HomeMy Public PortalAbout5351 PARMERTON AVE_Building__ �„ , ;•, � ; APPLICATION FOR BUILDING ,PENRMIT�T� .
COUNTY OF LOS ANGELES' = BUILDING�AND`SAFETY °, -
_ WORKER S COMPENSATION DECLARATION . FOR APPLICANT TO FILL IN- ADORE L
I hereby affirm that I have'a certdpaIs of consent to'self Insure BUILDING ADDRESS * '
4
or a certificate of Workers Compensation Insurance or a certified
copy,theect (Sec-3800 Lab,C) Lr r, OI G zI r b0 LOCnLRv -
O
��No �m' T SIZE OF LOT ` OF BLOCS NOW ON LOT ` 1
❑ Certlfed copy 6 hereby furn Lsfed 1 NEAREST CROSS
❑ Certified copy 6 filed with thelcounty building mspa iiron R TRACT BLOCK LOT NO ' 'I-
Aepartment N� USE ZONE I4PP'NO '
Data' Applicant PAGE f ' ASSESSOR MAP BOOK PAGE MRCEL r J�
v I r SPECIAL CONDITIONS ���� r
' CERTIFICATE OF EXEMPTION FROM WORKERS L OWNER TEL NO _^ A e,
COMPENSATION INSURANCE ' WITHIN 1000 FT OF SCHOOL+ - YES NO -
(This seam need not be completed II the permit Is for ane hundred ADDRESS' ,, ;
405� pSTRK ;-GROUP TYPECONST FREZONE PROCESSED BY
dollars($100)a less) m iI Carhty that M the performance of the work for,which,this permitZIP v a issued I shall rpt employ arty person In any manner so as toL �� (� t
become subject to the Workers Compensation Laws _ AACHR - TEL NO i
STATISTICAL CLASSIFICATION APT -CONDO -
Date J ' ApplicantADDRESS CLASS NO �`DWELL UNITS 2
NOTICE TO APPLICANT If atter maklrg this Cerhfwate of. V / [ REOL RED r TOTAL SE F M' EXIST
Exemption you should' become 'subject to the Workers CONTR TORY _ TE O qE j
Compensation prOnskons of,the Labor Code you must,fotlrwlth` . FRONT BACK YARD. HWV r P , WIDTH 'CO
comply with such prons,ons or this Permit shall be deemed revoked' ADDRESS- ' - -LIC NO - P l. `
LICENSED CONTRACTORS DECLARATION SIDE d
CITY - LIC CLASS • P L T s• - _ (3 �
I hereby affirm that I am licensed underprovSDre of Chapter 9 SEWER MAP LN
(commencing with Section 7000)of DNUINNI 3 of the Business and K ' SO FT SIZE NO OF STORIES' NO OF FAMIUES NEW ❑ SE r i C Yv t5(
Profeaswru Code and my license Ism full force and effect d _ r�
License Number LIc Class _ DESCRIPTION OF WORK ADD ❑ 7OATION ► CHANGE `+ .0!�c.T
O -Q d I l LLI
d
Contractor - Datei ALTER Tn
❑ 1 am exempt under Sec REPAIR ❑_ $ 0000-9001 2/14/96?
BBPC for this reason a DEMOL ❑ 4845 1 AN 9:22
LOMA P/C I, r t
T Date USE QF EXISTING SLOG + . . URM ❑
r $gnatura �, W APPLI ! TEL - LORA Perm! AitT.A ` r
I as Owner of the property or my employees with wages Bs L . 2
their sole comperlRatpn well do the work and the structure Is O ,33303 " 192:45,
not Intended or offered for sale (Sect,an,7044 Business and• 0 FINAL DATE F
Professions Code I O • 1 ITEMS A' '
W41 TrE ME DONT OR G A RDOUG MGIIFNNr HN10.E 1 R GREATER
THAN
THE 1 `�1
❑ I as owner of the property am exclusively contracting with OR A AMOl I sRECffTIEOTOI�A SS I ATERIT�us rrOORRNAPOR GU , T1UN TIE FINAL BY r W l a Ti1TAL 192- 45
licensed contractors to construct the project ISectKp 7044 VES❑ No❑ ')r ` , ' '` ` ' L
Busmess'and Professwre Code) - I �'A`" '. LFIECYx 192:45
WILL THE INTENDED USE OF THE 9UIOUIN f BY THE GPRJUWT OR FUTURE BUILDING i\11 1 ` �`C'HANGE v r ^ .00
i (OCCUPANT REOORE A PERMIT FOR CONSrRII[:TgN OR MGD TION FROM THE SOUTH„ +-
CONSTRUCTION LENDING AGENCY i -COAST AIR OwurY MANAGEMENT DSTRICT ISCAOMoj SCE PERMITTING CHECKLIST FOR
aLlpEulEs
I hereby affirm that there Is a`Aconstructan lending agency for YES❑ No❑
he performance of the wale for which lhL4 permR U3 Issued(Sec IHWE READ THE IAZARWLB IMTERALS INFORMATION DUDE AND THE SCAOMO PERMITTING , N��NT ('�(G + , 2 2
3097 CIV C) CHECKLIST I UNDERSTAND MY REQUIPEWNTS ORDER THE LOS ANGELES COUNTY �,' ; lRJO��IILJQ 1 /io/��
N TME 2 CHAPTER 220 MCTIONS 2 20100 THRWGH 2 20140 CONCERNN*HAZARDOUS - ,49O! 1 ` AM 1r i 1J'
Lender S NarT16 ANTEWALS REPORTING MV FOR CBTAnNO A PERMIT FROM THE SLAOMD
i Lender s Address
I cerhty that I have read this application and state under penalty
of perjury that the above Information Is correct I agree to comply PC FEE / L"� PERMIT FEE -
'n With all county ordinances and State Laws relating to building �.J ✓^S �.J t 1 1
construdwn and Hereby authorize representetives of this County Y ISSUANCE FEE
5e to enter n the above ned p fa Inspection POSes O� '
T1 oQ ?O "VESTIGATION FEE TOTAL FEE
SEE REVERSE FOR EXPLANATORY LANGUAGE
•APLI
CATION DING:.PERMIT `< .
'W I � ',� I ' �� COUNTY OF LOS ANGELES *' BUILDING AND'SAFETY
WORKER S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN , .,� G AODREss ��„r{ � _ • �' �-
,I hereby affirm that I have•a cerbflcate of,consent to sett Insure BUILDWG AODii S ME
1r Zr,!certificate of V.brkers Compensaton Insurance «•a certified 535 /" y4 �'I a- 4
V Copy •hereo[(Sec 3800 lab C)%"(' \ u�1 '.-t Y v CITY¢., M "T
\ • • - Rt vrTYIPLS Q/ /:7130 ocnury w
4• H
Policy�• r + � COmPenY 1 „ SIZE OF LOT` NO OF BLLIGS NOW ON LOT_ ' l�� T^ - `• - - z
r ❑' Cerbf•led copy u hereby furnished '• 1 - " r
NEAREST CROSS ST ' - R F ii
•'❑•Certified copy,Is filed with the county bulldirp'Inspecton - , £` TRACT "BLOCK LOT NO
,'tide'Partment. l • J. LISE ZONE
` ', , +• s ASSESSOR MAP BOOK"' PAGE + •• PARCEL . i. .-.. n 1 ••�+ L•b S -• - r •-.,.
1 k^Date ^ Hppflcant - -. _ , , _, - A•+ •�� S Z SPECIAL CONDFTQNS
•" ;CERTIFICATeOF EXEMPTION FROM WORKERS'"`�,� •oMrt+sR -' TSL NQ �' . , ,
COMPENSATION INSURANCE`" . 7:''M ' A��N ✓i L /�'� IMTHIN 1000 FT of SCHOOL'
�. vas No 14
(This sectxxi need not be completed IP the• - ' I ADDRESS,.' - • ^ .i
p«mit 19 fa ane`11 red-n #°s3 J�'l PA:x1f O 'TT U� - DISTRICT , GflOUP TY ST' FIRE ZONE PROCESSED BY
dollars (E 100)or less l n • ', " �+' _ rI < :
certify that m"the pert«mance ot'•he ,ark for which this'permd -
h at cm `TEM p�� QI T ZIP /r 780 i'
•3';m Iavoed I shall not employ any person in,arry manner'"'as"to•k _ �D� �
beCGrtla Sub CI t0 the WorKem ARCHITECT OR ENGINEER i r r TEL NO
la 7Compansaton Laws. ., . ,
£T STATISTICAL,CLASSIFICAT01N PPT CONDO 1 1
t- Date cd' , a Applicant_° a+ _. ^'. �`a ADDRESS - _ _ GLASS NO Dil UNITS£ �!
` NOTICE,ATO.APPL/CWT If'after making••the Certlicafe Of$ - ` REQUIRED - • I TOTAL SETBACK FROM EXIST •' t
• Ex PbOn ' yDU Shciuld,,become sub)eCt�Jo the "Workers CONTRACTOR TEL NO ` '. SET,BACK � YARD HWY _ PROP LINE - -WIDTH
Cbmpensato.0iirove ns ol'the Labor Code you must`forttwlth I -fN/�1/� .FRONT ' < - • '"•� -
comply,vnth`such provisone or this permit shall be deemed revoked•; ADDRESS - . JCIF
LIC NO-r -" p L
LICENSED CONTRACTORS DECLARATION ^t < t _r �� +~ SIDE I1�
iF CITY ^ LIC'CLASS 4 $ P L • U
I hereby6affi rn that I am licensed underprovisions of Chapter.9 �.. SEWER MAP `• '
(commencing with SectK 7000)Of Dlvimn 3 of the_&islness and SO FT SIZE NO.OF.STORIES NO IUES
Protesslrns Code'and my'IDerise islln fWl force and effect' -
NEW ❑ BK PG 0
License Number J 1 • Lo�CIas9 r} DESCRWTION OF WORK .r �. - N — {ADD ❑ -VALUAl10N a B-0 , ' .. iw
Contract« a 's
Date \ s _ , *$ ��Q< — _ T 1 - d
s ^` - _ , ,ALTER ❑ N
-❑ 1 am exempt under Sec _ - REPAIR ❑ 'r$ • ' H "Z
RBPC,fof this reason s -r, �' i' Y DEMOL ❑ pLDKU P/C
' •` ' USE OF EXISTING BLDG . URM i ❑ Y , '` a _ �' , -
Date - { '
AJ$gnatune APPLICANT(PfialTl - _ TEL NO r COMA Perm o - .♦` t '1• ,
jp I e9 owner Of the property.Or my employees with wages as _'r Y _ . 2 A�(} ,i
" tF101r sde CAmpereabOn will d0 the work land the structure IS ADDRESS , '! C: ' ' FINAL '� F ' j�OJ 00•55l
notonterided or offered f« sale`(Secton 7044 Susiross°end ' - �' Q
Pidessans Code)yi - ' y <wu,iHE naalcwNT OR cuTURE WILDING occLwANr H,viae rte,w,zw S M TERuL• ,F.� � .. ] ,. —,1 ITEM • i - ,'
❑'I as owner of the property am exclusively coritrachrg wlih OR A MImaE CONT"NG A w.z''noous WTFRI. Eo To OR GR AreR TPw+THE Q /�� i
AMOLNI9 y c ED ON THE H DODS MATERALS YFORWION GLIDE+ `FINAL BY. A> TOTAL 1 -,155
,licensed contractors to construct the prgect fsectiDn 7044 7-
"Business and Piotessions Code) , ~ <res❑ T NO❑" r _ P rr
WALL THE INTEfOED USE•OF.THE 3UIOUh3 BY.THE dPPLIUNT OR FUTURE OULDIN3
OCCUPANT REDURF A PEPMn FOR c«+srnlx:Taxr OR MODFIDATDN FPDN THE,SOUTH , CHECK d ' 125.
7 - ',CONSTRUCTION LENDING AGENCY r r COAST AB OUAUTY MANAGEMENT NSTROT ISCAOMDI SEE PERMnTING CHECKUST FOR
I hereby affirm that there is a construdon lending agency for yEs❑ NO❑� ,•'." _• + -___' .-� _ „4 a, ' t• may), `
the`perf«mance of the work for which this permit IS issued(sec • F r - •" - (�'1(1(ry r�/�i -(� p( '
30971,Cw,C) `' .CHECKUST UNDERmAND MY EGIaiEM NTS ALIDER THETION ELOS DANC£LETHE S COUNTY CODE sr �_ _ '`� p:♦ 0 00-0001 • _3/20�96' V
yf TME 2 CHAPTER 2 20 SECTIONS 2 20 100 TMOUGH 2 20 IAe GONCERNMi HAZ RDOUS r �� f
Q+ Lender,9 Name- , ,r • MATERALS REPprmNG AND FOR CVMdNiNG A PERMIT FROM TRE ee/-0AO r r , ' •
n-.(O.
•RO T Lenders Address
' r a aw+En u,.oLm •-� 'l. . s a'_ r • £..•T
@g 1 cetbly that^I havertead this appicatlon and state under penalty
g f 1 PC'FEE . y PERMIT FEE' t
of parlury that the above Inform a correct I agme tomomply
in with all cou`n • _
ry admances and`State laws relatuq b building
1 `k�
construct ho hereby !Utt�fIORJE�1a represen fives of ihls COUnty t - .+e� , -` ISSUANCE FEE ` JO •. ' ' '
to enter above-, d(Pr inspection S n TOT.ALFEEof Q _ L • , ' - ' t
INVESTIGATION FEE
�.• d Mani M• .' � } t 1' n b n ' i d • . .
1SEEIRE6lERSE FOR EXPLANATORY LANGUAGE
COUNTY OF LOS ANGELES TEMPLE CITY N 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD
r BUILDING AND SAFETY / LAND DRVELOPMENT TEMPLE CITY CA 91780 BL 0508 0512120012
PRONE (626) 285-0488 EXT
LEGAL ID - NO OF CONST NEW BUILDING ADDRESS
TR 13613 LT 62 SQ FT STORIES TYPE OCCUP GROUP 5351 PARMERTON AV
STRUCTURE 1067 - 1 VN R3 TENS CA 917803504
ASSESSOR INFORMATION NUMBER GARAGE NEAREST CROSS STREET DAINES
8573-005-023 OTTER 231 1 VN U1 THOMAS PAGE 597 GRID C3 "LOCALITY TEMPLE CITY C
TENANT EXIST BLDG USE USE ZONE ISSUED ON PROCESSED BY EXPIRES ON r
EXIST OCC GRP 07/27/06 JK 07/22/07
OWNER TEL NO BLDG9 NOW ON LOT VALUATION EvINAL DATE FINAL BY - CODE
LY DIANA V YIP PAUL (626) 443-0281- 92`650 –G/
5351 PARMERTON AV
TEMP 917803504 r FEES PAID D19SCRIPTION OF WORK
ADD MASTER BEDROOM BATHROOM FAMILY ROOM 1067 9 F AND
PER DESCRIPTION QUANTITY UOM AMOUNT COVER PATIO 231 S F
APPLICANT TEL NO
LY (626) 443-0281- B1 PLANCHECK W/ENERGY 60260 00 VAI 850 61
5351 PARMERTON AVE B1 PLANCHECK W/EWERGY 92650 00 VAI, 296 21 SPECIAL CONDITIONS
TEMPLE CITY CA 91780 AA BLDG PERMIT ISSUANCE 27 75
AC STRONG MOTION RESID 92650 00 VAL 9 27i.D
B2 PERMIT N/ENERGY 92650 00 VAI, 1 349 21 D
CONTRACTOR TEL NO TOTAL FEES - 2 533 05 APPROVALS DATE INSPECTOR SIGNATURE
SATURN SYSTEMS INC (310) 329-2728-
15916 S FIGUEROA LIC NO LOCATION AND SETBACKS -
GARDEHA CA 90248 683127,E
' SOILS ENGINEER APPROVAL
ARCHITECT OR ENGINEER TEL NO FOUNDATION TRENCH FORMS
LIC NO SLAB UNDER FLOOR
RAISID FLOOR FRAMING
ct—
MAP NO SEWER MAP BOOK PAGE FIRE ZONE CP UFOSRPLOOR INSULATION
3 01 �� c
' 1ST LEVEL FLOOR SHEATH
NO OF FAMILIES DWELLING UNITS APT/COND STAT CLASS
NO 21 2ND LEVEL FI R SHEATH -
SCHOOL WITHIN HAZARDOUS r ROOF SHEATeIN
AIR QUALITY 1000 FEST MATERIALS u✓ ~� L D 1
NO NO NO FIRE DEPT FRAME INSPECT
REQUIRED TOTAL SETBACK FROM EXIST BLDG DEPT FRAME INSPECT r
SET BACK YARD HWY PROP LINE WIDTH
FRONT PL- SHEAR PANELS
SIDE PL-
INSULATION WEATHER STRIP
INTERIOR LA)=
EKTERIOR,LATH
LOT DRAINAGE
` r SWORE DETECTION DEVICES
FIRE DEPARTMENT APPROVAL
REPORT ID DPR261 ROUTE TO BS0508
r
COUNTY OF IAS ANGELES _ TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0710100040
PHONE (626) 285-0488 EXT
LEGAL ID NO OF CONST NEW I BUILDING ADDRESS
TR 13613 LT 62 I SQ FT STORIES TYPE OCCUP GROUPI 5351 PARMERTON AV 1
(STRUCTURE 127 1 VN R3 I TEMP CA 917803504
ASSESSOR INFORMATION NUMBER GARAGE NEAREST CROSS STREET DAINES
18573-005-023 OTHER THOMAS PAGE 597 GRID C3 UJCALITY TEMPLE CITY Cl
TENANT EXIST BLDG USE USE 20NE ISSUED ON PROCESSED BY E%PIRE9 ON
EXIST OCC GRP 10/10/07 SR 04/07/08
I
LLYNER TEL NO DIANA V YIP PAUL (626) 443-0281- BLDGS NOW ON IAT VALUATION _�3 DAT FI�I/1BY CODE
10 000 IfnV
5351 PARMERTON AV
ITEMP 917803504 FEES PAID IDESCRIPTION OF WORK 1
I (ADD 1 BEDROOM IN LIVING ROO RELOCATING OF 1 BATHROOM, TO 1
I IFEE DESCRIPTION QUANTITY UOM AMOUNT (ENLARGE DINING AREA
(APPLICANT TEL NO I
ILY (626) 443-0281- IAA BLDG PERMIT ISSUANCE 27 75 1
15351 PARMERTON AVE IAC STRONG MOTION RESID 10000 00 VAL 1 00 ISPECIAL CONDITIONS 1
TEMPLE CITY CA 91780 IB2 PERMIT W/ENERGY 10000 00 VAI, 238 26
D7 ADDNL PLANCHECK FEE 1 00 HOU 109 35
TOTAL FEES 376 36
ICONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE
SATURN SYSTEMS INC (31 0)
329-2728-
115916 S FIGUEROA LIC NO 1 IIACATION AND SETBACKS 1 I
GARDENA CA 90248 683127 B
SOILS ENGINEER APPROVAL
(ARCHITECT OR ENGINEER TEL NO � FOUNDATION/TRENCH FORMS I
LIC NO
I (SLAB/UNDER FLOOR I I
RAISED FLOOR FRAMING
MAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP
01 iUNDERFLOOR INSULATION
IND OF FAMILIES DWELLING UNITS APT/COND STAT CLASS 19T LEVEL FLOOR SHEATH
NO 21
I 2ND LEVEL FLOOR SHEATH I
SCHOOL WITHIN HAZARDOUS ROOF SHEATHING I I 1
jAIR QUALITY 1000 FEET MATERIALS
NO NO NO _ FIRE DEPT FRAME INSPECTI
REQUIRED TOTAL SETBACK FROM EXIST (BLDG DEPT FRAME INSPECT( I
(SET BACK YARD HWY PROP LINE WIDTH
(FRONT PL- BREAK PANELS
SIDE PL-
INSULATION/WEATHER STRIP(
(INTERIOR LATH/DRYWALL
EXTERIOR LATH
(IAT DRAINAGE
SMOKE DETECTION DEVICES I I I
_ (FIRE DEPARTMENT APPROVALI ,
1
REPORT ID DPR261 ROUTE TO BS0508
I I I I I I