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Home My Public Portal About6037 OAK AVE_Building__ 0 �ORKERS'COMPENSATION DECLARATION i hereby affirm that I have certificate of consent to self APPLICATION FOR BUILDING PERMIT � insv"re, or a certificate of Workers'Compensation Insurance, or a certified copy thereof(Sec. 3800, Lab. C.) DAL rriG CD/WP�NS+`1T�o°� COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy NoK.J0r46?!n Company BUILDING Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS 603? r Certified copy is filed with the county building inspec- BUILDING �, /��k Sri tion department. ADDRESS t`/ Date /—?I —4?gApplicont ,�.�g,ya,%i. to. CITY c 1 r " ' ZIP 71LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. (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. US MAP ;Z6 o OWNER AIlf�1 NO. p, I certify that in the performance of the work for which this (� permit is issued, I shall not employ any person in any manner ` SPECIAL so as to become subject to the Workers'Compensation Laws. LADDRES T CONDITIONS V Date Applicant jA ZIP 29 NOTICE TO APPLICANT: If, after making this Certificate of ECT OR TEL. DISTRICT GROUP TYPE FIRE PRO ESSED BY Exemption, you should become subject to the Workers' ER NO. (� -1 CONST ZONE Compensation provisions of the Labor Code, you must forth- S �(4 A✓ l � with comply with such provisions or this permit shall be deemed revoked. ACTOR4. /Igyi/t Q, N �t�� —� STATISTICAL CLAS IFI TION APT. CO DO. LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS — LICENSED hereby affirm that I am licensed under provisions of Chapter 9 S rJT Z-7 NO. (commencing with Section 7000)of Division 3 of the Business and LIC. SEWER MAP Professions Code, and my license is in full force and effect. — jq CLASS / — BK PGVALIDATION Yn1 SQ.FT. NO.OF NO.OF CONE License Number /g � Lic.Class ig/ SIZE STORIES FAMILIES RE /� A., VALUATION L Contractor�. V i Date r DESCRIPTION OF WORK =)J2F_ ff% /j_ NEW ADD 7 , I am exempt under Sec. ~ } ALTER 0 B.&P.C. for this reason �f _ '01-PViVCe �G ni"W S REPAIR ❑; $ aew"Date: — USE OF r DEMOL ❑. 1 4 5 4 A EXISTING BLDG. Signature ;APPLICANT TEL f r FINAL r ' g OW -BUIL ER DEC LA 10 PRINT) , ! • — 4 DATE ( # o e o 0 0 1 I hereby affirm that I am exempt fro -1 e Contractor's License i Law for the following reason (Section 7031.5, Business and 1 ADDRESS t" %MaG 061 /I//, S. 'FIN o - 4Q50 Professions Code): PRESENT BY I, as owner of the property, or my employees with ADDRESS o 0 o 4 0,5 0 XL wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 0 1 3 1 —85 7044, Business and Professions Code). MOVING TEL. 0 I,as owner of the property,am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY SETBACK YARD HWY TOTAL SETBACK UNEFROM 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 �+ _ P.L. Lender's Name 02wa) as OW60 PvN9 CO A LDMA Ref.# P.C. Fee$ Permit Fee 6 Lender's Address /� /, I certify that I have read this application and state that the Issuance Fee /iV,J LDMA P/C# above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, ®e U and hereby authorize representatives of this County to enter Total Fee LDMA Perm.# upon the above-mention rty for inspection purposes. aSEE REVERSE FOR EXPLANATORY LANGUAGE Signature of licant or Agent Date O° 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 0503020039 PHONE: (626) 285-0488 EXT: - LEGAL D: NO.-OF CONST I DI G D . TR: 6561 LT: 337 SQ. FT STORIES TYPE 6037 OAK AV STRUCTURE: 1300 VN TEMP CA 917802030 ASSESSOR INFO I R: NEAREST CROSS STREET: GARIBALDI 5385-005-006 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, C TENANT: IS L G USE: RFSID USE : R- SS 0 ; 0 SS B : EXPIRES O : EXIST OCC GRP: 03/02/05 JK 02/25/06 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: ;rez_lw L A E FIN a CODE: TURNER WILLIAM L;INIS N TRS 0626) 233-6595- 3,200 s ' .� 1 3158 VERA AV LOSA 900343221 FEES PAID DESCRIPTION 0 TEAROFFH- REROOF WI A ALT SHINGLES FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. 0: SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75 AC STRONG NOTION RESID 3200.00 VAL 0.50 SPECIAL CONDITIONS: D2 PERMIT W/O EN-HC 3200.00 VAL 115.80 TOTAL FEES 144.05 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - LIC. NO LOCATION AND SETBACKS SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOUNDATIONPRENCH FORMS LIC. NO: SLAB/UNDER FLOOR RAISED Da MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: C P: UNDERFLOOR INSULATION 150H265 3 01 FLOOR SHEATHING 0. OF FAMILIES: DWELLING TS: P CON : STAT CL SS: NO 21 ROOF SHEATHING rQ SCHOOL WITHIN HAZARDOUS WEE-Ar—PAgErSF AIR QUALITY: 1000 FEET MATERIALS / NO NO NO FRAME INSPECTION REQUIRED OTA SETBACK-FROM EXIST R SPRINKLER HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- INSULATION/WEATHER STRIP SIDE PL- INTERIOR L- IN ER OR LATH/DRYWALL EXTERIOR LATH WED F 00 /C L ASSEM. RATED WALL ASSEMBLIES T-BAR CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508 .. .. ,. 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 0301220010 ' PHONE: (626) 285-0488 EXT: LEGALF CONST BUILDIN"D-DRESS: TR: 6561 LT: 337 SQ. FT STORIES TYPE 6037 OAK AV STRUCTURE: VN TEMP CA 917802030 A 50 ORA 0 B NEAREST CROSS STREET: GARIBALDI 5385-005-006 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY ENA T BLDG USE_._RESIDS NONE: - E 0N: PROCESSED BY: EX R S EXIST OCC GRP: 01/22/03 JK 01/17/04 . OWNER: TEL. 0: BLDGS. NOW ON LOT: VALUATION: FI L D FIN BY: CODE: TURNER WILLIAM L;INIS N TRS (626) 286-6663- 3,900 6037 OAK AVENUE TEMPLE CITY 91780 FEES PA DESCRIPTION OF WORK T/O HOUSE; INSTALL PLYWOOD SHEATING3OYR COMA P (s.E FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: J APPLICANT: . NO: opsZs4pr— SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RESID 3900.00 VAL 0.50 SPECIAL CONDITIONS: D2 PERMIT W/O EN-HC-_--__--_-_--3900.00 VAL 115.80 �&�G STO`T� F� \ 144.05 CONTRACTOR: TE 0: I'J APPROVALS ATE INSPECTOR SIG T R SAME AS OWNER LIC. NO �, LOCATION AND SETBACKS OILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. : - �/ I �r ; 0 A C FORMS LIC. N0: / / 11 NNIS DER FLOOR FRAMING P NO: SEWER 14AP BOOK: PAGE: FIRE ZONE: •MP•:=— UNDERFLOOR INSU LATION U gC 15OH265 3 09 [� SHEATHING .NO. 0 ING UNITS: 0 D: STAT CLASS.:- No SS:—NO 211 4- ROOF SHEATHING SCHOOL WITHINHAZARDOUS f`� �_ r.� SH EL AIR QUALITY: 1000 FEET MATERIALS NO NO NO ``\,\ ` t� ��-I�'• ,� /' FRAME INSPECTION REQUIRED 0 B CC R SPR L R E SET BACK YARD: HWY: PROP LINE: WIDTH: U - L-- FRONT P `ervic -fk%Z INSULATIO /WEATHER STRIP DE PL- INTERIOR L EXTERIOR LATH TED LOOR/CEL ASSEM. RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS LOT DRMNAGE REPORT ID: DPR261 ROUTE TO: BS05O8