HomeMy Public PortalAbout10714 MILOANN ST_Building__ APPLICATION FOR BU LI DING PERMIT
FOR APPVCANT.TO FILL IN (Print or type only)
BUILDfN 1,611.
� -COUNTY OF LOS ANGELES
ADD IjESS DEPARTMENT OF COUNTY ENGINEER
CITY f ZIP BUILDING AND SAFETY DIVISION
No.OF BLDGS. BUILDING
SIZE OF LOT X J a NOW ON LOT I ' • ADDRESS / —
TRACT ` �i,. BLOCK LOT NO. ,^ LOCALITY •�
TEL. L��Q�� NEAREST
OWNER. WatNO. O CROSS ST.
ASSESSOR
-ADDRESS kip MAP BOOK PAGE I PARCE
DISTRICT GROUP TYPE FIRE ROC S BY
-CITY {� i ZIP . �1 _! �++ CONST. Z
ARCHITECT OR TEL. S •oLq .L. e
ENGINEER NO. STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS TEL. CLASS NO. _� • DWELL.UNITS BK PG
CONTRACTOR NO. USE;ZONE MAP d '
LIC. !1 / NO.
ADDRESS NO. /`C! SPECIAL
UC CONDITIONS
CITY CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑•
CONSTRUCTION LENDER_
NAME AND BRANCH BLDG.SETBACK-FROM
FRONT PROP.LINE OF (STREET)
ADDRESS' CITY TOTAL SETBACK FROM TYPE OF EXISTING
HIGHWAY + YARDS
SQ.FT. OF {{ NO.OF CHECK - FRONT PROP.LINE HIGHWAY11
SIZE STORIES 1 FAMILIES ONE
DESCRIPTION_ OF WORK NEW ❑ O
• t a ADD • ❑ BLDG.SETBACK FROM r" '
SIDE PROP.LINE OF - '� (STREET) O
14 ALTER TOTAL SETBACK FSM TYPE OF EXISTING w
HIGHWAY +. YARD - SIDE PROP •INE HIGHWAY WIDTH.. N
USE REPAIR ❑ Z,
EXI ING BLDG. � ' DEMOL ❑ + !`
APPLICA , TEL - CORNER CUTOFF ES ❑ NO E3
RINT) NO.
IN OPEN SPACEYES'_Q NO ❑
BY(SIGNATUREI IN COASTAL PERMIT ZONE YES ❑ NO ❑
VALUATION1 . '
`7'13 cfI-�ZE� F 2 ME's 7N� .l
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES I �
AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE %✓D%
WORK AUTHORIZED HEREBY I ILL NOT EMPLOY ANY•PERSON IN VIOLATION OF
THE LABOR CODE OF THE STAT OF NOT
IN RELATING TO WORKMEN'S COM. �1+
PENSATION INSURANCE. ��•� �/��/�"O =�v%�_ _
SIGNATURE OF
PERMITTEE
ADDRESS ^y
TE ��` DAT FINAL lam/ -'/7
CITY to N
MAKE CHECKS PAYABLE TO: FEE,s: FWE4� a
T
HARVEY T.BRANDT,COUNTY ENGINEER '76
PLAN CHECK VALIDATION' CV_ M.O. CASH a �� PERMIT VALIDATIONcK: JM.o.• CASH
3:4,, 48..'75 .98 -
803 3.75'
®s 76A63BA CE tf
DIVISION
N�iT OF COUNTY ENGINEER
DIVISION OF BUILDING .AND SAFETYBUILDING
COUNTY OF LOS ANGELES
WILLIAM J. FOX, COUNTY ENGINEER APPLICATION
CASSATT D. GRIFFIN, SU!'T OF BUILDING
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
BUILDING f / DISTRICT NO. PUN CK.oR REC.No. 'PERMIT NO.
ADDRESS, 1 1 y I 0 R IV I :i✓ 63 s �' 1 T 7 J�� a
LOCALITY +�Pi. it RECEIVED BY DATE OF APPL. DATE ISSUED
NEAREST / 6A"" 1iI-C-•L- r— r—sz
CROSS ST Sm mt,3 N
BUILDING
OWNER ADDRESS
AMAILDDRESS R + LOCALITY ems/J. <�''�Z
TEL. NEAREST
CITY O 1 CROSS ST. JZ.;} .A-�. V502—
ARCHITECT OR TEL.. FIRE I NO. OF L TYPE I GROUPr_
ENGINEER NO. ZONE PLANS \` f
BLDG. ! NO.
ADDRESS SETBACK LINE D
CONTRACTOR C V N L• USE A _/ APPROVED
ONE BY
HOUSE ANUMBERING
ADDRESS
LEGAL MAP NUMBED D NO. ASSIGNED BY
DESCRIPTION I LOT NO. I BLOCK
CORRECTIONS
TRACT 1 f C 1 V J o C
NO.OF BLDGS. f
SIZE OF LOT v O NO ON LOT f 1 v
USE OF NO. OF
EXISTING BLDG. FAMILIES
DESCRIPTION OF WORK O -
NEW ALTERATION ADDITION F
REPAIR DEMOLITION I-7N —I� Y
SQ. FT. g r
SIZE 'O 3` ROOMS STORIES I
OVERING 4LO I COVERING eV►A��
usE of srRucTUR � "
r
APPROVALS
INSPECTOR'S SIGNATURE DATE
FOUNDATION:LOCATION
FORMS, MATERIALS
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FRAME: FIRE STOPS,
PLICATION AND-STATE THAT THE INFORMATION GIVEN IS BRACING, BOLTS
CORRECT. FURNACE:LOCATION,
I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES GAS VENT, DUCTS
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. _
SIGNATURE OFr LATH, INT. i'
PERMITTE
LATH. EXT.
ADDRE off
PLASTER, INT.
AUTHORIZED AGT. �
PLASTER, EXT.
$ -�
-� FEE $ HOUSE NUMBER COR-
LL
RECT AND POSTED
VALUATION FEE !- FINAL
76ASSaA 0883 9-52
C`1-77
rAPPLrCAT10N FOR COUNTY OF LOS ANGELES_
OF COUNTY ENG
BUILDING PERMIT DEPARTMENT BUILDING AND SAFETY DIVISIONER
BUILDING
FOR APPLICANT TO FILL IN ADDRESS 6r
BUILDING 6 6tkN LOCALITY
ADDRESS
CIT "� Zlpcj 0 NEAREST
CROSS ST. S Q
O.OF BLDGS. 1 ASSESSOR
SIZE OF LOT NOW ON LOT f MAP BOOK PAGE PARCEL
o DISTRICT GROUP TYPE FIRE RO SSE BY
TRACT ��
BLOCK LOT NO. QQQl �O Q CONST�.j Zf2p�E / �S
OWNER /�V \,(� S NO. -&9&3 STATISTICAL CLASSIFICATION SEWER�M-21 /
.ADDRESS 6 ( Q CLASS NO.' DWELL.UNITS BK PG
CITY ZIP ll Z] 'USE ZONE MAP A
NO. e
ARCHITECT O TEL. „I SPECIAL
ENGINEER NO. CONDITIONS
ADDRESS ROAD DEPARTMEN.T APPROVAL REQUIRED YES❑ NO❑
CONTRACT R� (� TEFL. BLDG./SETBACK FROM
LIC. FRONT PROP.LINE OF (STREET)
ADDRESS NO. HI GHW Y + YARD = TOTAL SETBACK FROM TYPE OF HIGHWAY WIDTH
LIC. FRONT PROP. L)NE
CITY CLASS _
CONSTRUCTION LENDER +
a
NAME AND BRANCH BLDG.SE KFROM o.,
Q
ADDRESS CITY SIDE PROP.LI (STREET) 8
SQ. FT. NO. OF NO. OF CHECK HIGHWAY + YARD = TOTAL SET FROM TYPE OF EXISTING CIS
SIZE STORIES FAMILIES ONE SIDE PROP. LINE HIGHWAY WIDTH
DE RIPTICJN OF WORK NEW 1:1 + -
ADD CORNER CUTOFF YES ❑ NO ❑
ALTER ❑ IN '
REPAIR❑ OPEN SPACE YES El 1:1USE OF IN COASTAL PERMIT ZONE YES ❑ NO
❑
FEXISTING �QG. DEMOL ❑
AP PRINT)CALITl CJ1�1 N!\� NO. `� l f/�r^-i/.�r°�✓ 7`- �' /r� YY_ �� "�.---
BY (SIGNATURE)
IHERkWJCCKLEDdkTHAT I HAVE READ THIS APPLICATION
AND STATE THAT THE BO E IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT E THAT ANY PERSON IN VIOLATION OF THE
LABOR CODE OYT S 'OF CA F ANIA INRELATING TO
WORKMEN'S COMI N U NC
SIGNATUR FINAL BY
PER MITT DATE
ADDRE S
TEL. P.C. Fee$ Permit Fee Z-
CITY NO.
Issuance Fee
VALUATION /F �'l Total Fee 12,
PLAN CHECK VALIDATION CK. M.O. CASH o -PERMIT VALIDATIO _ CK.. Moo. CASH
1l 1 2.0 0 F`
76A898A C908090 12/79
I. V
. T
WORKERS'COMPENSATION'DECLARATION
y
I hereby affirm that I have a certificate of consent to self
av' insure,or a certificate of Workers'Compenstion Insurance,or APPLICATION F®II BUILDING PERMIT
a certified copy thereof(Sec.381)0, Lob. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. • Company
Certified copy is hereby furnished. BUILDING
FOR APPLICANT TO FILL IN ADDRESS
❑ Certified copy is filed with the county building inspec- ;, BUILDING !/..r�
tion department. ADDRESS V 1 i Vv`\l �111V1pp��� LOCALITY
Date - Applicant CITY i,Q 1 ZIP "{ CROSS NEARESTT.
CERTIFICATE OF EXEMPTION FROM WORKERS' OF BLDGS. - ASSESSOR
COMPENSATION INSURANCE SIZE OF LOT I NOW ON LOT MAP BOOK PAGE PARCEL
.(This section need not be completed if the permit is for one USE ZONE ESPECIAL
P '
TRACT, 6 D BLOCK LOT NO. V . d `
huridred dollars ($100)or less.) �.
/� TEL. d,
OWNER 4- b�M%dlwcs NO.`�p' ��P�. NDITIONS
I certify that in the,performance of the ork for which this DISTRICT GROUP' TYPE FIRE PRO ESSED BY
,permit is issued,•1 shall not employ any rson in any manner ADDRESS
so.as to become subject to the Work Com ensu' Laws. a S CONS ZQNE
i `j
Da `� App'c Y CITY ZIP
Dot STATISTICAL CLASSIFICAT ON PT. CONDO. U
NOTICE TO APPLICANT: If, after ing thisARCHITECT OR TEL.
Certificate of �— UJI
Exemption, you should become subject to the Workers' ENGINEER NO. CLASS NO.
DWELL. UNITS y
'Compensation provisions of the Labor.Code, you must forth- 'ADDRESS SEWER MAP
with comply with such provisions or this permit shall be TEL.t
deemed revoked. CONTRACTOR fJyQ NO. BK. J PG, VALIDATION
LICENSED CONTRACTORS DECLARATION LIC.
I hereby affirm that I am licensed finder provisions of Chapter 9 ADDRESS NO. VALUATION
(commencing with Section 7000)of Division•3 of the Business and LIC.
Professions Code, and my license is in full force-and effect. `CITY '� CLASS $ I J 0 Q
SQ. F NO.OF NO. OF CHECK
License Number Lic.Class SIZE STORIES FAMILIES ONE
Contractor Date DESCRIPTION OF WORK t%A C V -re L'Z' NEW 1' .
❑ ! L .L ADD
I am exempt from the licensing requirements as I am a
licensed architect or a registered professional engineer , t _ ALTER FINAL
acting in my professional capacity (Section 7051, ! i/e t, REPAIR DATE r
Business and Professions Code). USE OF
a EXISTING BLDG. YPL 5sc� t DEMOL =O FINAL
Lic.or Reg,No. Date APPLICANT TEL.
OWNER-BUILDER DECLARATION. PRINT v ..�55 \ NO. 2������
I hereby affirm that I am exempt from the Contractor's License ADDRESS I FV1 �' . 4r L
Law for the following reason (Section 7031.5, Business and
Pfofessiorls Code): PRESENT Ity 7•{"��i'I` BUILDING '
I, as owner of'the property, or my employees with ADDRESS
wages as their sole compensation,will do the work and ! ' l L 0 �t
the structure is not intended or offered for sale(Section =. LOCALITY
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-, ! 2 u o Q
tion 7044, Business and Professions Code). ADDRESS
REQUIRED TOTAL SETBACK FROM EXIST.
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY. PROP. LINE WIDTH `
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. 022 6—8 1
(Sec. 3097, Civ. C.). SIDE
P.L.
Lender's Name �d :; •
P.C. Fee$ Permit Fee s
Lender's Address
I certify that I-have read this application and state that the Issuance Fee 1
above information is correct. I ogrebNo comply with all County Investigation Fee p
ordinances and.State laws relating to building construction, Total Fee
and hereby uthorize representatives of this County to enter
upon the ove- ntibn roperty for inspection purposes.
o2� SEE REVERSE FOR EXPLANATORY LANGUAGE
Si ture of Applicant,or Agent -Date ®s
- 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 1003170031
PHONE: (626) 285-0488 EXT:
LEGAL ID: NO. OF CONST BUILDING ADDRESS:
ITR: 17867 IT: 28 SQ. FT STORIES TYPE 10714 MILOANN ST
I ISTRUCTURE: 20 V-B I TEMP CA 917803413
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: EL MONTE
18574-002-004 I THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY, Cl
TENANT: EXIST BLDG USE: REBID USE ZONE: R-1 (ISSUED ON: PROCESSED BY:
(EXIST OCC GRP: 103/17/10 SR
(OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: IFINAL DATE FINAL BY: CODE: I
IMR. WILLIAMS (626) 448-5863- 1 6,000 6
I 1
110714 MILOANN ST 1
ITEMP 917803413 FEES PAID I SCR PTION OF WORK I
ITEM OFF EXISTING 3 ROOFS Off-FRONT SIDE OF_HOMh'. APPLY 40 I
IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT:ILB FELT OVER EXISTING PLYW06D-'INSTALL 30 YR OWENS CORNING *I
(APPLICANT: TEL. NO: I I 1
ILANSFORD ROOFING INC. (626) 390-3480- IAA BLDG PERMIT ISSUANCE 27.75 1 1
13535 LANDFAIR RD. IAB STATE GREEN BLDG FEE 6000.00 VAL 1.00 ISPECIAL CONDITIONS:
IPASADENA CA 91107 IAC STRONG MOTION RESID 6000.00 VAL 0.60 1
I ID2 PERMIT W/O EN-HC 6000.00 VAL 149.40 I
1 1 TOTAL FEES 178.75 I
ICONTRACTOR: TEL. NO: I APPROVALS DATE INSPECTOR SIGNATURE
ILANSFORD ROOFING (626) 390-3480- I 1
13535 LANDFAIR ROAD LIC. NO I ILOCATION AND SETBACKS I 1 I
(PASADENA CA 91107 775436039 I I I I 1
ISOILS ENGINEER APPROVAL I 1
]ARCHITECT OR ENGINEER: TEL. NO: I IFOUNDATION/TRENCH FORMS I I
LIC. NO: I ISLAB/UNDER FLOOR I I
1 I (RAISED FLOOR FRAMING I I
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( (UNDERFLOOR INSULATION I I I
1144H273 3 001 1 I 1 I
I I IFLOOR SHEATHING 1 I
INO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: I I I I I
NO 21 I IROOF SHEATHING fl I 1
SCHOOL WITHIN HAZARDOUS I ISHEAR PANELS I I I
(AIR QUALITY: 1000 FEET MATERIALS I I I I 1
NO NO NO [ IFRA.ME INSPECTION 1 1
(REQUIRED TOTAL SETBACK FROM EXIST ] IFIRE SPRINKLER HANGERS 1 I I
[SET BACK YARD. HWY: PROP LINE: WIDTH: 1 I I I
[FRONT PL- I (INSULATION/WEATHER STRIPI ]
I SIDE PL- I 1 1-1 I
1 ]INTERIOR LATH/DRYWALL I I I
1 1EXTERIOR LATH I 1 I
IRATED FLOOR/CEIL ASSEM. I ]
I I IRATED WALL ASSEMBLIES 1
I I
1 I IRATED SHAFTS/OPENINGS
IT-BAR CEILINGS
I �
[ I* ADDITIONAL DATA ON FILE I
] I I
[ I ILOT DRAINAGE ] I I
REPORT ID: DPR261 ROUTE TO: BS0508 I I