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Home My Public Portal About10217 RANDWICK DR_Building__ TEMPLE CITY IBA63M CC.#803.1-61 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS f BUILDING AND SAFETY DMSION LOCALITY 1 JOHN A. LAMBIE. COUNTY ENGINEER NEAREST WILLIAM A.JENSEN SUPT OF BUILDING CROSS ST. DIST NO. GROUP TYPE SSED BY FOR APPLICANT TO FILL.IN c Q CONST. _ BUILDING y� STATISTICAL C SIFICATION S ER MAP ADDRESS 4Nlo t C� 4/ K PG CLASS. NO-4- DWELL.UNIT LOT NO. BLOCK WATER NOT REQUIRED,• RECEIVED CERTIFICATE: TRACT O MAP HIGHWAY STATE MAJOR SECOND,, OCAL' NO.OF LDGS. NO (CIRCLE)=• SIZE OF LOT. I NOW ONBLOT USE ZONE SPECIAL USE CONDITIONS EXISTING BLD�G1. TE ��- OWNER UW40' t. . NO.A r6nd BUILDING EXIST. r�/�,�` ��y� • SETBACK YARD HWY STREET NAME WIDTH ADDRESS�77A�f. IGr//� CIYY � FRONT 1 ARCHITECT OR TEL. P.L. ENGINEER NO. SIDE P.L. >i ADDRESS TEL 1 .) INSPECTION RECORD p CONTRACTOR d AUW6R+ 'PEV Gyb• rNO. f 1!� /� t✓ U ADDRESS 5"7 Z4 F)"10LF CQTY� p I�(�i l• (/ f DESCRIPTION OF WORK %frT �i �..�.�%ri7! f%rte• prt��/r ��>I�//.IAtG� b� a ADD ALTER REPAIR DEMOLISH SQ.FT. NO OF NO.OF 1 -. • rU.�v/I � �! R ? IZE d STORIES FAMILIES SE OF 'D �`•,'y J STRUCTURE r -r vr r SIGNATURE OF Sv�oT. APPLICANT VALUATION APPROVALS ID/A�TE INSPECTOR'S 510144ATURE FEE Ao$ PMT. FO FORMS,MATERIALS LOTION I►A!�?Y�� CJS/ �// FEE $ FRAME:FIRE STOPS, « _ 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING,BOLTS +� AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE:LOCATION, WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS AA �;II BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK e 8 AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH,INT. 1 I( .. J 2F TION OF THE LABOR CODEOF THE STATE F LIFORNIA RELAT- ING TO WORKMEN'S CO N TION NS RA E. LATH,EXT. I SIGNATURE OF HOUSE NUMBER COR- "'- PERMITTE i RECT AND POSTED ADDRESS md- j qtr FINAL / 0, CLYDE N. DIRLAM, PRINCIPAL STR RAL ENGINEER PLAN CIECE VALIDATION ( cIL� M.O. CASH PERMIT VALIDATION CK.r M.G. CASH, LAuo 6 5. 2. 6% NOV. 7 2 3 D 2 8.5 0® a � 'G07 3 1 6 My 2 3 1 D 5 7.00- cm �i��E%I!`l7ilA�.riemr/ y�Z(�rla1 TEMPLE CITY i6e666eCe#666.1-61 APPLICATION. FOR BUILDING PERMIT ' , LI COUNTY OF LOS'ANGELES BUILDING DEPARTMENT OF COUNTY ENGMEER AD°RESH BUILDING AND SAFETY DMSION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST eOPNS:!;! WILLIAM A.JENSEN SUPT OF BUILDING CROSS ST.DISCT N GROUP PRFOR APPLICANT TO FILL IN• . BUILDING / STATISTICAL S ER MAP ADDRESS /OZ17_ ! TT CLASS.NO: DWELL.UNIT -- V LOT NO. 23 - BLOCK WATER NOT REQUIRED RECEIVED ❑ TRACT CERTIFICATE: NO OF BLDGS. NOP (CIRCLE] STATE MAJOR SECOND, OCAL SIZE OF LOT. I NOW ON LOT USE ZONE SPECIAL USE OF CONDITIONS EXISTING BLDG. TEL., ' OWNER t + + NO. 1 BUILDING YARD HWY STREET NAME EXIST. ADDRESS SETBACK WIDTH' FRONT �j. � ARCHITECT OR TEL. P.L. -a ENGINEER NO. SIDE P.L. AL ADDRESS � e NO.y TEL. + INSPECTION RECORD -� CONTRACTOR _ _ _ g �' i ADDRESS ,, _. � DESCRIPTION OV WORK ( � I i W d N NEW ADD ALTER REPAIR DEMOLISH � SIZE - NO.OF NO.OF STORIES AMILIES USE OF t STRUCTURE SIGNATURE OF APPLICANT VALUATION �9 APPROVALS DATE INSPECTORS SIGNATURE FEE $ FEE.$ FOUNDATION:LOCATION FORMS.MATERIALS i FRAME:FIRE STOPS, v 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE'LOCATION, WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS. BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY P SON IN VIOLA- LATH.INT. TION OF THE LABOR CODE OF THE STATE F C FORNIA RELAT- ING TO WORKMEN'S CO S NS AN LATH,EXT. SIGNATURE-OF HOUSE NUMBER COR- PERMITTEERECT AND POSTED r� + t ADDRESS '�' r �� FINAL a��i CLYDE N. DIRLAM, P INCIPAL URAL ENGINEER PLAN CHEM. VALIDATION CK. M.O. calx PERMIT VALIDATIM.o, CASH Auo 2 4 2 6 i�tiiR 2 1 D 6.0 0,• TEMPLE CITY raleoescehos.+—s+ APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DMSION ' LOCALITY JOHN A. LAMBIE. COUNTY EmgiNEER NEAREST WILLIAM A.JENSEN SUP'T OF BUILDING CROSS ST. FOR APPLICANT TO FU IN DISTR T N R TYPE P CE p BYLe ,�� CONST. BUILDINGO�i 7 �/• ADDR ��„r. STATISTICAL CLASSIFICATION SEWER'MAP ESS CLASS.NO. WELL.UNITS LOT NO. BLOCK WATER S CERTIFICATE: NOT REQUIREDR Li RECEIVED TRACT RJ d MAP /j� C H'HWA STATE MAJOR SECOND OCdL NO.OF BLDGS. NO. /0 SIZE OF LOT• NOW ON LOT I USE ZONE SPECIAL I I USEOF CONDITIONS. ; EXISTING BLDG. (ice OWNER NO. BUILDING- SETBACK YARD HY STREET NAME EXIST. WIDTH ADDRESS FRONT n/ ARCHITECT OR TEL. P.L. ENGINEER NO. SIDE P.L. } ADDRESS TEL INSPECTION RECORD 0 CONTRACTOR Q//'' � O. sL .- ADDRESS. 4'L Ld L:eI- r O DESCRIPTION OF .WORI ti W CL U) NEW ADD ALTER REPAIR• DEMOLISH Z SQ.FT. NO.OF NO.OF IZE STORIES FAMILIES USE OF STRUCTURE SIGNA URE OF APPLICANT VALUATION$ �� APPROVALS J DATE INSPECTORS SIGNATURE P.C. PMT. FOUNpAT10N:LOCATION FEE $ FEE $ FORMS,MATERIALS d�J FRAME:FIRE STOPS. 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE:LOCATION. / I• / WITH ALL COUNTY ORDINANCES AND STATE LAWS-REGULATING GAS VENT DUCTS BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK 1 / AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA. LATH,INT. TION OF THE LABOR CODE OF THEWSTAT OFFORNIA RELAT. ING TO WORKMEN'S COMP SATION IN RA ' LATH,EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTE RECT AND POSTED ADDRESS r• Ci FINALj/1 CLYDE N. DIRLAMADRINCIPAL ST R URAL ENGINEER PLAN CRECS VALIDATION CK. M.O. CASH PERM VALIDATION CK.' M.G.• CASH UjUo 2 4 2 7 i-m 2 2 1 D 6.00- Z' .G0- WORKERS'COMPENSATION DECLARATION ' hereby affirm that I have certificate of consent to self APPLICATION FOR 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 ❑ Certified copy is hereby furnished. FOR APPLICANT TO.FILL IN ADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING , -tion department. ADDRESS CITY' ( zip �/ �� LOCALITY Date Applicant NO.OF BLDGS. CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE..OF LOT NOW ON LOT NEAREST i ' COMPENSATION INSURANCE- CROSS ST.ASSESSOR " (This section need not be completed if the permit is for one TRACT I BLOCK LOT NO. MAP BOOKPAGE PARCEL hundred dollars ($100)or,less.) / 7EL. �� OWNER L. USE ZONE MAP 1•.certify that'in the performance.of the work for which this No . o� permit is issued, I shall not employ any person in any manner- ADDRESS �� SPECIAL• a h''. CONDITIONS • ' "so as to become subject to the Workers'•Compensation Laws. - � O• . CI ,L' ZIP I D U • ••'Date -Applicant '� ' ' 'ARCHITECT OW TEL, NOTICE TO APPLICANT:,If, after making this Certificate of ENGINEER = NO DISTRICT GROUP TYPE' ;'ORE P SED BY Q Exemption, you should- become subject.to• the .Workers' CO t ZONE w ffCompensation provisions of the Labor Code, you must forth- , ADDRESS@� ` a with comply with such provisions or this permit.•shall be TEL STATISTICAL CLASSIFICATION APT. NDOZ . u7 • .deemed revoked., - ' � CONTRACTOR � NC. CLASS NO. �� DWELL. UNITS • LICENSED.CONTPA CTORS•DECLARATION- ' ADDRESS NO. i I hereby affirm that-.1 am licensed under provisions of Chapterl? SEWER MAP (commencing with Section 7000)of Division 3 of the Business LIC. and Professions Code,and my license is in full force and effect. ( CITY.. CLASS BK PC,//0 VALIDATION SQ. FT. NO. OF NO. OF _ CHECK License Number ' Lic. Class SIZE STORIES. FAMILIES ONE VALUATION ContractorDate DESCRI ION OF W K NEW 1:1 $ Ate, i ADD ❑ At , ❑I am exempt under Sec. • ALTER. .❑ ► B.&P.C. for this reasonAga REPAIR ❑ $ nate: USE-OF . EXISTING BLDG. DEMOL ❑ Signature �. 'APPLICANT:• TEL. FINAL OWNER-BUILDER DECLARATION y (PRINT). NO DATE I hereby affirm that I ani exempt from the Contractor's License Law for the following reason (Section 7031.5, business and ADDRESS FINAL Professions Code): PRESENT B BUILDING y }•• `' I, as owner of the.property, or my'employees with , ADDRESS + wages as their sole compensation,will do the work and the structure is not intended or offered for sale'(Section i LOCALITY 7044; Business and Professions Code.) MOVING TEL. ► '`• '' - ❑ I,as owner'of the property,am exclusive) contractingCONTRACTOR NO.. with licensed contractors to construct the project.(Sec- j ADDRESS tion 7044, Business'dnd Professions Code.). �' REQUIRED YARD HWY • TOTAL SETBACK FROM` EXIST. CONSTRUCTION LENDING AGENCY SET BACK PROP.'LINE WIDTH - I hereby affirm that there is a construction lending agency for FRONT -the performance of-the. for which this permit is issued 1 P.L. ,� (Sec. 3097, Civ. SIDE - ��-` P.L. lr Lender's Name��%I LDMA Ref.# wool P.C. Fee$. Permit Fee Lender's Addres I certify that I have read this.application and state that the Issuance Fee 4::* .7 LD P/C# �. _ ' above informatidn'is correct.I agree to comply with all County Investigation Fee - ;L;;;'• . i I?.0-7' ordinances and State laws relating to•building construction, "'+" ' Total Fee ' }• �••�✓ CDMA Perm. # - S and hereby authorize representatives of this County.to enter :. + ' °°? f$ u the above-mention property for inspection purposes. • t: •� 40d�.� SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKO 9701 LAS TUNAS RESIDENTIAL ADD BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 9906230003 PHONE: (626) 285-0488 EXT: L NO. OF CONST NEW B D G ADDR SS: TR: 27309 LT: 23 S9. FT STORIES TYPE OCCUP GROUP 10217 RANDWICK DR STRUCTURE: 252 1 VN R3 TEMP CA 917803352 ASSESSOR 0 A 0 B R: GARAGE: NEAREST CROSS STREET: GLICKMAN 8585-004-022 OTHER: - THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: USE ZONE: ISSUED 0N: ----PROCESSED EXPIRES 0 : EXIST OCC GRP: 06/23/99 LC 12/20/99 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL 8Y CODE: WILSON W R;CATHERINE N TRS - 2,500 nn 10217 RANDWICK DR TEMP 917803352 F E E CR T O 0F WORK ' FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ADD AN ENCLOSED PATIO P C TEL. N0: SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RESOD2500.00 VAL 0.50 SPECIAL CONDITIONS: AX BUILDING REVdEV7=FEE�� 54.70 D2 PERMIT /0-E� C��E� 2 0.0:00 VAL 99.00 CONTRACTOR: TEL. N0: - VO � E�Ay 187.95 APPROVALS . DATE INSPECTOR SIGNATURE LIC. NO � LOCATION AND SETBACKS SOILS ENGINEER-APPROVAL ARCHITECT OR ENGINEER: 0: FOUNDATION/TRENCH- � 0 MS LIC. NOMI! X11111111 SLAB/U DER FL00 RAISED FLOOR FRAMING 14AP N0: SEWER MAP BOOK: PGE: FIRE•ZON3: C �q �n U(� D �� I�n�� UNDERFLOOR INSULATION L r I u r u 5LEVEL OOR SH T 0. OF FAMILIES, DWELL G S: AP 0 : STAT CL 5 :— NO 21j \ ,^, N LEVEL FLOOR SHEATH /] !] k-.1 SCHOOL WITHIN HAZARDOUSROOFSHEATHING AIR 9UALITY: 1000 FEET MATERIALS �+ull�y NO NO NO !'! FIRE-DEPT. FRAME INSPECT REA DTOTAL SETBACKEXIST 46 �_I 1 �JOQ� BLDG DEPT. FRAME INSPECT SET FRONTAPL-CK YARD: HWY: PROP LINE: WIDTH: ` erViC�.�hat� SHEAR PANELS SIDE PLTff- L TIO T H MUM r INTERIOR ATH DRYWALL EXTERIOR 0 LOT DRAINAGE SMOKE DETECTION CS FIRE DEPARTMENT APPROVAL REPORT ID: DPR261 ROUTE TO: BS0508