Loading...
HomeMy Public PortalAbout5833 OAK AVE_Building__ APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN (Print or type only) BUILDING .. COUNTY OF LOS ANGELES ADDRESS ' Oa DEPARTMENT OF COUNTY ENGINEER CITY S/77f BUILDING AND SAFETY DMSION SIZE OF LOT rV.<IP - NOW ON LOTBUILDING NO OF S ADDRESS -7 g3 3 A ©� 4. TRACT BLOCK LOT NO LOCA LIT TEL :� NEAREST OWNER p /OJ NO�.J� CROSS ST N�S ASSESSOR ADDRESS k 0'7s e-- MAP BOOK PAGE PARCEL DISTRICT G UP bCONSTPE FIRE ESSED BY CITY ZIP Z M ARCHITECT OR TEL lot ENGINEER NO STATISTICAL CLASSIFICATION SEWER MA ADDRESS G CLASS IN DWELL UNITS L BI/ G CONTRACTOR S"/A+4 P NOL 7 � E ZONEF ADPLIC O ADDRESS `3 N A2 re,. NO r PECIAL CITY LIC ONDITIONS 'Z, (,c r CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ CONSTRUCTION LENDER qVL' A NAME AND BRANCH , BLDG SET CK FROM FRONT PRO LINE OF (STREET) ADDRESS CITY HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING SQ FT NO OF NO OF CHECK FRONT PROP LINE HIGHWAY WIDTH SIZE ,3v STORIES FAMILIES ONE + = d DESCRIPTION OF WORK NEW U DD ❑ SIDE PROP L NE OF FROM (STREET) C ALTER ❑ HIGHWAY + -YARD = TOTAL SETBACK FROM PE OF EXISTING V EPAIR❑ SIDE PROP LINE HI WAY WIDTHUSE OF W CL _ H EXISTING BL i7"t '�� EMOL ❑ + Z APPLICAN ` f en41j NO IN ��,{ CORNER CUTOFF YES ❑ NO ❑ (PRINT) N BY (SIGNATURE IN OPEN SPACE YES ❑ NO ❑ IN COASTAL PERMIT ZONE YES ❑ NO ❑ VALUATION OD I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDI NO CON STRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY IWILL NOT PLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF E TATE OF CALIFORNIA IN RELATING TO WORKMENS COMPE SA ION NSURANCE SIGNATURE OF PERMITTEE Of Al J Aj ADDRE/S/S / /y / CITY (.I ~ZC�-'� NOL DIATE / L By MAKE CHECKS PAIABL6 IO FEE (, V FEE HARVEY T BRANDT COUNTY ENGINEER Z — a PLAN CHECK VALIDATION CK M o CASH PEIMM VALIDATIO CK M o CASH 58rSEP 1023 7.20Ayfj SS1 5 .5 912 SEP 10 1 0 1 2.0 0 A-% TSASaeA CH 0903 5/74 ,., 'k r WORKERS COMPENSATION DECLARATION A w .0. hereby affirm that I have a certificate of consent to self - APPLICATION FOR BUILDING PERMIT insure or a certificate of Workers Compenstton Insurance or a certified copy thereof (Sec 3800 Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company Certified copy is hereby furnished FOR APPLICANT TO FILL IN BUILDING ADDRESS Certified copy is filed with the county building inspec BUILDING C1 Q /7,s,� tion department ADDRESS ✓ .7 /J : E///9 LOCALITY (� `� �y CROSSNEARET pe ST T Date Applicant CITY �. ZIP CERTIFICATE OF EXEMPTION FROM WORKERS v NO OF BLDGS ASSESSOR COMPENSATION INSURANCE SIZE OF LOT Q�' O� NOW ON LOT � MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one USE ZONE MAP hundred dollars ($100)or less ) TRACT BLOCK LOT NO NO p TEL SPECIAL a. I certify that in the performance of the work for which this OWNER W\lit WtC\ NO T1 CONDITIONS O permit is issued I shall not employ any person in any manner DISTRICT GROUP TYPE FIRE PROCESSED BY U so as to become subject to the Workers Comp tion Laws ADDRESS 5 X6.3 06V eI rr CONST ZO E O t2 Z CITY n 1� V ��, r Date Applicant ` ZIP STATISTICAL CLASSIFICATION APT CONDO I U NOTICE TO APPLICANT If after making this Certificate of ARCHITECT OR TEL W Exemption you should become subject to the Workers ENGINEER NO CLASS NO DWELL UNITS H Compensation provisions of the Labor Code you must forth ADDRESS SEWER MAP with comply with such provisions or this permit shall be 3 deemed revoked CONTRACTO BK PG VALIDATION LICENSED CONTRACTORS DECLARATION �1 LIC I hereby affirm that I am licensed under provisions of Chapter 9 ADDRE ate.9.f� % NO VALUATION 1 (commencing with Section 7000)of Division 3 of the Business and LIC //�� r� 1 Professions Code and my license is in full force and effect CITY +ID C.peCLASS I $ VD 80 3�1''11Q� SIZEFT 3Z S ORIIEES , FAMILLIIES HEC License Nu be r Lic Class a `vim Date O - DESCRIPTION OF WORK Q YZ �a, NEW ❑ $ Confrocto ❑ ADD I am exempt from the licensing requirements as I am a licensed architect or a registered professional engineer ALTER ❑ FINADATE acting in my professional capacity (Section 7051 REPAIR E] Business and Professions Code) USE OF FINAL EXISTING BLDG DEMOL ❑ By / Lic or Reg No _Date APPLICANT C S TEL ^ OWNER BUILDER DECLARATION NT) p L NO 1 I hereby affirm that I am exempt from the Contractor s License ADDRESS \ ✓ o��p1' l4\T q 1� 0 Law for the following reason (Section 7031 5 Business and Professions Code) PRE EN BUILDING I as owner of the property or my employees with ADDRESS wages as their sole compensation will do the work and the structure is not intended or offered for sale(Section LOCALITY 7044 Business and Professions Code) MOVING TEL 4 9 1 3 a I as owner of the property am exclusively contracting CONTRACTOR NO with licensed contractors to construct the project (Sec ADDRESS # • o e • • 1 tion 7044 Business and Professions Code) REQUIRED TOTAL SETBACK FROM EXIST CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP LINE WIDTH 2 - • 3 1L O O 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 • a • 3 tL O O 5 (Sec 3097 Civ C ) SIDE PL 0712-82 Lenders Name T $ PC Fee$ Permit Fee G/ Lender s Address rn > I certify that I have read this application and state that the Issuance Fee v v = above information is correct I agree to comply with all County Investigot on Fee ordinances and State laws relating to building construction Total Fee i v" and hereby authorize representatives of this County to enter U u he above wh ned property for inspection purposes l —\2—'c Z SEE REVERSE FOR EXPLANATORY LANGUAGE n S gnature of Applicant or Agent Dote ®t WPRKERS COMPENSATION DECLARATION t i re affcertif ceirm rtificate of Workers r'ificate of Compensat on ent to Insurance t APPLICATION FOR BUILDING PERMIT or a certifi copy thereof(Sec 31"b C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company BUIL' Cert fied copy is hereby furnished + FOR APPLICANT TO FILL IN ADDREas> 7 Qcyk AW 141 Certified copy is filed with the county building mspec BUILDING / /7 JLC tion d/ePartmeett ADDRESS P LOCALITY ;i ( 4 d At REST Date 7 '� Applicant �� /C W/�6/ CITY�1/)') [ �( ZIP C OSS ST CERTIFICATE OF EXEMPTION FROM WORKERS NO OF BLDGS ASSESSOR COMPENSATION INSURANCE SIZE OF LOT - NOW ON LOT Z MAP BOOK PAGE I PARCEL (This section need not be completed if the permit is for one, USE ONE MAP hundred dollars($100)or less ) TRACT BLOCK LOT NO a NO O TEL l ��!/ JJ SPECIAL CL I certify that in the performance of the work for which this OWNERsuaNO7 �r� 6,6 v.// CONDITIONS d permit is issued I shall not employ any person in any manner DISTRICT GROUP TYPE FIRE PR ESSED BY O so as to become subject to the Workers Compensation Laws ADDRESS J P �� CON�j� ZONE U -` Date Applicant CITY ZIP STATISTICAL CLASSIFICATION CONDO V NOTICE TO APPLICANT If after making this Certificate of ARCHI7 CT`bR TELT BRIIIIIIIIIIR Exemption you should become subject to the Workers ENGINEER NO CLASS NO DWELL UNITS Compensation provisions of the Labor Code you must forth ADDRESS % SEWER MAP N with comply with such provisions or this permit shall be Z deemed revoked CONTRACTOR 1 NO BK PG VL aCALIDATION LICENSED CONTRACTORS DECLARATION UC 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 LIC Professions Code and my license is m full force and effect CITY C� T CLASS $ , SQ NO OF NO OF CHECK License Number L7rl��J�/Lc Class/ SIZE STORIES FAMILIES ONE `/��f�� �1) 00 Contractor` J� 0iC/N/7/Y Date �� �' 3 �� DESCRIPTION OF WOR_ NEW ❑ a /IS—, w I am exempt under Sec e� r C 90 ADD m Y St kS ALTER ❑ FINAL ' B 8P C for this reason EPAIR ❑ DATE USE OF FIN Date EXISTING BLDG DEMOL ❑ By Signature APPLICANT TEL , 79f OWNER BUILDER DECLARATION PRINT 7 G7 NOa I hereby affirm that I am exempt from the Contractor s License Law for the following reason (Section 7031 5 Business and ADDRESS ^ Professions Code) MINI ;2 5 6&7 A ❑ BUILDING I as owner of the property o my employees with ADDRESS # • • • • • 1 wages as their sole compensation will do the work and the structure is not intended or offered for sale(Section LOCALITY • 1 8 1 1 3 7044 Business and Professions Code) MOVING TEL CONTRACTOR NO • • 1 81 1 3 T I as owner of the property am exclusiJely contracting c. with licensed contractors to construct the project (Sec ADDRESS 017-86 tion 7044 Business and Professions Code) REQUIRED TOTAL SETBACK FROM EXIST CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP LINE 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 PC Fee E Permit fee ` I 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 / ordinances and State laws relating to building construction Total Fee 19 and er y authorize rntatives of this County to enter u n t abJovv en oned p operty for inspection purposs [ �L� SEE REVERSE FOR EXPLANATORY LANGUAGE ®s '1 Signature of Applicant or Agent Dote 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 9904230013 PHONE (626) 285 0488 EXT LEGAL0 OF CONST BUILDING ADDRESS TR 6561 LT 738 SQ FT STORIES TYPE 5833 OAK AV STRUCTURE 0 VN TEMP CA 917802132 ASSESSOR - NEAREST CROSS STREET 8587 006 008 THOMAS PAGE 596 GRID J3 LOCALITY TEMPLE CITY TENANT S L G USE RESID USE-ZONEE BY EVIRES ON EXIST OCC GRP 04/23/99 UT /20/99 OWNER TEL NO BLDGS NOW ON LOT VALUATION NAL DATE_,-�rFINAL BY E RUSSELL MERTON A TR 1 1 700 7 '� 5833 OAK AV TEMP 917802132 FEES PAID DRER M ION OF WORK REMOVE ORIGINAL OF HOUSE AND LEAVING ONE LAYER ON ADDITION FEE DESCRIPTION QUANTITY UOM AMOUNT APPLICANT TEL NO WEATHERITE ROOFING (626) 287 0669 AA BLDG PERMIT ISSUANCE 27 75 4016 TEMPLE CITY AC STRONG MOTION RESIPl1700 00 VAL 0 50 CIL CONDITIONS ROSEMEAD CA D2 PERMIT W/O EN HC=-- 1700 00 VAL 82 20 CONTRACTR��GELESTOT o 110 45 APPROVALS DAT INSPECTOR SIGN T WEATHERITR TEL N E ROOFING (626) 287 0669 S T� 4016 TEMPLE CITY BLVD LIC NO 10 ND SETBACKS ROSEMEAD CA 91770 423177C39 SOILS ENGINEERAPPROVAC- ARCHITECT OR ENGINEER IEL NU FOUNDATION/TRENCHFORMS LIC L NO/ llillll SLAB ER FLOOR RAISED FLOORREARM— MAP SEWER MAP BOOK PAGE LOOR INSULATION ISOH265 3 O� ulUD y © NO O NO 21 1[( O O �, �„iWO—OF SHEATHING SC \` �il�l�_ PANELSSHEAR AIR QUALITY 1000 FEET MATERIALS \ ❑ ��T� NO NO NO A n ®Il.JI�� FRAME INSPECTION REQUIRED K F 46 ' pti�Cti�' BACK YARD HWY PROP LINE WIDTH `it' 8erVICE Th V" a ATION/WEATHER STRIP SIDE PL INTERIOR LATHIDRYWALL EXTERIOR LATH RATED WALL ASSEMBLIES SHAFTS/OPENINGSRATED T BAR CEILINGS LOT DRAINAGE REPORT ID DPR261 ROUTE TO BS0508