HomeMy Public PortalAbout9708-9710 LONGDEN AVE_Building__ ®S 76AgJ�pA`�:I
FE A04iEV.6/78)
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELESt BUILDING AND SAFETY
BUILDING FOR APPLICANT TO FILL IN ADDRESS `/Q
BUILDING
ADDRESS GJ 6 LOCALITY
NEAREST
CITY TeZIP CROSS ST.
NO.OF BLDGS. ASSESSOR
SIZE OF LOT NOW ON LOT NOA)E MAP BOOK PAGE I PARCEL
U/U�f DISTRICT UP TYPE FIRE RR ES
TRACE 3 � BLOCK IBi446�. OT`� �- CONST.TEL. ` np , `0o 3 Ll:zff�
OWNER t . G C!y` NO 6' O,O .
/ STATISTICAL CLASSIFICATION SEWER P
ADDRESS f� C /e ��' CLASS NO. 0 "�DWELL.UNITS Z—BKPG
CITY y • 1p 6
zip
ENGINEER ORTIEL.// NO. / 0 d VALUATION J ' 4�
ADDRESS (Aj(p y BLDG.SETBACK FRO/lyl /
y. TEL. FRONT PROP.LINE OF �ly^� ISTREET)
CONTRACTOR%/� , eA NO. HIGHWAY + YARD TOTALS 'ACK FROM TYPE OF EXISTING
LIC. - FRONT PROP.LINE HIGHWAY WIDTH
ADDRESS, C NO. _
LIC. +
CITY jr� CLASS
CONSTRUCilO LENDER BLDG.SETBACK FROM
SIDE PROP.LINE OF (STREET)
NAME AND BRANCH
TOTAL SETBACK FROM TYPE OF EXISTING
j 1179 q ) HIGHWAY t YARD = SIDE PROP.LINE HIGHWAY WIDTH 12.
ADDRESS iU rl ITY /
SO.F . NO.OF NO.OF CHECK t =
SIZE STORIES
tt�� FAMILIES ONE
DESCRIPTION OF WORK CQ NEW ® P.C.Fee$ ')td Permit Fee
` /e ADD Issuance Fee CA
dwe/l n cah ALTER
.1 1SSS , REPAIR ❑ Total Fee
USE OF DEMOL ❑
EXISTING BLDG. ZC
APPLICANT TEL
IPRINTI �j Lok NO. , Z,. � p/ .2- [ y Q
a3
BY(SIGNATURE( >
ITHATHEREBY ACK LEDGE THAT I HAVE READ THIS APPLICATION AND STATE '� 7• 7� C`J Y
ORDINANCES
AND LAWS R LATING BUILDING DING CONS RUCTION.ANDnI CERTIFY T ATITHLIN DOING THE {=7 �3 5 8 9 A
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RE TIN ,TO WORKMEN'S COM- z �� o o 0 0
PENSATION INSURANCE. / F N�
d
SIGNATURE OF 2578.50 j�/ � �
PERMITTEE _ (/
ADDRESS •, v f ��� 2 3-70 Zaf TEL. - - 578.50'u'
CITY NO �Ic- o °-�� 04 06-79
D
USE ZONE NOP G3 Q
SPECIAL r
CONDITIONS
FINAL BY f/ 6
DATE �`/ry
• APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION
FOR APPLICANT TO FILL IN BU ING ADDRESS
I hereby affirm that I have a certificate of consent to self insure, a ILDING�ADDRESSZo
or a certificate of Workers'Compensation Insurance,or a certified `
copy thereo ( c.38a ab.C.) /1 wnoml
ZIP
LOCALITY
Policy o. � ® Company SIZE LOT NO.OF BLDGS.NOW ON LOT
ertified copy is hereby furnished.
NEAREST CROSS ST.
❑ Certified copy is filed with the co ty building n pection TRACT BLOCK LOT NO.
depa"ICATE
USE ZONE MAP NO.
DateApplicant r ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS ��� ^/
CEOF EXEMPTI FROM WORKERS' NER I TEL NO. YES NO
COMPENSATION INSURANCE &CtPO S WITHIN 1000 FT.OF SCHOOL?
(This section need not be completed if the permit is for one hundred KESS DISTRICT GROUP TYP ONST. FIRE ZONE PROCESSED BY
dollars($100)or less.) — , "
CRY ZIP
I certify that in the performance of the work for which this permit ��� GJ f ����
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 CLASSI KATION 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 to the Workers' CONTRAPTOR -� TEL NO. SET BACK YARD HWY PROP LINE WIDTH
Compensation provisions of the Labor Code, you must forthwith : /� / .4&7-0662 FRONT
comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL
LICENSED CONTRACTORS DECLARATION ��� C� L�� 51, SIDE
C LIC. PL
I hereby affirm that I am licensed underprovisions of Chapter 9 ;0aQ419 SEWER MAP
(commencing with Section 7000)of Division 3 of the Business and SQ NO.OF STORIES NO.OF FAMILIES
Professions Code,and m license is in full force and effect. NEW ❑ BK PG a
License Number 77 Lic.Class DESWIPTION OF WORKIV )_ ADD ❑ VALUATION ® V
Contractor�(/�/ �J A Date -�! ALTER 11 ;7.. cc
Al
❑ I am exempt under Sec. REPAIR $ i
B.BP.C.for this reason DEMOL ❑ a V
LDMA P/C# A","Cr p ,a W
to USE OF EXISTING BLDG. URM ❑ s— s IL
co
Signature APPLICANT(PRINT) TEL NO. LDMA Perm# cul L s' 1 z
❑ I, as owner of the rty, or my employees with wages as 0 1 ITEMS
their sole compe tion, will do the work and the structure is ADDRESS H TOTAL 202 o 05
not intended or offered for sale (Section 7044, Business and FINAL DATE Q
I=❑ Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL O C'HEC•14 1-1 o Y.-
El
1, as Owner of theOR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE _
property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY CHANGE o Qlicensed contractors to construct the project (Section 7044, YES❑ NO 11
Business and Professions Code.)
WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING
OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH
CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR I'•I('� L.�.( �I� J�",,+y,� 4
GUIDELINES L J• —-
I hereby affirm that there is a construction lending agency for YES❑ NO❑ 0'625 7 0 ;_
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 ,
W3097,CIV.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LAS ANGELES COUNTY CODE.
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
� OWNER OR AGENT
o I certify that I have read this application and state under penalty
4 of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE
N with all county ordinances and State laws relating to building /
a cons ion, and hereby'Juthorize representatives of this County ISSUANCE FEE /
' m to er er pon the abov ntioned prop fSl for inspection purposes.
a =�� ���%'�% INVESTIGATION FEE TOTAL FEE 7 D D
CO _'�" O�
� Sgc!uro•MCbn a
SEE REVERSE FOR EXPLANATORY LANGUAGE
C �
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 1107060035
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I NO. OF CONST I BUILDING ADDRESS: I
ITR: 35986 UN: 6 I SQ. FT STORIES TYPE I 9710 LONGDEN AV I
I 1STRUCTURE: V-B I TEMP CA 917801458 I
(ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET:
15385-021-033 1 1 THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY, Cl
(TENANT: EXIST BLDG USE: RESID USE ZONE: R-2 ISSUED ON: PROCESSED BY:
EXIST OCC GRP: 107/06/11 SR 1
(OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: IFINAL DATE FINAL BY: CODE: I
IDOVIAT EVELYN (626) 292-1017- 1 500 I 1
19710 LONGDEN AV I I I
ITEMP 917801458 1 FEES PAID IDESCRIPTION OF WORK 1
IDEMOLITION-CERAMIC TILE & HOT MOP NO FEE PER MANAGER THIS ISI
I IEEE DESCRIPTION: QUANTITY: UOM: AMOUNT:IA REPAIR FOR OLD HWP GRANT FROM 2009 I
(APPLICANT: TEL. NO: I I I
ICORONA, VICTOR M (310) 704-2656- IAA BLDG PERMIT ISSUANCE 0.00 1 I
14101 MARCASEL AVE IAB STATE GREEN BLDG FEE 500.00 VAL 0.00 1SPECIAL CONDITIONS: I
ILOS ANGELES CA 90066 IAC STRONG MOTION RESID 500.00 VAL 0.00 I
I JB2 PERMIT W/ENERGY 500.00 VAL 0.00 I 1
1 I TOTAL FEES 0.00 I
ICONTRACTOR: TEL. NO: 1APPROVALS DATE INSPECTOR SIGNATURE I
IVICTOR M CORONA GEN CONT.INC. (310) 919-0666- I 1_ 1
14101 MARCASEL AVENUE LIC. NO I [LOCATION AND SETBACKS I I I
ILOS ANGELES, CA 90066 NONE I I I J I
I I ISOILS ENGINEER APPROVAL I 1 I
1ARCHITECT OR ENGINEER: TEL. NO: 1 IFOUNDATION/TRENCH FORMS I I I
LIC. NO: i 1SLAB/UNDER FLOOR 1 1 1
1 IRAISr&D FLOOR FRAMING 1 1 1
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:l 1UNDERFLOOR INSULATION I I I
1153H269 3 001, I -1-1 1
I I IFLOOR SHEATHING I I 1
INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I- I I I
1 0 NO 21 I IROOF SHEATHING
I I
I SCHOOL WITHIN HAZARDOUS ISHEAR PANELS I I I
(AIR QUALITY: 1000 FEET MATERIALS I I- I I I
NO NO NO IFRAME INSPECTION I I I
I I IFIRE SPRINKLER HANGERS I 1 1
(INSULATION/WEATHER STRIPI I I
1 I Q1 NTERIOR LATH/DRYWALL 1 I 1
I 1 - p -`� 1 EXTERIOR LATH I 1 1
I I I I I I
1 1 IRATED FLOOR/CEIL ASSEM. I I 1
IRATED WALL ASSEMBLIES I I J
I IRATED SHAFTS/OPENINGS
I I I I I
I I IT-BAR CEILINGS
I I
1 (LOT DRAINAGE 1 1 1
IREPORT ID: DPR261 ROUTE TO: BS0508
I I! It ANI I