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Home My Public Portal About6237 RENO AVE_Building__ APPLICATION FOR BUILDING PERMIT FOR WL:CA; T"TO FILL IN (Print Or type only)' 77T COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER L., -LIP BUILDING AND SAFETY DIVISION LDING /.f SIZE OF LOT a x 10 ROW OON LOTS ADDRESS BLOCK TRAGTJ BLOCK LOT N D,a LOCA LIT TEL., 6 NEAREST / OWNER NO. D O CROSS ST. - JJ ^ ASSESSOR- ADDRESS (7 MAP BOOK AGE 66RCEL DISTRICT _GROUP TYPE FIRE PRO SSED BY CITY ZIP CONST, �E ARCHITECT OR TEL / ENGINEER NO. :STATISTICAL CLASSIFICATION SEWER MAR ADDRESS -CLASS NO DWELL,UNITS BKq G CONTRACTOR TEL SE ZONE MAP `' O _ No O. !/ ADDRESS p , SPECIAL LIC. CONDITIONS CITY CONSTRUCTION LENDER CLASS RO D DEPARTMENT APPRO REQUIRED YES❑ NO❑ - NAME AND BRANCH BLDG.SETBACK FROM FRONT PROP.LINE OF- ADDRESS F ADDRESS CITY - TOTAL SETBACK FROM TYPE OF EXISTING HIGHWAY + YARD SQ, FT� NO. OF NO. OF CHECK FRONT PROP. LINE HIGHWAY WIDTH SIZE 'J STORIES 'PF�AMILIES ONE DESCRIPTION OF WORK NEW ❑ + , ADD BLOG:SETBACKFROM (STREET) SIDE PROP.LINE OF ALTER ❑ HIGHWAY •f• YARD = TOTAL SETBACK FROM TYPE OF EXISTING USE OF REPAIR❑ t SIDE PROP. LINE HIGHWAY WIDTH = - - EXISTING BLDG. DEMOL ❑ AP(PRINT) �• � O�/„ NOL /3 CORNER CUTOFF YES ❑ NO ❑ BY (SIGNATURE) J. IN OPEN SPACE YES ❑ NO ❑ a M ` IN COASTAL ZONE YES ❑ NO ❑ VALUATION$ � QV Cie - CATEGORICAL EXEMPTION YES❑ NO ❑ I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION ENVIRONMENTAL - AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE) WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. I CERTIFY- THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE) HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF TME STATE OO F CALIFORNIA IN RELATING Td WORKMEN'S COMPEN TI N INSURANCE. e5 �� SIGNATURE OF PERMITTEE ADORES CITY ENOL. / DIATE`// o f1�3 BY P.C. PMT. MAKE CHECKS PAYABLE TO: FEE'� FEE HARVEY T. BRANDT. COUNTY ENGINEER PLAN CHECK VALIDATION CK. M.O. -CASH PERMIT VALIDATION cK. M:O. CASH ►�('� 1 9 6 373, JUL 2 'I_ D 69.00-, �r 76A638A CE9803 12/72 APPLICATION FOR BUILDING PERMIT ] COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN sul DI �pggEss n� I hereby affirm that I have a certificate of consent to self insure, BUILDIN ADD ESS s i �/` or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) � LOCAUT Policy Compan // i � SIZE O LITY LOT NO.OF BLDGS.NOW ON LOT �!/ C ertified copy is hereby furnished. NEAREST CROS ST. ❑ Certified copy is filed with the ffty buildin ' spection TRACT BLOCK LOT NO. department. USE ZONE MAP NO. Date Applicant . ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPT FROM WORKERS' ER TEL NO. COMPENSATION INSURANCE �� /� WITHIN 1000 FT.OF SCHOOL? YES No (This section need not be completed if the permit is for one hundred ADDRESS dollars($100)or less.) N DISTRICT GROUP TYP ONST. FIRE ZONE PROCESSED BY I , ZIP /1 I certify that in the performance of the work for which this permit �Q� �_� � /✓S is issued, I shall not employ any person in any manner so as to A CHI ECT O EN ER TEL NO. 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' CONTRACTORTEL O �y 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,N11, P L LICENSED CONTRACTORS DECLARATIONCI .C P L SIDE I hereby affirm that I am licensed underprovisions of Chapter 9 �� O� LICSEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORIES NO.OF FAMILIES Professions Code,and m license its in full force and effec Sg 4 NEW El BK PG O License Number / Lic.Class I D TION OF WOR V1(VL ADD ❑ Lu�A�noN ® C Contractor Date ALTER El as 3,e& d D fl 0 ❑ I am exempt under Sec. PAIR � C N a�1a BAP.C.for this re son — CPAI DEMOL ❑ LDMA P/C# D Q. I&A Of EXISTING BLDG. URM ❑ _ C Signat APPLICANT(PRINT) TEL NO. LDMA Perm# ❑ I, as owner of party, or my employees with wages as Z their sole comp ation, will do the work and the structure is ADDRESS .-•—•a,- not intended or offered for sale (Section 7044, Business and FINAL DATE Q _ Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL � ip cI� ❑ I, as Owner of theproperty, am exclusive) contracting With OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE Y 9 AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY L licensed contractors to construct the project (Section 7044, ves 11 No 1:1Business and Professions Code.) OWLLCC THE INTENDED USE MI THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTHL /,l CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR GUIDELINES I hereby affirm that there is a construction lending agency for YES❑ NO❑ the performance of the work for which this permit is issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING 3097,CIV.C.) 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 L Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. Lender's Address OWNER OR AGENT I certify that I have read this application and state under penalty of perjury that the above information is correct.I agree to comply PC.FEE PERMIT FEE with all county ordinances and State laws relating to building �0 consu ion,and her, authorize representatives of this County ISSUANCE FEE 14•�O to e, r pon the ab�a entioned pro ty for ins ect' n p rposes. (j eat INVESTIGATION FEE TOTAL FEE 13 Z / agmluro of Moim om ao SEE REVERSE FOR EXPLANATORY LANGUAGE r 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 0011200042 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: TR: 5904 LT: 55 SQ. FT STORIES TYPE 6237 RENO AV STRUCTURE: 0 VN TEMP CA 917801535 ASSESSOR INFORMATION NNUM-BFR---- NEAREST CROSS STREET: HERMOSA 5384-001-020 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: RESID USE ZONE: R-1 ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 11/20/00 UT 05/20/01 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE f/ FINAL BY: CODE: MICHAELSON DENNIS D CO TR (818) 286-9801- 1 1,870 %%/a"! 6 6237 RENO AV TEMP 917801535 FEES PAID DESCRIPTION-EW-WORK TEAR OFF FLAT SECTION & 1 LAYER OF SHINGLES, REROOF W/ 4 PLY FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: HOT BUILT UP ROOFING & 25 YR. DIMENSIONAL SHINGLES APPLICANT: TEL. NO: J N DAVIS ROOFING (626) 821-4665- AA BLDG PERMIT ISSUANCE 27.75 2 E LA PORTE AC STRONG MOTION RES-I. 1870.00 VAL 0.50 SPECIAL CONDITIONS: ARCADIA, CA D2 PERMIT 14/0 ENS $7,0.00 VAL 82.20 G�LEi-TO7.�®F 110.45 CONTRACTOR: TEL. NO: CJ L �/� APPROVALS DATE INSPECTOR SIGNATURE J N DAVIS ROOFING (626) 821-4665- 2 EAST LA PORTE LIC. NO LOCATION AND SETBACKS STE A 572125039 ARCADIA, CA 91006 /s SOILS ENGINEER APPROVAL ARCHITEC OR E ----RTI- ARCHITECT TEL. NO: FOUNDATION/TRENCH FORMS LIC. N0. / 1111111 SLAB/UNDER FLOOR L RAISED FLOOR FRAMING M53H261 SEWER MAP BOOK: PAGE: FIRE ZONE: O�P._�n n D L �� O�n�� UNDERFLOOR INSULATION Qui I IvJ I ILS^u5 luj FLOOR SHEATHING 0. OF FAMILIES: DWELLING UNITS: T/CO D: STAT CLAS . NO 21 0 0 -• ROOF SHEATHING SCHOOL WITHINA ARDO S SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS 0 ❑ �� 1 NO NO NO El �I,.�J�f/y FRAME INSPECTION REQUIRED TOTAL SETBACK FROM EXIST 48� 11 0% FIRE SPRINKLER HA GERS SETBACK YARD: HWY: PROP LINE: WIDTH: �C �@ tVjC T�a� INSULATION/WEATHER STRIP FRONT SIDE PL— TERIOR LATH/DRYWALL EXTERIOR LATH RATED FLOOR/CEIL ASSE . RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T—BAR CEILINGS * ADDITIONAL DATA ON FILE LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BSO5O8