HomeMy Public PortalAbout6223 MUSCATEL AVE_Building__ 7GA638A CERBOS 3-66 APPLICATION FORBU PERM ''If' Ll
COUNTY '6F-LOS ANGELES ...BUILDING /
DEPARTMENT OF COUNTY ENGINEER ADDRESS l0
P
BUILDING AND SAFETY DMSION LOCALITY
JOHN A: LAMBIE'. COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS.SUP'T OF BUILDING CROSS ST.
DIS TR CT N GR T PE P D B
FOR APPLICANT TO.FILL IN coNST. Q
Ess
G 6223 N• Muscat@�. STATISTICA�L��(���p5 SIFICATION' SEW R MAP
CLASS NO. DWELL UNITS BK PG
O BLOCK USE ZONE '•MAP
NO. D
TRACT 5-1949-3 SPECIAL
N0. OF BLD08. CONDITIONS -
SIZE OF LOT NOW ON LOT
USE OF
I T BLDG. SETBACK FROM
OWNER L'• Pfiffner NOL FRONT..PROP. LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY 'F YARD = TOTAL
ADDRESS 223 N• Muscatel - HIGHWAY I T FROM C:L.
CITY San Gabriel California L + 0 _ C'2�
ACK FROM
RCHITECT OR TEL. LDG. S TR
SIDE PROP. LINE OF (STREET).
ENGINEER NO. _
_ TYPE OF EXISTING SETBACK HIGHWAY + YARD – TOTAL
ADDRESS � HIGHWAY WIDTH FROM C.L.
CONTRACTOR VirginRoof Npk$(r�-050 +
ADDRESSbOO S. San GabFi"ej1,cl6OW CORNER CUTOFF YES ❑ NO E
C
CITY .San Gabriel LLIL C- SEE REVERSE SIDE FOR SPECIAL APPROVALS 9
DESCRIPTION OF WORK C
NEW ADD ALTER REIPAIIReroDEMOLISH .R�p C
SQ.FT. NO. OF NO. OF
SIZE STORIES FAMILIES f
USE OF %1a:_F �d' 7i6".l,lWf/•�".)
STRUCTURE Residence a- r
a.
SIGNATURE OF
APPLICANT
VALUATIbN$ 135P2 •00
APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. PMT. FOUNDATION, LOCATION
FEE$ / PEE$ FORMS, MATERIALS _
FRAME, FIRE STOPS,-
1 HEREBY ACKNOWLEDGE THAT'I HAVE READ THIS APPLICATION BRACING BOLT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION
WITHALL COUNTY ORDINANCES AND :STATE LAWS REGULATING GAS VENT. DUCTS
9UILD I NG CONSTRUCTION., I CERTIFY THAT. IN DOING THE WORK _
AUTHORIZED HERE Y I WILL NOT•EMPL'OY ANY PERSON IN VIOLA- 'LAT-H. INT.
TION OF THE LAB R CODE OF THE STATE OF CALIFORNIA RELAT-
ING TO WORK;&OMPENSATI N INSURANCE. LATH:EXT.
SIGNATUREL OF CO. HOUSE NUMBER COR-
PERMITTEE wUrlI K :TORS REC AND POSTED
ADDRESS 620 tee. Ss;gid eC�LJ FINAL 141 _
bAN A RIEL. CALIF, :?7?70+ JOHN F:-LEWIS. RIN'ePAL•S URAL ENGINEER
PLAN CHECK VALIDATI(:R,7-0507 MgU �a�iiy�_ PERMIT VALIDATION cK M.o CASH
LO't7 0 9`.^o SEP 1 8 1 D 9.0-0- s
i'fy,4U170. A1C
WORKERS'COMPENSATION DECLARATION
N. I hereby affirm that Ihavecertificate of consent to Leif APPLICATION FOR' B L I L D I N G P E RM I T
is insure, or a certificate',of Workers'Compensation Insurance, ,
�Or a certified copy thereof(Sec. 3800, Lob. C.)
W2710598 COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. Company— Cal Comp.•
El ./
Certified copy is hereby furnished. FOR APPLICANT TO BUILDING FILL IN ADDRE§s
Certified copy is filed with the county building inspecA BUILDING
tion department. ( , i ADDRESS 6223 N. .Muscatel •,,
CITY- .San Gabriel ZIP j
Date 1-.1-93 ;q licant Virgin Roof Co.#+ '` I LOCALITY
Applicant NO.OF BLDGS. NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' I ( SIZE OF LOT NOW ON LOT CROSS ST.
:1�
COMPENSATION INSURANCES I ASSESSOR
(This section need not be completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL
hundred dollars ($100)or.less..).. TEL.
}�• I OWNER Mrs. Leo Pfiffner NO. . USE ZONE MAP
I certify thatJii the performance•of the work for which this' I I ' I SPECIAL
permit is issued, I shall not employ any person-in any manner- I ADDRESS 6223 N. -Muscatel' CONI)ITIONS a
so as to become subject to the'Workers'Compensation Laws,i O
CITY' S-an Gabriel ZIP I U
Date Applicant I ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY at
NOTICE TO APPLICANT:'If, after makingthis.Certificate'iof: ENGINEER NO. O
Y CONST. ZONE
Exemption, you•:should'become subject to the W,orketsa• � p
Compensation-provisions of the Labor Code, you must forth= j ADDRESS •ad
with comply with.such• provisions or.this,permit,shall' e ! : = TEL. STATISTICAL CLASSIFICATION APT. CONDO. Z
deemed revoked. I CONTRACTOR Virgin NO. 287-0507 rr��--''
' ! LIC. CLASS NO. DWELL..UNITS
LICENSED CONTRACTORS DECLARATION,' ; (.' I ADDRESS' 'P.O. 'Box NO• 160650
)hereby affirm that.1 am.licensed under prbvlsions'of Chapte�9 1 SEWER MAP
(commencing with Sectiori 7000)of Division 3 of the Business LIC.
CITY San Gabriel• CLASS C39
and Professions.Code,and my license is in full force and effibi.: i BK. PG. VALIDATION
" 160650
SQ. FT. NO. OF NO'OF CHECK
License'Number Lid. Class C39 1i ; SIZE' 10 1 STORIES 1 FAMILIES ONE
VALUATION
Contractor Vi_ rgin.Roof Co.Dare !6=30-93• x f DESCRIPTION OF WORK Garage: A 94s" El $' 3563:00 ►
A Fiber a lass'. n es.. ' 10 s 'g ADD Li
I am exempt under Sec: I Shila ear .ALTER ED]then
BAP.C. for this reason REPAIR ❑ $ ,
+ USE OF
Date: I EXISTING.BLDG. • Dwelling DEMOL•❑ r
Signature ,. APPLICANT TEL.. FINAL
OWNER-BUILDER DECLARATION i (PRINT). Vir in' Roof Co. NO. 2$ —
DATE
I hereby affirm that.l am exempt from the Contractor's.License ADDRESS P.O. BOX 5010 : San Gabriel
Law for the following reason-(Section 7031.5, Business and FINAL' ,
Professions Code): {. 1 PRESENT 'By
BUILDING A., a
❑ I, as owner of the,property, or my employees with ADDRESS / L• ,:
wages as their sole compensation,will do the work and ,
LOCALITY
the structure is not intended or offered for...sale(Section •I
7044, Business and Professions Code.) I ) MOVING TEL. I �� "TO"
_
❑ 1,as owner.of the property,am exclusively contracting CONTRACTOR NO. �j,.'y
with licensed contractors to construct the-project (Sec- ADDRESS :1.16 r '
tion 7044, Business and Professions Code.) +.•
REQUIRED TOTAL SETBACK FROM EXIST. ")+ i.;--� ?:
CONSTRUCTION LENDING AGENCY !I) : SET BACK YARD HwY PROP. UNE WIDTH I�1
I hereby affirm that.there is a construction lending agency,for I FRONT 1 v r;;`i_' r•-
the performance of the work for which this permit-is issued P.L. "E=j
(Sec. 3097, Civ. C.). SIDE
Lender's Name 1_ t_ ,
I P:C. Fee$ Permit Fee LD [Re -
Lender's Address l(•� `` 1 ,
I certify that I have read this application and state that'the •rJ� Issuahcd F1eO $' LDMA.P/C p
above information is correct.I agree to comply with all County Investigatio Fee
ordinances and State laws relating'to building c.onstructipn ITatal Fee LDMAJPerm, p
and hereby authorize representatives of this County to enter
upon the ab me tinned promi 6perty for inspection purpo'es. 85 .1
—92. SEE REVERSE FOR EXPLANATONGUAGE f
ignature of Applicant or.Agent' Date - 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 1112280016
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I NO. OF CONST I BUILDING ADDRESS: 1
ITR: 5903 IT: 60 UN: .002 I SQ. FT STORIES TYPE I 6223 MUSCATEL AV N
_ISTRUCTURE: 1700 V-B I SGAB CA 917752626
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET:
15386-009-016 I I THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY CAI
(TENANT: IEXIST BLDG USE: RESID USE ZONE: R-1 (ISSUED ON: PROCESSED BY: 1
(EXIST OCC GRP: 112/28/11 SR I
(OWNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: IFINAL DATE FINAL BY: CODE: 1
ICHENG, ANNIE (626) 226-6662- 1 1 2,000 1 I
16223 MUSCATEL AV I I I
ISGAB 917752626 [ FEES PAID [D SCR PTION OF WORK I
I I IRE ROOF 30 YEAR SHINGLE - USE [
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:( I
[APPLICANT: TEL. NO: I I I
ISAME AS OWNER - [AA BLDG PERMIT ISSUANCE 27.80 1 1
I IAB STATE GREEN BLDG FEE 2000.00 VAL 1.00 [SPECIAL CONDITIONS:
IAC STRONG MOTION RESID 2000.00 VAL 0.50
D2 PERMIT W/O EN HC 2000.00 VAL 82.20
I I TOTAL FEES 111.50 I A)o
[CONTRACTOR: TEL. NO: 1 [APPROVALS DATE INSPECTOR SIGNATURE I
[SAME AS OWNER - I I I
LIC. NO i (LOCATION AND SETBACKS I I I
I SOILS ENGINEER APPROVAL 1
ARCHITECT OR ENGINEER: TEL. NO: - I (FOUNDATION/TRENCH FORMS [ I I
[ LIC. NO: 1 ISLAB/UNDER FLOOR [ [ I
IRAISED FLOOR FRAMING I I I
I I I
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:[ (UNDERFLOOR INSULATION I I
1153H261 3 00 1 I I
I I IFLOJR SHEATHING 1
INO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: I_
0 NO 21 i i ROOF SHEATHING
I SCHOOL WITHIN HAZARDOUS I ISHEAR PANELS I I
(AIR QUALITY: 1000 FEET MATERIALS I I [ I
1 NO NO NO IFRAME INSPECTION I I
[ IFIRE SPRINKLER HANGERS I I
I I (INSULATION/WEATHER STRI91 I I
I [ (INTERIOR LATH/DRYWALL I I
I I I
I EXTERIOR LATH I I
� I �
(RATED FLOOR/CEIL ASSEM. I I I
I I IRATED WALL ASSEMBLIES
I I I
I (RATED SHAFTS/OPENINGS I I
I � I
IT-RAR CEILINGS
� I I
ILOT DRAINAGE I I I
IREPORT ID: DPR261 ROUTE TO: BS0508 I I I [
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�CP?®6T"I'® I AND AOReB TO COMPLY WRN ALL COu"wr ORDMANCU
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