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Home My Public Portal About9616 LONGDEN AVE_Building__ APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDI �ADD RESS 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 9616 E. LONGDEN copy thereof(Sec.3800,Lab.C.) CITY ZIP TEMPLE CITY 91780 - LOCA Policy No. 1046140 Company STATE FUND SIZE OF LOT NO OF BLDG&NOW ON LOT Certified copy is hereby furnished. ST. NEAREST CR S * Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. USE ZONE MAP NO. Date 11-1-94App1ecant RANDOL ROOFING ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL NO. COMPENSATION INSURANCE MARGARET IMERIS 286-1562 WITHIN 1000 FT.OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred ADDRESS DISTRICT GROUP TYP NST. FIRE ZONE PROCESSED BY dollars($100)or less.) ,ki certify that in the performance of the work for which this permit CITYZIP CITY ZIP 91780 J 3 01 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 CONDO (� 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 t0 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 or this permit shall be deemed revoked. ADDRESS LIC.NO. P L LICENSED CONTRACTORS DECLARATION 529 E. VALLEY 45SIDE CITY LIC.CLASS P L I hereby affirm that I am licensed underprovisions of Chapter 9 qAN CARBTFT. In—31 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SO.FT.SIZE NO.OF 9:ZRIENO.OF FAMILIES } Professions Code,and my license is in full force and effect. NEW ❑ BK PG License Number 4531937 Lic.Class C-39 DESCRIPTION OF WORK ADD ❑ VALUATION ContractoRANnnT. RnnFTNG Date 1-31-96 ALTER El $ 2,000.00 w 20—YEAR CLASS A FIBERGLAS REPAIR j] c ❑ BAP.C.for this reason DEMOL ❑ Z SHINGLES OVER EXISTING COMP LDMA P/C# Date: USE OF EXISTING BLDG URM ❑ -- Signature AP TEL NO. LDMA Perm# = �_k i;'� � -.60 288-4040 I �NOOFING ❑ I,as owner of the property, or my employees with wages as 288-4040 z � -•:�r�: their sole compensation, will do the work and the structure is ADDRESS Cl s` not intended or offered for sale (Section 7044, Business and 529 E. VALLEY SAN GABRIEL CA FINAL DATE Q :!i s AL JL�'�`"1J 5 a 30 Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERAL { I M OR A MIXTURE CONDONING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THEll_i•I•. ,�_I:,s ❑ I, as owner of the property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY 7 licensed contractors to construct the project (Section 7044, C ::AN13i Business and Professions Code.) YES❑ NO❑ WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR OUAUTY MANAGEMENT DISTRICT ISCAOMD)SEE PERMITTING CHECKLIST FOR4 _`I j GUIDELINES !1=LI��-I- 1 •t ! 1 hereby affirm that there is a construction lending agency for YES❑ No❑ s Z� r),I ';'' CM the performance Of the WOfk for Wt11Ch this permit IS ISSUed(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING 1 3097,CIV.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE. N 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. o Lender's Address CI OWNER OR AGENT c I certify that I have read this application and state under penalty of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE 78.90 N with all county ordinances and State laws relating to building Go construction,fts?, authoriz re sentatives ofIt Cou ty ISSUANCE FEEa to enter up n entio erty or inspe rpo 26.40 I'D INVESTIGATION FEE TOTAL FEE 1. sorom.a Ao .�.; 17 105.30 SEE REVERSE FOR EXPLANATORY LANGUAGE • 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 1202170019 PHONE: (626) 285-0488 EXT: ILEGAL ID: I NO. OF CONST I BUILDING ADDRESS: I ON FILE I SQ. FT STORIES TYPE 1 9616 LONGDEN AV I [STRUCTURE: 1800 V-B I TEMP CA 917801447 I (ASSESSOR INFORMATION NUMBER: 1 I NEAREST CROSS STREET: I 15385-016-011 I I THOMAS PAGE. 596 GRID: J2 LOCALITY: TEMPLE CITY CAI I I I (TENANT: 1EXIST BLDG USE: RESID USE ZONE: R-2 (ISSUED ON: PROCESSED BY: (EXIST OCC GRP: 102/17/12 SR (OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: IFINAL DATE FI Y: CODE: IMONTRICHOK PAVINEE - 1 2 5,500 1 19616 LONGDEN AV I ITEMP 917801447 1 FEES PAID SCRIPTION OF WORK I I IREMOVED THE EXISTING ROOF AND INSTALL 1/2 PLYWOOD AND I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:IASPHALT SHINGLES 1 (APPLICANT: TEL. NO: I I 1 IIGNACIO, GARCIA (626) 333-8500- IAA BLDG PERMIT ISSUANCE 27.80 1__ I 12014 LYNDA LN IAB STATE GREEN BLDG FEE 5500.00 VAL 1.00 ISPECIAL CONDITIONS: 1 (WEST COVINA CA 91792 IAC STRONG MOTION RESID 5500.00 VAL 0.60 1 I D2 PERMIT W/O EN-HC 5500.00 VAL 149.70 1 I 1 TOTAL FEES 179.10 I- ICONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE ISOUTH COAST AND VALLEY ROOFING (626) 333-8500- 1 1 1 2014 LYNDA LANE LIC. NO 1 ILOCATION AND SETBACKS 1 1 IWEST COVINA, CA 91792 830059 C39 I I I I 1 I ISOIL3 ENGINEER APPROVAL 1 1 (ARCHITECT OR ENGINEER: TEL. NO: IFOUNDATION/TRENCH FORMS I 1 LIC. NO: 1 ISLAB/UNDER FLOOR I I I 1 I (RAISED FLOOR FRAMING I 1 I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( 1UNDERFLOOR INSULATION 1 I I 1153H269 3 001 1 1 1 I I IFLOOR SHEATHING 1 I 1 INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I I I 0 NO 21 1 I ROOF SHEATHING �j Yj 1 1 SCHOOL WITHIN HAZARDOUS I ISHEAR PANELS cr I I (AIR QUALITY: 1000 FEET MATERIALS I 1 1 NO NO NO 1 FRAME INSPECTION I I 1 I (FIRE SPRINKLER HANGERS 1 I 1 I I I I I I I 1 11NSULATION/WEATHER STRIPI I 1 I I I I I I 1 _1 (INTERIOR LATH/DRYWALL I 1 1 I I I I I I 1 1 (EXTERIOR LATH 1 1 1 1 1 IRATED FLOOR/CEIL ASSEM. I 1 I I IRATED WALL ASSEMBLIES I 1 I (RATED SHAFTS/OPENINGS I 1 I 1 IT-BAR CEILINGS 1 I I ILOT DRAINAGE I 1 1 1 (REPORT ID: DPR261 ROUTE TO: BS0508 1 I 1 1 I I I I I I ' 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 1202170020 PHONE: (626) 285-0488 EXT: ILEGAL ID: I NO. OF CONST I BUILDING ADDRESS: J [ ON FILE I SQ. FT STORIES TYPE I 9616 LONGDEN AV [ ISTRUCTURE: 400 V-B I TEMP CA 917801447 I (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: ] 15385- 016-011 1 I THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY CAI TENANT: EXIST BLDG USE: RESID USE ZONE: R-2 (ISSUED ON: PROCESSED BY: I I 1EXIST OCC GRP: 102/17/12 SR I (OWNER: TEL. NO: JBLDGS. NOW ON LOT: VALUATION: IFINAL DATE FINAL BY: CODE: 1 IMONTRICHOK PAVINEE - 1 2 1,000 _ 19616 LONGDEN AV 1� � 1 ITEMP 917801447 1 FEES PAID IDESCRIPTION OF WORK 91 I I IREMOVED THE EXISTING ROOF AND INSTALL 1/2 PLYWOOD AND [ I IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT:JASPHALT SHINGLES GARAGE 1 (APPLICANT: TEL. NO: I I 1 JIGNACIO, GARCIA (626) 333-8500- IAA BLDG PERMIT ISSUANCE 27.80 1 1 12014 LYNDA LN JAB STATE GREEN BLDG FEE 1000.00 VAL 1.00 ISPECIAL CONDITIONS: WEST COVINA CA 91792 AC STRONG MOTION RESID 1000.00 VAL 0.50 I [ ID2 PERMIT W/O EN HC 1000.00 VAL 65.40 1 1 I TOTAL FEES 94.70 [ 1 ICONTRACTOR: TEL. NO: 1 JAPPROVALS DATE INSPECTOR SIGNATURE ISOUTH COAST AND VALLEY ROOFING (626) 333-8500- 1 1 1 12014 LYNDA LANE LIC. NO 1 ]LOCATION AND SETBACKS 1 1 1 IWEST COVINA, CA 91792 830059 C39 I 1 1 1 1 I ISOILS ENGINEER APPROVAL I I 1 [ARCHITECT OR ENGINEER: TEL. NO: - [ IFOUNDATION/TRENCH FORMS I I I LIC. NO: 1 JSLAB/UNDER FLOOR 1 1 1 IRA SED FLOOR FRAMING I I 1 MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: JUNDERFLOOR INSULATION I I I 153H269 3 00 ] I IFLOOR SHEATHING 1 1 1 INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I I I I I0 NO 21 1 [ROOF SHEATHING 1 SCHOOL WITHIN HAZARDOUS 1 ISHEAR PANELS JAIR QUALITY: 1000 FEET MATERIALS 1 I J 1 1 [ NO NO NO [ IFRAME INSPECTION I I [FIRE SPRINKLER HANGERS (INSULATION/WEATHER STRIP( I 1 I I JINTERIOR LATH/DRYWALL I I 1 [ 1 [EXTERIOR LATH I I 1 J IRATED FLOOR/CEIL ASSEM. I ] 1 1 IRATED WALL ASSEMBLIES I I ] 1 [ IRATED SHAFTS/OPENINGS 1 [ IT-BAR CEILINGS I 1 [ I I I 1 (LOT DRAINAGE 1 I 1 IREPORT ID: DPR261 ROUTE TO: BS0508