HomeMy Public PortalAbout5436 MCCULLOCH AVE_Building_5/9/1974_ '`',6 APPLICATION FOR BUILDING PERMIT
FO PPLICANT-TC:FILL IN (Print or type only)
BUILDING �3COUNTY OF LOS ANGELES
ADDRESS TMENT OF COUNTY $NGINEER
CITYmcw_ y ZIP BUILDING AND SAFETY DIVISION
OF BLDGS. BUILDING
SIZE OF LOT NOW ON LOT ADDRESS
TRACT BLOCK LOT NO. LOCALITY
r r TEL NEAREST `
OWNE O. CROSS ST,
ASSESSOR
ADDRESS MAP BOOK PAGE PARCEL
DISTRICT GROUP TYPE FIRE ESSED BY
CITY ) ZIP Q CONST. ZONE
ARCHITECT EL, io(J
ENGINEER .TO•
STATISTICAL CLASSIFICATION SEWER M P
ADDRESS La. CLASS NO. DWELL,UNITS B11/0,712 G
CONTRACTOR TEL USE ZONE NOP
ADDRESS r . Np SPECIAL
LIC. CONDITIONS
CITY CLASS ) )
ROAD DEPARTMENT APPROVAL REQUIRED YES k--I NO❑
CONSTRUCTION LE a
NAME AND BRANCHJft1 BLDG.SETBACK FROM
FRONT PROP.LINE OF e STREET) G
ADDRESS CITY TOTAL SETBACK FROM TYPE OF EXISTING C
HIGHWAY + YARD C
SQ FT, NO. OF NO. OF CHECK FRONT PROP. LINE HIGHWAY WIDTH
SIZE �Cd� STORIES �/ FAMILIES ONE o
+ C
DESCRIPTION OF WORK NEW 10 C
ADD ❑ BLDG,SETBACK FROM a
SIDE PROP.LINE OF (STREET) v
ALTER ❑ _ TOTAL SETBACK FROM TYPE OF EXISTING
HIGHWAY + YARD -
REPAIR[:) SIDE PROP. LINE HIGHWAY WIDTH
USE OF . +•. _
EXISTING BLDG. DEMOL ❑
APPLIC• _ CORNER CUTOFF YES ❑ NO ❑
(PRINT) 0.
IN OPEN SPACE YES ❑ NO
BY (SIGNATURE) ❑
IN COASTAL ZONE YES ❑ NO ❑
VALUATION CATEGORICAL EXEMPTION YES❑ NO ❑
I HEREBY ACKNOWLE GE THAT I HAVE READ HIS 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 I WILL NOT EMPLOY ANY PERSON IN VIO ION OF THE
LABOR CODE OF THE STATE OF CAL ATING TO
WORKMEN'S COMPENSATION IM
SIGNATURE OF
PERMITTEE
ADDRESS
FINAL BY
TEL. DATE/_
CITY NO. r
,1 A KE C HEC KS P:1 YABLE TO: F E � FEE $
HARVEY T. BRANDT. COUNTY ENGINEERl/�95� 7�
CK.
PLAN CHECK VALIDATION M.O. CASH PERMIT VA TION CK. .0. CASH/
7 O-r'-'FEB 27 2 3- 3 3 4.9 5
— . 4
yogg3B,fq L6M103 i."� 2 2.5 0 Ay
_ _ 9 0 9 1 0 5 9 5.7 5 Ayd
/WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have certificate of consent self 4' APPLICATION FO R.. R•U:I WING P E RM I T
in36a,'or a certificate of.Workers'.Compensation Insurance,..
or a certified copy thereof(Sec. 3800, Lqb. C.)�-• COUNTY-OF LOS ANGELES BUILDING AND SAFETY
Policy No 0,6y791Z C
rBUILDING k��
a.❑' Certified copy,rs hereby furnished.. :; -FOR APPLICANT TO FILL IN ADDRESS Sy3(p " I�. GC
BUILDING. !
r Certified copy is filed with the county building irispec-. ADDRESS�,/ /' .�4�J '
+ tion department. r
N /O sy9. ,��JE7 'dOL/.F` /I1.J_�/f ' cITY.:� � �' L y zIP
!Date d i4pplicarit, - z NO.,OF BLDGS. LOCALITY
CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT.' NOW ON LOT' NEAREST
CROSS ST.
'COMPENSATION INSURANCE r ASSESSOR
':(This section need not be completed if'fhe permit is for one TRACT, :' BLOCK LOT NO. MAP BOOK PAGE, PARCEL
:'hund�ed'dollars ($100)or less.) TEL.Zia USE ZONE_' MAP
OWNER DE7!•4/E /E lE)�1 NO. .�yS_
I certify that !6-the performance of the work'for which this r NO.
SPECIAL
permit is issued, I shall not employ any person in any manner ADDRESS..300 So. �/E7✓h��E�t/L•' dU/T� ,�10 CONDITIONS
CL
SO as to,become subject to the-Workers,Compensation Laws.: // p O
CITY '4/h7y 447 41. zip // 74.S
Date' Appliicanf' ` ARCHITECT OR TEL.
I NOTICE TO APPLICANT: If, after making this Certificate•of r'• ENGINEER " ' NO DISTRICT' TYPE FIRE' p CESS
CONST. ZO E
Exemption, you_should become ;subject to the.' or, ' i
Compensation provisions of the Labor—Co you•must forth- ADDRESSa��' � a
with,comply.with' such;provisions or this,permit, shall be /� n /� TEL.Z/3 ', STATISTICAL CLASSIF CATION APi. CONDO. Z
deemed revoked. CONTRACTOR/'fid �(a 4/f OD�/s NO. 2C/3/77 _
"I LICENSED CONTRACTORS DECLARATION'• •.;' l B LIC. CLASS NO. DWELL. UNITS
yr I hereby affirm that I.am licensed under provisions of Chapter 9 ADDRESS•'/!'/` .L>J /TT/E17Z �✓ NO. g o 7OY'
r•+ ,(commencing'with.Section 7.000)of:Division;3 of the Business n / �Q SEWER MAP
and Professions Code;and my I)cerise is in full force and effect. CITE'`L05 H 0/El Lf�r 9B�z3 LIC
,3 5 BK. PGVALIDATION'
/ X , SQ. FT. " NO.OF . NO. OF 'CHECK
License Numberf[o 70 v // Lie. Class --O9 SIZE STORIES / FAMILIES / ONE VALUATION
Co'tractorll<Jy/YD��71LTJd4•�Jdl/U' Date' -��rQ' 1 DESCRIPTION OF WORK APPY " dE^Lt/ODd NEW El
a f[ S
• C'O6,EY W/> ADD
I am'exempt under Sec. ►
B.&P.C. for'-this reason �D' /�'�r�I�O:/�z�y�EXf , �o- .. ALTER;El
-USE OF REPAIR
i
Date` y .BLn65 DEMO`. -• .. �. EXISTING BLDG.•FEJ/GI&3/Tj
Signature. APPLICANT p pp rI //' TEL.Z/1
(PRINT)ir0 FObE`K7SONiJ01J�2Nc ' 'NO. /^.3/'77' FINAL
• OWNER-BUILDER DECLARATION � DATE '
• I hereby affirm that I am exempt from the Contractor's License t�76�L II 1E7 �lJ L�27
' Law for,the following'reason (Section 7031:5, 'Business and, ADDRESS 4Zyb'U1I� d COs /Jud FINAL;,
Professions`Code.): ,. PRESENT. BY. AT.A'. :
BUILDING -
❑. I;'as- owner of the property; or my.employees with ADDRESS �' J
• wages as their sole compensation,•will do the work and - - - Q/_ i�77■
' the structure is not intended or;-offered for sale(Section LOCALITY. •• j ( {? rrCtte
.r 7044, Business and Professions Code.) MOVING TEL. . . •_._ ��! A�� 1 ITEMS
GI S
= CONTRACTOR NO. ' +•, a '', / —.
❑ I, as owner of the• ro ert am exclusive.l contractin +�
r p. P .Y, v s l�;'. �/ .• ' TQTAL 81.3 8
with'licensed:contractors to;construct the project (Sec- ADDRESS _ I -
tion 7044, Business and-Professions Code:)` Al rz+ 7■
:-REQUIRED .TOTAL SETBACK FROM EXIST. �', C
38
CONSTRUCTION LENDING AGENCY • SET BACK YARD HWY PROP. LINE WIDTH % CHANGE
■ '
I hereby affirm that there is a construction lending agency for FRONT
the performance of the work for which this permit is issued P.L. i
(Sec. 3097, Civ. C.).' SIDE ••
P.L: ..
Lender's Name !. COW-0001 -9/19/39
i LDMA Ref. #"'
Lender's Address P.C..Fee$ Permitfe / " +�17 1 Ah11G� 1
' I certify that,I have"read this application and state that the Issuance Fee' / LDMA P/C#
' above information is correct.I agree.to comply with all County Ir. tigction:Fee Qom'
ordinances and State laws relating"to building construction, Total Fee 7e l� `DMA Perm. #
i and hereby authorize.representative of this County to enter
g i u above-menti ;dpe for inspection purposes. -•, " J o
o �`//� GDp/, SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Applrmnt or Agent Date ;,
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 1310230102
i PHONE: (626) 285-0488 EXT:
ILEGAL ID: NO. OF CONST I BUILDING ADDRESS: 1
ITR: 31886 UN: 9 I SQ. FT STORIES TYPE I 5436 MCCULLOCH AV E I
(STRUCTURE: 19 V-B I TEMP CA 917803562 1
'ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET:
18573-014-034 I I THOMAS PAGE: 597 GRID: D3 LOCALITY: TEMPLE CITY CAI
((TENANT: (EXIST BLDG USE: REBID USE ZONE: R-1 (ISSUED ON: PROCESSED BY:
JIM HORTSMAN EXIST OCC GRP: 110/23/13 SR
(OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: I (NAL IPATE FIVAL BY: CODE: I
IGARDEN VIEW APT (818) 442-2209- 1 4,900 I
( I
5436 MCCULLOCH AV _
TEMP 917803562 I FEES PAID I CR IN OF WORK I
I I (INSTALL NEW TORCH DOWN ROOFVER LOW SLOPE INSTALL NEW 1
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ASPHALT SHINGLES ROOF OVER IT. I
(APPLICANT: TEL. NO: I I 1
IRODGERS (626) 355-4585- IAA BLDG PERMIT ISSUANCE 27.80 1 1
15750 SAPPHIRE ST IAB STATE GREEN BLDG FEE 4900.00 VAL 1.00 ISPECIAL CONDITIONS: 1
(ALTA LOMA CA 91701 AC STRONG 4900.00 VAL 0.50
ID2 PERMIT W/O EN-HCS D 4900.00 VAL 132.60
I1 TOTAL FEES 161.90 1 I
ICONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE 1
RODGERS ROOFING (626) 355-4585- I 1 I
15750 SAPPHIRE STREET LIC. NO I ILOCATION AND SETBACKS I I I
IALTA LOMA CA 91701 620156 * I I,
I
I I IS07LS ENGINEER APPROVAL I I 1
(ARCHITECT OR ENGINEER: TEL. NO: IFOUNDATION/TRENCH FORMS I I I
LIC. NO. I (SLAB/UNDER FLOOR I I I
(RAISED FLOOR FRAMING I I
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:I 1UNDERFLOOR INSULATION I I I
3 001 1
IFLOOR SHEATHING I I I
INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I i
1 NO 21 1 (ROOF SHEATHING I I I
1 SCHOOL WITHIN HAZARDOUS 1 ISHEAR PANELS I I
1AIR QUALITY: 1000 FEET MATERIALS I I I I
1 NO NO NO 1FRAME INSPECTION I I I
1 1 IFIRE SPRINKLER HANGERS I I I
(INSULATION/WEATHER STRIP I 1
1 I 1INFERIOR LATH/DRYWALL 1 1 1
1 I 1 EXTERIOR LATH 1 1 1
I i(RATED FLOOR/CEIL ASSEM. I 1 I
RATED WALL ASSEMBLIES 1 I I
IRATED SHAFTS/OPENINGS I I
IT-EAR CEILINGS 1
I
I' ADDITIONAL DATA ON FILE i I 1 I
ILOfi DRAINAGE I 1 I
1 REPORT ID: DPR261 ROUTE TO: BS0508 I I I I 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 0411300030
PHONE: (626) 285-0488 EXT:
LEGAL ID: NO. OF CONST BUILDING D SS:
TR: 31886 UN: 11 SQ. FT STORIES TYPE 5436 MCCULLOCH AV G
STRUCTURE: 9 VN TEMP CA 917803562
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET:
8573-014-036 THOMAS PAGE: 597 GRID: D3 LOCALITY: TEMPLE CITY, C
TENANT: EXIST BLDG USE: RESID USE ZONE: R-3 ISSUED ON: PROCESS BY: EXPIRES-ON:
EXIST OCC GRP: 11/30/04 JK 11/25/05
OWNER: TEL. 0: BLDGS. NOW ON LOT: VALUATION: FI AL DATE FINAL BY: CODE:
GRAMDEMVIEW H.O.A. - 3,230s, S
5436 MCCULLOCH AV
TEMP 917803562 FEES PAID DESCRIPTION-OF WORK
TEAR OFF NAIL BASE TORCH ONE LAYER SBS MODIFIED US. INTEC
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:
APPLICANT: TEL. 0:
ALLEN (929) 981-5499- AA BLDG PERMIT ISSUANCE 27.75
1042 N. MOUNTAIN AC STRONG MOTION RESID 3230.00 VAL 0.50 SPECIAL CONDITIONS:
UPLAND, CA 91786 D2 PERMIT W/O EN-HC 3230.00 VAL 115.80
TOTAL FEES 144.05
CONTRACTOR: TEL. NO. APPROVALS DATE INSPECTOR SIGNATURE
RIGHT-WAY ROOFING (909) 981-5499-
1042 N. MOUNTAIN SUITE B-124 LIC. NO LOCATION AND SETBACKS
UPLAND, CA 91784 652996 C39 t
SOILS ENGINEER APPROVAL
ARCHITECT OR GINEER: TEL. NO: j FOUNDATION/TRENCH FORMS
LIC. NO: SLAB/UNDER FLOOR
RAISED FLOOR FRAMING
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION
XX 3 01
FLOOR SHEATHING
0. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS:
NO 21 ROOF SHEATHING C
SCHOOL WITHIN HAZARDO S SHEAR PANELS -
AIR QUALITY: 1000 FEET MATERIALS
NO NO NO FRAME INSPECTION
REQUIRED TOTAL SETBACK FROM EXIST FIRE SPRINKLER ANGERS
SET BACK YARD: HWY: PROP LINE: WIDTH:
FRONT PL- INSULATION/WEATHER STRIP
SIDE PL- INTERIORLATH/DRYWALL
i
EXTERIOR LATH
RATED FLOWEEIT-11SEM.
RATED WALL ASSEMBLIES
RATED S AFTS OP INGS
T-BAR CEILINGS
0 A NAG
REPORT ID: DPR261 ROUTE TO: BS0508
I
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT I TEMPLE CITY CA 91780 BL 0508 1111230001
PHONE: (626) 285-0488 EXT:
i
ILEGAL ID: f NO. OF CONST I BUILDING ADDRESS: I
TR: 31886 UN: 8 SQ. FT STORIES TYPE 1 5436 MCCULLOCH AV SC 1
STRUCTURE: 12 V-B I TEMP CA 917803562 I
1 ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: DAINES 1 8573-014-033 i I THOMAS PAGE: 597 GRID: D3 LOCALITY: TEMPLE CITY, Cl
ITENANT: �IEXIST BLDG USE: RESID USE ZONE: R-2 (ISS D ON: PROCESSED BY: 1
I IIEXIST OCC GRP: 111/23/11 SR 1
I I I I
(OWNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: 1FINA�L DATE FINAL BY: CODE: 1
(GARDEN VIEW HOA - 1 3,200
I u
I I1 FEES PAID ID C I�PTION OF WORK li1
I II ITEAR OFF NEW ROOF FLAT AND STEEP MOURAID LOWER LEVER OVER 1
I 'IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:IUNIT C 1
(APPLICANT: TEL. NO: I I I
IWARREN CROSS - IAA BLDG PERMIT ISSUANCE 27.80 I- I
I IAB STATE GREEN BLDG FEE 3200.00 VAL 1.00 ISPECIAL CONDITIONS: 1
IAC STRONG MOTION RESID 3200.00 VAL 0.50 I I
ID2 PERMIT W/O EN-HC 3200.00 VAL 116.00 I 1
I TOTAL FEES 145.30 I I
(CONTRACTOR: TEL. NO: i (APPROVALS DATE INSPECTOR SIGNATURE I
IWARREN CROSS ROOFING, INC. (626) 786-2477- 1 1 1 I
11522 MEADOW GLEN WAY LIC. NO 1 ILOCATION AND SETBACKS I I I
(HACIENDA HEIGHTS CA 91745 836560 C39 I I II I I
I 1 (SOI S ENGINEER APPROVAL I 1 I
(ARCHITECT OR ENGINEER: TEL. NO: IFOUNDATION/TRENCH FORMS I I I
LIC. NO: 1 JSLAB/UNDER FLOOR
RA
_ I I I
ISED FLOOR FRAMING I I I
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( (UNDERFLOOR INSULATION I I I
1147H277 3 001 I -1-1 1
(FLOOR SHEATHING I
INO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: I I I- I I
I 0 NO 21 1ROOF SHEATHING 1
SCHOOL WITHIN HAZARDOUS I ISHEPR PANELS 1
(AIR QUALITY: 1000-FEET MATERIALS I I_ I I
NO NO NO I 1FRAME INSPECTION I I I
I I IFIRE SPRINKLER HANGERS
I I (INSULATION/WEATHER STRIP( I I
I I I I I I
IINTFRIOR LATH/DRYWALL I I I
I I I
I I I
EXTERIOR LATH I I I
I 1RATED FLOOR/CELL ASSEM. I 1 I
I i IRATRp WALL ASSEMBLIES I 1 I
SHAFTS
/OPENINGS I 1 I
1 I IT-'AR CEILINGS I 1 I
I I (LOT RAINAGE I I
IREPORT ID: DPR261 ROUTE TO: BS0508 1 I I I
I I I I I I
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