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Home My Public Portal About10325 OLIVE ST_Building__ WORKERS'COMPENSATION DECLARATION APPLICATI FOR BUILDING PERMIT I hereby affirm that I have a certificate of consent to self insure, or a certificate of Workers'C�ab. penstion Ins rance, or a certi 'ed copy thereof(Sec. 3800, C. �� COUNTY OF LOS ANGELES l BUILDING AND SAFETY ompon Certified co is hereb furnished. BUILDING ❑ copy y 17:7l �� FOR APPLICANT TO FILL IN ADDRESS /v✓ + ®`—J v �/ . �ertified copy is filed with the county i spec- BUILDING tion departme ADDRESS 90&2—j— . LOCALITY ��/ C� 7 • NEAREST Date o Lica CITY ZIP CROSS ST. CE TIFI A E OF EXEMPTIOI�FRO OR O.OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the p r it is for one kDlfilgiCr MAPhundred dollars ($100)or less.) TRACT BLOCK LOT NO. NO.TEL. ��77SPECIALI certify that in the performance of the work for which thisOWNER NO. o2�7pCONDITIONSpermit is issued, I shall not employ any person in any manner GROUP TYPE FIRE P C ED BYADDRES �. � — CONST. ZONE so as to become subject to the Workers'Compensation Laws. l At.Date Applicant CITY / ZISTATISTICAL CLASSIF CATION APT. CONDO. NOTICE TO APPLICANT: If, after making this Certificate of Kill'ARCHITECT OR TEL.Exemption, you should become subject to the Workers' ENGINEER e N CLASS NO. DWELL. UNITS Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP with comply with such provisions or this permit shall be ,�� 9 TEL. deemed revoked. CO eAC' R !1/d N BK. PG, VALIDATION LICENSED CONTRACTORS DECLARATION LI . I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS ®/_P_ VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC Professions Code, and my license is in full force and effect. CITY CLASS $ SQ.FT. NO.OF NO.OF CH CK Lice a Number Lic.Class SIZE d STORIES FAMILIES ONE .41 a 1iW7 O ❑ $ Contract /�! DESCRIPTION OF WORK NEW ❑ 1Dv ADD Ia xempt f Iticensing requirements as I am alicensed architeegistered professional engineer ALTER ❑ FINALacting in my ional capacity'(Section 7051, , ` REPAIR ❑ DATE Business and Professions Code). USE OF FINAL EXISTING BLDG. � DEMOL ❑ 6y tL Lic.or Reg.No. Date APPLICANT EL. OWNER-BUILDER DECLARATION (PRINT) O. I hereby affirm that I am exempt from the Contractor's License f 2 7 7.b A Law for the following reason (Section 7031.5, Business and ADDRESS Professions Code): BUILD NG � �� 0 0 0 0 23 I, as owner of the property, or my employees with :ADDRESS wages as their sole compensation,will do the work and 2 0 0 2 8 8 0 the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. o 28805 ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS 0.24 —s o 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. 2 7 7 7 A (Sec. 3097, Civ. C.). SIDE P.L. 0 0 0 0 0 1 Lender's Name 'o P.C. Fee$ '" Permit Fee �/ fes• G 2 o c 3.00 Ys Lender's Address I certify that I have read this application and state that the Issuance Fee o r r C' above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, ToraI Fee I 0 �ll —811-1 and hereby authorize representatives of this County to enter u o4thob ove- ntioned property for inspecti n p rp es. 1 L SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of pplicant or A w�� ate /Q� /� ®s -� X y OUNTY 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 0709260028 PHONE: (626) 285-0488 EXT: (LEGAL ID: N0. OF CONST I BUILDING ADDRESS: I ON FILEI SQ. FT STORIES TYPE 1 10325 OLIVE ST I STRUCTURE: 20 VN I TEMP CA 917802861 I (ASSESSOR INFORMATION NUMBER: 1 I NEAREST CROSS STREET: I 18586-028-038 I I THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY, Cl [TENANT: [EXIST BLDG USE: RESID USE ZONE: R-1 11SSUED ON: PROCESSED BY: EXPIRES ON: 1 [EXIST OCC GRP: 109/26/07 SR 03/24/08 I 10WNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: [FINAL DAT FIN Y: CODE: ICHIEM JASON;PAULINA TRS (626) 390-5645- 1 I I 110325 OLIVE ST ] 6,800 I ' ITEMP 917802861 I FEES PAID IbESCRIPTIO OF WORK 1 I 1 [TEAR OFF & RE ROOF HOUSE & GARAGE. INSTALL MONIER LIFE TILE I IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT:IVILLA ICBG ER 2656 5.8 LBS. 1 (APPLICANT: TEL. NO: I I ISUNSHINE ROOFING (626) 581-7688- AA BLDG PERMIT ISSUANCE 27.75 1 I 1516 N. DIAMOND BAR IAC STRONG MOTION REBID 6800.00 VAL 0.68 ISPECIAL CONDITIONS: ] IDIAMOND BAR CA 91765 ID2 PERMIT W/O EN-HC 6800.00 VAL 166.20 TOTAL FEES 194.63 CONTRACTOR: TEL. NO: [ (APPROVALS DATE INSPECTOR SIGNATURE ISUNSHINE ROOFING (626) 581-7688- [ 1 I 151-6 N. DIAMOND BAR BLVD. LIC. NO 1 VACATION AND SETBACKS I I I IDIAMOND BAR CA 91765 755126 1 1 1 I I I 1 ISOILS ENGINEER APPROVAL I I I (ARCHITECT OR ENGINEER: TEL. NO: 1 IFOUNDATION/TRENCH FORMS I I I LIC. NO: 1 ISLAB/UNDER FLOOR I I I I (RAISED FLOOR FRAMING I I ] IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:I (UNDERFLOOR INSULATION I I 1147H273 3 011 I I I I I1 IFIOOR SHEATHING I I I INO. OF FAMILIES: DWELLING UNITS: APT/CONDI STAT CLASS: 1 I I I 1 NO 21 [ [ROOF SHEATHING I I I 1 SCHOOL WITHIN HAZARDOUS [ [SHEAR PANELS I I I (AIR QUALITY: 1000 FEET MATERIALS 1 I I I NO NO NO [ [FRAME INSPECTION I I IREQUIRED TOTAL SETBACK FROM EXIST 1 ]FIRE SPRINKLER HANGERS I I [ ISET BACK YARD: HWY: PROP LINE: WIDTH: 1 I [ [ I IFRONT PL- 1 JINSULATION/WEATHER STRIPI I I SIDE PL- I I I I I . 1 ]INTERIOR LATH/DRYWALL I I I I I I (EXTERIOR LATH I I ] 1 I IRATED FLOOR/CEIL ASSEM. I I ] 1 (RATED WALL ASSEMBLIES I 1 IRATED SHAFTS/OPENINGS 1 I I IT-BAR CEILINGS 1 I I I I ILOT DRAINAGE I I I IREPORT ID: DPR261 ROUTE TO: BS0508 1 I I I 1 I I I I I F • • 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 0706180047 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: ON FILE SQ. FT STORIES TYPE 10325 OLIVE ST (STRUCTURE: 473 VN TEMP CA 917802861 1 [ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: 18586-028-038 [ THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY, Cl [TENANT: JEXIST BLDG USE: RESID USE ZONE: R-1 JISSUED ON: PROCESSED BY: EXPIRES ON: (EXIST OCC GRP: 106/18/07 SR 06/12/08 1 OWNER: TEL. NO: [BLDGS. NOW ON LAT: VALUATION: IFINAL DATE FI BY: CODE: ICHIEM JASON;PAULINA TRS (626) 350-5645- I 35,0001 110325 OLIVE ST I I TEMP 917802861 FEES PAID ID SCRIPTION OF WORK IICBO #3190 PATIO ENCLOSURE 14' X 35.6' 473 S.F. W/ELECTRICAL IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. NO: ICREPAULT (800) 763-4000- [AA BLDG PERMIT ISSUANCE 27.75 I 115261 CONNERCTOR LN [AC STRONG MOTION RESID 35000.00 VAL 3.50 ISPECIAL CONDITIONS: HUNTINGTON BEACH AX BUILDING REVIEW FEE 54.70 I IB2 PERMIT W/ENERGY 35000.00 VAL 662.15 I [ TOTAL FEES 748.10 CONTRACTOR: TEL. NO: JAPPROVALS DATE INSPECTOR SIGNATURE IGALKOS CONSTRUCTION, INC. (714) 373-8545- I 115261 CONNECTOR LN LIC. NO ILACATION AND SETBACKS [HUNTINGTON BEACH CA 92649 4927158 1 (SOILS ENGINEER APPROVAL 1 1 1ARCHITECT OR ENGINEER: TEL. NO: - 1 1FOUNDATION/TRENCH FORMS 1 LIC. NO: (SLAB/UNDER FLOOR IRAISED FLOOR FRAMING IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:[ !- [UNDERFLOOR INSULATION I I I147H273 3 01I I I 1 IFLOOR SHEATHING 1 INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: t( I 1 NO 21 1 \� 1ROOF SHEATHING 1 SCHOOL WITHIN HAZARDOUS 1 �� 1SHEAR PANELS AIR QUALITY: I 1000 FEET MATERIALS NO NO NO IFRAME INSPECTION [REQUIRED TOTAL SETBACK FROM EXIST I (� IFIRE SPRINKLER HANGERS ISET BACK YARD: HWY: PROP LINE: WIDTH: ' 1 FRONT PL- [INSULATION/WEATHER STRIP SIDE PL- II i 1 II I IINTERIOR LATH/DRYWALL I &liC� �1 oD� dl I e b 7-0 O I I EXTERIOR LATH `�I[�� jam pcd I ! I [RATED FLOOR/CEIL ASSEM. II [ [ [RATED WALL ASSEMBLIES 1 [ [RATED SHAFTS/OPENINGS 1 I [ [ [ IT-BAR CEILINGS [ [ [ I I I [ ILOT DRAINAGE [ IREPORT ID: DPR261 ROUTE TO: BS0508 [ [ [ I I I [ I