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Home My Public Portal About5708 OAK AVE_Building__ • WORKERS COMPENSATION DECLARATION hereby affirm that I have a certificate of consent to self APPLICATION F O�BUILDING PERMIT nsure or a certificate of Workers Compenstion Insurance or i certified copy thereof(Sec 3800 Lab C ) COUNTY OF LOS ANGELS BUILDING AND SAFETY lolicy No Company 4_ Certified copy is hereby furnishedNG FOR APPLICANT TO FILL IN ADDRESS Certified copy is filed with the county building inspec BUILDINGQ �/1� ave, tion department ADDRESS 40 6 /i (i/�ve, LOCALITY )ate Applicant CITY LE �� NEAREST ZIP �j O CROSS ST CERTIFICATE OF EXEMPTION FROM WORKERS SIZE OF LOT? y�X NOW NO F BLDGS LOT 4. ASSESSOR COMPENSATION INSURANCE MAP PAGE PARCEL & iW& I This section need not be completed if the permit is for one �°`P iundred dollars($100)or less ) TRACTK �L SPECIAL INO ®� certify that in the performance of the work for which this OWNS NO —2_4 CONDITIONS iermit is issued I shall not employ any person in any manner DISTRICT GROUP TYPE FIRE 09 o as to become subject to the Workers Compensation Laws ADDRESS �t CONST CITY E ` ZIP Q )ate Applicant STATISTICAL CLASSIC, TIONI APT CONDO U 40TICE TO APPLICANT If after making this Certificate of ARCHITECT O TEL �/ UJI :xemption you should become subject to the Workers ENGINEER /� LEE NO -7 CLASS NO DWELL UNITS y .ompensation provisions of the Labor Code you must forth ADDRESS S -1h SEWER MAP Z vith comply with such provisions or this permit shall be VALIDATION teemed revoked CONTRACTOR Nil. BK PG LICENSED CONTRACTORS DECLARATION C hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS VALUATION commencing with Section 7000)of Division 3 of the Business and LIC 'rofessions Code and my license is in full force and effect CITY CLASS $ DOO SO FT ,, NCS OF NO OF CHECK f icense Number Lic Class SIZE STORIES NO ONE :ontractor Date DESCRIPTION OF WORK AOD/ NEW ❑ $ I am exempt from the licensing requirements as I am a ADD licensed architect or a registered professional engineer ALTER ❑ FINAL acting in my professional capacity (Section 7051Amo L �. M REPAIR ❑ DATE Business and Professions Code) USE OF I If EXISTING BLDG 5 6W.0 DEMOL ❑ FINA is or Reg No Date APPLICANT TEL By OWNER BUILDER DECLARATION PRINTS hereby affirm that I am exempt from the Contractor s License ADDRW? &,S ar /4'✓ D / 71 ow for the following reason (Section 7031 5 Business and irof ionsCode) MPRIPT BUILDING I as owner of the property or my employees with ADDRESS wages ct their sole compensation will f o the work and d 2 5 7 4 A 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 / # o o s e • with licensed contractors to construct the project (Sec ADDRESS 2 - 36250 tion 7044 Business and Professions Code) REQUIRED TOTAL SETBACK FROM EXIST CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP L W TH s - 362505 hereby affirm that there is a construction lending agency for FRONT he performance of the work for which this permit is issued P L 0 108-82 Sec 3097 Civ C ) SIDE PL .ender s Name P C Fee$ � Permit Fe — .ender s Addressj� , certify that I have read this application and state that the Issuance Fee above information is correct I agree to comply with all County Investigation Fee irdinances and State laws relating to building construction Total Fe 01 ind hereby authorize representatives of this County to enter ip the above mention!J property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Os Signa re of Applicant or Agentif WORKERS COMPENSATION DECLARATION hereby affirm that 1 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 BUILDING Certified copy is hereby furnished FOR APPLICANT TO FILL IN ADDRESS Certified copy is filed with the county budding inspec BUILDING `' �d tion department ADDRESS /v• ��7� VC • LOCALITY �D NEAREST Date Applicant CITY MM G6' ` ZIP / 0 CROSS ST CERTIFICATE OF EXEMPTION FROM WORKERS /J I /f MIJ�W �� MAS KKR PAGE PARCEL COMPENSATION INSURANCE SIZE OF LOT (This section need not be completed if the permit is for one 'TRACT L LOT NO USE ZONE P O hundred dollars(E100)or less ) I certify that in the performance of the work for which this OWNS '(�Q.�NCLG 'T CONDITIONS d permit is issued I shall not employ any person in any manner /1/� STRICT GROUP TYPE FIRE PROCESSED BY O so as to become subject to the Workers Compensation Laws ADDRESS P "• CONST ZO E V i� HC Date Applicant ARCHITECT CITYLE IP TEL STATISTICAL CLASSIFICATION APT CONDO NOTICE TO APPLICANT If after making this Certificate of ENGINEER NO CLASS NO DWELL UNITS W Exemption you should become subject to the Workers y Compensation provisions of the Labor Code you must forth ADDRESS SEWER MAP with comply with such provisions or this permit shall be Z deemed revoked CONTRACTOR TEL BK PG VALIDATION LICENSED CONTRACTORS DECLARATION LIC I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO ALU ON (commencing with Section 70W)of Division 3 of the Business and LIC ON t Professions Code and my license is in full force and effect CITY CLASS , SQ NO OF NO OF CHECK REINER License Number Lic Class SIZE STORIES FAMILIES ONE Ci�ttroctor Date DESCRIPTION OF WORK I NEW $ 13 I am exempt under Sec e. DE fl ADD ALTER 0 FINAL ` B 8P C for this reason REPAIR DATE USE OF y� / Dote EXISTING BLDG t�/T!�+ f DEMOL FINAL Signature APPLICANT 6y OWNER BUILDER DECLARATIONW PRINT O I hereby affirm that I am exempt from the Contractor s License ADDRESS 430"'Ilr , Law for the following reason (Section 7031 5 Business and Professions Code) BUILDING �•D�� e a owner of the property or my employees with ADD wages as their sole compensation will do the work and LOCALITY L�C/ 2020 A the structure is not intended or offered for sale(Section 7044 Business and Professions Code) MOVIN CTOR TEL # I as owner of the property am exclusively contracting • • • • • _ with licensed contractors to construct the project (Sec ADDRESS 2 • - 4060 tion 7044 Business and Professions Code) REQUIRED TOTAL SETBACK FROM EXIST CONSTRUCTION LENDING AGENCY �BApI YARD Hwv PWC WIDTH • • • 4 0 5 0 v 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 0 3 0 4—8 3 (Sec 3097 Civ C) SIDE o PL Lender s Name Lender s Address PC Fee E Permit Fee .®'40 I certify that 1 have read this application and state that the Issuance Fee above information is correct I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction Total Fee and hereby authorize representatives of this County to enter u the above mentioned properly for inspection purposes SEE REVIEISE FOR EXPLANATORY LANGUAGE AIMO � ®s Signa re of Applicant or Agent if Doti I APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDI ADDRESS I hereby affirm that I have a certificate of consent to self In BUILDING AD S3 � or a certificate of Workers Compensation Insurance or ified copy thereof(Sec 3800 Lab C) G ZIP G LOCALITY — Policy No Comps SIZE p NO F YS NOW ON LOT ❑ Certified copy is hereby fu m NEAREST CRO ST ❑ Certified copy Is file the county building Inspection TUC � BLOCK LOT NO deartment i� USE DUNE MAP O Da��RTIFICATE Applicant ASSESSOR MAP K PA(aE PARCEL Q�O 03� SPECIAL CONDRI NS �m OF EXEMPTION FROM WORKERS OWNER TEL NO YES NO COMPENSATION INSURANCE WITHIN 1000 FT OF SCHOOLS (This section need not be completed If the permit Is for one hundred ADORE dollars($100)or less) O DISTRICT p GROUP TYPE CONST FIRE DONE PROCESSED BY CIT ZIP Or/ 3 `� I certify that In the performance of the work for which this permit Is issued I shall not employ any pereo In any manner so as to ARCHITECT ENGINEER --4 TEL NO beco )ect to the Workers Cq9peVtion Laws STATISTICAL CLASSIFICATION APT CONDO Date Z Applicant �1 AI ADDRESS CLASS NO �� DWELL UNITS AIOT1d 70 APPLKANT If after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption you should become subject to the Workers CON TEL NO SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code you must forthwith FROM comply with such provisions or this permit shall be deemed revoked ADDRESS LIC NO PL LICENSED CONTRACTORS DECLARATION SIDE CITY LIC CLASS P L I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ FT SaE NO OF 87RIES NO OF FAM ES Professions Code and my license Is In full force and effect NEW ❑ BK PG ► a License Number LTC r'lags DE RI O OF WORK ADD VALUATION O Contractor Date ALTER ❑ $ OO V ❑ 1 am exempt under Sec �I REPAIR ❑ B&PC for this reason DEMOL ❑ LOMA PTC# W Date USE OF EXISTING BLDG URM ❑ i I IL Si lure APPLICANT(PlIINT) TEL NO LDMA Perm# j_' A j J`h' C0J �i I Z as owner 0' a property or my employees with wages as 1 l! their sole pensation will do the work and the structure is ADORES I - not ants d or offered for sale (Section 7044 Business and o FINAL DATE Prof ions Code) HC C T `e WILL THE APPLICANT OR RE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL ❑ owner of the property am exclusive contractor with OR A MIXTURE CONAU A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE Q -: t- t�7 ren N 9 AMOUNTS SPECI ED THE HAZARDOUS MATERIALS INFORMATION GUIDE? Fl BY ��J 6LL .++ censed contractors to construct the project (Section 7044 YES❑ No Business and Professions Code) ,. I fE1_ WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING I OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH I .y a- CONSTRUCTION LENDING AGENCY COAST AIR QUALITY EMENT DISTRICT(9CAOMD)BEE PERMITTING CHECKLIST FOR -IA L a� ® +� GUIDELINES '„�_ ..�., I hereby affirm that there Is a construction lending agency for YES❑ NO (,� �1 7 -. CM the performance of the work for which this permit Is Issued(Sec I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMrMNG °a' 3097 Civ C) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE I HALE C,JTITLE 2 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS Lenders Name MI1TE PO AND FOR OBOUNING A PERMIT FROM THE SCAOMD 93 Lenders Address ' /Sit 0 OW11ER tx+ (�[IQ(,f—�JCI 1 J/,.4 c I certify that I have read this kation and state under penalty D c of perjury that the above rmabon is correct I agree t0 comply PC FEE �� PERMIT FEE / � i9 j °I 'tom N with all county ordpoTces and State laws relating to building construction ereby authorize representatives of this County ISSUANCE FEE /�/ # m to ante r p above mentioned property for msp purposes p?6 solo m INVESTIGATION FEE TOTAL FEE gWl . I AWWR t SEE REVERSE FOR EXPLANATORY LANGUAGE COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 1 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0212090050 PHONE (626) 285 0488 EXT LEGAL 10 NO OF co BUILDING ADDRESS SK 27 PG 94 PC 1 SQ FT STORIES TYPE 5708 OAK AV STRUCTURE VN TEMP CA 917802430 ASSESSOR BER NEAREST CROSS STREET LIVE OAK 8587 010 032 THOMAS PAGE 596 GRID J3 LOCALITY TEMPLE CITY TENANT EXIST BLDG USE RESID USE ZONE R I TOWN- PROCESSED BY EXPIRES ON EXIST OCC GRP 12/09/02 JK 06/07/03 OWNER TEL NO BLDGS NOW ON LOT ON FINAL BY CODE YU MONGENS C 8 ABIGAIL (626) 287 4318 V 1,500 5768 OAK AV kw TEMP 917802430 FEES PAID BESCRffTIUN UF WORK REPLACE EXISTING FLAT ROOF (HOUSE ONLY) FEE DESCRIPTION QUANTITY LION AMOUNT APPLICANT TEL NO SAME AS OWNER AA BLDG PERMIT ISSUANCE 27 75 AC STRONG MOTION RESID 1500 00 VAL 0 50 SPECIAL CONDITIONS D2 PERMIT W/O EN-HC 1500 00 VAL 82 20 TOTAL FEES 110 45 CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATUffr— SAME AS OWNER LIC NO LOCATION AND SETBACKS SOILS ENGINEER APPROVAl- I - FOUNDATION/TRENCH � I LIC NO _ i I I __ i umuff roarroac 147HH265 3 01 r FLOOR SHEATHIffr NO OF F NG UNITS APT NO 21 ` ROOF SHEATHING SCHOOL WITHIN HAZARDOUS IffmarlRiErg— AIR QUALITY 1000 FEET MATERIALS NO NO NO FRAME INSPECTION REQUIRED TO FIRE SPRINKLER HANGERS SET BACK YARD HWY PROP LINE WIDTH FRONT PL INSULATION/WEATHER STRIV SIDE PL INTERIOR LATH/DRYWALL EXTERIOR LATH RATED WALL AS9091rffg-- RATED SHAFTS/OPENINGS LOT DRAINAGE REPORT ID DPR261 ROUTE TO BS0508 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 0310170017 PHONE (626) 285 0488 EXT LEGAL 10 NO Of CONST BUILDING ADDRESS BK 27 PG 94 PC 1 I SQ FT STORIES TYPE 5708 OAK AV STRUCTURE VN TEMP CA 917802430 ASSESSOR INFOR14ATIUN NUMBER NEAREST CROSS STREET 44411 fC 8587 010-032 y THOMAS PAGE 596 GRID J3 LOCALITY TEMPLE CITY TE kNT I ' EXIST BLDG USE RESID USE 2Sr 11 1 ISSUED ON BY EXPIRES ON EXIST OCC GRP 10/17/03 JK 10/11/04 OWNER TEL NO BLDGS NOW ON LOT VALUATION F I NIIA A FINAL BY CODE YU MONGENS (626) 215 2111 4,000 5708 OAK AV TEMP 917802430rOW-UF WORK /0 OL ROOF REPAIR ROTTED WOOD INSTALL MODIFIED TORCHDOWN FEE DESCRIPTION QUANTITY UOM AMOUNT ITU APPLICANT TEL NU— ' ALFRED LAU (626) 285 9016 AA BLDG PERMIT ISSUANCE 27 75 4533 SHIRLEY AVE AC STRONG NOTION RESID 4000 00 VAL 0 50 3PE�CONDITIONS EL MONTE 91731 D2 PERMIT W/O.EN:HC�j4000 00 VAL 115 80 CONTRACTOR TEL NU-- S GELES COOTALeFEES 144 05 I GOLDEN KEY, INC (626) 285 9016 �® APPROVALS��'� i 4533 SHIRLEY LIC NO LOCATION AND SETBACKS EL MONTE CA 91731 715115 C3y lurcrTwam- ARCHITEC TEL NO FOUNDATION/TRENCH FORffr LIC NoRAISED FLOOR FRAMING // SLAB/UNDER FLOOR p/� - littlli MAP NO -or 147H265 S 3 1 If01 1 o f O U NO OF F ING UNITS APT/COND STAT CLAN fJ �J 0 V � ' NNNJJJ No 2\\� .,t- � 03 ,moi -SCHOOL WITHIN --RXZMMDU9-- 0 AIR QUALITY 1000 FEET MATERIALSX 0 Q +�3� 7, NO NO NO O ® �� ' REQUIRED TOTAL SETBACK Ffffflr--UM D FRONTPL AYARD HWY PROP LINE WIDTH 48/� s vica SIDE PL INTERIOR LATH/DRTWALLLATH LL ASSEMBLIES RATED SHAFTS/OPENINGS mmsi LOT, REPORT ID DPR261 ROUTE TO 8SO508 1