSEMBLIES 1
I � I
I I IRATED SHAFTS/OPENINGS I I
I I I 1 I I
I J IT-BAR CEILINGS
I I
ILOT DRAINAGE I I I
I I I
J IREPORT ID: DPR261 ROUTE TO: 13SO508 I I I I
I I I I I I