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Home My Public Portal About9501-9503-9505 LONGDEN AVE_Building__ WORKERS'COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent toc self APPLICATION FOR BUILDING PERMIT insure, or a certificate of Workers'Compe ion Insurance,o a certif p ri jo'.c. 3800, Lab. COUNTY OF LOS ANGELES ± BUILDING AND SAFETY Policy"No- $ !/Company iG� ertified co is hereby fur '!shed. BUILDING Pv v ��— / FOR APPLICANT TO FILL IN ADDRESS Certified copy is filed with the county building inspec- BUILDING ' tion department. ADDRESS Q �'f� Ili — LL 0LOCALITY NEAREST Dote Applicant CITY W dl.•I,, ZIP -W7,FQ CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' + NO OF BLDGS. /�/�t{ ASSESSOR , COMPENSATION INSURANCE SIZE OF LOT 60 201c) NOW ON LOT AVON MAP BOOK , PAGE PARCEL (This section need not be completed if the permit is for one [�° Ct D USE ZONE MAP a TRACT 4IL BLOCK LOT O. NO. hundred dollars ($100)or less.) I } / TEL. SPECIAL9116 1 certify that in the performance of the work for which this OWNER tP_ V I/ NO.� Z CONDITIONS t permit is issued, I shall not employ any person in any manner I / DISTRICT GROUP TYPE FIRE POC D BY LJ ADDRESS, Llti /L� ! so as to become subject to the Workers'Compensation Law's. �� 0/ ^� CONST E Date Applicant CITY ZIP STATISTICAL CLASSIFICATION A CONDO. U IL ARCHITECT O '� TEL. NOTICE TO APPLICANT: If, after making this Certificate of -� - IW Exemption, you should become subject to the Workers ENGINEER NO. CLASS NO._v�. DWELL. UNI7S�- d Compensation provisions of the Labor Code, you must forth- with comply with such provisions or this permit shall be ADDRESS j� SEWER MAP' l deemed revoked. CONTRACTOR t�? //^ /� NO.��/ �` 'O 13K. 4 PG,c3 U VALIDATION LICENSED CONTRACTORS DECLARATION / �j I , I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS L`Z.fo I Ls VALUATION (commencing with Section 7000)of Division 3 of the Business and .-�� IC. } Professions Code, and my license is in full force and effect. CITY /�?iv� �f CLASS $ ,a SO. F7 INC.OF NO.OF CHECK License Number Lic.Class SIZE 2�(�L� STORIES FAMILIES ONE DESCRIPTION OF WORK NEW $ 3 1 9,O.A Contractor Date 7 LL .❑ P 9 9 I�/ �� e7L4 DD I am exempt from the licensing requirements as I am a L j` licensed architect or a registered professional engineer ALTER ❑ FINAL �� ;r,, u a o o 23 acting in my professional capacity (Section 7051, REPAIR ❑ DATE `f �� a o O 7 20 Business and Professions Code). USE OF ' DEMOL FINAL EXISTING BLDG. ❑ ✓ Lic.or Reg.No. Date I APPLICANT QLd" TEL. / OWNER-BUILDER DECLARATION (PRINT) rJ _ Ir ��1!. O.��(� Gd�1$ 4' 03.09-82 1 hereby affirm that I am exempt from the Contractor's License --t ) r� Law for the following reason (Section 7031.5, Business and ADDRESS Z�v� %ekJ4 !e c, S/✓dam Professions Code): PRESENT v73 BUILDING I, as owner of,the •property, or my employees with ADDRESS wages os their sole compensation,will do.the work and LOCALITY the structure is not intended or offered for sale(Section 7044, Business and Professions Code). MOVING TEL.. 4` I,'os owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct-the project (Sec- ADDRESS tion 7044, Business and Professions Code). _ 1 9, I A. REQUIRED TOTAL SETBACK FROM EXIST. �; CONSTRUCTION LENDING AGENCY SET BACK YARD ' HWY PROP. LINE WIDTH {1- o a o o ;a 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., o P.2 7 J (Sec. 3097, Civ. C.). i SIDE P.L. ° ° G I, ` Lender's Name � G 00 03.09-8i Lender's Address P.C. Fee$ d ' Permit Fee �r I certify that I have read.this application and state that the I ,.52 Issuance Fee /J above information is correct. I agreFe to comply with all County t Investigation Fee ordinances and State-laws elati to building construction, j lot e and hereby authorize repr, sent ves of this County to enter r upon t e v e tion pr erty for-inspection purposes. -SEE REVERSE FOR EX ANATORY o V Si nature of Applicant or Qgent Do e l ®s WORKERS'COMP':NSATION DECLARATION J y ' APPLICATION FOR,, BUILDING PERMIT I hereby affirm that I have a certificate of consent to self insure, or a certificate of Workers'Compens Ion Insurance,o a c t ed�pyr (Sec'. 3800, Lab. !� COUNTY OF LOS ANGELES I+ BUILDING AND SAFETY Pj1ic o. Company ertified copy is hereby fu shed. BUILDING ` ❑ /Q' /+J j•—�''-� .FOR APPLICANT TO FILL IN _ADDRESS ; G / I il/ Certified copy is filed with the county•building inspec- BUILDING L4J tjon department. ADDRESS � �1' �� F` Vt'� LOCALITY NEAREST Date Applicant CITY f_✓H•PAr ZIP J 77 CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' NOW NO OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT X;2 G ON LOT 1?�'� MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one �(�µ' USE ZONE ESPECIAL ..( hundred dollars ($100)or less.) TRACT BLOCK LOT NO. No. o�Q � � TEL.+�77 '' 77 � CL OWNER NO.^�Is ��•$ DITIONS I certify that in the performance of,the work for which this U permit is issued, I shall not employ any person in any manner / DISTRICT GROUP TYPE FIRE PROCESSED BY ADDRESS� ZG-^ 7 �•_-m �� di r U�f CONST. ZONE so as to become subject to the Workers'Compensation Laws. S or y OC Date Applicant CITY / �. ZIP STATISTICAL CLASSIFICATION Ffr ]CONDO. V / NOTICE TO APPLICANT: If,.after making this Certificate of ARCHITECT OR TEL. LU Exemption, you should become subject to the Workers' ENGINEER NO. r CLASS NO. 0 � DWELL. UNIT 911. Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP Z with comply with such provisions or this,permit shcgll be }»� TEL. / deemed revoked. <.1;.. CONTRACTOR in Y NO.Z 1 BK. L PG, VALIDATION LICENSED CONTRACTORS DECLARATION �f -� p I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS G(O—Ie�K e CE J VALUATION (commencing with Section 7000)of Division 3.bf the Business and11 . LIC. Professions Code, and my license is in full force and effect. CITY � �/ CLASS $ t SQ. FT. r-21-2 NO.OF NO.OF CHECK Ltcense'Number Lic.Class SIZE - d ISTORIES FAMILIES ONE DESCRIPTION OF WORK NEW pzrz Contractor Date 13El1 am exempt from the licensing requirements as I am a .�.rj ' ADD r w licensed architect or a registered professional engineer ALTER ❑ FINAL"?� ! /`- ;7 1 r, �; acting in my professional capacity. .(Section 7051, DATE Business and Professions Code). USE OF REPAIR ❑ , n DEMOL FINAL EXISTING BLDG. ❑ B f. +W' - - Lic.or Reg..No.' - Date APPLICANT /j� TEL. . rte/ y � 2 c.1 C OWNER-BUILDER DECLARATION (PRINT) 4 • � NO.� (J®?S� j L 7/•�� /E t I hereby affirm that I am exempt-from the Contractor's License ISO �2 /� • � r� Law,for the following reason (Section 7031.5, Business and ADDRESS- T /�/s Professions.Code): PRESENTin 1 n I' BUILDING• .• - ❑ I, as owner of the property, or my employees with ADDRESS p wages as their sole compensation,will do the work and 4r op o "-the.structure isnot 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. ` 7 with licensed contractors to construct the project (Sec- ADDRESS tion 7044,.Business and Professions Code). C, REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BASK YARD HWY PROP. LINE WIDTH >> _ n c o .I I heteby affirm that there is a construction lending agency for I FRONT T the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE () `•(' III P.L: i Lender's Name I () II ,`L, P i +I P.C. Fee$ t5 T / Permit Fee -� C L• ._`: . Lender's Address I certify that I have read this application and state that the ' Issuance Fee ' �� j 1 above information is correct. I agree t amply with all County I Investigation Feej] ordinances and-State laws relq n building construction, I Total Fee 7�� I and hereby authorize teprese at' sof this County to enter Upon th e- io a rty for inspection purposes. E iJ/�� SEE REV E FOR EXPLAN RY LA GE Signature of Applicant or Agent Date j es 1 COUNTY OF LOS 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 0907150021 PHONE: (626) 285-0488 EXT: ILEGAL ID: I NO. OF CONST I BUILDING ADDRESS: 1 ON FILE 1 SQ. FT STORIES TYPE 1 9501 LONGDEN AV ISTRUCTURE: 3100 V-B I TEMP CA 917801611 1 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 1 1 [ I5382-020-067 iTHOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY, Cl TENANT: EXIST BLDG USE: RESID USE ZONE: R-2 IS$UED ON: PROCESSED BY: 1EXIST OCC GRP: 107/15/09 SR (OWNER: TEL. NO: ]BLDGS. NOW ON LOT: VALUATION: IF DA F BY: CODE: 1WU, JULIE (626) 241-4621- 1 8,700 I 1 19501 LONGDEN AV I I I ITEMP 917801611 I FEES PAID ID SCR PTI N OF WORK v1 I I ]TEAR OFF & REROOF HOUSE & GARAGE INSTALL MONIERLIFE TILE IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:]SPLIT SHAKE ICBO SR 2656 5.9 LB. 1 ]APPLICANT: TEL. NO: I I I ISUNSHINE ROOFING (626) 581-7688- IAA BLDG PERMIT ISSUANCE 27.75 11 1516 N. DIAMOND BAR IAB STATE GREEN BLDG FEE 8700.00 VAL 1.00 ISPECIAL CONDITIONS: IDIAMOND BAR CA 91765 AC STRONG MOTION RESID 8700.00 VAL 0.87 I I [ 1D2 PERMIT W/O EN-HC 8700.00 VAL 199.80 ] [ 1 TOTAL FEES 229.42 1 ICONTRACTOR: TEL. NO: ] ]APPROVALS DATE INSPECTOR SIGNATURE 1 ISUNSHINE ROOFING (626) 581-7688- [ 1 [ 1516 N DIAMOND BAR BLVD #183 LIC. NO I ]LOCATION AND SETBACKS I [ [ IDIAMOND BAR CA 91765 755126 C39 1 I [ ISOILS ENGINEER APPROVAL ] 1 1 ]ARCHITECT OR ENGINEER: TEL. NO: - :1 ]FOUNDATION/TRENCH FORMS I I I 1 LIC. NO: 1 1SLAA/UNDER FLOOR 1 1 I I I IRAISED FLOOR FRAMING 1 1 1 IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( ]UNDERFLOOR INSULATION 1 I I 1153H265 3 001 1 [ I I [FLOOR SHEATHING I [ INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I I I NO 21 [ IROOF SHEATHING I [ 1 SCHOOL WITHIN HAZARDOUS 1 ISHEAR PANELS I I [ (AIR QUALITY: 1000 FEET MATERIALS I [ I [ ] NO NO NO I IFRAME INSPECTION I ] I ]REQUIRED TOTAL SETBACK FROM EXIST 1 ]FIRE SPRINKLER HANGERS ISET BACK YARD: HWY: PROP LINE: WIDTH: I (FRONT PL- (INSULATION/WEATHER STRIP( I I 1 SIDE PL- INTERIOR LATH/DRYWALL I [ 1 [ 1EXTERIOR LATH 1 1 1 1 1I IRATED FLOOR/CEIL ASSEM. 1 1 [ 1 I ]RATED WWALL ASSEMBLIES 1 1 1 1 1 ]RATED SHAFTS/OPENINGS BAI 1 1 [ I IT- (R CEILINGS I I I [ I ILOT DRAINAGE 1 1 [ 1 [ IREPORT ID: DPR261 ROUTE TO: BS0508 1 1 1 1