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Home My Public Portal About10203 NADINE ST_Building__ 7GA698A CE#809 6 62 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION p LOCALITY r JOHN A LAMBIE COUNTY ENGINEER NEAREST WILLIAM A JENSEN SUP T OF BUILDING CROSS ST j DIST�iICT G YPE CESSED BY FOR APPLICANT TO FILL IN / coNsr BUILDINGSTATISTICAL CLASSIFICATION EWER MAP -ADDRESS 104-03 R M6 ST K CLASS NO DWELL UNITS �a LOT NO cl BLOCK WATER CERTIFICATE NOT REQUIREDcz RECEIVED TRACT MAP HIGHWAY STATE MAJOR SECOND LOCA NO OF BLDGS / NO (CIRCLE) SIZE OF LOT K a NOW ON LOT USE ZONE SPECIAL USE OF _ CONDITIONS EXISTING BLDG TEL OWNER W/d NO BUILDING YARD HWY STREET NAME EXIST SETBACK WIDTH ADDRESS O�L 0.3 Il-Q/'v ST FRONT , SG ARCHITECT OR TEL P L ENGINEER NO SIDE �. P L d ADDRESS O / D/��/ V CONTRACTORWA/ 9.4 N I i✓/4A�ID6� !j/O/JAI � `� � � ` / y ADDRESS 14' /i* 1W6 - G, V j O DESCRIPTION OF WORK -/° ' r r#?r f!/ %i go r (c tr1� c 7 & / a d �` .c �t Bio�. d NEWADD ALTER REPAIR DEMOLISH / h SQ FT NO OF NO OF /� w`tm 2- h �/ ~� y 1,e / ?It 6vl"t[ Z SIZE O STORIES 1 FAMILIES /USE OF h / STRUCTURE 6 C,E �`'�� GIo CG a s jr SIGNATURE O ® Ai /' AUZ e APPLICANT #Lt" 4 VALUATION $ -DO IO -eP-.v.A- ! r2�6/ APPROVALS c 4 #DATE) INSPECTOA 6 SIGN u PC PMT FOUNDATION LOCATION FEE ��' FEE $ O FORMS MATERIALS FRAME FIRE STOPS 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING, RACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT 2•Z/—(® Z TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT ING TO WORK N 8 C MPENSATI N INSUJZ 1 LATH EXT SIGNATURE OF �� HOUSE NUMBER COR PERMITTEE n J RECT AND POSTED ADDRESS /5 ��t..-LO � FINAL JOHN F LEWIS 11FANCIPAL ST RAL EN INEER PLAN CHECK VALIDATION CK M D CASH PERMff-J A`=ATION cK M D CASH E 7378Qu NOV 26 1 D 2200, a , 1 DEFARTwm OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES l! I L D I N G WM J FOX OHIEF EMGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING ADDRESS /II�iO4I/✓� DIB'TRICT NO PLAN Or, NO PERMIT NO VATsf 08 g7 3 7 3 LOCALITY 6-A0 « `/�IrR IVED Y DATE OF APPL DATE ISSUED NEAREST !T 3-rr �/ N ,/� ��/� , OWNER //��L��1� J ��/Ktil BUILDING 2 TY-3 �/ /� '�/� ADDRESS ADDRESS 7 3 A t J �I�{/ f PA-4 LOCALITY CNRoam BT NTEL. ZONE [ NO IOBF TYPE GROUP ENOIARCNIEER OR 4 w/� ^� 'r NO BLDG O N E +` SETBACK LINE G G APPROVED 011 CONTRACTOR TEL. BY DATE UBEAPPROVED AD ZONE BY DATE DESCRIPTLION LOT NO BLOCK `ao � 'CTIONB TRACT / z BIZB OF LOT / No r^ / NOW pS � N LO &,,a. UBE OF NO OF NO OF EXIST B Fw I ROOMS joo- DESCRIPTION OF WORK NEW ALTERATION ADDITION D >0 REPAIR MOVING DEMOLIBH q No or s BI2E �� ROOMS STORIES P WALL v`sC4 ROOF COVERING COVERING UBE OF NEW OUILDING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROV S APPLICATION AND BTATE THAT THE ABOVE IB CORRECT FOUNDATION LOCATION ECTOR ATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMB MATERIALS AND STATE LAWS RBOU INN BUILDING CON UCTI -� FRAME FIREGTOPB. + BRACING BOLTS SIGNATURE OF q PERM LATH INT AUTHORIZED ABT-__ �~ LATH. EXT wow VV r 76^638^3M7�49 p C # r PLASTER INT ��.l-- 't 1 �� PLASTER EXT VALUATI N FEED FINAL d WORKERS COMPENSATION DECLARATION G I by affirm that I have a certificateomof con nt r self APPLICATION FOR BUILDING PERMIT insure a certificate of Worker Compensatpn Insurance or a cern copy thereof(Sec 3800 Lab COUNTY OF LOS ANGELES BUILDING AND SAFETY Polity No Company BUILDING CI Q Certified copy is eby furni FOR APPLICANT TO FILL IN ADDRESS Z QCertified copy is fled a county budding inapec UILDING G tion department ADDRESS ��/(� LOCALITY �f'� NEAREST Dare pplicanr CITY ZIP cRoss ST CERTIFICA EXEMPTION FROM WORKERS 51 L Now OtViOT MAP ASSESSORDGS K PAGE PARCEL MPENSATION INSURANCE (This sects need not be completed if the permit is for one ,./ Q USE ZONE MAP hundr .Ilan($IW)or less) TRACV'&_ BLOCK LOT NO NO c TEL / SPECIAL I certify that in the performance of the work for which this OWNER J 3' CONDITIONS 06 permit is issued I shall not employ any person in any manner r DISTRICT GROUP TYPE FIRE PROCESSED BY O so as to become subject to the Workers Compensatio Laws ADDR �• j�j/� CONST ZONE i fV b 09 Data 0� App AIRCHITECT OR TY el'vov ZIP TEL STATISTICAL CLASSIFICATION APT CONDO V NOTICE O PPLICANT If or making this Ce irate of ENGINEER S - NO CLASS NO DWELL UNITS W Exemption you should become subject to the Worker /� IL Compensation provisions of the Labor Code you must forth ADDRESS e4 �/— SEWER MAP W with comply with such provisions or this permit shall be Z deemed revoked CONTRACT L BK PG VALIDATION LICENSED CONTRACTORS DECLARATIONnL� NC g�� I hereby affirm that I am licensed under provisions of Chapter 9 ADDR _ /Y N VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC n Professions Code and my license is in full force and effect CITY ,�� C.�l/r C<.sw S p SQ FT NO OF NO OF CHECK License Number v6 Liic Cla ! SIZE STORIES FAMILIES ONE /� ;25890A Contract �&&&4ate �� J DESCRIPTION OF WORK NEW $ �w�r # e • • • 2 3 CC ADD I am exempt under Sec ALTER Q FINAL B&P C for this reason REPAIR Q DATE Date EXISTING BLD �` Ems_ DEMOL ❑ Br AL �e r �i•-u 2 • - 36.58 Signature APPLICANT OWNER BUILDER DECLARATION PRIM �� le< 'r2w •i• • 3 4.5 8 5 I he by affirm that I am exempt from the Contractor s license ADDRESS`�� !/` //.�.Sr Law the following reason (Section 7031 5 Busi en and 1 0 1.1 —83 Professio Code) QBUILDING 1 as nor of the property or my a ployees with ADDRESS wages as eir sole compensation will o the work and the structur s not intended or offs for sale(Section LOCALITY 7044 Busine and Professions Co ) MOVING TEL I as owner oft property am xclusively contracting CONTRACTOR NO ;9589 1 A with licensed co actors to c struct the project(Sec e tion 7044 Business nd Pro scions Code) ADDRESS R + REQUIRED TOTAL SETBACK FROM EXIST # • • • • • 1 CONSTRUCTIO DING AGENCY �BApT YARD HWY pRpp LIN WIDTH I hereby affirm that there is a struction lending agency for FRONT ► 2,- • b$ 63 the performance of the wor for hick this permit is issued P L (sec 3097 civ c) SIDE • • • b&6 3 se P L ' Lender s Name 1 0 1 1 -83 Lender s Address PC Fee$ 7 b Permit Fee 1 certify that I h e read this application and sta that the Issuance Fee ►l♦� above informati is correct 1 agree to comply with a County Investigation Fee ordinances an State laws relating to building const Ion Total Fee CO A and hereby authorize representatives of this County to a for upon th above mentioned pr a for inspection purpo s 1,° r �� / �� $EE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant Agent Erwo ®s APPLICATION FOR BUILDING PERMIT Cc� COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL W BUILDING ADDRESS f I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS Z- , , N :, _a. . or a certificate of Workers' Compensation Insurance, or a certified CI Y ZIP f't I copy thereof(Sec.3800,Lab.C.) _ Policy No. t Z t ;.t L'3 Company �-�� fle4 1 ! t' LOCALITY SIZE OF LOT O.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. NEAREST CROSS ST. 'Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. USE ZONE MAP NO. "1 ASSESSOR MAP BOOK PAGE PARCEL Date^r'' `�G Applicanty=. . SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL NO. ` ,�.�� COMPENSATION INSURANCE ° 7r r ` WITHIN 1000 FT OF SCHOOL? Yes (This section need not be completed if the permit is for one hundred ADDRESS ' dollars($100)or less.) N 4 •, r � a DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY CITY 1 ,- ZIP I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to ARCHITECT OR ENGINEER TEL NO. become subject to the Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CONTRACTOR TEL NO. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith ^ ti -o ")i d•• 01 FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL LICENSED CONTRACTORS DECLARATION t"-- k R' � Z-11 ti'` r SIDE } CITY LIC.CLASS PL Q. I hereby affirm that I am licensed underprovisions of Chapter 9 Ifs` `. � + SEWER MAP 0 (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORIES NO.OF FAMILIES Professions Code,and my license is in full force and effect. -� 1 NEW 11 BK PG License Numbed i-•+ �� Lic.Class �� DESCRIPTION OF WORK ADD ❑ VALUATION , J_ Contractor } ' " ALTER ❑ ❑ I am exempt under Sec. REPAIR ❑ � Ly B.BP.C.for this reason 0 �G y r: Y+, MOL ❑ LDMA P/C# Date: US OF EXISTING BLDG. URM ❑ iL Signature APPLICANT(PRINT) TEL NO. LDMA Perm# W ❑ 1, as owner of the property, or my employees with wages as ZO �gr1"Y their sole compensation, will do the work and the structure is ADDRESS •1s�11� not intended or.offered for sale (Section 7044, Business and L w f� i%1 C ic,r L 44 FINAL DATE Q + i Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL y! ��I� f ❑ I, as owner of theproperty, am exclusive) contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE Q !'R+. 2111 Y g licensed contractors to construct the project (Section 7044, AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY I� ,.:. '2 Business and Professions Code.) ves❑ No R �'..I t, • WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING +�' OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH 1�y.�.,try, .00 j CONSTRUCTION LENDING AGENCY COAST AIR QUAUTY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR / r GUIDELINES. I hereby affirm that there is a construction lending agency for YES❑ NOJV 9 N a the performance Of the work for which this permit IS issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING ammml ,1 /95 3097,CIV.C-) - CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS Antis% Lender's Name MATERIALS REPORTING AND.FOR OBTAINING A PERMIT FROM THE SCAQMD. o Lender's Address OWNER OR AGENT O o I certify that I have read this application and state under penalty 0 of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE o with all county ordinances and State laws relating to building < construction, and hereby authorize representatives of this County ISSUANCE FEE Go to enter upon the above-mentioned property for inspection purposes. INVESTIGATION FEE TOTAL FEE slgnaw,of Appli nt w Agent Dere 7 SEE REVERSE FOR EXPLANATORY LANGUAGE 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 0710310037 PHONE (626) 285 0488 EXT ILEGAL ID I NO OF CONST I BUILDING ADDRESS ITR 15862 IT 22 I SQ FT STORIES TYPE 1 10203 NADINE ST I I (STRUCTURE VN I TEMP CA 917802728 1 (ASSESSOR INFORMATION NUMBERI NEAREST CROSS STREET I 18586 027 022 1 1 THOMAS PAGE 597 GRID B3 LOCALITY TEMPLE CITY 1 TENANT (EXIST BLDG USE REBID USE ZONE R 1 (ISSUED ON PROCESSED BY EXPIRES ON 1 (EXIST OCC GRP 110/31/07 SR 04/28/08 (OWNER TEL NO 1BLOGS NOW ON LOT VALUATION 1FINAL DATE i1f) Y CODE 1 IJACOBS RAYMOND D NANCY L (626) 575 0728 I 6 000 1 Psa I 110203 NADINE ST I I I ITEMP 917802728 I FEES PAID IDESCRIPTION OF WORK 1 I I IBATHROOM REMODEL DRYWALL AS NEEDED + TI*E WALLS 1 I IFEE DESCRIPTION QUANTITY DOM AMOUNT I I 1APPLICANT TEL NO I I I IMORAD (818) 519 7706 IAA BLDG PERMIT ISSUANCE 27 75 I I 112348 MAGNOLIA BL IAC STRONG MOTION RESID 6000 00 VAL 0 60 ISPECIAL CONDITIONS IVALLEY VILLAGE 91607 132 PERMIT W/ENERGY 6000 00 VAL 164 34 1 I 1 TOTAL FEES 192 69 1 1CONTRACTOR TEL NO (APPROVALS DATE INSPECTOR SIGNATURE I (AMERICAN HOME IMPROVEMENT INC (818) 348 7020 I 1 I 120335 VENTURA BLVD STE 422 LIC NO I ILOCATION AND SETBACKS I I IWOODLAND HILLS CA 91364 835537B * I I I 1 I 1 1 (SOILS ENGINEER APPROVAL I I I 1ARCHITECT OR ENGINEER TEL NO I IFOUNDATION/TRENCH FORMS I I I 1 LIC NO I ISLAB/UNDER FLOOR I I I 1 I 1 1RAISSD FLOOR FRAMING 7 IMAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP I (UNDERFLOOR INSULATION I I I 1147H273 3 Oil INO OF FAMILIES DWELLING UNITS APT/COND STAT CLASS 1 1FLOOR SHEATHING I I I I NO 21 1 IROOF SHEATHING I I I SCHOOL WITHIN HAZARDOUS I ISHEAR PANELS I I I 1AIR QUALITY 1000 FEET MATERIALS I I I I I 1 NO NO NO 1 IFRAME INSPECTION I I 1 I I IREQUIRED TOTAL SETBACK FROM EXIST 1 1FIRE SPRINKLER HANGERS ISET BACK YARD HWY PROP LINE WIDTH I I I I I IFRONT PL I (INSULATION/WEATHER STRIP( I I 1 SIDE PL- II I (INTERIOR LATH/DRYWALL I (EXTERIOR LATH I I I I I I 1 1 (RATED FLOOR/CEIL ASSEM I !1 1 I (RATED WALL ASSEMBLIES I I 1 1RATED SHAFTS/OPENINGS 1 I 1 I I IT BAR CEILINGS I I 1 1 I* ADDITIONAL DATA ON FILE _ I LOT DRAINAGE I I I I IREPORT ID DPR261 ROUTE TO BS0508 1 I I I I I I I I I