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Home My Public Portal About6038 MUSCATEL AVE_Building__ • ` • ORKERS'CQJV!PENSAJION DECLARATION `cul + I hereaffirm I have certificate of consent to self APPLICATION FOR BUILDING P E �� insure,, or a certificaficate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. 16'12)146 Company .Sk (' F%;nJ ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING STV ADDRESS GO�} M ❑ Certified copy,is filed*Ith the county building inspec- BUILDING `„ M tion department. '{ un P) ADDRESS Date 1-2Z Applicant � N) Tri CITY ZIP LOCALITY Cl CERTIFICATE OF EXEMPTION FROM WORT S' NO.OF BLDGS. NEAREST p� COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. lkG\ awi (This section need not be completed if the permit is for one ASSESSOR hundred dollars ($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL OWNERNO. S3o USE ZONE MAP I certify that in the performance of the work for which this SPE permit is issued, I shall not employ any person in any manner SPECIAL 8f so as to become subject to the Workers'Compensation Laws. ADDRESS ' CONDITIONS U Date Applicant— CITY ZIP NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY O Exemption, you should become subject to the Workers' ENGINEER NO.� � CONST. ZONE J U Compensation provisions of the Labor Code, you must forth- ADDRESS J` R�? ✓ W with comply with such provisions or this permit shall be TEL STATISTICAL CLASSIFICATION APT. ONDO. N' deemed revoked. CONTRACTOR NO Z 7i LICENSED CONTRACTORS DECLARATION LIC, CLASS NO. DWELL. UNITS "a I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. SEWER MAP (commencing with Section 7000)of Division 3 of the Business and LIC. Professions Code, and my license is in full force and effect. CITY L A- CLASS BK A PG VALIDATION SQ.FT. OF NO.OF CHECK License Number �J 2"4_Lic.Class SIZE t1 = STORIES I FAMILIES ONE ^�4 r�� ❑ VAL TION �� Contractor r (h S�1YT1(4te �—L(1 DESCRIPT1013 OF WORK DD ❑ $ 6 ❑I am exempt under'Sec. ❑ V ALTER B.BP.C. for this reason REPAIR ❑ $ Date: USE OF DEMOL EXISTING BLDG. ❑ Signature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION PRINT NO. DATE 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS FIN 0 7J Q 2 A Professions Code): PRESENT BY ❑ BUILDING I, as owner of the property, or my employees with ADDRESS � # 0 0 0 0 0 wages as their sole compensation,will do the work and the structure is not intended or offered for sole(Section LOCALITY ® 0 - 4(150 7044, Business and Professions Code). MOVING TEL. _ ❑ CONTRACTOR NO. o 0 a 4 Q 5 O I, as owner of the property,am exclusively contracting v with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). o7.28-88 CONSTRUCTION LENDING AGENCY SETT BACK YARD HWY TOTAL SETBACK NEER 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. (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name Aim —SI-A LDMA Ref. # oP.C.Fee$ Permit Fee (/ Lender's Address 6��[�1 1)SC4:EarL_ 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 Investigation Fee ordinances and State laws relating to building construction, Total Fee V tLDMA Perm. # and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. 0 SEE REVERSE FOR EXPLANATORY LANGUAGE 1 Signature of Applicant or Agent Date �. ;WftKE.RS'COMPENSATION DECLARATION o I A surety affcertifica I have r certificate of consent to self APPLICATION R BUILDING W R Q T insure, or a certificate of Workers'Compensation Insurance, u or a certified copy thereof(Sec. 3800, Lab. C.) P �Company COUNTY OF LOS ANGELES BUILDING AND SAFETY BUILDING ❑olicyNo. f Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS �Cs 0167 Certified copy is filed with the county building inspec- BUILDING tion department: ADDRESS ep� ` r7 L Date Applicant F3"'"' CITY ZIP / 7cJ LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT S-o'�C 0 NOW ON LOT NEARESST. �,9�tia• COMPENSATION INSURANCECROSA (This section need not be completed if the permit is for one ASSESSOR hundred dollars($100)or less.) TRACT BLOCK �i LO MAP BOOK PAGE PARCEL OWNER /�l'j L !— NOZC.Sv�w0V* USE NE MAP . I certify that in the performance of the work for which this NO. permit is issued, I shall not employ any person in any mannery SPECIAL so as to become subject to the Workers'Compensation Laws. ADDRESS CONDITIONS V Date Applicant CITY ,F} , L./L ZIP 7 NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PROC ED BY O ENGINEER I /�O NO. �1!/L'rp CONST. INE Exemption, you should become subject to the Workers' .t-� Compensation provisions of the Labor Code, you must forth- ADDRESS \J 1 '3 4� W with comply with such provisions or this permit shall be 0- deemed revoked. 1 TE U STATISTICAL CLASSIFIC TION APT. NDO. fA CONTRACTOR i 0 S ID -N . ) S' // Z LICENSED CONTRACTORS DECLARATION LIC, CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS W jv NO. ZU*�b s�weR MAP o (commencing with Section 7000)of Division 3 of the Business and LIC. Professions Code,and my license is in full force and effect. CITY CA CLASS BK Y� G G VALIDATION �'�„�/ jrJ SQ. FT. NO.OF NO.OF CHECK License Number w Lir.Class (�� SIZE STORIES FAMILIES ONE ` •► L ,� VALUATION Contractor �I1 rD� "R('U`�(hhi Date 2 DESCRIPTION OF WORK �y ° Jam/ NEW ❑ $ 1 I am exempT under Sec. (�,f d �� J ADD ❑ �) ALTER B.BP.C. for this reason 01111. REPAIR ❑ $ USE OF � Date: EXISTING BLDG. d)r DEMOL ❑+ # Q Signature APPLICANT TEL. 1 0 2 5 6 1 FINAL OWNER-BUILDER DECLARATION PRINT NO. DATE I hereby affirm that I am exempt from the Contractor's License a a 256 1 3 U Low for the following reason (Section 7031.5, Business and ADDRESS FINA Professions Code): FROM q By 0 728-88 BUILDING I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and 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- ADDRESS tion 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY SETOBACK YARD HWY TOTAPROP L NE WIDTW PIM H 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. (Sec. 3097, Civ. C.).^ /, SIDE I s 1 � � I��_ P.L. Lender's Name . Q • o n �� P.C.Fee$ Permit Fee - LDMA Ref. R Lender's Address Aalz e) (yl u+O A `" r'" C 1 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 Investigation Fee ordinances and State laws relating to building construction, Total Fee , t J and hereby authorize representatives of this County to enter J LDMA Perm. q upon the above-mentioned property for inspection purposes. c z.7 SEE REVERSE FOR EXPLANATORY LANGUAGE o Signature of Applic nt orlfgent bate COUNTY OF LOS ANGELES I TEMPLE CITY # 0508 I BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT I TEMPLE CITY CA BL 0508 9608200051 PHONE: (818) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: TR: 5903 LT: 66 SQ. FT STORIES TYPE 6047 MUSCATEL AV N STRUCTURE: V SGAB CA 917752656 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 5386-008-038 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY TENANT: EXIST UBCO USE: RESID ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 08/20/96 TC 08/20/97 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE /- FINAL Y: CODE: SUK KOO SHIM - 1 2,600 8 2 2_'9' 309 BENNET PL CLMT 917111974 FEES PAID ESCRIPTION OF WORK REMOVE/RECOVER WITH CLASS °A" COMP. SHINGLE FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. 0: GREATER PACIFIC ROOFING (714) 836-1966- AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RESID 2600.00 VAL 0.50 SPECIAL CONDITIONS: D2 PERMIT W/O EN,-HC- l``i = (2600..00 VAL 99.15 If�, TOTAL FEES 127.40 CONTRACTOR: TEL. N0: (-� �' .> -=� �c_i/;� APPROVALS DATE INSPECTOR SIGNATURE EATER PACIFIC ROOFING (714) 836-1966- `� 1016 E. FIRST ST. LIC. NO :� �`. . LOCATION AND SETBACKS SANTA ANA, CA 92701 621368 SOILS ENGINEER APPROVAL .' , �;"r-fes^+ � '.•.'•i, r`� ARCHITEC ORENGINEER: TEL. N0: i ,' �_ \\ �= FOUNDATION/TRENCH FORMS LIC. N0: t+ l, i =j-=-=+ SLAB/UNDER FLOOR ' RAISED FLOOR FRAMING MAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: — n , •r` UNDERFLOOR INSULATION 150H261 3 01 FLOOR SHEATHING NO. OF FAMILIES: DWELLING UNITS: APT/COND: SAT CLASS: NO 21 ROOF SHEATHING SCHOOL WITHIN HAZARDOUS SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO NO _ _ FRAME INSPECTION REQUIRED TOTAL SETBACKFROM EXIST - FIRE SPRI LER HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: 5 FRONT PL- INSULATION/WEATHER STRIP SIDE PL- - INTERIORLATH/DRYWALL EXTERIOR LATH RATED LOOR/CEIL ASSEM. RATED WALL ASSEMBLIES RATED SHAFTS OPENINGS I T-BAR CEILINGS I LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508 j I