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HomeMy Public PortalAbout10137 NADINE ST_Building__ r (8f 76A6�A GE C8031REV 8/78) Y APPLICATION FOR BUILDING 15ERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN BUILDING ADDRESS O BUILDING ADDRESS 161,1 vo S LOCALITY CITY Q ZIP p/s NEAREST 7P�G CROSS ST ^ �L ! ASSESSO SIZE OF LOT X Y ��U' NOW ON LOT MAP BOORK PAGE I PARC TRACT�ca 3(9 BLOCK LOT NO a� / {DISTRICT G_ROOUP TYPECONFIRE ENIBI039PG R E ED BY OWNERF11/S d P uNO '" TJX O - l V —A c STATISTICAL CLASSIFICATION WER AW ADDRESS AO/.3 G. 440461;t/� CLASS NO DWELL UNITS CITY -P P C ZIP 17,fO ARCHITECT OR �+ TEL VALUATION }-� ENGINEER �71C NO V V ADDRESS BLDG SETBACK FROM TEL FRONT PROP LINE OF (STREET) CONTRACTOR B NO HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING LIC FRONT PROP LINE HIGHWAY WIDTH ADDRESS NO LIC + _ CITY CLASS CONSTRUCTION LENDER BLDG SETBACK FROM NAME AND BRANCH SIDE PROP LINE OF (STREET( HIGHWAY + YARD = TOTAL SETBACK FROM I TYPEOF EXISTING ADDRESS CITY SIDE PROP LINE HIGHWAY WIDTH 0 SQ FT e NO OF NO OF CHECK + = V SIZE 8 STORIES FAMILIES ONE / O DESCRIPTION OF WORK NEW ❑ PC Fee$ Permit Fee .4v D ,V!(yJ7 Issuance Fee ALTER REPAIR ❑ Total Fee USE OF � ',� D SicsJP/yI DEMOL EXISTING BLDG ! /EeZ APPLICANT TEL _ 0 (PRINT) / , s NO y� O BY(SIGNATURE) IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE Y THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCESId 2 b 0 9 A AND LAWS REGULATING BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE S WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF V THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN S COM Z # • • • • • 1 PENSATION INSURANCE SIGNATURE OF 49 - 43.00 . @43,005 4 O O PERMITTEE 4 3,O 0 v ADDRESS TEL O 02,06-79 CITY NO D US NO ��PC��C- IAL > 7g- �ZA6iDITIONS FINAL 9 BY DATE .5 76^611 ►Oss s a ss /o / 7/ya o�` APPLICATION FOR BUILDING PERMIT 1 .DIVISION OF SUBMING AND SAFETY ADDRESS_ Deporme d o1 2:17n 17 >r�g 0w Count= 11� Los Aagsles LOCALITY WM J FOX COUNTY ENGINEER NEAREST CASSATT D GRIFFIN SUP T OF BUILDING CROSS ST Daines 40/. OR APPLICANT TO ML IN DISTRICT NO I GROUP I TYPE � SEWER MAP CONST BUILDS G wSTATE YES NO ADDRESS NUMBER HWY LOT NO BLOCK USEZONE .. CONDITIONS TRACT 22438 A-1 SIZE OF LOT NOW ON LOTS BUILDING YARD HWY STREET NAME EXIST SETBACK WIDTH USE OF FRONT ISXISTING BLDG w P L 201 4 OWNER SSIDE MAIL ADORE89 O TRACT DWELL 1 UNIT 8 INDUSTRIAL mI�,�,,v11t -Ie Ci TEL NO 1 DWELL 1 UNIT CIWIi © 6 PUBLIC BLDG ARCHITECT OR *T TEL 2 DUPLEIC 1 UNIT 7 ADDN ALT ETC ENGINEER 1� NO $ APT --L-UNITS 8 M18CEL ADDRESS 4 COMMERCIAL CONTRACTOR TEL INSPECTION RECORD NO ADDRESS J � h DESCRIPTION OF WORK (�t NEW R ADD ALTER REPAIR DEMOLISH SQ NO OF NO OF SiZBFT 1445 STORIES 1 FAMILIES ySE OF UCTURE LW91 Standard SIGNATURE OF APPLICAN APPROVALS ADDRESS ' DATE INSPECT 11 8 816 TURF y FOUNDATION LOCATION FORMS MATERIALS FRAME FIRB 8TOP8 VALUATION 'a� BRACING BOLTS gowe FE FURNACE LOCATION 1HEREBY ACKNOWLEDGE THAT i NAVE READ THIS GAB VENAPPLICATION AND STATE THAT THE ABOVE I8 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH INT '* AND STATE LAWS REGULATING BUILDING CON8TRUC C �d TION LATH EXT —7 SIGNATURE n 141 HOUSE NUMBER COR- PERMITTEN VIRG RECT AND POSTED ADORES , m op FINAL WM J FOX COUNTY ENGINEER VAIRDATION C N DIRLAM CHIEF BLDG INSPECTOR L'Auro900 n J;u 71 6 8 7 5 a w LG9009LC- JUN 7 1 3500 in ? WORKERS COMPENSATION DECLARATION hereby affirm that I have a certificate of consent to self APPLICATION` FOR BUILDING P E RM I T insure or a certificate of Workers Compensation Insurance or a certified copy thereof(Sec 3800 Lab C) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company �/ Certified co is hereby furnished BUILDING ( r �/I rI copy y FOR APPLICANT TO FILL IN 3 ❑ Certified copy is filed with the county budding mspec BUILDING c tion department ADDRESS _/O/J7 G ` 7 O� LOCALITY Date Applicant CITY716^74-1,0100ZIP ( D NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS NO OF BLDGS ASSESSOR COMPENSATION INSURANCE SIZE OF LOT Z f NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one qq �j USE ZONE MAP r� v hundred dollars(;100)or less) TRACT ,T��6 BLOCK LOT NO 3 NO !�+ OWNER 1A — NOLTEL 1W SPECIAL CONDITIONS d I ce �fy that in the performance of the work for which this DISTRICT GROUP TYPE FIRE PROCESSED BY LOJ mit is issued I shall not employ any person m any manner ADDRESS / ZIP b�QA V 3 CONST ` ZONE ©� O as to become subject to the Workers Compensate n Laws v T O (�- Date Applicant , CITY /Lf e STATISTICAL CLASSIFICATION APT CONDO V NOTICE TO APPLICANT If after making this Certificate of ARCHITECT OR TEL ^� Exemption you should become subject to the Workers ENGINEER NO CLASS NO DWELL UNITS d Compensation provisions of the Labor Code you must forth ADDRESS SEWER MAP h with comply with such provisions or this permit shall be deemed revoked CONTRACTOR rte— NO BK PG 1. D VALIDATION LICENSED CONTRACTORS DECLARATION LIC I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO �- VALUATION (commencing with Section 7000)of Division 3 of the Business and Professions Code and my license is in full force and effect CITY CLASS $ , SQ FT NO OF NO OF CHECK License Number Lic Clasp SIZE STORIES FAMILIES ONE Contractor Date DESCRIPTION OF WORK NEW ❑ $ ❑I am exempt under Sec �� �Q ADD B&P C for this reason �� r6Q� ALTER D FINAL S REPAIR DATE Date USE OF EXISTING BLDG /� &e11A/ /DEMOL ❑ FINAL C.J Signature APPLpRINTT TEL /.s NO 7 ?� OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor s License �1.�7 / / e n 7 6 0 7 A ADDRESS Law for the following reason (Section 7031 5 Business and / M ce L Professions Code) 4 BUILDING D�3 ���/.�r e e s • • 1 I as owner of the property or my employees with ADDRESS - - 5925 wages as their sole compensation will do the work and the structure is not intended or offered for sale(Section LOCALITY o — 592-56 7044 Business and Professions Code) MOVING TEL ❑ I as owner of the property am exclusively contracting CONTRACTOR NO 1 214-83 with licensed contractors to construct the project(Sec ADDRESS tion 7044 Business and Professions Code) REQUIRED TOTAL SETBACK FROM EXIST CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP LIN 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 m PL + Lender s Name Lender s Address .,�'� P C Fee S Permit Fee " l off 7_ I certify that I have read this application and state that the Issuance Fee Ot above information is correct I agree to comply with all County Investigation Fee ordinances and State laws relating to budding construction Total Fee •A2. and hereby authorize representatives of this County to enter upon the above mell prty for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE No Signature of Applicant or Agent Date ®t - - 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 0704090027 PHONE (626) 285 0488 EXT ILEGAL ID I NO OF CONST I BUILDING ADDRESS [ ITR 22438 LT 25 I SQ FT STORIES TYPE 1 10137 NADINE ST I (STRUCTURE 2700 VN I TEMP CA 917802726 I (ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET 18586 027 034 I I THOMAS PAGE 597 GRID B3 LOCALITY TEMPLE CITY Cl ITENANT IEXIST BLDG USE RESID USE ZONE R 1 (ISSUED ON PROCESSED BY EXPIRES ON 1 IEKIST OCC GRP 104/09/07 JK 04/03/08 (OWNER TEL NO IBLDGS NOW ON LAT VALUATION IFFI CODE I 1HURST ELLIS L ANNE A TRS (626) 448 5776 1 9 000 1 I 110137 NADINE ST I ITEMP 917802726 1 FEES PAID IWESCRIPTION OF WORK I I I IREMOVE WOOD SHINGLE INSTALL 1/2 OSB PLYWOOD INSTALL CLASS Al I IFEE DESCRIPTION QUANTITY DOM AMOUNT (COMPOSITION ROOF I (APPLICANT TEL NO I I I IJAMES POLLARD (818) 262 7472 (AA BLDG PERMIT ISSUANCE 27 75 1 1 128091 OAK SPRINGS IAC STRONG MOTION RESID 9000 00 VAL 0 90 ISPECIAL CONDITIONS I CANYON COUNTRY 91387 ID2 PERMIT W/O EN HC 9000 00 VAL 199 80 I 1 TOTAL FEES 228 45 1 1 ICONTRACTOR TEL NO I J (APPROVALS DATE INSPECTOR SIGNATURE 1 IS B R INC (818) 843 0544 1 I 1801 S FLOWER STREET LIC NO I ILOCATION AND SETBACKS I I I IBURBANK CA 91502 LOMITA B/L •I I I 1 I I I ISOILS ENGINEER APPROVAL I I 1 (ARCHITECT OR ENGINEER TEL NO (FOUNDATION/TRENCH FORMS I I I LIC NO 1 ISLAB/UNDER FLOOR I I 1 1 I IRAISED FLOOR FRAMING I I I IIMAPH1I [ NO SEWER MAP BOOK PA13E FIRE TONE CMPUNDERFLOOR INSULATION I I 1 I I IFLOOR SHEATHING INO OF FAMILIES DWELLING UNITS APT/COND STAT CLASS I i OI I I (ROOF SHEATHING I SCHOOL WITHIN HAZARDOUS I ISHEAR PANELS I I I (AIR QUALITY 1000 FEET MATERIALS I I 1 1 1 1 NO NO NO I IFRAME INSPECTION I I (REQUIRED TOTAL SETBACK FROM EXIST I IFIRE SPRINKLER HANGERS I I I ISET BACK YARD HWY PROP LINE WIDTH 1 I I I I [FRONT PL 1 [INSULATION/WEATHER STRIP( 1 I SIDE PL I (INTERIOR LATH/DRYWALL 1-1 1 I I I I I 1 I I I 1EXTERIOR LATH I I 1 IRATED FLOOR/CEIL ASSEM I I I IIRATED WALE, ASSEMBLIES IIRATED SHAFTS/OPENINGS I I IT BAR CEILINGS ( I I I Ii ADDITIONAL DATA ON FILE I 1 (LOT DRAINAGE I I I I I IREPORT ID DPR261 ROUTE TO BS0508 I I I I I I I ! I I