HomeMy Public PortalAbout10726 MILOANN ST_Building__ WIAPPLICATION FOR -BUILDING PERMIT �
COUNTY OF LOS.ANGELES' -ASSESSOR
DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL
- BUILDING AND SAFETY" DIVISION BUILDING
61AKE CHECKS PAYABLE TO: ADDRESS O L 7J
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY
FOR APPLICANT TO FILL IN NEAREST" Q ,
Print ort a onl CROSS ST:
DISTRICT NO. GROUP TYPE P OQESSED BY
BUILDING ��aG! CONS'(.
ADDRESS Cf V K�LC.s+t+a
STATISTICAL CLASSIFICATION SEWER"MAP
LOT NO.: BLOCK . tZ
CLASS NO. -DWELL.UNITS � BK PG(V
TRACT' f USE ZONE MAP
NO.OF BLDGS.'. NO:
SIZE OF LOT �� �� �� NOW.ON LOT- (2-1 SPECIAL.
USE OF CONDITIONS .
EXISTING BLDG. rr
OWNER d BLDG.SETBACK FROM
ADDRESS�Q FRONT PROP.LINE OF. (STREET)
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
Lie
HIGHWAY WIDTH FROM C.L.
ARCHITECT OR TEL: +
ENGINEER NO. . BLDG.SETBACK FROM ' a
ADDRESS SIDE PROP.LINE OF, (STREET)
TEL. - TYPE OF EXISTING SETBACK HIGHWAY - + YARD = TOTAL C
CONTRACTOR UOZ-� NO. HIGHWAY WIDTH FROM C.L. C
ADDRESS `��✓� NO. + G
LIC. - _ col
CITY CLASS CORNER CUTOFF. YES'❑ NO
CONSTRUCTION LENDER
NAME AND BRANCH k1 UNC SEE REVERSE-SIDE-FOR SREC ,LAPPROVALS
ADDRESS _
SQ. FTs:Z.::?P} NO. OF ii NO. OF' NEW ❑
SIZE STORIES 1 FAMILIES '
USE OF ADD
STRUCTURE
h_( - 1
ALTER ❑ :��?� ��'J,',,P" >�F�e+)»• ?'d,. `+:�:' ! S A-:
REPAIR❑ r.. y`. ..! _;� // / f3.v , e!�/G: ro
SIGNATURE OF ,.+'
APPLICANT DEMOL ❑ r /
VALUATIONS (,�� APPROVALS INs TURF
P.C, PMT, r" ?_� FOUNDATION: LOCATION
FEES' FEE$ FORMS, MATERIALS.
FRAME: FIRE-STOPS, /
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING, BOLTS !/
AND STATE THAT THE ABOVE AS CORRECT AND AGREE TO:COMPLY. FURNACE: LOCATION,- _
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING-CON- GAS VENT, DUCTS
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED _
HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
LATH, INT.
LABOR CODE OF THE STATE OF -CALIFORNIA IN--'RELATING TO : I I ;mrdyy/,; .L;tw�•� .
WORKMEN'S COMPENSATION INSURANCE. L' r
'
V AT'H, EXT,- jD f "y
SIGNATURE-0 F r � HOUSE-NUMBER COR= '
PERMITTEE RECT-AND POSTED �J
ADDRESS FINAL
PLAN CHECK VALIDATION CK. M.O.- CASH _ P .'VALIDATION CIi: M.O. CASH
►_,' .;.0 '.1 s 3?3 .;'IAft 2 1 '� 3 5.2.5 N
DEPARTIMST OF COUNTY ENGaaft
'"ONION OF BUILDING AND SAFETY .
COUNTY OULOS LOS ANGELffi .O
WILLIAM J: FOX, COUNTY ENGINEER -�
CASSATT'D. GRIFFIN, SUPT OF BUILDING APPLICATION
FOR APPLICANT TO FB.L IN FOR OFFICE USE.,ONLY
BUILDING DISTRICT NO. PLAN CK.OR REC.'NO. PERMIT NO.
ADDRESS
LOCALITY RECEIVEDAY DATE'OF'APPL.. DATE ISSUED .
NEAREST
f CROSS ST a BUILDING
OWNER a 0 f, ADDRESS.MAIL co nn
ADDRESS I'/ r i LOCALITY q
NEAREST
TEL. CROSS
ST.
CITY r " O
ARCHITECT OR TEL. ZONE ,� I PLANS �S NO. "I TYPE -: I IJ
CiROU�—
ENGINEER NO.
• ADDRESS BLDG. ✓ R NO.
SETBACK LINE
CONTRACTOR �e U I N I USE APPROVED
ZONE "I BY'. DA
ADDRESS HOUSE NUMBERING
LEGALMAP NUMBER d S/ NO: ASSIGNED BY •
DESCRIPTION LOT NO. 21, BLOCK
CORRECTIONS
TRACT 7. ) 3 —
NO. OR BLDGS.
SIZE OF LOT _ I• NOW.ON LOT
USE OF NO. OF _.
EXISTING BLDG. FAMI Ie
DES-AWTION OF WORK
RE AIR -I DEMOLITION TIbN
I ' ADDITION z
BQ..FT. Q NO. OF"
SIZE 1 ROOMS STORIES.
CRF
O EKING U C C. I COVER NG Q.OrA�•
USE OF STRUCTURE
3 a: a
A'FPBOVALS:
.INSP 'S SIGNATURE: " DATE
FOUNDATION:LOCATION ePay��
FORMS, MATERIALS ..00�ti tt99
1.HEREBY ACKNOWLEDGE THAT 'I HAVE READ THIS AP- FRAMEd FIRE STOPS,
PLICATION AND STATE THAT THE INFORMATION GIVEN IS BRACING, BOLTS
CORRECT. FURNACE:LOCATION.
1 AGREE TO COMPLY RNA
WITH ALL. COUNTY ORDINANCES;, RNAGAS ENTDUCTS
AND.STATE.LA ULATING BUILDING CONSTRUCTION.. VENT.-
SIGNATURE OF r 'LATH, INT.
PERM Al e
QIP -LATH. EXT. r _
ADD
PLASTER, INT.—
AUTHORIZED'AGT.
PLASTER, EXT.
$ d O P. C. $ S. HOUSE NUMBER COR=
r.7.W FEE �j/ RECT AND POSTED
VALUATION FINAL /
O
78A888A DEW 3 8-82
1 „WORKERS' COMPENSATION DECLARATION
hereby affirm that I have certificate of consent self ®P L I CAT'® BUIL®I PERMIT E IT
insure, or a certificate of Workers' Compensation Insurance, �®
or a certified copy,thereof (Sec. 3800, Lab. .) COUNTY OF LOS ANGELES , • ;� BUILDING AN® SAFETY
Policy NoblCompany
Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS
ertified copy is filed with The unty building inspec- BUILDING f)
t o/n partment. ADDRESS 6J
Date ` Applic CITY ` ZIP LOCALITY
NO.OF BLDGS. NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT r CROSS ST.
COMPENSATION.INSURANCE2 ASSESSOR
(This section need not be completed if the permit is for one TRACT BLOCK 9 LOT NO. f MAP BOOK PAGE aA PARCEL-12-6
hundred dollars ($100)or less.) TEL
OWNER USE ZONE MAP
NO. NO.
I certify that in the performance of the work for which this /1
permit is issued, I shall not employ any person in any manner ADDRESS „y_/ SPECIAL O
I� CONDITIONS
so as to become subject to the Workers'Compensation Laws. U
CITY ZIP
Ce
Date Applicant ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY
NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. CON ZONE
Exemption, you should become subject to the Workers' ��
Compensation provisions of the Labor Code, you must forth- ADDRESS
with comply with such provisions or this permit shall be TEL• STATISTICAL CLASSIFICATION APT. CONDO. N
Z
deemed revoked. '• CONTRALTO NO.
LICENSED CONTRACTORS DECLARATION LIC. 3 CLASS NO. 4—r-0-/ DWELL. UNITS
—
I hereby affirm that I aADDRESS
m licensed under provisions of Chapter 9 �j ` NO' SEWER MAP
(commencing with Section 7000)of Division 3 of the Business LIC. ”'
and Professions Code,and m license is in full force a effect. CITY CLASS BK PG� VALIDATION
SQ. FT. NO. OF NO.OF CHECK
License Numb Lic. Class SIZE STORIES FAMILIES ONE
VALUATION ,�
DESCRIPTION OF WORIE '
1 NEW ❑ ::3 �
Contractor �– e , yr $ 3'700 pjo4
❑I am exempt under Sec. CJU 1/'L/✓ ADD -
ALTER ❑ � � ° f
B.&P.C. for this reason '' REPAIR ❑ $
Date: USE OF 1
EXISTING nel- _ DEMOL ❑ ACCT
i APPLICANT TEL. AC 1°4
Signature (PRINT) �` ; FINAL
OWNER-BUILDER DECLARATION S NO. DATE – �17 lav°
I hereby affirm that I am exempt from the Contractor's License
Low for the following reason (Section 7031.5, Business and 673
ADDRESS FINAL ,3 ITEMS
Professions Code): PRESENT By I
El1, as owner of the property, or my employees with BUILDING TOTAL 20"R .34
wages as their sole compensation,will do the work and
the structure is not intended or offered for sale(Section *LOCALITYCHECK/ G+1°.,�
7044, Business and Professions Code.) MOVING TEL. I
❑ I,as owner of the property,am exclusively contracting CONTRACTOR NO. CHANGE °[I[I
with licensed contractors to construct the project (Sec- 3
tion 7044, Business and Professions Code.) ADDRESS �y a
CONSTRUCTION LENDING AGENCY
REQUIRED BACK YARD HWY TOTAPROPALINEFROM WIDTH rJ�–Q��1 ��14/��
I hereby affirm that there is a construction lending agency for FRONT 1 t+°46the performance of the work for which this permit is issued P.L. u°
(Sec. 3097, Civ. C.). SIDE
P.L.
Lenders NameA4-
7,/
P.C. Fee$ , '71 Permit Fee dLDMA Ref. #
Lenders Address
1 certify that I have read this application and state that the Issuance Fee 1;7 73� LDMA P/C# POl
above information is correct. I agree to comply with all County Investigation Fee j2 �l •`
ordina and State laws relating to building construction, Total Fee . LDMA Perm. #
and h re authorize representatives of this County to enter
Upon b Z�re-mentio d prope y nspe • pur�poses.
on
o ___1
/ SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Applicant or en Date
COUNTY OF LOS ANGELES I 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 1001070013
PHONE: (626) 285-0488 EXT:
LEGAL ID: NO. OF CONST BUILDING ADDRESS:
ITR: 17867 IT: 26 SQ. FT STORIES TYPE 10726 MILOANN ST
I ISTRUCTURE: 25 V-B I TEMP CA 917803413
ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET:
18574-002-002 I THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY, Cl
(TENANT: (EXIST BLDG USE: RESID USE ZONE: R-1 ISSUED ON: PROCESSED BY:
(EXIST OCC GRP: 101/ 07/10 SR
OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: JFIYAL DATE FINJ&L Y: CODE:
1VALDEZ RAYMOND (626) 445-1215- I 6,500
10726 MILOANN ST
TEMP 917803413 FEES PAID IDESCRIPTION OF WORK 1
I TEAR OFF TO EXISTING SHEATING, INSTALL 30 LB FELT + 40 YR
I [FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: GAP ASPHALT SHINGLES 25 S.F.
APPLICANT: TEL. NO: I I
IJN DAVIS ROOFING (626) 815-1279- IAA BLDG PERMIT ISSUANCE 27.75 I
IAB STATE GREEN BLDG FEE 6500.00 VAL 1.00 ISPECIAL CONDITIONS:
JAC STRONG MOTION RESID 6500.00 VAL 0.65
D2 PERMIT W/O EN-HC 6500.00 VAL 166.20
TOTAL FEES 195.60
CONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE
IJ N DAVIS ROOFING (626) 815-1279- I
11308 H. COLORADO BLVD., #B LIC. NO ILOCATION AND SETBACKS
]PASADENA, CA 93.106 572125C39 * - I
ISOILS ENGINEER APPROVAL I I I
(ARCHITECT OR ENGINEER: TEL. NO: - I IFOUNDATION/TRENCH FORMS I I I
1 LIC. NO: I (SLAB/UNDER FLOOR
IRAISED FLOOR FRAMING I I I
IMAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:J (UNDERFLOOR INSULATION I I I
I147H277 3 001 I I I I
I I IFLOOR SHEATHING I I I
INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I
NO 21
I ROOF SHEATHING
SCHOOL WITHIN HAZARDOUS I ISHEAR PANELS I I V I
(AIR QUALITY: 1000 FEET MATERIALS I I I I I
NO NO NO I IFRAME INSPECTION I I
(REQUIRED TOTAL SETBACK FROM EXIST I IFIRE SPRINKLER HANGERS
ISET BACK YARD: HWY: PROP LINE: WIDTH: I I I I I
IFRONT PL- I (INSULATION/WEATHER STRIPI I I
I SIDE PL- I I 1-1 I
NTERIOR LATH/DRYWALL I I I
I (EXTERIOR LATH I I
IRATED FLOOR/CEIL ASSEM. I I I
I [RATED WALL ASSEMBLIES I I I
IRATED SHAFTS/OPENINGS I I I
IT-BAR CEILINGS
I* ADDITIONAL DATA ON FILE ILOT DRAINAGE
I I I
(REPORT ID: DPR261 ROUTE TO: BS0508 I I I I