HomeMy Public PortalAbout5104 MCCLINTOCK AVE_Building__ ►� APPLICATION FOR BUILDING PERMIT 1
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NO.OF BLDGS.
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' APPROVALS
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APPLI DATE INSPECTOR•!SIIINVIIHE
ADDRESS . FOUNDATION•LOCATION _•�,_.
PORMB MATERIALS' \
O P.C. .S FRAME:FIRE STOPS. t
V„� paE BRACING.BOLTS
VALU ON ps BD FURNACE:
VENT. UCTS N• r� -�� •,5:.:
• l
1 HEREBY ACKNOWLWGM THAT I HAVE READ THIS AP- LATH INT.
PLICATION AND STATE THAT THU ABOVE 18 CORRECT AND t
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND LATH,Mr.
STATE. LAWS R U T O BUI NO U O
SIGNATURE 01 ` HOUSM NUMBMR CON•
PERMI M RECT AND POSTED
ADDR •• FINAL �•�% 1 {+
OHN A.LAMBIE COUNTY ENGINEER CLYDE N:DIRLAM PRINCIPAL ISTRUMNAL ENGINEER
PLRE CHIZZ TAZMAMOM m m.o. wx .PRMaTVZI==Mff t=L I mA. cA6H
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76AG38A CEit803 s-66 APPLICATION- FOR BUILD NG PERM-.1,'_
COUNTY OF LOS ANGELES BUILDING �� r
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE-, COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS,SUP'T.OF BUILDING CROSS ST.
DIST ICT I U TYPE _ BY
FOR APPLICANT TO FILL IN CONS C
fDD
NG STATISTICAL C 4/ASSIFICAT70N SEWER/ -SPG
S 1 � W
CLASS NO. DWELL UNITS
. BLOCK USE ZONE MAPNO.
SPECIAL
N0. OF SLOGS. CONDITIONS
SIZE OF LOT NOW ON LOT
USE OF ®_R
E (STING BLDG. i BLDG. SETBACK FROM
N.tTEL.e ,� +� FRONT PROP. LINE OF _ (STREET)
OWNER • p O• J/A TYPE OF EXISTI NO I SETBACK HIGHWAY YARD = TOTAL -
ADDRESS �]CJ-V' �6G� HIGHWAY WIDTH FROM C.L. -
CITY �!f BLDG. SETBACK FROM _
ARCHITECT OR Q 1 TE � jm0f PROP. LINE OF - (STREET)
ENGINEER
E OF EXISTING SETBACK HIGHWAY + YARD --- TOTAL
ADDRESS // HIGHWAY WIDTH FROM'C.L.
CONTRALTO d L�`'�• NO Qc{B.C� + - -
ADDRESS �� 1)�Q>CdO 4� _ O
CORNERCUTOFF YES NO V
CITY `� c lis c - SEE REVERSE SIDE FOR SPECIAL APPROVALS O
DESCRIPTION OF WORK W
a
NEW ADD ALTER REPAIR DEMOLISH - N
z
SQ,FT. NO. OF NO. OF
SIZE STORIES FAMILIES
USE OF
STRUCTURE �qv
SIGNATURE OF - -
APPLICANT
VALUATION$ ' �®
r
APPROVALS DATE INSPEC;qR'S SIGNATURE
P.C. PMT. ,FOUNDATION, LOCATION ""�
FEE$,3a FEE$ X (J v FORMS,MATERIALS y 11 -
FRAME, FIG RE STOPS,
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACINBOLT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE- LOCATION
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS
BUILD I NG 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 COMPENS TION INSURANCE. 'LATH. EXT.
SIGNATURE OFHOUSE NUMBER COR--
PERMITTEE RE
CT AND POSTED
ADDRESS 'Fl N A L
JOHN F. LEWISi, PR■IINCIPAL STR RAL ENGINEER
PLAN CHECK VALIDATION ��--o- CASH - PERMIT VALIDATION _CK. M.O CASH
SILO'! 5 9 5 APR 2 8 2D 3.75-
- �'
LAGO 1 5 9 6 0 APR 2 8 1 D . 1 5.0 O N
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10A080A cE#8037/60 APPLICATION.- FOR BU1L®I•NG PERMIT - Z
COUNTY OF LOS.ANGELES BUILDING
DEPARTMENT OF COUNTY ENGRIEER ADDRESS
BUILDING AND SAFETY DIVISION LocALlnr /T
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A.JENSEN SUPT OF BUIL13I140 CROSS ST. '. G v
,A &]
DISTRICT NO. GROUP I TYPE PROCESSED'BY
FOR APPLICANT TO FILL IN �rj CONST-
BUILDINGSTATISTICAL CLASSIFICATION SEWER MAP
ADDRESS �� �� /N/P Ce
el I;k
CLASS.NO.J6_mWELL.UNITS
LOT N0. BLOCK MAP NUMBERHWYE YES
TRACT 3 USEZONE. SPECIALNO LDG - '
OF B
SIZE OF LOT �S� NOW ON LOTS CONDITIONS
USE OF
EXISTING BLDG. BUILDING -EXIST.
A TEL / SETBACK YAI2r? -HWY- STREET NAME WIDTH.
OWNER ��X �/ /� NO. FRONT
P.L. /!/L°! L-t,]A,17'0,C r �O
ADDRESS IJ /`'� �!C A/
SIDE
ARCHITECT OR. TEL P.L.
ENGINEER Odv/Ir' No. 'INSPECTION WORD
ADDRESS V /
fir+ QTEL u r �rer�� V�.I..C�.✓� e �.�
CONTRACTOR`� NO-. x v r..14 O
ADDRESS V
DESCRIPTION OF WORK Z��x:4'::�. -�'= n�n �^,teat flq
NEW AD ALTER REPAIR DEMOLISH
SQ.FT. NO.OF. / NO.OF /�✓ -Gt3 dL ' vim_ P i ++a++�-
SIZE STORIES / FAMILIES r N
USEOF
i
STRUCTURE i/r/0N o )&J1i ,6WC-Z' .
SIGNATURE OFef
APPLICANT
VALUATION$ / O
APPROVALS ATE INSPE 0Ft'S,SIGhATORE
P.C. PMT. ^^ •-FOUNDATION:.LOCATION
FEE $ I FEE $ QCJ. FORMS,MATERIALS Gp•/,['�,A �P.J-. .,:
FRAME:FIRE STOPS,
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- BRACING BOLTS . :C. 77 :�' 1J.Ltr-
'PLICATION AND STATE THAT THE ABOVE IS CORRECT AND FURNACE:LOCATION,
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND GAS VENT-DUCTS
STATE LAWS REGULATING BUILDING CONSTRUCTION. I lei
L'
1 CERTIFY THAT IN DOING THE WORK AUTHORIZED I LATH,TNT. jgzw:- L'—
WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
WORKMEN'S COMPENSATION LAWS OF• LI'FORNIA. i
®A LATH;EXT,
SIGNATURE OF HOUSE NUMBER COR-
PERMITTE URECT AND POSTED
ADDRESS �/ro 1 C,' ��bs�0 r_& All& FINAL
CLYDE N.;DIRLAM, PRIhlCIPAL STR RAL ENGINEER
PLAN CMC$ VALIDATION CK. M.D. CASK PERMIT VALIDATION ' ;cic e�.0.. CASH.
`:�'a3 7 8 1 MIAR 10 1 U 1 2,0 0
4
- APPLICATION FO : ' •:''::1NG PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT T FILL IN ILDING A BUD ES �y s
WORKER'S COMPENSATION DECLARATION �, ��I f'�I�LbN� .
I hereby-affirm that I have a certificate of consent.to self insure, BUILDING ADDRESS . I f'
17
or a certificate of Workers'Compensation Insurance,or a certified
copy thereof(Sec.3800,Lab.C.) �j
e 'zip
�i� LOCALITY
Policy No. Company IZE iOF 2LW NO.OF LDGS NOW ON LOT
❑ Certified copy is hereby furnished. NEAREST CROSS ST.
❑'Certified copy 1s filed with the county building inspection T /? d BLOCK LOT NO.
department. �•7 Q USE ZONE MAP NO.
Date Applicant ASSESSOR MAP BOOK PA PARCEL I
? O D SPECIAL CONDITIONS
CERTIFICATE OF EXEMPTION FROM WORKERS. NER TEL NO.
COMPENSATION INSURANCE /6 a WITHIN 1000 FT.OF SCHOOL? YES No
(This section need not be completed if the permit is for one'hundred A ESS . 10 DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY
dollars($100)or less.)
ITYZIPdQ
I certify that in the performance of the work for which this permit (�I((yy�r
is issued, I shall not employ any person in any manner ' as to
become subject to the Workers'Compensation Laws. ARCHITECT OR ENGINEER TEL NO.
STATISTICAL C SIFICATION 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' CONTRACTOR TEL NO. SET BACK YARD HWY PROP LINE WIDTH
Compensation provisions of the Labor Code;you must•.fdrthwith 3 FRONT-*
comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. P L'
LICENSED CONTRACTORS DECLARATIONSIDE,
CITY LIC.CLASS P L
I hereby affirm that I am licensed underprovislons of Chapter 9 SEWER MAP
(commencing with Section 7000)of Division 3 of the Business•and So.FTJSIZFQ/ NO.OF STORIES NO.OF AMILIES
Professions Code,and.my license is in full force and effect. s�6 NEW BK PG a
DESCRIPTION OF WORK VALUATION polo.' License Number Lic.Class ADD ❑ U
Contractor Date ALTER OL $/���"06
lIN� r_
REPAIR ❑ O
- ❑'I am exempt under Sec. � . $
BAP.C.for this reason DEMOL ❑ LDMA PIC# . W
Date. ' USE OF EXISTING BLDG. URM ❑ D.
I co
Signature APPLICANT(PRINT) TEL NO. LDMA Perm# /�'t 3 Z
ACCT.B
as owner of the property, or my employees with wages'as Z �., c
0.511
their sole compensation, will do the work and the structure is ADDRESS ,�L,i.�
not intended or offered for sale (Section 7044, Business and FINAL DATE G
Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL
OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE 5 � ' J ft{'•'( 3
I, as owner of the property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY Ci;s4
1 vJJ licensed contractors to construct the project (Section 7044: YES❑ No❑ •�;n-� "' 13
Business and Professions Code.) �1117 �u o
WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING
OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH I•(E
CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR
MS
GUIDELINES _
I hereby affirm that there is a construction lending agency for YES 11 NO❑ TOTAL t AL x-37:°l90
C11 the performance of the work for which this permit is issued(Sec. 23 .W01
® I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING CHECK V
3097,CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE,
i Lender's Name MATERITITLE ALS REPORTING AND FOR OBTAINING A PERMIT FROM CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 4THE CONCERNING
G HAZARDOUS CHANGE
0 Lender's Address C7 47
0 OWNER OR AGENT
o I certify that I have read this application and state under penalty P.C.FEE PERMIT FEE �1 rlrl— =1
of perjury that the above information is correct.I agree to comply JVD �0 - B� i_L (- `'� �
N with all county ordinances and State laws relating to buildingVr� All `G�y
g const io and hereby authorize representatives of.this County ISSUANCE FEE
C9 t e r t bo ed property for inspe on p rposes.'_ p�(v 7"
v INVESTIGATION FEE TOTAL FEE
SEE REVERSE FOR EXPLANATORY LANGUAGE
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 0303270032
PHONE: (626) 285-0488 EXT: i
CONST
TR: 13384 LT: 6 ( SQ. FT STORIES TYPE i 5104 MCCLINTOCK AV
STRUCTURE: VN TEMP CA 917803556
8574-005-007 N0991W.-
NEAREST CROSS STREET: FREER
THOMAS PAGE: 597 GRID: D4 LOCALITY: TEMPLE CITY
TENANT: EXIST I
BDG S ESD SSUED0 PROCESSED EXPIRES ON:
EXIST OCC GRP: 03/27/03 A 03/21/04
OWNER: TEL. 0: BLDGS. NOW ON LOT: A ION: NAL DATE ----CODE-.
FENG ZHENG (626) 673-6141- 3,000EXPM
5104 MCCLINTOCK AV
TEMPLE CITY 91780 PAID DESPRIPTIONOF WORK
REPLACE 8 DOORS AND 3 WINDOWS; REMOVE WINDOW IN LIVING ROOM
-TEL. FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:
SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75
AC STRONG MOTION RESID 3000.00 VAL 0.50 SPIET AL CONDITIONS:
D2 PERMIT W/O EN;HC___ 3000.00 VAL 99.00 I
'moi _-_�-TO_TAL.*FEES 127.25
CONTRACTOR-—.__ TEL. N0: f ----�;`;;��; APP OVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER
LIC. NO �, j ' ./ ,� `�'• OC 0 SETBACKS
SOIL GI EE APPR
ARCHITECT ORE GINE 0: `% f l' ` 0 ATI S
LIC. NO:11, / I I "i I i -- '---- --\, k SLAB/UNDER FLOOR
RAISED FLOOR FRAMING
U Al
MAP NO: SEWER MAP BOOK: PAGE: FIWE ZONE: CMP: - -- ---- -` - UNDERFLOOR INS CATION
147H277 3 017,i` fl i i it
0. 0 S: G S: CO D: ST CLAS
h I :I L'���LI ( .� �, L._ . F 00 G
NO 21_ y. _ - - _- _ - ROOF SHEATHING
A11,
SCHOOL S RDO \ J !, S PA ELS
AIR QUALITY: 1000 FEET MATERIALS ' '
NO NO NO �t _ _ r _ �� FRAME INSPECTIO
RE
0 IR D 0 SETBACK R IS ��'`.` \ �r-=ice:,�?. R SP ER G R
SET BACK YARD: HWY: PROP LINE: WIDTH: '
FRONT PL- INSULATION/WEATHER� ; ! STRIP
SIDE PL-
OR
EXTERIOR LATH
T OOR ASSER7.
A DL ASSEMBLIES
RATED SHAFTS/OPENING
T-WR CEILINGS
,I 0 i f ;
I REPORT ID: DPR261 ROUTE T0: BS0508 i
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