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Home My Public Portal About5116 PAL MAL AVE_Building__ «` V, APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS r I hereby affirm that I have a certificate of consent to self insure, BUILDI G DDRESS or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) CITY/ IP LO LITY Policy No. Company V&r OTNO.OF DGS.NO ON LOT ElCertified copy is hereby furnished. J NEAREST CROSS ST.❑ Certified copy is filed with the county building inspection BLOCK LOT NO. department. I USE ZONE MAP NO. Date Applicant ASSESSOR MAP BO K PAG PARCEL �- j SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWN TEL NO. f/ COMPENSATION INSURANCE .k� WITHIN 1000 FT.of SCHOOL? I I ves No (This section need not be completed if the permit is for one hundred ADDRESS , dollars($100)or less.) - DISTRICT GROUP T CONST. FIRE ZONE PROCESSED BY I certify that in the performance of the work for which this permit C� 3/�} ZIP is issued, I shall not employ any person in any manner so as toAR T OR GINEER TEL NO. r� become subject to the Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT CONDO` Date Applicant ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT If, after making this Certificate Of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you Should become Subject to the Workers' CONTRACTOR TEL NO. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith 61 lt<n FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. P L LICENSED CONTRACTORS DECLARATION SIDE CITY LIC.CLASS PL I hereby affirm that I am licensed underprovislons of Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ.Fr.SIZE NO.OF STORIES NO.OF FAMILIES Professions Code,and my license is in full force and effect. NEW BK PG d License Number Lic.Class DE CRIPTI F s ADD ❑ VALUATION �� 0 Contractor DateALTER ❑ 4fd� v ❑ I am exempt under Sec. �� h REPAIR ❑ $ 0 BAP.C.for this reason l�� DEMOL ❑ LDMA P/C# Date: USE OF EXISTI LDG. URM ❑ /gnature APPLICANT(PRINT) TEL NO. LDMA Perm# owner of the property, or my employees with wages as Z L their sole compensation, will do the work and the structure is ADDRESS O f not intended or offered for sale (Section 7044,Business and FINAL DATE • .f Q TOTL !2.ice o ,� Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL ` \ � '.=. -, ❑ 1, as Owner of the property, am exclusively contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE ��~='=1-i ilF'�# AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? licensed contractorst0 construct the project (Section 7044, YES 11 NO❑ FINAL Y > -.,�i�4 j ( N ` Business and Professions Code.) HALL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES. I hereby affirm that there is a construction lending agency for YES❑ NO❑ Em the performance of the work for which this permit is issued(Sec. W 3097,CIV.C.) I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING a CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, Lender's Name TITLE 2,CHAPTER 2 20 SECTIONS 2 20.100 THROUGH 2 20.140 CONCERNING HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOVID 0 Lender's Address 0 OMER OR AGENT o I certify that I have read this application and state under penalty 0 of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE Lq a with all county ordi nces and State laws relating to building m con ct n, and h by authorize representatives of this County ISSUANCE �J at ente pon a -mention roper inspa n p/u sea. n _! — INVESTIGATION FEE TOTAL F Sgn,1 APCz:nl«A�nl SEE REVERSE FOR EXPLANATORY LANGUAGE ' APPLICATION FOR BUILDING PERMIT • COUNTY OF LOS ANGELES " ,f BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDINGADDRESS NIZEOF DRESSr� I hereby affirm that I have a certificate of consent to self insure, r AlAy or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) ZIP LOCALITY Policy No. Company T NO.OF BLDGS NOW ON LOT ❑ Certified copy is hereby furnished. /Y J NEAREST CROSS%7. 01 ❑ Certified copy is filed with the county building inspection TRA BLOCK LOT NO. department. USE ZONE MAP NO. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL �'�� Og Q 0� SPECIAL CONDITIONS /J� n` / CERTIFICATE OF EXEMPTION FROM WORKERS' OWNE XQ�6j",_N�Roq , $ YES NO Ci Y COMPENSATION INSURANCE WITHIN 1000 FT.OF SCHOOL? (This section need not be completed if the permit is for one hundred ADD S DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY dollars($100)or less.) J� I certify that the performance of the work for which this permit ZIP OO / �✓49fJ &a 3 is issued, I shall not employ any person in any manner so as to ARCHIT oR ENGINEER L NO. .4-49? Q become subject to the Workers'Compensation Laws. STATISTICAL CLASSIFICATION i APT CONDO Date Applicant ADDRESS CLASS NO. e::z/ DWELL UNITS NOTICE TO APPLICANT.' If, after making this Certificate Of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CONTRACTOR TEL NO. 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. ADDRESS , LIC.NO. PL LICENSED CONTRACTORS DECLARATIONSIDE CITY LIC.CLASS PL I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SO.FT.SIZE NO.OF STORIES NO.OF FAMILIES Professions Code,and my license is in full force and effect. NEW BK PG ® a License Number Lic.Class DESCRIPTION QFOVORK ADD VALUATION C Contractor Date ALTER ❑ $ �� • jY/`� O ElI am exempt under Sec. REPAIR 11 $ P BAP.C.for this reason DEMOL ❑ LDMA P/C# C Date: USE OF EXISTING BLDG. URM ❑ U ir• Signature APPLICANT(PRINT) TEL NO. LDMA Perm# 1 as owner of the property, or my employees with wages as Z their sole compensation, will do the work and the structure is ADDRESS ?�;_(:: n•_�_ not intended or offered for sale (Section 7044, Business and FINAL DATE G00. 1 Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL \y, OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE J ❑ I, as Owner of the property, am exclusively contracting with ,I� AMOUNTS SPECIFIED ON THE HAZARDOUS MATERUILS INFORMATION GU,DE� FINAL licensed contractors to construct the project (Section 7044, V YES❑ NO❑ Business and Professions Code.) L_t;w HALL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH �t CONSTRUCTION LENDING AGENCY COAST AIR OUAUTY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDEUNES I hereby affirm that there is a construction lending agency for �� YEs 11 NO❑ 4 4!i AL =% I �( _ '`it'6 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 O1 3097,CIV.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, :•FI�:•S', -I- 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. L• 11�Rii].L n _)_. o Lender's Address ONNER OR AGENT O o I certify that I have read this application and state under penalty C.FEE PERMIT FEE " c of perjury that the above information is correct.I agree to comply Ns S V �/ CM with all county ordinances and State laws relating to building fr �.- m construction, a hereby authorize representatives of this County ISSUANCE FEE - m to me upon a above-m ntione perty for inspection purposes. Z !O a rJ INVESTIGATION FEE TOTAL FEE � 5 -1I w AP un a Aa'm on SEE REVERSE FOR EXPLANATORY LANGUAGE APPLICATION FI®RUILDING PERMIT COUNTY OF LOS ANGELES V -- BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDIN ADDRESS I hereby affirm that I have a certificate of consent to self insure, BUILDING A DRIESr v/2 or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) CIT a ZIP LOCALITY Policy No. Company SIZE OF L ele. NO.OF BLDGS.NOW ON LOT ❑ Certified Copy is hereby furnished. NEAREST CROSS ST ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. USE ZONE MAP NO Date Applicant ASSESSOR MAg80 PAGE PARC0 3 OCI SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER /� TEL NO. COMPENSATION INSURANCE s`�`i4 WITHIN 1000 FT.OF SCHOOL? YES No (This section need not be completed if the permit is for one hundred ADDRESS dollars($100)Cr less.) 27 DISTRICT GROUP TYP ONST. FIRE ZONE PROCESSED BY CIT � ZIP I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to ARC IT OR ENGINEE TEL NO. d become subject to the Workers'Compensation Laws. STATISTICAL CLSIFI�ATION APT CONDO Date Applicant ADDRESS CLASS NO. Z2 / 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 TEL NO. 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. ADDRESS LIC.NO PL LICENSED CONTRACTORS DECLARATIONSIDE CITY LIC.CLASS PL I hereby affirm that I am licensed underprovislons of Chapter 9 ar SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ. NO.OF STORIES NO.OF FAMILIES Professions Code,and my license is in full force and effect. NEW ❑ BK PG } License Number Lic.Class DESCRIPTION OF-WORKADDE] VAL0ATIpN C Contractor Date Li ALTER �i E3 $ (Q/ C ❑ 1 am exempt under Sec. lie. - BAP.C.for this reason •%� ,�� DEMOL ❑ LDMA P/C# C Date: U OF EXISTING BL URM ❑ a Cf. Signature APPLICANT(PRINT) TEL NO. LDMA Perm# r''� L 4L•�09 IVI, as owner of the property, or my employees with wages as Z their sole compensation, will do the work and the structure is ADDRESS O =�1� itti•° f= not intended or offered for sale (Section 7044, Business and FINAL DATE G i i -. Professions Code.) !TEM-: 'F THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE J { + 1 El 1, as owner of the property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE'+ FINAL BY 0 I 0 I& 165 - 60 licensed contractors to construct the project (Section 7044, Business and Professions Code.) WiEl No 11C:( OH i¢5°%P WILLL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING LD OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH !:�rki�L i�� CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR '"'RR LL ° 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. r- , _ W 3097,CIV.C.) I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING 0000—]39IrI1 .J/ii i a CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE TITLE 2 CHAPTER 2 20 SECTIONS 2 20.100 THROUGH 2 20 140 CONCERNING HAZARDOUS i r}jr-, jt I! ° Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. 11 ° iL ❑ Lender's Address 0 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.C.FEE PERMIT FEE cm with all county ordinances and State laws relating to building zJ con ion,and ereby authorize representatives of this County ISSUANCE FEE �, 0 C9 to upo th bove-menti0 d prop rty for inspecn purposes• INVESTIGATION FEE TOTAL FEE / L� v sw_ a A"cnl ar Ami G"^ �i a SEE REVERSE FOR EXPLANATORY LANGUAGE COUNTY OF IAS 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 1105240019 PHONE: (626) 285-0488 EXT: ILEGAL ID: I NO. OF CONST I BUILDING ADDRESS: 1 ITR: 12205 LT: 26 I SQ. FT STORIES TYPE 1 5116 PAL MAL AV 1 (STRUCTURE: 220 V-B I TEMP CA 917803433 1 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: ARROWOOD I 18585-030-031 I I THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY, Cl [TENANT: (EXIST BLDG USE: RESID USE ZONE: R-1 TISSUED ON: PROCESSED BY: (EXIST OCC GRP: 105/24/11 SR 1 [OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: IF T8 FIN CODE: 1 ISANDOVAL RACHEL (626) 443-8098- 1 15116 PAL MAL AV 1 41,685 I I ITEMP 917803433 1 FEES PAID DESCRIPTION OF WORK I I IFINALIZED EXPIRED PERMIT FOR TUDY ROOM, DEN 220.5 SQFT. 1 IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:IPORCH 450 SQFT. 1 (APPLICANT: TEL. NO: I I I ISAME AS OWNER - IAA BLDG PERMIT ISSUANCE 27.80 1 I I JAB STATE GREEN BLDG FEE 41685.00 VAL 2.00 ISPECIAL CONDITIONS: [ I IAC STRONG MOTION RESID 41685.00 VAL 4.20 1 JB2 PERMIT W/ENERGY 41685.00 VAL 76.14 1 1 I -1 TOTAL FEES 110.14 1 I ICONTRACTOR: TEL. NO: I JAPPROVALS DATE INSPECTOR SIGNATURE ISAME AS OWNER - I I_ ILIC. NO [ ILOCATION AND SETBACKS I I I I 1 ISOILS ENGINEER APPROVAL I I I (ARCHITECT OR ENGINEER: TEL. NO: - 1 IFOUNDATION/TRENCH FORMS I I I LIC. NO: I ISLAB/UNDER FLOOR I I I I IRAISED FLOOR FRAMING I I I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP-1 JUNDERFLOOR INSULATION I I I 1147H273 3 001 11 I I I I IFLOOR SHEATHING INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I I I I 0 NO 21 1 IROOF SHEATHING 1 SCHOOL WITHIN HAZARDOUS 1 [SHEAR PANELS I I I JAIR QUALITY: 1000 FEET MATERIALS 1 I I I 1 1 NO NO NO 1 IFRAME INSPECTION I I I IFIRE SPRINKLER HANGERS 1 I I I I I JINSULATION/WEATHER STRIPI I I I I IINTERIOR'LATH/DRYWALL 1-1I I I I 1 I [EXTERIOR LATH I I I I I IRATED FLOOR/CEIL ASSEM. I I I I I 1 [RATED WALL ASSEMBLIES I I I I 1 IRATED SHAFTS/OPENINGS I I I IT-BAR CEILINGS I I I [LOT DRAINAGE 1 I I I IREPORT ID: DPR261 ROUTE TO: BS0508 1 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 1103070005 PHONE: (626) 285-0488 EXT: ILEGAL ID: I N0. OF CONST BUILDING ADDRESS: I ITR: 12205 IT: 26 I SQ. FT STORIES TYPE ] 5116 PAL MAL AV I I ISTRUCTURE: 3417 V-B I TEMP CA 917803433 [ [ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: ARROWOOD 18585-030-031 [ I THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY, Cl (TENANT: (EXIST BLDG USE: RESID USE ZONE: R-1 (ISSUED ON: PROCESSED BY: [ (EXIST OCC GRP: 103/07/11 SR I (OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: IF AL DATE FI Y: CODE: I SANDOVAL RACHEL (626) 443-8098- I 21,000 15116 PAL MAL AV ))) ITEMP 917803433 [ FEES PAID 1 `CR PTION OF WORK [ I IDEMO (E) COMP ROOFING, PLYWOOD & FASCIA INSTALL 271 LF ON I I IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT:INEW 2X6 FASCIA, 596 LF ON NEW lX8 SHIP LAP STARTER & 2,658 I (APPLICANT: TEL. NO: I ISQFT ON NEW 5/8" OSB TECHSHIELD RADIANT BARRIER PLYWOOD * 1 [STP ENTERPRISES INC. (626) 287-7544- IAA BLDG PERMIT ISSUANCE 27.80 I 5454 TEMPLE CITY BL. IAB STATE GREEN BLDG FEE 21000.00 VAL 1.00 ISPECIAL CONDITIONS: [ TEMPLE CITY CA 91780 IAC STRONG MOTION RESID 21000.00 VAL 2.10 I ID2 PERMIT W/O EN-HC 21000.00 VAL 402.60 I I TOTAL FEES 433.50 I I CONTRACTOR: TEL. NO: I [APPROVALS DATE INSPECTOR SIGNATURE 1 ISTP ENTERPRISES, INC. (626) 287-7544- I 1 [ 15454 TEMPLE CITY BLVD. LIC. NO [ [LOCATION AND SETBACKS I I I ]TEMPLE CITY, CA 91780 598157BC36 [ I [ I I [ ISOILS ENGINEER APPROVAL [ [ [ (ARCHITECT OR ENGINEER: TEL. NO: - I (FOUNDATION/TRENCH FORMS I I I LIC. NO: I (SLAB/UNDER FLOOR I I I I I IRAISED FLOOR FRAMING I 1 [ IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:[ (UNDERFLOOR INSULATION I I ] 1147H273 3 001 1 1 1 [ I I IFLOOR SHEATHING [ I I [NO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: I I I I [ NO 21 1 I ROOF SHEATHING (((JJJLLLy777��.. r 4 [ SCHOOL WITHIN HAZARDOUS [ ISHEAR PANELS I I I [AIR QUALITY: 1000 FEET MATERIALS I I I ] NO NO NO ] [FRAME INSPECTION I [ ] 1 I IFIRE SPRINKLER HANGERS I I I I I (INSULATION/WEATHER STRIPI I I [INTERIOR LATH/DRYWALL [ ] I I I I I (EXTERIOR LATH I I ] I I (RATED FLOOR/CEIL ASSEM. I I I (RATED WALL ASSEMBLIES I [ (RATED SHAFTS/OPENINGS IT-BAR CEILINGS I I I [ I* ADDITIONAL DATA ON FILE ILOT DRAINAGE I I ] I IREPORT ID: DPR261 ROUTE TO: BS0508 I ] I I I I I I I