HomeMy Public PortalAbout5420 MCCULLOCH AVE_Building__ APPLICATI L NG PERMIT
FOR APPLICANT TO FILL IN (Print or type only)
F
v dG COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
ZIP / BUILDING AND SAFETY DIVISION
OF SLOGS. BUILDING _,NOW ON LOT ADDRESS o2
TRACT BLOCK LOT NO. LOCALITY
TEL. NEAREST
OWNER Ci / NO. CROSS ST.
j ASSESSOR
ADDRES �+ //�G [� MAP BOOK PAGE PARCEL
CI �+ ZIP 17RO
DISTRICT
GRLOJUITYPE P CONST FARE RO SSED BY
ARCHITECT OR TEL. -1 . 08 /-T
ENGINEER NO.
STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS CLASS NO..- DWELL.UNITS jit= BK/Q jg
CONTRACTOR �/sry'�i�i 0L - *USE ZONE MAP O
�rrrLIC a^ NO.
ADDRE J2j � oP' NO.,�vl�r 7 3 SPECIAL
CITY LIC. CONDITIONS
zi Al CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑
CONSTRUCTION LENDER
NAME AND BRANCH BLDG.SETBACK FROM
FRONT PROP.LINE OF (STREET)
ADDRESS CITY HIGHWAY + YARD - ;TOTAL SETBACK FROM TYPE OF EXISTING
SQ. FT NO, OF NO. OF CHECK FRONT PROP. LINE HIGHWAY WIDTH
SIZE rf STORIES ,�` ,FAMILIES j ONE
11�1��/ l-�7 + CL
DESCRIPTION OF WORK NEW ❑ �
BLDG.SETBACK FROM
L,1 !) � ADD SIDE PROP.LINE OF (STREET) m
L (/� ALTER :1 - TOTAL SETBACK FROM TYPE OF EXISTING h'
HIGHWAY •F YARD - V
REPAIR❑ SIDE PROP. LINE HIGHWAY WIDTH CL
_ CL
EXISUSE
OT NG BLDG. QrG OEMOL ❑ + Z
APPLICANT Aw' TEL//J/ CORNER CUTOFF YES ❑ NO ❑
(PRINT) f.f��(�iy N0: (/2-/a`
BY (SIGNATURE) IN OPEN SPACE YES ❑ NO ❑
IN COASTAL PERMIT ZONE YES ❑ NO ❑
VALUATION;
N5
HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY `-
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
LABOR CODE OF THE S F TE OALIFORNIA IN RELATING TO '
WORKMEN'S COMPENSATI INSU NCE. n
SIGNATURE OF lof
PERMITTEE
ADDRESS
�d�
CITuiD�)"� �/ 1016• v NOL T��•7 TEDIATE �NAL �7� /� BY
MAKE CHECKS TO: FEC. j FEE
HARVEY T. BRANDY, COUNTY
ENGINEER
PLAN'CHECK VALIDATIONCK. M.O. CASH — PERM VALIDATION CK. M.O. CASH
'. 44�MAY a �' 1.4
7 4 b MAY 7 1 1) 9,0 0
76AS38A CH x O09 5/74 dy
Y" APPLICATION FOR BUILDING PERMIT
FOR APPLICANT TO FILL IN (Print or type only) _
8 BUILD'NG .. COUNTY OF LOS ANGELES
ADDRESS �YI :ilcst- G. �ARTMENT OF COUNTY ENGINEER
CITY ej _ t ZIP
BUILDING AND SAFETY DIVISIONGWJ-.
r NO.OF BLDGS. BUILDING
SIZE OF LOT ` NOW ON LOT ADDRESS r
TRACT &OL-111BLOCK LOT NO. LOCA LIT ~
i /�� TEL NEAREST
OWNE dG'Gjj' r , V Q W = NO. / CROSS ST.
ASSESSOR
ADDRESS �,. J� MAP BOOK PAGE PARCEL
//]] � DISTRICT GROUP TYPE FIRE SED BY
CITY Q'-( ^71� ZIP G / p J� CONST. ZONE
ARCHITECT. R TEL. ��9, ( L
ENGINEER- { . ) NO 7 STATISTICAL CLASSIFICATION
SEWER MAP
ADDRESS ✓ -7 r L.A. CLASS NO.0_-y__DWELL,UNITS f6 BK Q PG
CONTRACTOR r i �; NOL QUZONEFM�APLIC. YO.ADDRESS 0rc NO. J� r AL
ONDSPEC,IT ONS
Lt / LIC.
CIT Q_ �+ a7 CLASS
ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑
CONSTRUCTION LEND Q '
NAME AND BRANCH �. V{ ,9 BLDG.SETBACK FROM
FRONT PROP.LINE OF '___tSTREET) n
ADDRESS. /Jr in -) CITY keL - TOTAL SETBACK FROM TYPE OF EXISTING
SQ. FT. NO. OF NO. OF CHECK HIGHWAY + YARD FRONT PROP. LINE HIGHWAY WIDTH
SIZE �� STORIES/� FAMILIES �p ONE C
DESCRIPTION OF WORK NEW + / D y
ADD BLDG.SETBACK FROM O
SIDE PROP.LINE OF (STREET)
ALTER ❑ HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING
REPAIR❑ SIDE PROP. LINE HIGHWAY WIDTH
USE OF
EXISTING BLDG. j` �-CZj r j/ DEMOL ❑ +
APPLICACORNER CUTOFF YES ❑ NO ❑
(PRINT)' I J 1 IN OPEN SPACE YES ❑ NO ❑
BY (SIGNpTUR
Q 001 IN COASTAL ZONE YES ❑ NO ❑
VALUATION$ / CATEGORICAL EXEMPTION YES❑ NO ❑
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE)
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION. IC
THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE)
HEREBY 1 WILL NOT EMPLOY ANY PERSON IN V LAT) OF THE
LABOR CODE OF THE STA No NG TO
WORKMEN'S COMPENSAT
SIGNATURE OF
PERMITTEE _
ADDRESS
TE FINAL BY
CITY NO. DATE 17 ( gn JI
P.C. • PMT.
MAKE CHECKS PAYABLE 7'O FEE � FEE
HARVEY T. BRANDT, COUNTY ENGINEER 8r 6o ��
PLAN CHECK VALIDATION CK. . M.O. CASH — PERMIT V I DATION CK. M.O. CASH
8 7 3 FEB 27 2 3 3 1 8.6 0 89,, 14T
76A63BA CE 8803 12/72 (J 9 0 3 r-.MAY 9 1 0 5 3 1.0 0 A88
APPLICATION FOR BUILDING PERMIT
FOR APPLICANT TO FILL IN (Print Or type only)
ADDRESS 0 , C COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
CITY / Gil ZIP BUILDING AND SAFETY DIVISIOW;jK0
Nd OF BLDGS. BUILDING '
SIZE OF LOT NOW ON LOT ADDRESS p7 d
TRACT C L C.5
LOT NO. LOCALITY
TI
OWNER ss jvp �L� Ja NO A03S*8f1.
ASSESSOR
ADDRESS /-/ t' MAP BOOK PAGE PARCEL
DISTRICT GROUP TYPE FIRE LPSHWW4SED BY
CITY I f �e`Tr' IP Q CONST ZONE
ARCHITECT R TE
ENGINEER I '4r%.wO• �O
A A.TATptISTICAL CLASSIFICATION SEWER MAP
ADDRESS ,rj'�� #q cy✓9 6 +�� `F',CLASS NO.9=?0 ,/ DWELL.UNITSBK�0 PG
CONTRACTO .0 A A e.c NE + �, 'USE ZONE NMAOP a �--Z
ADDRESS „�'yCyat� .� pw N) _� SPECAL
LIC. jf CONDITIONS
CITY�� 90Q Lp CLAS��(p ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑
CONSTRUCTION LENDER Vd -f__NAME AND BRANCH /• BLDG.SETBACK FROM
_ FRONT PROP.LINE OF (STREET)
ADDRESS CITY HIGHWAY } YARD TOTAL SETBACK FROM TYPE OF EXISTING
SQ. FT. NO. OF NO. OF CHECK FRONT PROP. LINE HIGHWAY WIDTH
SIZE D STORIES FAMILIES 'ONE
❑ } _
DESCRIPTION OF WORK a NEW C)
ADD ❑ BLDG.SETBACK FROM
r Q C= OSIDE PROP.LINE OF (STREET)
LTER ❑ HIGHWAY } YARD = TOTAL SETBACK FROM TYPE OF EXISTING IF
REPAIR❑ SIDE PROP. LINE HIGHWAY WIDTH W
_ a
USE OF
EXISTING BLDG. j9W a jj /At EMOL F1 } Z
APPLICA TE CORNER CUTOFF YES ❑ NO ❑
(PRINT) + NO , S
BY (SIG • IN OPEN SPACE YES ❑ NO ❑
IN COASTAL PERMIT ZONE YES ❑ NO ❑
LUATION :70. `e
IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION. IC
THAT IN DOING THE WORK AUTHORIZED
HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
LABOR CODE OF THE STPTE OF -CALIFORNIA IN RELATING TO
WORKMEN'S COMPENSATION INSURANCE.
SIGNATURE OF
PERMITTEE
ADORES] �( aJ1► .� Q
CITY SK NO.
MAKE CHECKS PAYABLE TO: FEE' FEEPMT.'
HARVEY T. BRANDT, COUNTY ENGINEER
(� ,U a
LPLAN'CHECK VALIDATION CK. ` M.O. CASH PERMIT VALIDATION cK. M.O. CASH
2 .3 6 P nr;T 20 23 0 5.40 A! 6
2 :3 7 Pnr.T c0 1 0 9.0 0A_qb
76AG36A C6#607 5/74
�* 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 1210100083
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I NO. OF CONST BIIILDING ADDRESS: 1
ITR: 31886 UN: 22 I SQ. FT STORIES TYPE I 5420 MCCULLOCH AV E 1
I (STRUCTURE: V-B I TEMP CA 917803562 1
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 1
18573-014-047 I I THOMAS PAGE: 597 GRID: D3 LOCALITY: TEMPLE CITY, CI
I I
1TSNANT: EXIST BLDG USE: RESID USE ZONE: R-2 ISSUED ON: PROCESSED BY:
1 IEXIST OCC GRP: 110/10/12 SR 1
(OWNER: TEL. NO: IBLDGS. NOW ON IAT: VALUATION: IFINAL DATE FINAL BY: CODE: I
IMATCHETT SUSAN A (626) 350-4884- 1 3,600 I
15420 MCCULLOCH AV
ITEMP 917803562 I FEES PAID IDESCRIPTION OF WORK 1
I I IDEMO ON TUB, MINOR DRYWALL REPAIR, REMOVE & REPLACE ROUGH 1
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:IIN VALVE (SHOWER VALVE) 1
(APPLICANT: TEL. N0:
IYENULONIS, LAURA (951) 977-9630- 1AA BLDG PERMIT ISSUANCE 27.80 1 I
19901 INDIANA AVE. IAB STATE GREEN BLDG FEE 3600.00 VAL 1.00 1SPECIAL CONDITIONS: 1
RIVERSIDE, CA 92503 ACSTRONG MOTION REBID 3600.00 VAL 0.50
I IB2 PERMIT W/ENERGY 3600.00 VAL 127.40 1
I 1 TOTAL FEES 156.70
(CONTRACTOR: TEL. NO: JAPPROVALS DATE INSPECTOR SIGNATURE 1
IEZ HOME IMPROVEMENT GROUP (951) 977-9630- I 1
19901 INDIANA AVE., LIC. NO ILOCATION AND SETBACKS 1 1
ISTE 102 947714-B I I I I I
1RIVERSIDE, CA 92503ISOILS ENGINEER APPROVAL I I I
(ARCHITECT OR ENGINEER: TEL. NO: 1 1FOUNDATION/TRENCH FORMS I I I
I -
LIC. NO: 1 (SLAB/UNDER FLOOR 1 I I
I 11�XPRED
IRAISED FLOOR FRAMINGIMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( IL�E (UNDERFLOOR INSULATION I 1 1
1147H277 3 001 1 I I
I IIFLOOR
r IFLOOR SHEATHING I I I
INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I _/ _
1 0 NO 21 1 1ROOF SHEATHING I I I
SCHOOL WITHIN HAZARDOUS I ]SHEAR PANELS I I I
(AIR QUALITY: 1000 FEET MATERIALS 1 I_ I I I
NO NO NO 1FRAbiE INSPECTION I I I
1FIRE SPRINKLER HANGERS
I I 1T-NSULATION/WEATHER STRIP 1 I
I I 1INTERIOR LATH/DRYWALL
I 1 I I
1 1EXTERIOR LATH I 1 1
1 (RATED FLOOR/CELL ASSEM. I I I
I I IRATED WALL ASSEMBLIES I I
IRATED SHAFTS/OPENINGS
I 1 1T-BAR CEILINGS 1 I
ILOT DRAINAGE I I I
I I I
I (REPORT ID: DPR261 ROUTE TO: BS0508 1 I I I
I 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 0503290058
PHONE: (626) 285-0488 EXT:
LEGAL I S :
TR: 31886 UN: 26 SQ. FT STORIES TYPE 5420 MCCULLOCH AV A
STRUCTURE: 38 VN TEMP CA 917803562
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: FREER
8573-014-051 THOMAS PAGE: 597 GRID: 03 LOCALITY: TEMPLE CITY, C
TENANT: S LDG S I USE-MNE: R-3 ISSUED 0 PROCESSED B XP S 0 :
EXIST OCC GRP: 03/29/05 JK 03/24/06
OWNER: TEL.-NO: B DGS. NOW ON LOT: ALUATION: FINAL DATE FIN BY: CODE:
GARDEN VIEW HOA (626) 444-5577- 10,450
5420 MCCULLOCH AV --,,
21,
TEMP 917803562 FEES P DSS
TEAR OFF ONE LAYER BASE SHEET TOUCH ONE LAYER SBS MODIFIED
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 4.5 U.S. INTEE
APPLICANT: . NO:
ALLEN (909) 981-5499- AA BLDG PERMIT ISSUANCE 27.75
1042 N. MOUNTAIN AVE AC STRONG MOTION RESID 10450.00 VAL 1.05 SPECIAL CONDITIONS:
UPLAND, CA 91786 D2 PERMIT W/O EN-HC 10450.00 VAL 233.40
TOTAL FEES 262.20
CONTRACTOR: TEL. 0: APPROVALS--- DATE INSPECTOR S GNATURERIGHT-WAY ROOFING (909) 981-5499-
1042 N. MOUNTAIN SUITE B-124 LIC. NO LOCATION AND SETBACKS
UPLAND, CA 91784 652996 C39
SOILS ENGINEER PR A
C EC O E S
- i
LIC. NO: SLAB%UNDER FLOOR
RAISED
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION
147H277 3 01
FLOOR SHEATHING
0. OF FAMILIES: D L G N S: APT CO : STAT C ASS:
NO 21 ROOF SHEATHING
SCHOOL I A 2 AROOM SHEAR PANELS
AIR QUALITY: 1000 FEET MATERIALS
NO NO NO FRAME INSPECTION -
ii o3 -
REQ I ED TOTAL SETBACK FR IST FIRE SPRIG 5
SET BACK YARD: HWY: PROP LINE: WIDTH:
FRONT PL- INSULATION/WEATHER S RIP
SIDE PL-
INTERIOR LATH/DRYWALL
Ej(TERIOR LATH
RATED FLOORMIL ASSE9.7
TED WALL ASSEMBLIES
S GS
-BAR CEIL N S
G
REPORT ID: DPR261 ROUTE TO: BS0508