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HomeMy Public PortalAbout10258 RANDWICK DR_Building__ 76A688A CE#803 6.62 APPLICATION FOR BUILDING PE IT COUNTY OF LOS ANGELES BUILDING I DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A.JENSEN,SUP'T OF BUILDING CROSS ST. FADDRE OR APPLICANT TO FILL IN D1sTC]; ROUP CONST. P ssEDB/ /�� - h STATISTICAL CLASSIFICATION S ER MAP U��, d Lv 'Y�e BK PG CLASS. NO. DWELL.UNITS BLOCK WATER NOT REQUIRED ❑ RECEIVED ❑ CERTIFICATE: 7_34 MAP HIGHWAY STATE MAJOR SECOND LOCAL NO.OF BLDGS. NO (CIRCLE) OT lJ! NOW ON LOT USEZONE SPECIAL CONDITIONS BLDG. TELNOQ BUILDING YARD HWY TREET NAME EXIST. SETBACK WIDTH , f2l,- .4 FRONT ARCHITECT R TEL. P. L. ENGINEER NO. SIDE j a P. L. ADDRESS C EL IL CONTRACTOR ep ,© M O. I V; ADDRESS 2(.—T LLi C ESCRIPTION OF ORK t • LL CL NEW ADD ALTER REPAIR DEMOLISH SQ.FT. NO.OF NO. OF SIZE STORIES FAMILIES USE OF STRUCTURE -lofte L�-- SIGNATURE OF APPLICANT VALUATION APPROVALS DATE INSPECTOR'S SIGNATURE FOUNDATION: LOCATION FEES FEE'S FORMS, MATERIALS FRAME: FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING. BOLTS \ /I 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 I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. TION OF THE LABOR CODE OF THE STATE OF CALIF NIA RELAT. .. INC TO WORKMEN'S COMP ATI INSURA - LATH, EXT. SIGNATURE OF HOUSE NUMBER COR. PERMITTEE RECT AND POSTED ADDRESS E irJ r FINAL JOHN F. LEWIS. FyRI CIPAL ST URAL ENGINEER PLAN CHECK VALIDATION CK. M.o. CASH PERMIT VALIDATION CK. M.O. CASH L&O 9 4 9 .5% JAN 14 1 D 8.00-- I. TEPAPLE CHT F9An.A CIE#11G&1_61 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING - DEPARTMENT OF COUNTY ENGINEER ADDRESS BUII.DII�TG AND SAFETY DMSION LOCALITY kJ JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A.JENSEN SUPT OF BUILDING CROSS ST. f/ss DISTRICT NO. GROUP1 YpE P ESSED BY FOR APPLICANT TO FILL IN -CONST. BUILDING STATISTICAL CLASSIFICATION WER MAP ADDRESSgg pLt1 GlC fl BK PG CLASS.NO. DWELL.UNIT LOT NO. BLOCK WATER NOT REQUIRED ❑ RECEIVED CERTIFICATE: TRACT 30 f MHIGHWAY �+ NO.OF BLDGS. NAP (CIRCLE) STATE MAJOR SECO CAL SIZE OF LOT.V D K J I NOW ON LOT -` USE ZONE SPECIAL USE OF �� CONDITIONS EXISTING BLDG. �(•��pp / /�.�. p �y OWNER .V.iGDsL QUI �+ • NO.A 423.10 BUILDING EXIST. �p SETBACK YARD HWY STRE NAME WIDTH ADDRESS :5f7-6 -re"P� G•rY &w. FRONT ARCHITECT OR TEL. P.L. ENGINEER NO. SIDE ADDRESS TEL _ INSPECTION RECORD, 0 CONTRACTOR O D C67. NO. r. ADDRESS 5 y6 ` ,PCE CrtY flYJ• Iii�f�� f ?�(ss ✓l /i; 1�!/'.e DESCRIPTION OF WORK T IIL,cO�i 1 , t a N ADD ALTER REPAIR DEMOLISH l ' - 6'.�p/�� / U) SQ.FT. / p NO.OF NO.OF Ia�,:r�2 ii�tf^ /w. /.►J)F " :S" /I1 ? IZE 1�Sb STORIES j FAMILIES USE OF STRUCTURE SIGNATURE OF APPLICANT VALUATION 5IF J �, APPROVALS DATE INSPECTOR'S.SICA,6RE FEE $ FEE $ FOUNDATION:LOCATION �� FORMS,MATERIALS f� / ' �^'�si "•�r FRAME:FARE STOPS, ' )f6 //! I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS '\ /v AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE:LOCATION, ✓���.�-,��1' WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS A ' 1 1... . BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK s pyj 9 r AUTHORIZED HEREBY ICWILL NOT EMPLOY ANY PERSON IN VIOLA- LATH,INT. �F ,i!((+i) •ama" J r/, TION OF THE LABOR ODE OF THE STATE OF CALIF O NIA RELAT- ING TO WORKMEN•ACOMP SATION INSURANC . LATH,EXT. rlP 7 SIGNATURE OF HOUSE NUMBER COR- Y(� PERMITTE ��,� RECT AND POSTED { ADDRESS- 5F,- "`�' FINAL CLYDE N. DIRLAM, PRINCIPAL ST URAL ENGINEER LID PLAN CHECK VAATION cK, M.O. CASH PFJWT VALIDATION cK. M.O. CASH LAC0 6.6 1 5 oI NOV 7 2 3 D 3 0.2.5 A c LACO 7 3 0 9 NOV 2 3 1 D 6 4.0 O-1 'L WORKERS'COMPENSATION DECLARATION lf 4insure bor affcertif carte of Workers'Compensation InsurI have a certificate of ancee, APPLICATION FOR BUILDING P E RM I T or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company BUILDING _Q ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS f ®2 S r8 2 w'�r� ❑ Certified copy is filed with the county building inspec- ADDRIESs Z S StJAl) 'C— `�Qra t G(` 4 %/78o tion department. -I p Date Applicant CITY ek U C,T Zip r O Q LOCALITY Na. OF BLDGS. CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST. J_l'C/4! j//7✓ S COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK 8 S PAGE Da PARCEL o� hundred dollars ($100)or less.) TEL. OWNER NO.�Lf - O� USE ZONE MAP I certify that in the performance of the work for which this NO. permit is issued, I shall not employ an manner ADDRESS SPECIAL so as to become subject to the W Co en atio Laws. CONDITIONS ' O y/ CITY .� P / Date--U-1.5Applicant ° ARCHITECT OR TEL. C' DISTRICT GROUP TYPE FIRE PROCESSED BY ixO NOTICE TO APPLICANT: If, aft this C Cate of ENGINEER NO. CONST0 . ZONE Exemption, you should beco a subject to the Workers' Q' 2 k Compensation provisions of the Labor Code, you must forth- ADDRESS I 44A oil lof7a WS, 0 I'3 ✓ a with comply with such provisions or this permit shall be TEL- STATISTICAL CLASSIFICATION APT. CONDO. to deemed revoked. CONTRACTOR NO. —`6 Z LICENSED CONTRACTORS DECLARATION / LIC. CLASS NO. -;I-/ UNITS 719 1 hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 7 G O CrsO�O G NO.3°(yS (commencing with Section 7000)of Division 3 of the Business LIC. SEWER MAP and Professions Code,and my license is in full force and effect. CITY C 4N O G A 7A-A4 Cc-• CLASS 8 BK 55`PG /40 VALIDATION 3'9C/S'7 19 Lic- Class SFr. F OF CHECK License NumberSIZE STORIES FAE STORIES FAMILIES ONE ` ,��, 5, l DESCRIPTION OF WORK S el NGJ� NEw ❑ VALUATION Contractor 1 O s P �•��/ Date _j ^�/ ❑ $ O El am exempt under Sec. tF�IN 0 FltdA ADD 4 �®�Srr�G�+ea ► ALTER ❑ B C. for this reason _ Z-QR/C/C CaLv fja .4- RRib/C goieoAL REPAIR ❑ $ e: — USE OF EXISTING BLDG. DEMOL ❑ Si no APPLICANT r� TEL. g - UILD LARATION (PRINT) D$ C_ t! NO. 3'11-1'633 FINAL DATE I hereby affirm that I am exempt from the Contractor's License ADDRESS 7!9 D 7 /7F.1a k� G y/ 3 O Law for the following reason (Section 7031.5, Business and FINAL Professions Code): PRESENT By S i BUILDING ❑ I, as owner of the property, or my employees with ADDRESS— wages , i � 'ti.- wages as their sole compensation,will do the work and �,t3_,.�,�t l the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code.) MOVING TEL. ❑ 1,as owner of the property,am exclusively contracting CONTRACTOR NO. TOTAL t,1 with licensed contractors to construct the project (Sec- ADDRESS I')•(Rj L 116 � �_F - tion 7044, Business and Professions Code.) CHECKi��5°E_� REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH 4i1 i sij °�lyl 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- (Sec. 3097, Civ. C.). SIDE P.L. t_Irl lk_Irll�l! +t f 15.1",1 Lender's Name t/ LDMA Ref. # p '"r 1 AN -7 Lender's Address e P.C. Fee$ Permit Fee f I I certify that I have read this application and state that the ` Issuance Fee 15• U LDMA P/C# g above information is correct. I agree to comply with all County Investigation Fee /p ordinances and State laws relating to building construction, Total Fee 416• LDMA Perm. # and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. , SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date WORKERS'COMPENSATION DECLARATION hereby affirm that I have certificate of consent to self APPLICATION FOR BUILDING PERMIT insure, or a certificate of Workers'Compensation Insurance, ora�cIe/r�ified copy thereo?ompany . ec. 3800, L/abs. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Po il�cy Na. /Tk/Lf�d/I 1:1 BUILDING is furnished.Certecopy hereby se . FOR APPLICANT TO FILL IN ; ADDRESS Certified copy is filed with the county building inspec- BUILDING t tion department. ADDRESS .n LOCALITY NEAREST Date fr� Applicant CITY �✓ ZIP CROSS ST. CERTIFICATE OF EXEMPTI FROM WORKERS' NO.OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one USE ZONE MAP dJCS hundred dollars ($100)or less.) TRACT BLOCK LOT NO. NO. o� TEL. r ( SPECIAL i I certify that in the performance of the work for which this OWNER r NO. CONDITIONS a. permit is issued, I shall not employ any person in any manner DISTRICT GROUP TYPE FIRE PR ESSEB BY O so as to become subject to the Workers'Compensation Laws. ADDRESS �`Qr/ A� CONST. ZONE Date Applicant CIN ZIP STATISTICAL CLASSIFICATION APT. CONDO. 9 ARCHITECT OR TEL. ` NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. CLASS NO. / DWELL. UNITS W Exemption, you should become subject to the Workers' IL Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP with comply with such provisions or this permit shall be TEL deemed revoked. CONTRACTOR NO.. ' BK, PG VALIDATION ' LICENSED CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS (� NO. Z 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 CHECK License Number IX f Z Lic.Class SIZE STORIES FAMILIES ONE ,,,✓✓����� ^�7. DESCRIPTION OF WORK NEW ❑; $ ContractoTG't✓ t� Date ❑ ADD I am exempt under Sec. ❑, ALTER ❑ FINAL O B.BP.C. for this reason DAT �Q REPAIR ❑; USE OF DEMOL i Date: EXISTING BLDG. ❑ BIN Signature APPLICANT TEL. OWNER-BUILDER DECLARATION i PRINT NO. I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS Professions Code): ��qq E T 2 7 P 9 A ❑ RIALDING 1 I, as owner of the property, or my employees with ADDRESS " o 0,0 0 0 wages as their sole compensation,will do the work and 2 -'o,8 0.'5 0 the structure is not intended or offered for sale(Section LOCALITY 4 O G 1 '� G'I 2. 7044, Business and Professions Code). MOVING TEL. 0 C)1! El1, NO.I, as owner of the property,am exclusively contracting 0 7•1 S­9 U with licensed contractors to construct the project(Sec- ADDRESS 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. tSec. 3097,.Civ. C.). SIDE :P.L.• Lender's Name_ 3 'P.C.Fee$ ' ' Permit Fee '70 , O Lender's Address I certify that I have read this application and state that the Issuance Fee above information is correct. I agree to comply with.all County Investigation Fee ordinances and State laws relating to building construction, Total Fee Q. and hereby authorize representatives of this County to enter upo he ov -mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Dche ®s COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9808110021 PHONE: (818) 285-0488 EXT: GA D: NO. OF CONST UI DI G ADDRESS: TR: 27309 LT: 16 SQ. FT STORIES TYPE 10258 RANDWICK DR STRUCTURE: 3200 VN i TEMP CA 917803351 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 8585-004-014 THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY, C I TENANT: EXIST BLDG S ESID USE ZONE: R-1 ISSUED ON: PROCESSED-BY: EXPIRES ON: EXIST OCC GRP: 08/11/98 VG 8/11/99 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL CODE: BEECHER ANNIE CO TR BEECHER TRUST — 3,500Q /B A� r 10258 RANDWICK DR (Y !f TEMP 917803351 FEES PAID DESC IPTION OF WOR T/0 EXIST ROOF, RESHEAT AND APPLY 30-YR ELK FIBERGLASS FEE DESCRIPTION: QUANTITY: UDM: AMOUNT: SHINGLES APPLICANT: TEL. N0: WEATHERITE (626) 287-0669— AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RESID - 3500.00 VAL 0.50 SPECIAL CONDITIONS: D2 PERMIT W/O EN-HC _ 3500.00 VAL 115.80 i :•.TOTAL•FEES, 144.05 CONTRACTOR: TEL. N0: WEATHERITE ROOFING (626) 287-0669— APPROVALS DATE INSPECTOR SIGNATURE ;% 4016 TEMPLE CITY BLVD LIC. NO LOCATION AND SETBACKS ROSEMEAD CA 91770 423177C39 SOILS ENGINEER APPROVAL ti ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS LIC. N0: _ j -— —�. SLAB UNDER FLOOR RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: ; UNDERFLOOR INSULATION XX 3 ,01 ; ` FLOOR SHEATHING NO. OF FAMILIES: DWELLING I S: AP /CON : STAT CLASS:. NO 21 a. `.` ,� , � _ J ti ROOF SHEATHING SCHOOL I HAZ DO S — • SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO NO ° FRAME INSPECTION REQUIRED TOTAL SETBACK FROM EXIST �' *�.'`'' I _ -i�`.',' FIRE SPRINKLER HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: = _ - FRONT PL— INSULATION/WEATHER STRIP SIDE PL— NT rIOR LATH/DRYWALL EXTERIOR LATH RATED F OOR/CEIL ASSEM. RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T—BAR CEILINGS i LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508