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HomeMy Public PortalAbout5332 NOEL DR_Building__ •, APPLICATION FOR.BWILOING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING KESS I hereby affirm that I have a certificate of consent to self Insure T ADDN0CL .DR 0 or a certificate of Workers Compensation Insurance or a certified copy thereof(Sec 3800 Lab C) CITY TL-MIPL& airr ZIP 9A/79'0 LOCALITY /� Policy No Company SIZE OF LOT `/ O-POIF BLDGS NOW ON LOT -e 1:1X Certified copy is hereby furnished /10 NQWSe :, CwW4rr NEAREST CROSS ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO/ USE ZONE MAP NO department Date Applicant ASSESSOR BOO PAGE PARCEL S. SPECIAL CONDITIONS CERTIFICATE Oi'EXEMPTION FROM WORKERS OWNER K (� SZE�p �I8 LNO292-72/� YES NO COMPENSATION INSURANCE WITHIN 1000 FT OF SCHOOL (This section need not be completed if the permit Is for one hundred A RES3 w r dollars($100)or less) -W,4M� pry �4 ROva-r DISTRICT GROUP TY FIRE FIRE ZONE PROC§WDBY CRY ZIP l of 1/ / 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 subje to the Workers Compensation Laws 4 18 IrAppllcant Ie W S'e l-o STATISTICAL CLASSIFICATION APT DO Date ADDRESS CLASS NO .�e2_.� 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 ���e���1 TEL NO SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code you must forthwith ��riic�/v FRONT comply with such provisions or this permit shall be deemed revoked ADDRESS LIC NO P L LICENSED CONTRACTORS DECLARATION SIDE CITY LIC CLASS P L I hereby affirm that I am licensed underprovislons of Chapter 9 - SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ FJ� IZE NO OF STORIES NO F FAMILIES Professions Code and my license is In full force and effect `7 NEW 13 BK BK PG a License Number LID Class DESCRIPTION GOOF WORK � SSR ADD 9 VALUATION � , U Contractor Date oucm arb P,01 ALTER [3 $ AooO >Kx 0 ❑ 1 am exempt under Sec / ISAIN, AAO DO r6VD REPAIR ❑ B BP C for this reason L/VI'Vis IRAgIJ7 DEMOL ❑ LoMA Pic# W Date USE OF EXISTING BLDG URM ❑ n Signature �1pPDU�NT(� TEL NO LDMA Perm# g 90 90 ? ' �ZE ❑ 1 as owner of the property or my employees with wages as K 7-0 �� 2 Z= 21 A Z their sole compensation will do the work and the structure Is ADDRESS F IT 626 70 not Intended or offered for sale (Section 7044 Business and 1F FINAL DI / Q Professions Code) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL xU y ✓ ❑ 1 as owner of the property am exclusively contracting With AAM0UNTS SPECIFMIXTURE IED a ON LATHE HAZARDOUS HAZARDOUS MATERRIALS INFORMATION GUIDE?IAL EOUAL To OR GREATER THAN THE FINAL BY { licensed contractors to construct the project (Section 7044 Business and Professions Code) ves 13 No � TT � WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING ■ OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES I hereby affirm that there Is a construction lending agency for YES❑ NO LSI 1 (��-00�� 9/ 2/991 a the perfOrmarice of the work for which this permit Is Issued(Sec I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING N1 3097 CIV C) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE 1 AM 9 22 TITLE 2 CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS 0243 iLender s Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD r o lenders Address 0 OWNER OR MiENT G 4 1 certify that I have read this application and state under penalty C of perjury that the above Information Is correct I agree to comply PC FEE ^ 5o PERMIT FEE C r with all county ordinances and State laws relating to building U •7 C3ostruction and authorize representatives of this County ISSUANCE FEE Q co er o�n mentioned property for inspects pu es a mu` 2 INVESTIGATION FEE TOTAL FEE �, D /� I AG. D 1 SEE REVERSE FOR EXPLANATORY LANGUAGE WORKERS COMPENSATION DECLARATION insu eboraafcertif cafirm tharte of Worke srtCompensat onSeInsuran elf APPLICATION FOR BUILDING P E RM I T or a certified copy thereof(Sec 3800 Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy NoAlf:Q��,,,,�s i —Company F-A" BUILDING Certified copy is hereby furnished FOR APPLICANT TO FILL IN ADDRESS .S J ❑ PC Certified copy is filed with the county building snspec BUILDING tion department ADDRESS .53 3R 46loEL Date&—Rva Applicant CITY ZIP LOCALITY ERT KATE OF EXEMPTION FRO WORKERS NO OF SIZE OF LOT NOW ON LO CROSS ST �� NEAREST COMPENSATION INSURANCE Ty (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 TEL USE ZONE MAP 1 certify that in the performance of the work for which this OWNER NO NO 14 7aZ�Zf permit is issued I shall not employ any person in any mannerSPECIAL so as to become subject to the Workers Compensation Laws ADDRESS CONDITIONS Date 2JO4 Applicant CITY % r-A ZIP 111740 NOTICEfTO APPLfICANT If after make g this Certificate of ARCHITECT OR TEL DISTRICY GROUP TYPE FIRE D BY Exemption you should become subject to the Workers ENGINEER NO COPUS 3 Compensation provisions of the Labor Code you must forth ADDRESS s� with comply with such provisions or this permit shall be TEL STATISTICAL CLASS KATION APi CONDO deemed revoked CONTRACTOR / NO '� LICENSED CONTRACTORS DECLARATION yjC CLASS NO DWELL UNITS — 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 JQ6Sff jM C CLASS C3 BK Al PG_fa3 VALIDATION SQ FT NO OF NO OF CHECK LcenseNumber 4��/79 Lc Class !:�-3 _ SIZE STORIES FAMILIES ONE ❑ VALUATION Contractor JEQO`� �� pate DESCRIPTION OF WORK Nov s3 v©V O ADD ❑I am exempt under S - ALTER W B&P C for this reason ,qAYA6,6-L,9; 1176V=4 REPAIR : N USE OF Date EXISTING BLDG DEMOL ❑ Z Signature APPLICANT T 7 68 FINAI OWNER ICn UILD R DECLARATION DATEy �( � 1 hereby offirrrt that I am exempt from the Contractor s License Low for the following reason (Section 7031 5 Business and ADDRESS 41dife00o, FIN A Professions Code) FRtbtNT1 BUILDING ❑ I as owner of the property or my employees with ADDRESS /t�, r/ �GTi.A wages as their sole compensation will do the work and ( i the structure is not intended or offered for sole.(Section LOCALITY , GOA 7044 Business and Professions Code) MOVING JEL y r — ti�z 3 r•UWv ❑ 25 1 as owner of the property am exclusively contracting CONTRACTOR NO ' ^ 1 ITM with licensed contractors to construct the project (Sec ADDRESS + tion 7044 Business and Professions Code) TOTAL. r..>'' 8.25 REQSETBACK FROM eXIST CONSTRUCTION LENDING AGENCY SET BACK YARD HWY TOT PROP LINE WIDTHS' I hereby affirm that there is a construction lending agency for FRONT IDECK the performance of the work for which this permit is issued P L e (Sec 3097 Civ C ) SIDE Ori PL Lender s Name PC Fee S Permit Fee y� LDMA Ref N 1 9/12/89 � Lender s Address d �� 5658 1 AN11:05 I certify that I have read this application and state that the Issuance Fee LDMA P/C M above information is correct I agree to comply with all County Invests tion Fee ao ordinances and State laws relating to building construction Total Fee LDMA Perm / R and hereby authorize representatives of this County to enter I upo the above mentio ed property for inspection purposes m a9 SEE REVERSE FOR EXPLANATORY LANGUAGE nature of Applicant or Agent ro 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 1206040041 PHONE (626) 285 0488 EXT ILEGAL ID I NO OF CONST I BUILDING ADDRESS I ITR 11218 LT 17 BL E I SQ FT STORIES TYPE I 5332 NOEL DR I ISTRUCTURE 19 V B I TEMP CA 917803020 1 (ASSESSOR INFORMATION NUMBERI NEAREST CROSS STREET 1 15388 007 024 1 1 THOMAS PAGE 596 GRID H4 LOCALITY TEMPLE CITY Cl ITENANT (EXIST BLDG USE RESID USE ZONE R 1 (ISSUED ON PROCESSED BY I 1EXIST OCC GRP 106/04/12 SR 1 (OWNER TEL NO 1180 BLDGS NOW ON LOT VALUATIONIF TE FINAL BY CODE ISZETO VIC (626) 292 7216 15332 NOEL DR ITEMP 917803020 1 FEES PAID 1DESCR PTION OF WORK I I IREMOVE EXISTING ROOF ON HOUSE APPLY NEW RADIANT BARIER I _IFEE DESCRIPTION QUANTITY UOM AMOUNT IPLYWOOD APPLY NEW 15 LB PAPER UNDERLAYMEN APPLY NEW COMPOSITI (APPLICANT TEL NO I IION SHINGLE CLASS A PARTIAL ROOF AREA 19 SQ I IBELTRAN BRENDA (213) 749 9938 IAA BLDG PERMIT ISSUANCE 27 80 1 13912 S GRAND AVE IAB STATE GREEN BLDG FEE 4180 00 VAL 1 00 (SPECIAL CONDITIONS I IL.OS ANGELES CA 90037 IAC STRONG MOTION REBID 4180 00 VAL 0 50 I 1 ID2 PERMIT W/O EN HC 4180 00 VAL 132 60 1 I _ I TOTAL FEES 161 90 I ICONTRACTOR TEL NO I IAPPRONALS DATE INSPECTOR SIGNATURE I ISOUTH WEST ROOFING CO (213) 446 4677 I 1 I 13912 S GRAND AVE LIC NO 1 ILOCATION AND SETBACKS I I I LOS ANGELES CA 90037 826921 C39 I I I I I ISOILS ENGINEER APPROVAL I I 1 ARCHITECT OR ENGINEER TEL NO 1 1FOEiMATION/TRENCH FORMS I- II LIC NO 1 1SLAB/UNDER FLOOR I I I I (RAISED FLOOR FRAMING I I I IMAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP I (UNDERFLOOR INSULATION I I I 1147H265 3 001 1 I I 1 IFLOOR SHEATHING INO OF FAMILIES DWELLING UNITS APT/COND STAT CLASS I I I I I 1 0 NO 21 -1 1ROOF SHEATHING L1 I SCHOOL WITHIN HAZARDOUS I (SHEAR PANELS I I LAIR QUALITY 1000 FEET MATERIALS I I I 1 I NO NO NO I IFRAME INSPECTION I I (FIRE SPRINKLER HANGERS 1 I 1 (INSULATION/WEATHER STRIPI I I I 11NTERIOR LATH/DRYWALS, I I I I 1EXTERIOR LATH I I I I (RATED FLOOR/CEIL ASSEM I I I I I (RATED WALL ASSEMBLIES 1 1 1RATED SHAFTS/OPENINGS I 1 1 IT BAR CEILINGS I I 1 ILOT DRAINAGE I I I IREPORT ID DPR261 ROUTE TO BS0508 1 I I I I I I I I 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 1206040043 PHONE (626) 285 0488 EXT LEGAL ID NO OF CONST BUILDING ADDRESS ITR 11218 LT 17 BL E I SQ FT STORIES TYPE 5332 NOEL DR I (STRUCTURE 19 V B TEMP CA 917803020 1 ASSESSOR INFORMATION NUMBERNEAREST CROSS STREET 15388 007 024 1 THOMAS PAGE 596 GRID H4 LOCALITY TEMPLE CITY Cl ITENAN'r (EXIST BLDG USE DETAC USE ZONE R 1 (ISSUED ON PROCESSED BY [EXIST OCC GRP 106/04/12 SR 1 OWNER TEL NO IBLDGS NOW ON LOT VALUATIONIF DATE FINAL CODE ISZETO VIC (626) 292 7216 I 880 /r 5332 NOEL DR 1 TEMP 917803020 FEES PAID ID SCRIPTION OF WORK I IREMOVE EXISTING ROOF ON DEACHED GARAGE APPLY NEW RADIANT I. IFEE DESCRIPTION QUANTITY UOM AMOUNT IBARUER PLYWOOD APPLY NEW 15 LB PAPER UNDERLAYMEN APPLY NEW APPLICANT TEL NO I ICOMPOSITION SHINGLES CLASS A IBELTRAN BRENDA (213) 749 9938 IAA BLDG PERMIT ISSUANCE 27 80 I 13912 S GRAND AVE IAB STATE GREEN BLDG FEE 880 00 VAL 1 00 ISPECIAL CONDITIONS ILOS ANGELES CA 90037 IAC STRONG MOTION RESID 880 00 VAL 0 50 ID2 PERMIT W/O EN HC 880 00 VAL 65 40 TOTAL FEES 94 70 CONTRACTOR TEL NO ( (APPROVALS DATE INSPECTOR SIGNATURE SOUTH WEST ROOFING CO (213) 446 4677 13912 S GRAND AVE LIC NO IL,OCATION AND SETBACKS ILOS ANGELES CA 90037 826921 C39 I ISOIL.S ENGINEER APPROVAL ARCHITECT OR ENGINEER TEL NO IFOUNDATION/TRENCH FORMS I I I 1 LIC NO ISIAB/UNDER FLOOR RAISED FLOOR FRAMING I I IMAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP IUNDERFLOOR INSULATION I147H265 3 001 I I I IFLOOR SHEATHING INO OF FAMILIES DWELLING UNITS APT/GOND STAT CLASS I I 1 0 NO 21 1 IROOF SHEATHING I SCHOOL WITHIN HAZARDOUS I [SHEAR PANELS 1 [ LAIR QUALITY 1000 FEET MATERIALS 1 NO NO NO 1 FRAME INSPECTION FIRE SPRINKLER HANGERS 1 11NSULATION/WEATHER STRIP( [ II (INTERIOR LATH/DRYWALL [ i [EXTERIOR LATH [RATED FLOOR/CEIL ASSEM I 1 RATED WALL ASSEMBLIES I I I [ 1 +RATED SHAFTS/OPENINGS [ I I IT BAR CEILINGS 1 [LOT DRAINAGE I I I IREPORT ID DPR261 ROUTE TO BS0508 I I I I I I