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Home My Public Portal About9439 LONGDEN AVE_Building__ 76A638A.CE b8032-63 APDL CATION FOR BiUILDI•lVG''�PERIVIIT COUNTY OF LOS ANGELES BUILDING. DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY'=DIVISION LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST ,1 112 WILLIAM A.ANSEN, SUPT OF BUILDING CROSS ST., - DI§TRICTU TYPE FOR APPLICANT TO FILL IN ` ON CONST. BUILDING STATISTICAL CLA S ICATION SEWER MAP ADDRESS - CLASS. NO. WELL:UNITS LOT NO. '•z LO K WATER CERTIFICATE: klEr RECEIVED - TRACT AQ MAP AY �V v .(ICGRCILE), -� NO.OF BLDG NO• STATE MA lOR'SECON OCAL SIZE OF LO r, NOW ON LOT USE ZONE. SPECIAL USE OF CONDITIONS' ' EXISTING.13DG. /- ' TEL. ' OWNER O D lau BUILDING YARD• HWYSTREET NAM EXIST. SETBACK W TH ' ADDRESSop , FRONT fl -ARCH ITECT O. TEL:-{' P. L. (40 ENGINEER NO. SIDE > P. L. ADDRESS r 0' TEL.' CONTRACTOR IVO. G I ADDRESS. ` DESCRIPTION OF-WORK NEW ADD ALTER REPAIR DEMOLISH SO.FT. NO.OF NO: OF SIZEQ. -STORIES FAMILIES _ USE OF p ' STRUCTURE SIGNATURE O APPLICANT VALUATION $�� P APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. FOUNDATION: LOCATION FEE $ FEE $ r u FORMS.-MATERIALS FRAME: FIRE STOPS, IHERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS " AND STATE THAT THE ABOVE IS.CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. A WITH ALL COUNTY ORDINANCES AND STATE LWS 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-LABOR CODE OF THE STATE OF CALIFORNIA RELAT. ING TO WORKMEN'S COMPENSATION INSURANCE. ' - •• ' LATH,EXT. _ - SIGNATURE QF HOUSE'NUMBER COR- PERMITTEE / 9 kECT AND POSTED ��/f. ADDRESS ` �/ ' .FINAL: '6% JOHN F. LEWISrPRINCIPAL STRUCTURAL EN E PLAN CHECK VALIDATION. CK. M.O. CASH - _ PERMIT VALIDATION CK. M.O. cnsH i Sl�o Q 7' „JL 2 6 -1- D 3,C) 1 - 7I PLE CITY F8A888A Cr,}7808•i-81 AT N APPLIC IO FOR B.LJIL,DING- PERMIT COUNTY OF LOS ANGELES BUILDING . DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVLSION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A.JENSEN SUPT OF BUILDING CROSS ST. 'DISTR T N GR P TYPE OC ,S FOR APPLICANT TO FILL IN (� CONST. BUILDING STATISTICAL CLAS IFICATION SEWER MAP ADDRESS ! �1 .�/f�9 B CLASS.NO.-DWELL.UNIT / - LOT NO. BLOCK WATER _NOT REQUIRED RECEIVED CERTIFICATE: TRACT MAP. HIGHWAY i /J O'.OFBLDGS. NO. D! (CIRCLE)' STATE MAJOR SECOND OGAL SIZE OF LOT }r T''a /q/�(�'�NOW ON LOT,CyI jYrc,.' -USE ZONE. SPECIAL O USE OF CONDITION EXISTING BLDG. _ • - ' OWNER '' ,�� ' NO BUILDING EXIST. r :'•�'^•,= 'SETBACK YARD HWY STREET NAME WIDTH ADDRESS. FRONT / ARCHITECT OR �'' J9 TEL. •-,?.'L. ENGINEER' NO. �..'� SIDE ADDRESS :::. ::`' .. INSPECTION RECORD CONTRACTOR .•.- ��-�' c✓l � �J '�' I /' �: ' V ADDRESS, <y: _ ✓,K✓' 'L�r ./ I. I..(//��i�� F�� /, i! r.'J',!.'�"��--*°1' Ci `.DESCRIPTION •OF' RK' Lu U7'1)r ? �, . v NEW+ ADDr i4LTER•: REPAIR. DEMOLISH' e e 7 Y' om: ~ ' II SQ 'FT. I.� ' NO ..OF' NO.OF IZE' •'::....:.j i,��.1';.*:.;STORIES'. FAMILIES .� _/� .�,7•.• /�� /` ) USE OF! ``b' �� STRUCTURE OFGNATURESIr APPLICANT' VALUATION$• /�ri^ '.e- r:-'r•'t!' .I.�• APPROVALS .E+ 'S;!"-INSPECTOR'S SIGNATURE �+ J' FOUNDATI.ON:.LOCATION P.C. �((��(?'c7 PMT. �U 4 ;,i,i•:; :. i�.. FEE $ J` FEE $ D✓, FORMS.,MATERIALS FRAME:.F•IRE STOPS, /�y / I HEREBY'ACKNOWLECGET.HAT 1 HAVE READ THIS APPLICATION BRACING BOLTS _ ! (1f'�"6' * -?` _ { �-fi%• . •+"+�• ' AND STATE THAT THE ABOVE.15 CORRECT.AND AGREE TO COMPLY FURNACE:LOCATION. WITH AUL COUNTY�O.RDIN/kNCES+AND STATE LAWS REGULATING ,GAS:VENT DUCTS BUILOING CONSTRUCTION.'1'CERTIFY THAT,IN DOING THE.WORK AUTHORIZED HEREBY 1,WILL NOT EMPLOY ANY PERSON IN VIOLA- _ LATH,INT. I �q/ L. •,ii.Jl��J.J•�/ �.. TION OF THE'LABOR'CODE OF THE STATE OF CALIFORNIA RELAT- INC TO WORKMEN'S COMPE�8AT1 N INSURp1N .• � � !r, J 7 F LATH,EXT. / I /✓i'T ��.t\1 :r��.. SIGNATURE OF J L� HOUSE NUMBER COR' PERMITTEE ' :sem' fF�/ RECT AND POSTED FINAL / r ADDRESS, { l j CLYDE N. DIRLAM,rPRINCIPAL ST TURAL"ENGINEER . PLAN CHECK' VALIDATION cK. 'M.o. QkSN PFJU%= VALIDATION cK. M.o., CASH' L'10'6 -2 1 6 QCT3O 2 3 D 2 5.00b L o 68 7 2 taov 13 1 -D 5 0.00' WORKERS'COMPENSATION DECLARATION to self insure, or a�irm certif carte of Workers'Compensat onve a certificate ofs Insurance, APPLICATION F R BUILDING PERMIT . or a certified copy thereof(Sec. 3800, Lab. C.) JOB # 3042 COUNTY OF LOS ANGELES BUILDING AND SAFETY PolicyNoRCS 13788CtompanA-oYa1 Ins, Co. BUILDING ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDLD RESS `7 l 7 R1 Certified copy is filed wi�th �ntybuil�dinginsp�ec- i BUILDING tion department. ADDRESS 9439 Lon den AvenueDate 122185 ApplicaCITYjem le ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. (This section need not be completed if the permit is for one ASSESSOR hundred dollars($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL �L• USE ZONE MAP I certify that in the performance of the work for which this OWNER M/M George Matson NO. ' NO, }G. permit is issued, I shall not employ any person in any manner 9439 Longden Avenue SPECIAL so as to become subject to the Workers'Compensation Laws. ADDRESS g CONDITIONS V CITY Temple City, CA 91789iP Cd Date Applicant ARCHITECT OR TEL. NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO DI TF GROUP TYPE FIRE PR ESSED BY Exemption, you should become subject to the Workers' `�(� �� CONST. ZONENw�l � Compensation provisions of the Labor Code, you must forth- ADDRESS !J 3 G' with comply with such provisions or this permit shall be deemed revoked. CAL-PAC ROOFING, INE.. 978-2668 STATISTICAL CLAS IF`CATION APT. CONO. CONTRACTOR NO. r LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS — I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. '471[ilrinj SEWER MAP (commencing with Section 7000)of Division 3 of the Business and LIC. Professions Code,and my license is in full force and effect. CITY Orange, CA 92668 CLASS B BK E PG.-20VALIDATION 379503 B SQ. FT. NO.OF NO.OF CHECK License Nu er Lic.Class SIZE STORIES FAMILIES ONE VALUATION 1/22/85 DESCRIPTION OF WORKReroof with Decra NEW ❑` $ 3,450.00 2 1 4 0,3 A Contra ate D : ADD ❑ 000. ❑ I am exempt under Sec. Tile 23 squares, ICBO # 3409• ALTER # 0 0 0 0 a 1 B.BP.C. for this reason REPAIR ® $ Date: USE OF single family dwellin DEMOL ❑:` I a a 6 8,6 3 EXISTING BLDG. Signature APPLICANT TEL. FINAL a a o66 3 OWNER-BUILDER DECLARATION PRINT CAL-PAC ROOFING INQ 978-2668 DATE '� ,, 1 hereby affirm that I am exempt from the Contractor's License (aD1DkESS • Eckhoff St° Orange, CA 92668 FINAL 01.24 8 5 Law for the following reason (Section 7031.5, Business and Professions Code): PRESENT By ❑ BUILDING I, as owner of the property, or my employees with ADDRESS , I wages as their sole compensation,will do the work and 1;2(/�}[ G the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. ❑ 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). y CONSTRUCTION LENDING AGENCY SETT BACK YARD HWY TOTAPROP.SETBpLINE CK FR 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 o' P.L. Lender's Name LDMA Ref. # P.C. Fee$ Permit Fee 58.13 Lender's Address p I certify that I have read this application and state that the Issuance Fee l0°SC LDMA P/C# above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, Total Fee $68.63 LDMA Perm.# i and hereby authorize representatives of this County to enter up n the above-mFenne. raper for inspection purposes. 22/85 SEE REVERSE FOR EXPLANATORY LANGUAGE 01 Sig Lure of Applicant or Agent Date