Loading...
HomeMy Public PortalAbout6023 OAK AVE_Building__ APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN (Print or type only) BUIEBING j COUNTY OF LOS ANGELES ADDRESS r �/ DEPARTMENT OF COUNTY ENGINEER CITY ' zip BUILDING AND SAFETY DIVISION N OF BLDGS BUILDING 01-11 SIZEOFLOT �NOWONLOT ? ADDRESS 0o23 r TRACT BLOCK OT NO L,.7 3 LOCALITY TEL NEAREST OWNERWjA 12UNO CROSSST ASSESSOR ADDRESS MAP BOOK PAGE PARCEL CITY ZIPc/`7' Q DISTRICT GRTOUP CONST ZON TYPE FIREP E56ED Y ARCHITECT OR TEL ENGINEER NO STATISTICAL CLASSIFICATION SEWER P ADDRESS TEL CLASS NO� DWELL UNITS SK PG7- CONTRACTOR NO NE NOP DLIC O ADDRESS NO / SPECIAL LIC v \ CONDITIONS LIC 67 CITY CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ CONSTRUCTION LENDER NAME AND BRANCH BLDG SETBACK FROM FRONT PROP LINE OF (STREET) ADDRESS CITY TOTAL SETBACK FROM TYPE OF EXISTING SQ FT NO OF NO OF CHECK HIGHWAY t YARD FRONT PROP LINE HIGHWAY WIDTH SIZE I% STORIES FAMILIES ONE } DESCRIPTION OF WORK NEW ® + O ADD BLDG SETBACK FROM ae eHal SIDE PROP LINE OF (STREET) O ALTER ❑ TOTAL SETBACK FROM TYPE OF EXISTING HIGHWAY + YARD SIDE PROP LINE HIGHWAY WIDTH h USE OF REPAIR 1:1Z EXISTING BLDG DEMOL ❑ + APPLICANT W TEL 1513.11CORNER CUTOFF YES ❑ NO ❑ (PRINT) V j NO IN OPEN SPACE YES ❑ NO ❑ BY(SIGNATURE( o. IN COASTAL PERMIT ZONE YES ❑ NO ❑ VALU N s QD 3//r I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN S COM PENSATION INSURANCE SIGNATURE OF 4 K xv., PERMITTEE ADDR FINAL TEL 01 q7 / �-�J BY CITY NO DATE 7 — / MAKE PAYABLE FEE FEET HARVEY T BRAA ENGINEER COUNTY ENGINEER PLAN CHECK VALIDATION CK. M o CASH PERMIT VALIDATION cK RR�As�_ 6 tZft 14 - �, 9 2 1.7 5 esc es 76A638A CE#803 3 75 1 ©I w APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS 3 I hereby affirm that I have a certificate of consent to self Insure B I G ESS or a certificate of Workers Compensation Insurance or a certified copy thereof(Sepi 4 C) '11581a -1 LOCALITYNo eCom + SIZE O NO OF BLDGS NOW ON LOT rtrfled copy Is hereby furnfis NEAREST CROSS ST Certsao dreopy Is filed with he o Ildmg Inspection TRACT BLOCK LOT NO d p m t USE ZONE MAP NO Data Applican ASSESSOR MAP BOOK PAGE PARCEL G: SPECIAL CONDITIONS CE FICATE OF EX MPTION FROM WORKERS IN TE COMPENSATION INSURANCE WITHIN 1000 FT OF SCHOOLS Yes No (This section need not be completed if the permit Is for one hundred ES DISTRICT GROUP TYPE CONST FIRE ZONE PROCESSED BY 1 dollars($100)or less) I cert) that in the CITY zIP certify 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 �b� _3 become Subject to the Workers Compensation Laws eo STATISTICAL CLIIFICATION APT CONDO Date Applicant ADDRESS - CLASS I DWELL UNITS NOTICE 70 APPLICANT If after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption you should become subject to the Workers �1 r SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code you must forthwith y FRONT comply with such provisions or this permit shall be deemed revoked D �I n �-. P L LICENSED CONTRACTORS DECLARATION •(/^ (� SIDE u PL I hereby affirm that I am licensed underprovisions of Chapter 9 KTJ_ SEWER MAP (commencing with Section 7000)of Division 3 of the Business andNO A STORIES NO FF FAMILIES Professions Code I fis In full force l NEW ❑ BK PG , a License Num Llc Class ' RIPTIF WO ` ADD ❑ VALUATION O —Al A1.1111 Contractor ON Date R (8 ALTER $ ❑ 1 am exempt under Sec 1 , rC 1 REPAIR ❑ $ BBPC for this reason1 DEMOL 13 LDMA P/C# W Date USE OF EXWnNG BLDG i.J URM ❑ � 4 Signature APPLICANT(PMVT) TEL NO LDMA Perm# 1 Z ❑ 1 as owner of the property or my employees with wages as O �T 8 their sole compensation well do the work and the structure is ADDRESS A not Intended or offered for sale (Section 7044 Business and FINAL DATE aJ25.55Professions Code) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL ❑ 1 as owner of the property exclusively g OR A MIXTURE OONWNING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE p party am exclusive COMrectm with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDES FINAL BY Bulicensedes contractors to construct the protect (Section 7044 MAL 1205 505 Business and Professions Code) r TEs❑ No❑ MAL WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING a CONSTRUCTION LENDING AGENCY OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH MICK COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES /��t/�� I hereby affirm that there Is a construction lending agency for YES 13 No 111rI9Ult7G °00 W the performance of the work for which this permit Is issued(Sec I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING N 3097 Civ C) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LAS ANGELES COUNTY CODE TITLE 2 CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS 12/18/99�7/1 A/aC� Lenders Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD 0000—Ml it/10/7 0 Lenders Address 1 AM 10 a 36 C owxsn OR ALiENT I ce fy that I have read this application and state under penalty I$ of ryury the above information is correct I agree t0 co ly PC FEE PERMIT FEE N wit II coainances and State laws relating lw Ing ' co u Ioneby authorize representatives of t s C my ISSUANCE FEEto er e mentioned property for inspectfio I m INVESTIGATION FEE TOTAL FEE I, s e i SEE REVERSE FOR EXPLANATORY LANG 6-.3—:5 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 0411230023 PHONE (626) 285 0488 EXT LEGAL 10 NO OF CONST BUILDING ADDRESSL TR 6561 LT 338 SQ FT STORIES TYPE 6023 OAK AV STRUCTURE VN TEMP CA 917802030 ASSESSOR INFORKMAT NEAREST CROSS STREET 5385 005-009 THOMAS PAGE 596 GRID J3 LOCALITY TEMPLE CITY C TENANT EXIST BLDG USE—RMD USE E R 5 ISSUED ON BY EXPIRES ON EXIST OCC GRP - - 11/23/04 JK 11/18/05 1 OWNER No BLDGS NOW ON LOTVALUAT I FIINAL BY CODE GUNDERMAN, LOUIS (626) 287 9721 + 3 000 6023 OAK AV ;,2 TEMP 917802030 FEES PAID UN OF WORK FOUNDATION BOLTING PER LA CITY STND PLAN VOLUNTARY FEE DESCRIPTION QUANTITY LION AMOUNT APPLICANT TEL NO SOTO (323) 655 0960 AA BLDG PERMIT ISSUANCE 27 75 1009 E GARFIELD AV AC STRONG MOTION RESID 3000 00 VAL 0 50 SPECIAL CONDITIONS GLENDALE, CA 917205 D2 PERMIT W/0 EN HC 3000 00 VAL 99 00 TOTAL FEES 127 25 CONTRACTOR TEL NO APPROVALS IN P TOR SIGNATURE SINAI CONSTRUCTION (323) 655 0960 490 S SAN VICENTE BLVD LIC NO LOCATION AND SETBACKS SUITE# 4 457238/ B LOS ANGELES CA 90048 ARCHITECT OR ENGINEER TEL NO FOUNDATION/TRENCH FORMF L1C NO SLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP NO SEWER MAP BOOK PAGE FIRE ZONE CHP XX 3 03 NO OF FAMILIES DWELLING UNITS APT/COND STAT C1159— NO 21 ROOF SHEATHING SCHOOL WITHIN HAZARDOUS SHEAR PANELS AIR QUALITY 1000 FEET MATERIALS NO NO NO FRAME INSPECTION REQUIRED TOTAL SET13ACK FROM EXIST FIRE SPRINKLEF-HERT-- SET BACK YARD HWY PROP LINE WIDTH FRONT PLINSULATION/WEATHER SIDE PL INTERIOR LATH/DRYWALL EXTERIOR LATH RATED WALL ASSEMBLIES RATED SHAFTS/OPENIT99-- LOT DRAINAGE REPORT ID DPR261 ROUTE TO BS0508 r