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HomeMy Public PortalAbout6430 OAK AVE_Building__ •awl } � 7GA638A CE#809 B-BB APPLICATION FOR'BUILDING PERMIT COUNTY OF-LOS ANGELES BUILDING 6430 No. Oak Ave . DEPARTMENT OF'COUNTY ENGINEER . BUILDING AND SAFETY:DIVISION•' LOCALITY ' JOHN A. LAM13IE.`COUNTY'ENGINEER NEAREST \ WILLIAM A.JENSEN, SUPT OF BUILDING CROSS ST. DIIC N P TYPE P D •FOR APPLICANT TO FILL IN CONST. BUILDING STATISTICAL C SSIFI ATION SEWER MAP ADDRESS 6430 No. Oak' Ave. t!BK PG 3 CLASS..NO. DWELL.UNITS C LOT NO. 3 BLOCK WATER CERTIFICATE: NOT REQUIRED ❑ RECEIVED Cl TRACT Santa Anna Land Co. MAP /J HIGHWAY-. NO.OF BLDGS. NO. (J (cIRCLE� STATE_MAJOR SECOND, OCAL SIZE OF LOT NOW ON LOT 2 USE ZONE SPECIAL • USE OF p CONDITIONS EXISTING DG-HgWg Se'lf(/ EL. OWNER NayneCol eman NO. BUILDING' YARD HWY STREET.NAME EXIST. SETBACK WIDTH ADDRESS FRONT �f ARCHITECT-OR TEL. ENGINEER Standard plan NO. --SIDE P. L. } ADDRESS O CONTRACTOR Anthon POolS N@.nc. SP(! / ! ADDRESS T ( �� Gs E /��. l:V't�fi"11 /S� m 5871 Firestone Blvd. Say:' ! ,f � p DESCRIPTION OF WORK ' G NEW X ADD ALTER REPAIR DEMOLISH SQ.FT. NO.OF NO.OF r�~'r :�T?�✓"�. d 1' /� SIZE '5522 STORIES FAMILIES USE OF '� �S14.7 .A . /`C"If'�F:4;1 L. STRUCTURE swim ! SIGNATURE O `4-lA �l of +fiL���A APPLICANT VALUATION 3 200.00 APPROVALS• ✓ IDAT,F INSPECTOR'S SIGNATUFjE P.C. PMT. '' FOUNDATION: LOOATION .l it / FEE FEE S ./ © FORMS, MATERIALS >J•i•/ 9 't.+=,��i�,.•,,�+' FRAME: FIRE'STOPS, ` "r I HEREBY ACKNOWLEDGE THAT I HAVE.READ THIS APPLICATION BRACING. BOLTS AND STATE THAT THE ABOVE IS'CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS ' BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING WORK AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PER50 I VIOLA- LATH, INT. TION OF THE LABOR CODE OF THE STATE OF C LI R RELAT- ING TO WORKMEN'S CO E TION INSUR CE' LATH, EXT. SIGNATURE OF O MBER COR-. PERMITTEE ECT AND POSTED / ADDRESS aAAAL JOHN F. LEWIS. PRINCIPAL ST URAL ENGINEER PLAN CHECK VALIDATION cK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH L . S.U 4 2:o FEB 17 2 1 D . 4.63- -r L, Lo s 6 ,4 3 FE817 1 D 1 .8.50- Q L)ZVAJdWZ4ENT OF BUILDING AND SAFETY raatiavaaa ry COUNTY OF LOS ANGELES BUIL D114- WM. J. FOX. CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY ADD[IBB �� C..[ "��4 DISTRICT NO. PLAN CK.NO. PERMIT NO. LOCALITY RECEIVED BY DATE OrAPPL. DATE ISSUED NEAREST (/arlc5 CR088 BT. '!� BUILDING OWNER �p� ADDRESS MAILADDR - ��{ t Z.c,,. LOCALITY.' NEAREST TELy� CROBB BT. G �✓C7!/ CITY NO.N ® �. FIRE NO.OFTYPE GROUP ARCHITECT OR TEL. ZONE PLANBO__` ENGINEER NO. BLDG. s O�f3D.NOS. ADDRESS SETBACK LINE , APPROVED ! /i+ TEL By DATE CONTRACTOR NO. USEAPPROVED AD Rrim BY DATE LEGALo_a CORRECTIONS DESCRIPTION LOT NO. TRACT !)e3. 6—/3� �J / ' � L l) --3NO.Of BLDGS. + SIZE OF L�OT / d¢���I(,` fy,NOW ON LOTusEd © f" S EX 9T N0 B [ �`/J/rf�/✓1 FAM Ee ROOMS -� /,,o 7 — ]DESCRIPTION —DESCRIPTION OF WORK NEW ALTERATION ADDITION % D REPAIR MOVING DEMOLISH p q.FT. NO.OF Z 6 91ZE 4 el ROOMS � STORIES WALL ROOF COVERING ��� I COVERING Caja UNEOF NEW BUILDING 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATIONII LOCATION INSPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRESTOPB, �.' • �� �� SIGNATURE O BRACING,BOLTS PERMITTE.- �"^ ''� LATH, INT. AUTHORIZED AST LATH, EXT. 76A636A-3 a-so P.C.® PLASTER,1 NT. • FEE PLASTER,EXT. VALUATION FEE �C FINAL MAXIMUM SCC MPL1SrlED 8-15-5 76A638A CE 8031-62 APPLICATION FOR BUILDINg . :_r a,: _�• COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY'ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST / WILLIAM A.JENSEN, SUPT OF BUILDING CROSS ST. f FN T NO. GROUP TYPE ESSED BY FOR APPLICANT TO FILL IN � CONST. BUILDING TICAL CLASSIFICATION S WER MAP ADDRESS J . NO._�DWELL.UNITS j`� �P� LOT NO. izW- LOCK ICATE: NOT REQUIRED12 RECEIVED ❑ TRAC f HIGHWAY O.OF BLDGS. (CIRCLE) STATE MAJOR SECOND, OCA SIZE OF LOT NOW ON LOT NE SPECIAL USE OF CONDITIONS EXISTING BLDG. TEL. OWNER ( NO. G YARD HWY EET ME EXIST. K WIDTH ADDR S ARCHITECT O TEL. ENGINEER NO. SIRE ADDRESS + C � TEL. �v it f�;' :+Z-.• 1.`l c'-' ���'i %�� �/,.; Gr"-"„f/'-="~,'�•"`(�.=.��' CONTRALTO NO. ' ADDRESS F DESCRIPTION OF WORK u o NEW ADD ALTER REPAI DEMOLISH t SQ.FT. NO. NO. OF SIZE STORIES FAMILIES USE OF STRUCTURE SIGNATURE OF APPLICANT VALUATION $ APPROVALS DATE INSPECTOR'S SIGNATURE FOUNDATION: LOCATION FEE $ "^� FEE'$ FORMS, MATERIALS FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE:ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK _ AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH,,INT. TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- ING TO WORKMEN' O APENSATION INSURA E. LATH,EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS ' FINAL i JOHN F. LEWIS, PRINCIPAL ST RAL ENGINFItR PLAN' CHECK VALIDATION CK. M.O.. CASH _ PERMIT VALIDATION CK. M.O. CASH Lt,o 5 .2 7 4 OCT 8 1 A 15.00- v _ WORKERS'COMPENSATION DECLARATION h eby; affirm that I have a certificate of consent to self APPLICATION F®R BUILDING PERMIT � ¢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 Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING ADDRESS Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS , tt Date Applicant CIT ZIP L] LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF NEAREST SIZE OF LOT NOW ON LOTS COMPENSATION INSURANCE 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. USE ZOIE [rSPE� P I certify that in the performance of the work for which this OWNE O. permit is issued, I shall not employ any person in any manner IAL 8t so as to become subject to the W r ers' Ompensat• n ws. ADDRESS _ CONDITIONS V Date Applican CITY ZIP 0 NOTICE T AP Ni. If, after aking this Cerfi icate of ARCHITECT OR TEL. DISTRICT GRQQQUP TYPE FIRE PROCESSED BY O Exemption, you should become subject to the Workers' ENGINEER NO• ;/ CONST. ZOO W Compensation provisions of the L or Code, you must forth- ADDRESS �� �� V with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. LNDO. U) deemed revoked. CONTRACTOR NO. !�/ Z LICENSED CONTRACTORS DECLARATION LIC. CLASS NO.= DWELL. UNITS — I hereby affirm that 1 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 IMOV,3 CLASS BK PG VALIDATION - SQ.FT. NO.OF NO.OF CHECK License Number Lic.Class SIZE STORIES FAMILIES ONE VALUATION Contractor Date DESCRIPTION OF WORK x ADD NEW ❑❑ $ �J I am exempt under Sec. JIJ1,A1 t`el 65 J ALTER B.BP.C. for this reason REPAIR $ USE OF Date' EXISTING BLDG. DEMOL Signature APPLICANT TEL. L d r l 8 5 6 A FINAL � OWNER-BUILDER DECLARATION PRINT NO. DATE '� I herebyaffirm that I am exempt from the Contractor's License i Law fothe following reason(Section 7031.5, Business and ADDRESS FINAL 1 # 0 0 0 0 0 Professions Code): BY l / I o 028,50 ❑ BUILDING I, as owner of the property, or myemployees with ADDRESS wages as their sole compensation,Will do the work and / (,r✓(�,Z rC t e structure is not intended or offered for sale(Section ILOCALITY `!���"� 0 0028,5070- . 044, Business nd Professions Code). MOVING TEL. Lkj/✓t-- LL/ OvT 1,044 , as owner of the property, am exclusively contracting CONTRACTOR NO. lk f�`Z n o�✓/� I Q 17-87 with licensed contractors to construct. onstruct the project (Sec- ADDRESS Z-7- tion 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY SETT BACK YARD HWY TOTAPROPLINE WIDTFROM FI 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. ..l 5. � .k Lender's Name n LDMA Ref. # Lender's Address P.C. Fee$ Permit Fee I certify that 1 have read this application and state that the Issuance Fee C q o above information is correct. I agree to comply with all County Investigation Fee 0 ordinances and State laws relating to building construction, Total Fee LDMA Perm. R and hereby authorize representatives of this County to enter m u the above-menti ed roper for inspection purposes. I `L;o c, I $ SEE REVERSE FOR EXPLANATORY LANGUAGE 0 'gnat re of Applicant or Agent Date r n WOS'KERS'COMPENSATION DECLARATION hereby affirm that I have certificate of consent to self APPLICATION Ft�`n EIU[WILDING PERMIT T insure, or a certificate of Workers'Compensation Insurance, 1 u or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company D Certified copy is hereby furnished. FOR APPLICANT TOFILLIN ADDRIESSNG w3o A+J (!� ElCertified copy is filed with the county building inspec- BUILDING tion department. ADDRESS 4.1 r Date Applicant CITY '° ZIP (� '<LOCALITY NO.OF BLDGS. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE SIZE OF LOT Z 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. n USE ZONE MAP I certify that in the performance of the work for which this OWNS NO. y NO. permit is issued, I shall not emploVorCode, on in any manner ADDRESS _, SPECIALS so as to become sub'ect to the Wmpens 'on Laws. CONDITIONS 0 Date Applicant CITY ZIP NOTICE TO APPLICANT: If, aftehis Certificate of ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY O Exemption, you should becomto the Workers' ENGINEER NO. CONST. ZONE V Compensation provisions of the you must forth- ADDRESS �'��Q `� {/ w with comply with such provisions or this permit shall be deemed revoked. TEL. , STATISTICAL CLASSIFICATION APT. CO DO. f!) CONTRACTOR W NO. ; Z LICENSED CONTRACTORS DECLARATION LIC, CLASS NO.. DWELL. UNITS — I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS Sgm"Z 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. CITY CLASS BK PG VALIDATION SQ.FT. NO.OF NO.OF CHECK License Number Lic.Class SIZE STORIES I FAMILIES ONE VALUAVALUATION Contractor Date DESCRIPTION OF WORK 2000 NEW ADD ® $ I am exempt under Sec. ALTER B.BP.C. for this reason REPAIR $ USE OF ;20855A Date: EXISTING BLDG. I DEMOL APPLICAN 11 TEL. # 0 0 0 0 0 Signature PRINT FI NO. � — FINAL OWNER-BUILDER DECLARATION 3' DATE I hereby affirm that I am exempt from the Contractor's License ( o 049.88 it ng reason (Section 7031.5, Business and ADDRESS FINAL i \By1o oo [j.9889 BUILDINGof the property, or my employees with ADDRESSQ06 88 ages as their sole compensation,will do the work and LOCALITY /,�/� LvG/9 I L the structure is not intended or offered for sale(Section 7044, Business and Professions Code). MOVING TEL. LA"I+—' /Vo 7- 1, 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). REQUIRED TOTALI-TE TBAC 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 P.L. .V Lender's Name Boom= LD MA Ref, # P.C.Fee$ Permit Fee 201 3 Lender's Address I certify that I have read this application and state that the ; Issuance Fee V + LDMA P/C# lop o above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws luting to building construction, Total Fee LDMA Perm.# N n ereby authorize re entatives of this County to enter upon he e-mentio pert for inspection purposes. n / r6 �� SEE REVERSE FOR EXPLANATORY LANGUAGE Signal e f App Icant or Agent Date WORKERS' COMPENSATION DECLARATION reF}y affirm that I have certificate of consent to self APPLICATION FOO 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 ElCertifiedcopy is hereby furnished. FOR APPLICANT TO FILL IN ?ADDRESS El [ADDRE G Certified copy is filed with the county building inspec- S 6430 N. OAK AVENUE tion department. Date Applicant EMPLE CITY zip 91780 V'LocALlrr . CERTIFICATE OF EXEMPTION FROM WORKERS' LOT 78 X 240 NOOF ON LOT 2 NEAREST COMPENSATION INSURANCE • CROSS ST. (This section need not be completed if the permit is for one OOK 6-1 BLOCK J LOT NO. 3 AssESSORhundred dollars ($100)or less.) T MAP BOOK PAGEPARCEL JOHN & ANNE MIKOLAT&O 445-46 PSEZONEOP I certify that in the performance of the work for which this �! SPECIAL >- permit is issuedI shall not employ any person in any manner S 6430 N. OAK AVENUE TIONS aso as to become subject to the Workers'Compensation Laws. O EMPLE CITY zip 91780 Date Applicant ARCHITECT,pR TEL DISTRICT GROUP TYPE FIRE $?CESS D BY fy NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER 1J lJ N P E R R Y MA N TT— 0 2 3 CONS: ZONE Exemption, you should become subject to the Workers' ? �2 w Compensation provisions of the Labor Code, you must forth- ADDRESS 9035 HAVEN AVE. SUITE 202 �'® �✓ a with comply with such provisions or this permit shall be TEL• STATISTICAL CLASSIFI ATION APT. ]CONDO. to deemed revoked. CONTRACTOR OWNER TN 4 4 5—4 6 5 7 CLASS No.�DWELL. UNITS '� Z LICENSED CONTRACTORS DECLARATION *ADDRESS SAME NO, `� I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business LIC. SEWER MAP ACCTAr and Professions Code,and my license is in full force and effect. CITY CLASS BK PG -LDATION p SQ. F7 NO OF NO OF CHECK �� 9'�a.5oV7 License Number Lir- Class SIZE 1400 STORIES 2 IFAMILIES 1 ONE DESCRIPTION OF WORK WOOD FRAME ADD .NEW �❑-t r V LUATION 1 ITEMS Contractor Date iJ $ TOTAL 44-33 a 47 ElADD I am exempt under Sec. ► CHECK /O"' v ALTER ❑ {�hj� �� s YV�SoV7 B.&P.C. for this reason REPAIR ❑ $ �� 1 IUl I, CHANGE .00 Date: . USE OF RESIDENCE DEMOL ❑ tll/// V EXISTING BLDG. Signature APP(PRINrLICT)ITOHN MIKOLASKO N6.445-5657TEL DATE 0000-0001 10/101/89OWNER-BUILDER DECLARATION DATE 1 hereby affirm that I am exempt from the Contractor's License 6430 N. OAK AVE. ,, T.C . 6271 1 AM u o xl Law for the following reason (Section 7031.5, Business and ADDRESS FINAL Professions Code): PRESENT By ❑ I, as owner of the property, or m employees with BUILDING SAME K h P P Y. Y •ADDRESS wages as their sole compensation,will do the work and TEMPLE CITY the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code.) MOVING TEL. 1b, (n/ ❑ .I, as owner of the property,am exclusively contracting CONTRACTOR NONE NO with licensed contractors to construct the project (Sec- Y 1 ADDRESS 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 i� I n the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE y'' P.L. si Lender's Name - P.C. Fee$ / Permit Fee LDMA Ref: # Lender's Address iPoo I certify that I have read this application and state that the r Issuance Feel/ LDMA P/C# above information is correct. I agree to comply with all County Investigation Fee G' i d ordinances and State laws relating to building construction, Total Fee v r `� ? LDMA Perm. # 6 and hereby authorize representatives of this County to enter 3 upon the above-mentioned property for inspection purposes. c SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date . w APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN B DIG DRESS BJJI�DING DRESS L I hereby affirm that I have a certificate of consent to self insure, or a certificate of Workers'Compensation Insurance,or a certified copy there ( 800,Lab.C.) CIT ZI � � , TNO. Company .1 OF BLD S.NOW ON LOT -1 Certified copy is hereby furnished. NEAREST CROSS ST/- Certified TRACT BLOCK LOT NO. ❑ Cee/pr�taified copy is filed with�the buildin pection USE ZONE MAP NO. Datde�rt �n pplicant ASSESSOR MAP BOOK PAGE PARCEL -�f/G� SPECIAL CONDITIONS CERTIFICATE OF EXEMPTI FROM WORKERS' OWNER TEL NO. COMPENSATION INSURANCE WITHIN 1000 FT.OF SCHOOL? ves No (This section need not be completed if the permit is for one hundred AD ESS DISTRICT GROUP TYP�gCONST. FIRE ZONE PROCESSED BY dollars($100)or less.) n //�/���_ 1 certify that in the performance of the work for which this permit G ��D� ,{/ I is issued, I shall not employ any person in any manner 30 as to 4 P"[ARCHITECTREN I EER TEL NO. /l. become subject to the Workers'Compensation Laws. STATISTICAL C: 4PSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO. DWELL UNITS NOTICE 70 APPLICANT. If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you Should become subject to the Workers' CONTRACTOR SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith FRONT comply with such provisions or this permit shall be deemed revoked. 'AD ® `U LI �� P L LICENSED CONTRACTORS DECLARATION L SIDE LIC.CRSS-, 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 Z� NO.OF STORIES NO.OF FAMILIES Professions Code,and m is nse is in full force and effec /� NEW ❑ BK �PGi /�jpoli. a License Number Tt2 97 Lic.Class S �QON OF iOO& i� ADD ❑ L oRj (! ® L./ C. Contractor Date C/ 11 ` ,,tt ALTER ❑ ❑ I am exempt under Sec. / o?ils�' `�/Y�� REPAIR $ C BAP.C.for this reason WW % / Lf>l L �ilf,� DIE ❑ LDMA P/C# c. te: N/�SEO6 EXISTING G. 'TCo �� URM ❑ _ u Cr. Signature ICANT(PR/N r �Q�jJ r �,,c,�-�, LDMA Perm#Wi� ❑ I, as owner of th p erty, or my employees with wages as /r�� `7 �if/ ——`r Z - °s their sole compensation, will do the work and the structure is AD ESS 0 _7-r;- not intended or offered for sale (Section 7044, Business and Gu FINAL DAT=� - Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL ' OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE ❑ 1, as owner of the property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GII-r FINAL BY r )+I ?L 1 �--°-m 65 licensed contractors to construct the project (Section 7044, YES❑ NO❑ Business and Professions Code.) WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION D) MODIFICATION FROM THE SOUTH �.y_ I/� o`C `r^ CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR Z��fi`f 66(� i�lt t��t(�t GUIDELINES I hereby affirm that there is a construction lending agency for YES❑ No❑ N the performance of the Work for Which this permit Is Issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING "' �f rl fir,• ,+" W 3097,Civ.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, i i=)_f�� TITLE 2,CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD ��'+�' a LSM 7:47 a-`t f' r Imo•: a Lender's Address O OWNER OR AGENT c I certify that I have read this application and state under penalty of perjury that the above information is correct.I agree to comply P.G FEE PERMIT FEE �j/ ` N with all county ordinances and State laws relating to building D(p con st and hereby orize representatives of this County ISSUANCE FEE /—0 to the above- oned propert r inspection urposes. Z(/11 INVESTIGATION FEE TOTAL FEE A SglL.luni of AP°'ynl a D SEE REVERSE FOR EXPLANATORY LANGUAGE 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 0704300038 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: ON FILE SQ. FT STORIES TYPE 6430 OAK AV STRUCTURE: 2059 VN I TEMP CA 917801337 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 15382-014-038 I THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY, Cl TENANT: JEXIST BLDG USE: RESID USE ZONE: R-1 JISSUED ON: PROCESSED BY: EXPIRES ON: (EXIST OCC GRP: 104/30/07 JK 04/24/08 OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: (FINAL DABY: CODE: ICHAVEZ, SERGIO (714) 240-2421- 1 31,500 1 �� ML 16430 OAK AV = n TEMP 917801337 FEES PAID IDESCRIPTION OF WORK 1 IREPLACE 14 WINDOWS & REPLACE EXISTING SIDDING IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT: I APPLICANT: TEL. NO: I I I 1CHAVEZ (626) 443-5342- IAA BLDG PERMIT ISSUANCE 27.75 1 1 6430 OAK AVE. 1AC STRONG MOTION RESID 31500.00 VAL 3.15 ISPECIAL CONDITIONS: TEMPLE CITY CA 91780 ID2 PERMIT W/O EN-HC 31500.00 VAL 562.80 TOTAL FEES 593.70 CONTRACTOR: TEL. NO: JAPPROVALS DATE INSPECTOR SIGNATURE ICHAVEZ, SERGIO/MAYVER (626) 446-5342- 16430 OAK AVENUE LIC. NO ILOCATION AND SETBACKS TEMPLE CITY, CA 91780 NONE I I (SOILS ENGINEER APPROVAL [ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS I I I LIC. NO: ISLAB/UNDER FLOOR IRAISED FLOOR FRAMING I 1MAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:1 JUNDERFLOOR INSULATION 1153H265 3 011 I I IFLOOR SHEATHING I I INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I I 1 I NO 21 I IROOF SHEATHING I I SCHOOL WITHIN HAZARDOUS I ISHEAR PANELS I I (AIR QUALITY: 1000 FEET MATERIALS I I I I I NO NO NO I IFRAME INSPECTION I I I IREQUIRED TOTAL SETBACK FROM EXIST I IFIRE SPRINKLER HANGERS 1 ISET BACK YARD: HWY: PROP LINE: WIDTH: I I I I I IFRONT PL- I IINSULATION/WEATHER STRIPI I I 1 SIDE PL- I I I I I (INTERIOR LATH/DRYWALL I I I I (EXTERIOR LATH I I I I I IRATED FLOOR/CEIL ASSEM. I I IRATED WALL ASSEMBLIES 'RATED SHAFTS/OPENINGS I IT-BAR CEILINGS I I I ILOT DRAINAGE I I I IREPORT ID: DPR261 ROUTE TO: BS0508 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 0703220021 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: ON FILE SQ. FT STORIES TYPE 6430 OAK AV (STRUCTURE: 2059 VN I TEMP CA 917801337 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 15382-014-038 THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY, Cl (TENANT: (EXIST BLDG USE: RESID USE ZONE: R-1 (ISSUED ON: PROCESSED BY: EXPIRES ON: (EXIST OCC GRP: 103/22/07 JK 03/16/08 OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: [FINAL DATECODE: ICHAVEZ, SERGIO (714) 240-2421- 1 15,000 1 Expl 16430 OAK AV Rn ED: TEMP 917801337 FEES PAID IDESCRIPTION OF WORK ITEAR OFF AND REROOF WITH COMPOSITION TILE IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. NO: ICHAVEZ (626) 443-5342- IAA BLDG PERMIT ISSUANCE 27.75 16430 OAK AVE. IAC STRONG MOTION RESID 15000.00 VAL 1.50 ISPECIAL CONDITIONS: TEMPLE CITY CA 91780 ID2 PERMIT W/O EN-HC 15000.00 VAL 300.60 TOTAL FEES 329.85 CONTRACTOR: TEL. NO: [APPROVALS DATE INSPECTOR SIGNATURE ICHAVEZ, SERGIO/MAYVER (626) 446-5342- 1 16430 OAK AVENUE LIC. NO [LOCATION AND SETBACKS TEMPLE CITY, CA 91780 NONE I SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: IFOUNDATION/TRENCH FORMS ICHRISTIANSEN, SCOTT (310) 395-7641- I 1710 WILSHIRE BLVD LIC. NO: (SLAB/UNDER FLOOR SUITE# 230 NONE * (SANTA MONICA CA 90404 (RAISED FLOOR FRAMING IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( (UNDERFLOOR INSULATION 1153H265 3 Oil I I IFLOOR SHEATHING INO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: I I I I NO 21 I (ROOF SHEATHING SCHOOL WITHIN HAZARDOUS I ISHEAR PANELS I I I (AIR QUALITY: 1000 FEET MATERIALS I I I I I NO NO NO 1 (FRAME INSPECTION I I I IREQUIRED TOTAL SETBACK FROM EXISTI IFIRE SPRINKLER HANGERS I I I ISET BACK YARD: HWY: PROP LINE: WIDTH: I II I I IFRONT PL- IINSULATION/WEATHER STRIPI I I SIDE PL- I 1-1 I (INTERIOR LATH/DRYWALL I I I I (EXTERIOR LATH I I IRATED FLOOR/CEIL ASSEM. I I I IRATED WALL ASSEMBLIES I I I I I I I (RATED SHAFTS/OPENINGS IT-BAR CEILINGS I I I* ADDITIONAL DATA ON FILE I I I I ILOT DRAINAGE I I I I I I IREPORT ID: DPR261 ROUTE TO: BS0508 I I I I I I ' J COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT 5F-PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD/ALT/REP BU3LDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0601300051 s PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST NEW BUILDING ADDRESS: ON FILE SQ. FT STORIES TYPE OCCUP GROUP 6430 OAK AV STRUCTURE: 1084 2 VN R3 TEMP CA 917801337 ASSESSOR INFORMATION NUMBER: GARAGE: NEAREST CROSS STREET: 5382-014-038 OTHER: THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY, C TENANT: EXIST BLDG USE: USE ZONE: ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 08/29/06 JK 08/24/07 CHAVEZ, SERGIO (714)L240O2421- HLDGB. NOW ON LOT: VALUAT107,180 FINAL DA�iD7p ��I BY: CODE: 6430 OAK AV TEMP 917801337 FEES PAID DESCRIPTION OF W09X- ADD 2ND:STORY MASTER BEDROOM, MASTER BATH W/WIObSET 1084 S.F FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1ST:FLOOR EXTENTNOOK, FMLY RM.150 S.F.TRALLIS 100 S.F. PATIO APPLICANT: TEL. NO: SULEJMANI (949) 722-0289- B1 PLANCHECK W/ENERGY 89760.00 VAL 1,119.05 9582 HAMILTON AVE AA BLDG PERMIT ISSUANCE 27.75 SPECIAL CONDITIONS: HUNTINGTON BEACH AC STRONG MOTION REBID 107180.00 VAL 10.72 B1 PLANCHECK W/ENERGY 107130.00 VAL 135.35 H2 PERMIT W/ENERGY 107180.00 VAL 1,475.76 CONTRACTOR: TEL. NO: TOTAL FEES 2,768.63 APPROVALS DATE INSPECTOR SIGNATURE CHAVEZ, SERGIO/MAYVER (626) 446-5342- 6430 OAK AVENUE LIC. NO LOCATION AND SETBACKS TEMPLE CITY, CA 91780 NONE SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS r CHRISTIANSEN, SCOTT (310) 395-7641- 710 WILSHIRE BLVD LIC. NO: 3 /UNDER FLOO n SUITE# 230 NONE * y SANTA MONICA CA 90404 RAISED FLOOR FPN4ltZG MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION 3 01 IST LEVEL FLOOR SHEATH NO. OF FAMILIES: DWELLING UNITS: APT COND: STAT CLASa: NO 21 2ND LEVEL FLOOR SHEATH SCHOOL WITHIN HAZARDOUS ROOF SHEATHING72� AIR QUALITY: 1000 FEET MATERIALS r NO NO NO FIRE DEPT. FRAME INSPECT REQUIRED TOTAL SETBACK FROM EXIST BLDG DEPT. FRAME INSPECT SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- SHEAR PANELS SIDE PL- pFw INSULATION WEATHER STRIP INTERIOR LATH/DRYWALL EXTERIOR LATH LOT DRAINAGE SMOKE DETECTION DEVICES FIRE DEPARTMENT APPROVAL * ADDITIONAL DATA ON FILE REPORT ID: DPR261 ROUTE TO: BS0508