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Home My Public Portal About5812 PRIMROSE AVE_Building__ WORKERS'COMPENSATION DECLARATION ' I hereby affirm that I have certificate of consent to self APPLICATION F BUILDING P E I T insure, or a certificate of Workers' Compensation Insurance, or a cer' Q copy thereof(Sec. 3800 Lab r,C.`) ` i- COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. "��`O Co pay ®161) &4glfr— ' BUILDING ry El Certified copy is hereby furnished. �`J� TAPPLICAO FILL IN ADDRESS �CJ�� L7 Certified copy is filed with the county building inspec- BUILDING tion depart ent. ADDRESS it • ///��n CITY �hyZIP LOCALITY x/4 C�.Date _ - Applicant ^ Q— O.OF BL NEAREST CERTIFICA OF EXEMPTION FROM WORKERS' SIZE OF LOTOW ON LOT CROSS ST. COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit Is for one TRACT LOT NO. MAP BOOK PAGE PARCEL hundred dollars ($100)or less:) TEL.OWNER NO. _ USE ZONE MAP I certify that in the performance of the work for which this , SPE permit is issued, I shall not employ an person in an manner ADDRESS �w SPECIAL y P P Y Y P Y ��U W-L La- CONDITIONS o- so as to become subject to the Workers'Compensation Laws. �,� OO i ClZIP Date Applicant ARCH Ci OR TEL. ; DISTRICT GROUP TYPE FIRE PROCESSED BY 0 NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. CONST. ZONE o Exemption, you should become subject to the Workers' �_Q �/ i( V Compensation provisions of the Labor Code, you must forth- ADDRESS �� ✓ y ✓ G✓�� N with comply with such provisions or this permit shall be TEL STATISTICAL CLASSIFICATION APT. CONDO. deemed revoked. CONTRACTOR •NO l1 z LICENSED CONTRACTORS DECLARATION LIC. CLASS NO.. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRES 2- NO' �5 SEWER MAP (commencing with Section 7000)of Division 3 of the Business LIC. „rjj q and Professions Codeand my license is in full force and effect. CITY ' CLASS 7 BK PG VALIDATION SQ. FT. NO.OF / NO.OF CHECK Nums License ber Lic. Class SIZE STORIES ( FAMILIES ONE . VALUATIO Contractor0pJ"91 -Date $ �( I" s DESCRIPTION OF WORK NEW ❑ /� .CIO� ElI am exempt under Sec. ADD ❑ ALTER LJB.B+P.C. for this reason REPAIR ❑ -. $ DUSE OF Date: EXISTING BLDG. DEMOL ❑ o- Signature APPLICANT (PRINT) NOFINAL . OWNER-BUILDER DECLARATION DATE 2-7-15 1 hereby affirm that I am exempt from the Contractor's License ADDRESS FINAL Law for the following reason (Section 7031.5, Business and 1 Professions Code): s` PRESENT BY ❑ I, as owner of the property, or m employees with BUILDING ACCTo4 p p y. YADDRESS wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY3,07 98.63 7044, Business and Professions Code.) MOVING TEL. ❑ I, as owner of the property,am exclusively contracting CONTRACTOR NO. 1 ITEMS with licensed contractors to construct the project (Sec- ADDRESS TOTAL 98_63 tion 7044, Business and Professions Code.) CONSTRUCTION LENDING AGENCY SEETTBACK YARD HWY TOTAL SETBACK WIDTH CHECK 98.66 I hereby affirm that there is a construction lending agency for FRONT CHANGE •00 the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE P.L. LDMA Ref. # Lender's Name 0000-0001 1/19/931 � 3 I � P.C. Fee$ Permit Feec7 � p+� q 1 A A 9o�lrs� Lender's Address 2 1 certify that I have read this application and state that the Issuance Fee LDMA P/C# '- Investigation Fee above information is correct.I agree to comply with all County g if,, • / �J ordinances and State laws relating to building construction, Total Fee a LDMA Perm.# = and hlowereby author' a representatives of this County to enter the ab tion d property for inspection rposes. o • SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of A plicant or Agent Date 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 1112190066 PHONE: (626) 285-0488 EXT: ]LEGAL ID: 1 NO. OF CONST I BUILDING ADDRESS: I ITR: 6561 LT: 648 I SQ. FT STORIES TYPE 1 5814 PRIMROSE AV I ISTRUCTURE: 12 V-B I TEMP CA 917802110 I (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: ] 18587-015-027 I I THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, Cl IL (TENANT: (EXIST BLDG USE: RESID USE ZONE: R-2 (ISSUED ON. PROCESSED BY: (EXIST OCC GRP: 112/19/11 SR (OWNER: TEL. NO: [BLDGS. NOW ON LOT: VALUATION: IFINAL DATE FINAL BY: CODE: [ 1PATTISON ROBERT L JR (626) 286-5490- 1 7,000 1 15812 PRIMROSE AV I I '/Z / I ITEMP 917802110 [ FEES PAID IDESCRIPTION OF WORK I I ] ITEAR OFF EXISTING WOOD ROOF, RESHEET 1/2 CDX AND INSTALL 25 I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:ICOMP SHINGLE TEAR OFF 1 WOOD 2 COMP I APPLICANT: TEL. NO: I I I ILUCE, DAVID - IAA BLDG PERMIT ISSUANCE 27.80 1 I IAB STATE GREEN BLDG FEE 7000.00 VAL 1.00 ISPECIAL CONDITIONS: I IAC STRONG MOTION RESID 7000.00 VAL 0.70 1 I [ D2 PERMIT W/O EN HC 7000.00 VAL 166.60 1 I I I TOTAL FEES 196.10 1 [CONTRACTOR: TEL. NO: 1 (APPROVALS DATE INSPECTOR SIGNATURE [MODERN ROOFING (818) 843-5050- 1 1 I 12219 W OLIVE AVE LIC. NO 1 ILOCN.ION AND SETBACKS I I I 1#282 807881 [BURBANK CA 91506 1 ISOILS ENGINEER APPROVAL [ I I (ARCHITECT OR ENGINEER: TEL. NO: 1 ]FOUNDATION/TRENCH FORMS I I I LIC. NO: I ]SLAB/UNDER FLOOR I I I I ]RAISED FLOOR FRAMING MAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:] ]UNDERFLOOR INSULATION I I I 1150H269 3 001 1 I I I I I IFLOOR SHEATHING I [ I INO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: I I I I I 0 NO 21 [ [ROOF SHEATHING 1 SCHOOL WITHIN HAZARDOUS 1 SHEAR PANELS 4 1 ]AIR QUALITY: 1000 FEET MATERIALS I I I I I 1 NO NO NO I ]FRAME INSPECTION I I I IFIRE SPRINKLER HANGERS I I I I I I I I I ]INSULATION/WEATHER STRIP] I I I (INTERIOR LATH/DRYWALL I I I I I 1EXTERIOR LATH [ I I IRATED FLOOR/CEIL ASSEM. I I ] IRATED WALL ASSEMBLIES [ I I IRATED SHAFTS/OPENINGS I I [ IT-BAR CEILINGS 1 I I* ADDITIONAL DATA ON FILE I I I I I [ ILOT DRAINAGE ] I I IREPORT ID: DPR261 ROUTE TO: BS0508 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 1112190067 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: ITR: 6561 LT: 648 SQ. FT STORIES TYPE 5812 PRIMROSE AV 1 STRUCTURE: 18 V-B TEMP CA 917802110 ASSESSOR INFORMATION NUMBER: 1 1 NEAREST CROSS STREET: 18587-015-027 1 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, Cl TENANT: 1EXIST BLDG USE: RESID USE ZONE: R-2 ISSUED ON: PROCESSED BY: 1 1EXIST OCC GRP: 12/19/11 SR (OWNER: TEL. NO: JBLDGS. NOW ON LOT: VALUATION: IFINAL DATE FINAL BY: CODE: IPATTISON ROBERT L JR (626) 286-5490- 1 3,000 �J'`� 5812 PRIMROSE AV I I�1--1y -IO TEMP 917802110 1 FEES PAID ID SCRIPTION OF WORK TEAR OFF EXISTING WOOD ROOF, RESHEET 1/2 CDX AND INSTALL 25 I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:JCOMP SHINGLE TEAR OFF 1 WOOD 2 COMP DETACHED GARAGE APPLICANT: TEL. NO: ILUCE, DAVID - JAA BLDG PERMIT ISSUANCE 27.80 JAB STATE GREEN BLDG FEE 3000.00 VAL 1.00 ISPECIAL CONDITIONS: JAC STRONG MOTION RESID 3000.00 VAL 0.50 ID2 PERMIT W/O EN-HC 3000.00 VAL 99.10 1 TOTAL FEES 128.40 1 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE MODERN ROOFING (818) 843-5050- 12219 W OLIVE AVE LIC, NO LOCATION AND SETBACKS #282 807881 1BURBANK CA 91506 1 SOILS ENGINEER APPROVAL 1ARCHITECT OR ENGINEER: TEL. NO: - 1 FOUNDATION/TRENCH FORMS' 1 LIC. NO: 1 SLAB/UNDER FLOOR 1 1 1 1 iRAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:J JUNDERFLOOR INSULATION 1150H269 3 001 1FLOOR SHEATHING INO. OF FAMILIES. DWELLING UNITS: APT/COND: STAT CLASS: 0 NO 21 IROOF SHEATHING M SCHOOL WITHIN HAZARDOUS ISHEAR PANELS � I AIR QUALITY: 1000 FEET MATERIALS 1 NO NO NO 1 1FRAME INSPECTION FIRE SPRINKLER HANGERS 1 1 11NSULATION/WEATHER STRIP INTERIOR LATH/DRYWALL EXTERIOR LATH RATED FLOOR/CEIL ASSEM. 1 1 iRATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS 1T-BAR CEILINGS 1 J* ADDITIONAL DATA ON FILE LOT DRAINAGE 1 1REPORT ID: DPR261 ROUTE TO: BS0508 1 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 1112190065 PHONE: (626) 285-0488 EXT: (LEGAL ID: I NO. OF CONST I BUILDING ADDRESS: I ITR: 6561 IT: 648 I SQ. FT STORIES TYPE 1 5812 PRIMROSE AV I ISTRUCTURE: 18 V-B I TEMP CA 917802110 ] (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 18587-015-027 I I THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, Cl ITT° (EXIST BLDG USE: REBID USE ZONE: R-2 TISSUED ON: PROCESSED BY: 1 (EXIST OCC GRP: 112/19/11 SR (OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: IFINAL DATE FI Y: CODE: I IPATTISON ROBERT L JR (626) 286-5490- 1 8,000 11 15812 PRIMROSE AV I I � V ITEMP 917802110 I FEES PAID IDESCRIPTION OF WORK 1 I I ITEAR OFF EXISTING WOOD ROOF, RESHEET 1/2 CDX AND INSTALL 25 I I IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT:ICOMP SHINGLE TEAR OFF 1 WOOD 2 COMP 1 (APPLICANT: TEL. NO: I I ILUCE, DAVID - IAA BLDG PERMIT ISSUANCE 27.80 1 I 1AB STATE GREEN BLDG FEE 8000.00 VAL 1.00 ISPECIAL CONDITIONS: 1 I IAC STRONG MOTION REBID 8000.00 VAL 0.80 D2 PERMIT W/O EN-HC 8000.00 VAL 183.40 I I TOTAL FEES 213.00 1 I ICONTRACTOR: TEL. NO: 1 (APPROVALS DATE INSPECTOR SIGNATURE IMODERN ROOFING (818) 843-5050- [ 1 I 12219 W OLIVE AVE LIC. NO I ILOCATION AND SETBACKS 1#282 807881 1 I I I IBURBANK CA 91506 1 ISOILS ENGINEER APPROVAL I I I (ARCHITECT OR ENGINEER: TEL. NO: I IFOUNDATION/TRENCH FORMS I I I I - I ILIC. NO: 1 (SLAB/UNDER FLOOR I I I 1 IRAISED FLOOR FRAMING I MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:I (UNDERFLOOR INSULATION I I I 150H269 3 001 1 1 I I I [FLOOR SHEATHING INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I I I 0 NO 21 I (ROOF SHEATHING Z h 1 SCHOOL WITHIN HAZARDOUS 1 ISHEAR PANELS ]AIR QUALITY: 1000 FEET MATERIALS 1 I I I I 1 NO NO NO I [FRAME INSPECTION I I I [ I (FIRE SPRINKLER HANGERS` I I I I I IINSULATION/WEATHER STRIP( I I I ] IINTERIOR LATH/DRYWALL I ] I ] I I ] I 1EXTERIOR LATH ] I I I I I I [RATED FLOOR/CEIL ASSEM. [ ] IRATED WALL ASSEMBLIES I I I � I I IRATED SHAFTS/OPENINGS I I I I I I IT-BAR CEILINGS I ] I* ADDITIONAL DATA ON FILE I (LOT DRAINAGE IREPORT ID: DPR261 ROUTE TO: BSnE08 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 0111200033 PHONE: (626) 285-0488 EXT: GA 0. OF CONST BUTLDT9 TR: 6561 LT: 648 ! SQ. FT STORIES TYPE 5812 PRIMROSE AV � WRUCTURE: VN TEMP CA 917802110 ASSESSOR 0 R: NEAREST CROSS STREET: LAS TUNAS 8587-015-027 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG . RESID USE ZON9: R-2 ISSUED ON: — PROCESS-ED . EXIST OCC GRP: 11/20/01 JK 05/19/02 i OWNER: TEL. NO: B DGS. NOW ON LO VALUATION: FINAL E FI B CODE: PATTISON ROBERT L JR (818) 286-5490- 2,000 / 0/ 'j5812 PRIMROSE AV r 7 TEMP 917802110 FEES PAID —DOGRIPTioN VOLUNTARY FOUNDATION BOLTING RETROFIT, L.A. CITY STD PLAN #1 FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: WEINSTEIN CONSTRUCTION CORP (818) 789-1400- AA BLDG PERMIT ISSUANCE 27.75 13557 VENTURA #200 'AC STRONG MOTION RESID 2000.00 VAL 0.50 SP C� A CONDITIONS: SHERMAN OAKS 91423 D2 PERMIT W1fC /0 EN= --- 2000.00 VAL 82.20 ATO(-, Z F.E` 110.45 CONTRACTOR: TEL. NO: ®�/I�i �1 APPIOVALS DATE INSPECTOR SIG TURE WEINSTEIN CONSTRUCTION (818) 789-1400- 13557 VENTURA BLVD LIC. NOLOCATION STE. 200 6304398 SHERMAN OAKS, CA 91423-3999 6 / f'� �'� �. S0I4S ENGINEER PPROVAL ARCHITECT 0 0: �✓ I Ld'1 r, �� a 0 I _ rION/TRENCH FORMS7Z 9 LIC. N0. 't --- r I I �� ± ``�� SLAB/UNDER FLOOR �— RAISED FLOOR MOM P NO: SEWER MAP BOOK: PAGE: FIRE 0 E: CMP,: 1 1 f� `, I I�� t r }�i i I I ,�7 r UNDERFLOOR NSULATION 150H269 3 Ole'��II I ff r��( n r^ 1 0 : DWELLING S: P CO D: STAT CLASS-:---- --- _ -- -- -- NO ,, 21 - — .r% f/ ii ` ,—;--- — `/ ROOF, SHEATHING SCHOOL WITHIN IMIXIDOUS 16 p "' s s AIR QUALITY: 1000 FEET MATERIALS �� NO NO NO `, 1��j i f' '�s� E INSPECTION REQUIRED TOTAL SETBACK FROM EXIST ; - FIRE S R RS SET BACKYARD: HWY: PROP LINE: WIDTH: � $ P� CC E�aAT ON/WEATHRS SIDE PL- /DRYWALL EXTERIOR LATH i 00 SSE . RATED WALL ASSEMBLIES SHAFTS/OPENINGSRATiD -BAR CEILINGS I REPORT ID: DPR261 ROUTE TO: BS0508