HomeMy Public PortalAbout5211 MCCLINTOCK AVE_Building__ �i
76AG38ACE#8033-66 APPLICATION FOR BUILDIN PERMS IT
COUNTY OF LOS ANGELES ABUILDING
DDRESS V +
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION L O C A L I T Y
JOHN A. LAMBIE•. COUNTY ENGINEER NEAREST J '
COLEMAN W. JENKINSSUP'T OF BUILDING CROSS ST. /
DC NO O TYPE
FOR APPLICANT TO FILL IN "T b CONST.
BUILDING STATISTICAL CLASSIFICATION SEmwRMAP
ADDRESS 5211McClintock3 Temnle Cux CLASS NO. DWELL UNITS BK&PG
LOT NO. BLOCK USE ZONE MAP
NO.
TRACT SPECIAL
N0. OF SLOGS. CONDITIONS
SIZE OF LOT NOW ON LOT
USE OF
SLD:. SETBACK FROM
TEL. _ �� FRONT PROP. LINE OF (STREET)
OWNER NO. TYPE OF EXISTING SETBACK HIGHWAY YARD = TOTAL
ADDRESS HIGHWAY FROM C.L.
CITY Tem e Cit + _2,0
ARCHITECT OR TEL. BLDG. 9E BACK FROM
ENGINEER NO. SIDE PROP. LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C.L.
TEL. + _
CONTRACTOR NO1. 9
ADDRESS Np CORNER CUTOFF YES [ NO C
CITY San Gabriel LI` C-39 SEE REVERSE SIDE FOR SPECIAL APPROVALS C
DESCRIPTION OF WORK
O
coyyyy
NEW ADD ALTER QKIR DEMOLISH
SQ.FT. NO. OF NO. OF
SIZE STORIES FAMILIES
USE OF
. STRUCTURE Reroof House with 30# and
SI T OF
APPLICANT
.00
VALUATIbN$ ; ;, 1 : APPROVALS DATE INSPECTOR'S SIGNATURE
�° p— � PMT' FOUNDATION, LOCATION
FEE$
f FEE* FORMS, MATERIALS
FRAME, FIRE STOPS,•
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS
SUILOING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK
AUTHO
OR
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT.
TION OF THE LABO CODE OF THE STATE OF CALIFORNIA REL
A
ING TO WORKMEN'S °grNSAirgiu 4URrCE' LATH. EXT. _
SIGNATURE OF HOUSE NUMBER COR-
PEftMITTEE RE AND POSTED
ADDRESS G FINAL
n
JOHN F. LEWIS. PRINCIPAL ST URV ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH _ PERM VALIDATION CK. M.D CASH
IACD 0 0 9 0 SEP 1 8 1 D 1 2.0 0- 4
TEMPLE CITY .
russmCE#.oe•I-61 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGEIM BUILDING
DEPARTMENT OF COUNTY ENGIIMM ADDRESS Q
BUIIAING AND SAFETY DMSION LOCALITY
JOHN A. LAMBIE. COUNTY EmgimEER' NEAREST
WILLIAM A.JENSEN SUPT OF BUILDING CROSS ST. e
DISTRICT NO. GROUP TYPE CESSED BY
FOR APPLICANT TO FILL IN . �'
CONS
STATISTICAL CLAS91FICATION WyER MAP
ADDRESS c'LDINIn
CLASS.NO. DWELL..UNITS ✓✓✓��`lll
LOT NO. BLOCK WATER NOT REQUIRED RECEIVED
CERTIFICATE:
TRACT MAPHIGHWAY STATE MAJOR SECOND, C
NO.OF BLDGS. NO. (CIRCLE)
SIZE OF LOT.7 S Y J L.SA I NOW ON LOT USE ZONE SPECIAL
USE.OFCONDITIONS'
EXISTING BLDG. -'Alb11'S'e.
•
TEL.
OWNER NO. BUILDING YARD HWY SIRE AM EXIST.
SETBACK WIDTH
ADDRESS S FRONT
ARCHITECT OR TEL. M L.
ENGINEER NO. SIDE.
P.L. O}
ADDRESS TEL. INSPECTION.RECORD O
'•p
CONTRACTOR CSI NO. 2 � � � �
ADDRESS Q
DESCRIPTION OF WORK o/ r`f_ �~iL-/` - -:•� W
NEW ADD ALTER REPAIR DEMOLISHL ,1,8
SQ.FT. NO.OF NO.OF ,r.,;I w 1�.i+)-014
IZE STORIES FAMILIES
USE OF
STRUCTUREJ
. a
SIGNATURE OF
APPLICANT
VALUATIONS Q'Q
APPROVALS .BATE INSPECTOR:S SIGNATURE
FEE $ I FEE.$ FOUNDATION:.LOCATION ' I• rte-y�
�^ ��/ FORMS,MATERIALS /Z-11, I' •:..'��'t�//�
FRAME:FIRE STOPS. Ff , vI
1 HEREBY ACKNOWLEDGE THAT I HAVE READ TH16 APPLICATION BRACING BOLTS _
AND -If
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE:LOCATION,
WITH ALL COUNTY'ORDINANCES AND STATE LAWS REGULATING' GAS VENT 'DU.CTS• . A
BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK [ 2
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH,INT. 'O
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT-
ING TO WORKMEN'S COMPENSATION INSURANCE. — �.�J `y��
LATH,EXT. P17 Yb_
SIGNATURE OF V / n �L. 1' A HOUSE NUMBER COR-
PERM ITTEEIII��� (� u` FFFJJJIIINNNIYY(14411Kff 111 RECT AND POSTED ! I, J_) .
ADDRESS FINAL ?
CLYDE N. DIRLAM, PkINCIPAL'STRyQZURAL ENGINEER
PLAN CFIECK VALIDATION cK. m.0. CASH' PERMIT VAIMATION ,V N.D. CASH
�'IL;o 7 0 4 9" juu 5 1 D 1 8.5 J
'CITY
rUnaA C6#80.Sl00 APPLICATION FOR BUIL®ING •PEDMI'T ' . .. � •�.,.
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY:ENGB EER ADDRESS A _
BUILDING AND SAFETY DMSION LOCALITY' Y
JOHN.A. LAMBIE. COUNTY'ENGINEER NEAREST
WILLIAM A.JENSEN SUPT OF BUILDING CROSS ST.
DIST ICT NO. GROUP TYk- P ESSED''BY'
FOR APPLICANT TO FILL INCONST.
BUILDING��yy yy �e STATISTICALFICATION S WER MAP.
ADDRESSrja ii rC.,a,&n2a.EI . BK, PG
CLASS.:NO WELL.UNITS- - ��`
LOT,NO. BLOCK' MAP HUMBER STATE
YES "
TRACT /,3 3 1p USEZONE' • SPECIAL
NO..OF BLDGS. yi CONDITIONS
SIZE'OF'LOT NOW ON LOT J
USE'OF -
EXISTING BLDG. US BUILDING EXIST.
TEL
SETBACK' YARD HWY STR ET Ni4 E WIDTH
OWNER r! NO FRONT
P.L
ADDRESS �' SIDE
ARCH ITECTOR TEL. P.L.
ENGINEER NO. INSPECTION REC RD
\-._
ADDRESS
TEL.
CONTRACTOR NO. - O
ADDRESS ,l6. .L C�1z. ..^Yt�. .€�a n• fC�/�: C�. C)
DETCHNTION OF WORK os 'G o - O
cell
u E.,
NEW - ADD. A TER REPAIR DEMOLISH =
SO.FT. NO.OF NO.OF
SIZE STORIES FAMILIES..
USE OF
STRUCTURE 04 A + +; IP
.. R r , r .. .' .. _
SIGNATURE OFP�. i
APPLICANT
VALUATION$ ��[��` ..''- _ „ .•
APPROVALS�- DATE INSPECTOR'S SIGNATURE
P.C. PMT. FOUNDATION:LOCATION �- '
FEE '$ FEE FORMS,MATERIALS A
FRAME:FIRE STOPS, /
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- BRACING BOLTS or /7r
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. n f
I CERTIFY. THAT IN DOING THE WORK•AUTHORIZED 1 LATH,INT. / •C�
WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE r -
WORKMEN'S COMPENSATION LAWS OF(CALIFOj NIA. LATH,EXT.
SIGNATURE tj HOUSE NUMBER COR-
RECT AND POSTED
PERMITTE -
-
ADDRESS FINALI Wag
CLYDE N. DIRLAM-, Pf*INCI0A' L7dTRVZTURAL ENGINEER
PLAN CHECK VALIDATION M. - M.O. . CASHPERMT- VALIDATION.', as. M.O. CA H-
io 1 6 4 3 ,)Aft 7 6 .1 D `.9.0 0 M r ®P
i
WORKERS' COMPENSATION DECLARATION
hereby affirm that I have certificate of consent to self APPLICATION FOR BUILDING PERMIT
insure, or a certificate of Workers' Compensation Insurance,
or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. Company
BUILDING
Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS trfP � Lri
❑ Certified copy is filed with the county building inspec- BUILDING
�z t'll C L •rC AV t—,
tion department. ��A
Date Ifr ltll Applicant CITY CUT ZIP 1408 LOCALITY
NO.OF BLDGS. NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT -3 NOW ON LOT tZ CROSS ST.
COMPENSATION INSURANCE ASSESSOR
(This section need not be completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL
hundred dollars ($100)or less.) TEL
OWNER M NO. is$6D USE ZONE MAP
I certify that in the performance of the work for which this NO
SPECIAL aPermit is issued, I shall not employ any Person in any manner ADDRESS Z�iMC u Rock— AVL . CONDITIONS
so as to become subject to the Workers'Compensation Laws. O
CITY7EM 11016 16 U
Date Applicant ARCHITECT OR /� `�qq TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY O
im
NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER M V NO$ CONST. ZONE G
Exemption, you should become subject to the Workers' �/
Compensation provisions of the Labor Code, you must forth- ADDRESS M W PT Jam, 1D �1 '�O —3 I� p"-t•,
with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION -:APT. CONDO. Z
deemed revoked. CONTRACTOR NO.
O.
LICENSED CONTRACTORS DECLARATION ADDRESS NO.LIC. CLASS NDWELL. UNITS
.`.r•.
I herby affirm that I am licensed under provisions of Chapter 9 SEWER MAP
(commencing with Section 7000)of Division 3 of the Business CITY CLASS
and Professions Code,and my license is in full force and effect. BK. PG. "VALIDATION
SQ. FT. NO. OF NO. OF CHECK
License Number Lic. Class SIZE a.03AW STORIES FAMILIES ONE
VALUATIONi"f:F 'i_s 77 z1
DESCRIPTION OF WORK NEW ❑ _ �_4
Contractor Date ADD $ 5G,006 , '-"=�L!
❑I am exempt under Sec. ALTER ❑ �.,.;'!�.iyf�'.- �IT.
B.&P.C. for this reason SWR — FAMW W a REPAIR ❑ $
Date: USE OF
EXISTING BLDG. Q&JCqW PA7MI" DW 11a I DEMOL ❑
Signature APPLICANT TEL,
j'_ti y
(PRINT) FINAL" V OSOWNER-BUILDER DECLARATION a 1'�=i�;•7 j eFirr+,�:
DATE = '--
I hereby affirm that I am exempt from the Contractor's License ADDRESS (OOD � � ST Z{O AW
Law for the following reason (Section 7031.5, Business and FINAL
Professions Code): PRESENT By
ElBUILDING
I, as owner of the property, or my employees with ADDRESS-
wages
DDRESSwages as their sole compensation,will do the work and h
the structure is not intended or offered for sale(Section LOCALITY 7
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 1
tion 7044, Business and Professions Code.) 1 QI
REQUIRED TOTAL SETBACK FROM EXI57.
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH
I hereby affirm that there is a construction lending agency for FRONT y� '
the performance of the work for which this permit is issued P.L.
(Sec. 3097, Civ. C.). SIDE
P.L.
Lender's Name /�/ Q
Lender's Address P.C. Fee$ eZ1, O 6 Permit Fee LDMA Ref. #
I certify that I have read this application and state that the Issuance Fee LDMA P/C#
3 above information is correct. I agree to comply with all County Investigation Fee
ordinances and State laws relating to building construction, Total Fee LDMA'Perm. #
and hereby authorize representatives of this County to enter
upon the above-mentioned property for inspection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Applicant or Agent Date
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS _ „� RESIDENTIAL ADD/ALT/REP
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA s BL 0508 9611260007
PHONE: (818) 285-0488 EXT:
LEGAL D: 0. OF CONST NEW BUIEMNG ADDRES
TR: 13384 LT: 21 SQ. FT STORIES TYPE OCCUP GROUP , 5211 MCCLINTOCK AV
STRUCTURE: 330 1 VN R3 'TEMP CA 917803559
ASSESSOR INFORMATION NUMBER: GARAGE: NEAREST CROSS STREET:
8574-004-006 OTHER: THOMAS PAGE: 597 GRID: D4 LOCALITY: TEMPLE CITY
TENANT: EXIST BLDG USE: USE ZONE: SS ED 0 PROCESSED BY: EXPIRES ON:
EXIST OCC GRP: 12/11/96 TC 11/26/97
OWNER: TEL. NO: BLDGS. NOW ON LOT: VAL TION: FINAL DATE FINAL ODE:
CHO BYUNG H;IN KI (818) 575-8260- 1 19,800 ,/J
5211 MCCLINTOCK AV GG
TEMP 917803559 FES PAIF DESUKIPTION OF WORK
ADDITION OF BEDROOM
FEE DESCRIPTION: QI�NTI
k-%#=,%OdM�; AMOUNT:
APPLICANT: TEL. NO: D��
CAMINO REAL BUILDERS (818) 447-0715- AA BLDG PERMIT ISSUANCES 27.75
AC STRONG MOTION RESID+ 19800. 0—VAI �t1�98 SPECIAL CONDITIONS:
AX BUILDING REVI'EW�FEE. '98
5470
B2 PERMIT W/ENERGY '/79800.00 VAY \1426..03`',
f TOTAL FEES 51,0,.46P'A
CONTRACTOR: TEL. NO: ' -TQT`;�,I , O—A PRO ALS DATE INSPECTOR SIGNATURE
cl
CAMINO REAL BUILDERS (818) 447-0715- 3� / ,Tj fit'�' r ,•' �� �,
600 S. OLD RANCH RD LIC. NO OCATION AND SETBACKS
ARCADIA CA 91007 240278 B -----
_ 1 SOILS ENGINEER APPROVAL
ARCHITECT OR ENGINEER: TEL. N0: .4' ` �1J 11 4�/1 `J J 1 FOU DATION/TRE CH FORMS
LIC. N0: m; �_- I SLAB/UNDER FLOOR
�j U L I �� RAISED FLOOR FRAMING
MAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: L
- ;UNDERFLOOR INSULATION
3 01i
N0. OF FAMILIES: DWELLING UNITS: P /CON : ST C SS: f, \tom �% ST LEVEL FLOOR SHEAT
NO 21 _�/' gj ND LEVEL FLOOR SHEATH
SCHOOL WITHIN HAZARDOUS � ROOF SHEATHING
AIR QUALITY: 1000 FEET MATERIALS
NO NO NO FIRE DEPT. FRAME INSPECT
REQUIRED TOTAL SETBACK FROM EXIST BLDG DEPT. FRAME INSPECT
SET BACK YARD: HWY: PROP LINE: WIDTH:
FRONT PL- SHEAR PANELS
SIDE PL-
NS LATIO /WEAT R S R ,!s
INTERIOR LATH/DRYWALL
EXTERIOR LATH
LOT DRAINAGE
SMOKE' DETECTION DEVICES
FIRE DEPARTMENT APPROVAL
REPORT ID: DPR261 ROUTE TO: BS0508