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Home My Public Portal About5447 MCCULLOCH AVE_Building_11/8/1977_ .-PPLICATION FOR - - °UILDINGPERMIT- FOR APPLICANT TO'FILL'IN ' ' ADDRESS 15� 141 C_ BUILDING1 ` ADDRESS � -C L& \O.CG V% LOCALITY NEAREST CITY . .LU C I V ZIP.', d CROSS ST. i --•�� NO.OF'BLDGS. ' ASSESSOR SIZE OF LOT 0 Q V NOW ON LOT MAP BOOK PAGE PARCEL � DISTRICT GROUP. YPE ' FIREiRACi 7 BLOCK LOT NO. pQ NST. ZONE [7ZSYIED ;TEL. C / �4 OWNER E NO. O STATISTICAL CLASSIIFFII TION SEWER MA ADDRESSs q70 c6ol dCd- 71 CLASS NO. / DWELL.UNITS B PG CITYr � CC .Z ZIP 0 V.Sq,ZONE MAP ARCHITECT OR TEL: -1 NO. ENGINEER NO. SPECIAL 7 - J CONDITIONS ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ TEL: CONTRACTOR A NO. BLDG.SETBACK FROM LIC. FRONT PROP.LINE OF (STREET) ADDRESS A NO. HIGHWA t 'YARD __ TOTAL SETBACK FROM TYPE OF EXISTING LIC. � FRONT PROP.LINE HIGHWAY WIDTH CITY CLASS CONSTRUCTION LENDER t O NAME AND.BRANCH BLDO.SETBACK FROM U ADDRESS CITY SIDq PROP.LINE OF (STREET) Q SQ.FT. NO.OF NO.OF CHECK -HIG Y + YARD TOTAL SETBACK FROM TYPE OF EXISTING SIZE STORIES FAMILIES ONE -NPiE HIGHWAY WIDTH N DESCRIPTION OF WORK L� .{�+ALA- NEW ADD ❑ CORNER CUTOFF YES ❑ NO ❑ ALTER ' ❑ IN OPEN SPACE YES ❑ NO ❑ REPAIR ❑ USEOF BLDG. DEMOL ❑ IN COASTAL PERMIT ZONE YES ❑ NOEXISTIN ❑ APPLICANT TEL (PRINT) NO. BY(SIGNATURE) • I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE - THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE ' WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORK COM- PENSATION INSURANCE. SIGNATURE O FINAL 3�f 3A! BY PERMITTEE DATE ADDRES G ' TEL. �'� P.C.Fee$ Permit Fee Z CITY NO. Issuance Fee VALUATION /. Total Fee z/ PLAN CHECK VALIDATION CK. •M:O. CASH PERMIT VALIDATION cam`M.O. CASH 0 0 6 NOV 8 11 i 1 2.0 0 ®S 76AS38B CE 06038 6/76 ' APPLICATION FOR A',js JILDING PERMIT FOR APPLICANT TO FILL IN AD(DR)ESS BUILDING ADDRESS LOCALITY NEAREST ' CITY ZIP CROSS ST. OF BLDGS. ASSESSOR SIZE OF'LOT WSd,1,po NOW ON LOT MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE PROCESSED BY TRACT BLOC LOT NO. /J CONST. J/�'PIE TEL. 0 /� �' .�✓��:�". OWNER ® NO. STATISTICAL CLASSIFICATION SEWER MAP ADDRESS /J • CLASS NO. �-5 DWELL.UNITS BK PG CITY G C,:/ G ZIP USE ZONE I ARCHITECT OR TEL. AL ENGINEER NO. DITIONS ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ TEL. CONTRACTOR No. Ct `s/L BLDG.SETBACK FROM LIC. `� FRONT PROP.LINE OF —ISTREET) ADDRESS HIGHWAY + YARD = TOTAL O ALS PROP.LINE TYPEOF HIGHWAY EXISTING LIC. CITY CLASS + _ CONISTRLICTION LENDER a NAME AND BRANCH BLDG.SETBACK FROM VO SIDE PROP.LINE OF (STREET) ix ADDRESS CITY O SQ.FT/. NO.OF NO.OF CHECK HIGHWAY + YARD - = TOTAL SETBACK FROM TYPE OF EXISTING SIZE � STORIES FAMILIES ONE SIDE PROP.LINE HIGHWAY WIDTH N DESCRIPTION OF WORK NEW 11 + Z X ADD U CORNER CUTOFF YES ❑ NO ❑ ALTER ❑ IN OPEN SPACE YES ❑ NOUSE ❑ REPAIR ❑ EXISTING BLDG. �/,��G lr' � DEMOL ❑ IN'COASTAL PERMIT ZONE YES ❑ NO ❑ APPLICANT TEL (PRINT) �j NO BY(SIGNATURE) (/ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICJNANT TATE • /THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITHNCESAND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY TTHEWORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSONN OFTHE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO COM•PENSATION INSURANCESIGNATU .PRMTTEEE OF , DATEL u ADDRESSS�Asy -�s x'/411/" TEL.NO. G P.C.Fee$ Permit Fee 36-orI CITY Q ya. Issuance Fee /.�y• QQ $ VALUATION �j� 04z) y ✓ r' Total Fee �J ACAS = PERMIT VALIDATION GK. M.O. CASH 4 tiJiliV• 6 D 4 3;0 0 ,&a to APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS e or a certificate of Workers'Compensation Insurance,or a certified __5'4i1-7C vL t-D Cf/ t/E copy thereof(Sec.3800,Lab.C.) CITY » ZIP Policy No. Company %EW r IF C%T� �7�� LOCALITY SIZE OF LOT NO.OF BLDGS,NOW ON LOT ❑ Certified copy is hereby furnished. f NEAREST CROSS STe 61-91 ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. USE ZONE MAP NO. department. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL NO. COMPENSATION INSURANCE JDVEAiT/NO PAAi6AAI 1143-477A WITHIN 1000 FT.OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred ADDRESS dollars($100)or less.) 541/7 M,'Cu L L•oC1H AVF• DISTRICT GROUP ENST, FIRE ZONE PROCESSED BY CITY ZIP %��I certify that in the performance of the work for which this permit '�7`/JaLr C/ n is issued, I shall not employ any person in any manner so as to ARCHITECT OR ENGINEER TEL NO. G'� 3 G� become subject to the Workers'Compensation Laws. STATISTICAL C SSIFICATIC 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 forthwith FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL LICENSED CONTRACTORS DECLARATIONSIDE CITY LIC.CLASS PL I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP } (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORIEq NO.OF FAMILIES NEW BK PG V Professions Code,and my license is in full force and effect. License Number Lic.Class DESCRIPTION OF WORK oF'7t-tC f-20w ADD ❑ VALUATION TAKE ONE 4696K001 D $ � .on Contractor Date ALTER ❑ � � w POT A 0-9J ONE 04 . IQL-800E REPAIR ❑ y ❑ I am exempt under Sec. $ Z B.BP.C.for this reason &AWT s'�/A/�GI�v . DEMOL ❑ LDMA P/C# Date: USE OF EXISTING BLDG. sQa URM ❑ Sigrylture APPLICANT(PRINT) TEL NO. LDMA Perm# owner of the property, or my employees with wages as Z y their sole compensation, will do the work and the structure is ADDRESS F not intended or offered for sale (Section 7044, Business and FINAL DATE Q •I 7 D :.Fi4.4 i �u- •.I Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL �t V ✓✓ J OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE {; ❑ I, a3 owner of the property, am exclusively contracting 44, AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY J licensed contractors to construct the project (Section 7044, YES 1:1 NO❑ Business and Professions Code.) / i jl T q '`d''� ' WILL THE INTENDED USE'OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING "�''�4 OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH /`� ,� '•3 ,!••�? +,:,a "r CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR S��(� Cf�yf L•r[-+:(': 141 n V•.E GUIDELINES os•H"% � rbTi•f/ I hereby affirm that there is a construction lending agency forYes❑ No❑ /`"'-��ANGE IY!I the performance of the work for which this permit is issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING 3097,CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS 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. LI (�ILj- jt�F�! Fr 71 9 Lender's Address - ,yy OWNER OR AGENT fr 111 1-1 I certify that I have read this application and state under penalty of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE with all county ordinances and State laws relating to building construction,and hereby authorize representatives of this County ISSUANCE FEE 17pon thove-mentiproo perty for inspectio purposes.q INVESTIGATION FEE TOTAL FEEJ. dApp«AM«AMMr 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 1208020010 PHONE: (626) 285-0488 EXT: [LEGAL ID: NO. OF CONST BUILDING ADDRESS: ITR: 13613 LT: 100 SQ. FT STORIES TYPE 5447 MCCULLOCH AV I (STRUCTURE: V-B TEMP CA 917803516 [ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 18573-007-028 THOMAS PAGE: 597 GRID: D3 LOCALITY: TEMPLE CITY, C TENANT: JEXIST BLDG USE: RESID USE ZONE: R-1 JISSUED ON: PROCESSED BY: [ -JEXIST OCC GRP: 108/02/12 SR OWNER: TEL. NO: 1HLDGS. NOW ON LOT: VALUATION: AT FI AL HY: CODE: ICHIU, YOK YEE (626) 807-5716- 5,500 15447 MCCULLOCH AV I L ITEMP 917803516 I FEES PAID IMSCRIPTION OF WORK 1 I I (KITCHEN AND BATHROOM REMODE 1 I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:( I (APPLICANT: TEL. NO: I I I ISAME AS OWNER - IAA BLDG PERMIT ISSUANCE 27.80 I I I IAB STATE GREEN BLDG FEE 5500.00 VAL 1.00 [SPECIAL CONDITIONS: [ [ IAC STRONG MOTION RESID 5500.00 VAL 0.60 B2 PERMIT W/ENERGY 5500.00 VAL 164.30 I [FR INV WORK W/O PERMIT 342.20 DOL 342.20 [ CONTRACTOR: TEL. NO: I TOTAL FEES 535.90 [APPROVALS DATE INSPECTOR SIGNATURE [ ISAME AS OWNER - 1 LIC. NO i ILOCATION AND SETBACKS [ � I � I [ ISOILS ENGINEER APPROVAL [ I I [ARCHITECT OR ENGINEER: TEL. NO: I FOUNDATION/TRENCH FORMS I I [ LIC. NO: i (SLAB/UNDER FLOOR I [ [ I [ IRAISED FLOOR FRAMING [ I [ IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:[ [UNDERFLOOR INSULATION I I [ 1147H277 3 001 I 1 1 I I I IFLOOP SHEATHING [ I I INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: 'l I_ I I 1 0 NO 21 1 [ROOF SHEATHING [ [ SCHOOL WITHIN HAZARDOUS [ ISHEAR PANELS I [ I (AIR QUALITY: 1000 FEET MATERIALS [ I [ I I NO NO NO i [FRAME INSPECTION [ I I I FIRE SPRINKLER HANGERS I I I I [ INSULATION/WEATHER STRIP( I I I I [INTERIOR LATH/DRYWALL [ I I I I I [EXTERIOR LATH [ I I I I RATED FLOOR/CEIL ASSEM. I IRATED WALL ASSEMBLIES i [ [ i (RATED SHAFTS/OPENINGS I [ 1T-BAR CEILINGS I I I I I I I [ [LOT DRAINAGE [ [ I I � [ IREPORT ID: DPR261 ROUTE TO: BS0508 I I I I