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HomeMy Public PortalAbout5731 RIO HONDO AVE_Building__ 76AG38A CE 9803 12/6.9 ' b %JI,C ���f APPLICATION FO BU- IILDING PGIRMIT COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION 'BUILDING 710584 JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS J/� 3/ 24 COLEMAN W. JENKINS, SUPT OF BUILDING ` LOCALITY FOR APPLICANT TO FILL IN NEAREST Print or tvae onl CROSS ST. BUILDING DISTUST CJ GROUP TYP PR ESSED BY ADDRESS 5731 North Rio Hondo Avenue © CONST. e• STATISTICAL CL SSIFICATION SEWER MAP LOT NO. BLOCK CLASS NO. DWELL.UNITS BR---PG' TRACT USE ZONE MAP NO.OF SLOGS. NO. SIZE OF LOT NOW ON LOT / SPECIAL USE OF CONDITIONS EXISTING BLDG. TEL. OWNER Ms TC1.1rez NO' BLDG.SETBACK FROM ADDRESS Same FRONT PROP.LINE OF (STREET) TYPE ING SETBACK HIGHWAY + YARD = TOTAL CITY Temple City HIG AY WIDT C.L. - ARCHITECT OR TEL. } ENGINEER NO. BLDG.SETBACK FROM ADDRESS SIDE PROP.LINE OF (STREET) TEL.��cc�� TYPE OF EXISTING SETBACK HIGHWAY ••I' YAR = TOTAL CONTRACTOR Viz' In Roof Co. NO. �p7-0 07 HIGHWAY WIDTH FROM G.L. ADDRESS �j S NO t = O LIC. c CITE' San Gabriel 91776 CLASS 0-39 CORNER CUTOFF YES E) NO 13C CONSTRUCTION LENDER NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS c u ADDRESS v SQ. FT. NO. OF NO. OF NEW ❑ SIZE -STORIES l FAMILIES USE OF ADD ❑ STRUCTURE ALTER ❑ With composition shl les REPAIR SIGNATURE OF APPLICANT DEMOL ❑ VALUATION$ 662X0 APPROVALS DATE INSPECTORS SIGNATURE FON EE$ FEE$ 12e 00 rOUNDATFORMS!MATERIAALS FRAME: RE FISTOPS, 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 ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS ST R UCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSOW IN VIOLATION OF THE LATH, INT. LABOR CODE OF THE STATE OF 'CALIFORNIA IN RELATING TO WORKMEN'S COMPENSATION INSURANCE. LATH, EXT. , SIGNATURE OF HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS v FINAL �D g` JOHN F. LEWIS. PRINCIPAL STR URAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH (,tCC, � 4:� �_= SE�p16 1 0 12.0011. woea-s 1.55 APPLICATION FOR BUILDING PERMIT I-ss DIVISION OF BUILDING AND SAFETY BU I EISNs - ��p ' ��fJ�o Department of County Engineer _. a.,-V County of Los Angeles LOCALITY f JOHN A.LAMBIE, COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST. DISTRICT NO. GROUP TYPE SEWER MAP FOR APPLICANT YYY111TO FILL IN �J�'"' CONST I LBK /3 G FADDRESS ING �/ �� ld�� ��^ NUMMAPBER CD-00:7 STATE / i'O 'L vc r HWY YE NO O. �Q �� IkBLOCK USE ZONE SPECIAL CONDITIONS T 6167 / �C�'o 040 NO.OF BLDGS. 2 SIZE OF LOT NOW ON LOT BUILDING YARD HWY STREET NAME EXIST. USE OF SETBACK WIDTH EXISTING BLDG. FRONT 2-0 (c= �'L /'Q OWNER SIDE (¢ MAIL P. L. ADDRESS 7 3/ O TRACT DWELL. I UNIT 5 INDUSTRIAL r"� TEL. q DWELL. 1 UNIT CITY NO. UBLIC BLDG. ARCHITECT Olt I TEL. 2 DUPLEX 2 UNITS/ 7 ADDN. TC. ENGINEER NO. 3 APT. —UNITS B MISCEL. ADDRESS 41 COMMERCIAL r TEL' ��s+ INSPECTION RECORD CONTRACTOR 1'NO. Jr�d ADDRESS 6 DESCRIPTION OF WORK' NEW DD ALTER REPAIR DEMOLISH 50.FNO. OF NO.OF SIZE T. I S*t D STORIES / FAMILIES / =RugREE&jm _ A 4 SIGNATURE OF APPLICANT APPROVALS ADDRESSAalf r DATE INSP. CTOR'S SIGNATURE FOUNDATION:LOCATION. , + �� 0 P.C. $ FORMS.MATERIALS "S FEE FRAME: FIRE STOPS, r VALUATION S 0®. BRACING, BOLTS q S C �J[� FEE FURNACE: LOCATION. 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GAS VENT.DUCTS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH. INT. AND STATE LAWS REGULATING BUILDING CONSTRUC- TION. LATH. EXT. 5 SIGNATURE OFf �� HOUSE NUMBER COR- PERMITTEE RECT AND POSTED I { ADDRES O 'U FINAL I,—ri IOHN A.LAMBIE.COUNTY ENGINEER VALIDATION CLYDE N- DI1_ AiA, CHIEF BLDG. INSPECTOR CK MO CASH ._,�Co'7 7 8 4 JLq_ 5 1 4,I"1 v APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADD I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDR SS or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Se . 0, b.C.) CIT ZIP ��fp LOCALITY Policy No.' • Company SIZE OF LCT NO OF BL NOW ON LOT 1:1 Certified copy is hereby furnished. NEAREST CROSS ST. -EMertified copy is filed with the county building inspection TRACT BLOCK LOT NO de a je t. (/�� USE ZONE MAP NO. Date 1 1 Applicant �-G� \ ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL NO, COMPENSATION INSURANCE �OOYY WITHIN 1000 FT OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred ADDREbZi � ` '^ - 1 r 1 DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY dollars($100)or less.) I certifythat in th CICA C 1 ZIP .Opp performance of the work for which this permit U is issued, I shall n employ arty person in any manner so as to ARCHITECT DRER TEL No. (*4�— become subject to t e Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT C15NDO 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 t0 the Workers' CQT`RAgTOR\ TEL �C� SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith Imo Jl FRONT comply with such provisions or this permit shall be deemed revoked. ADR Cp P L LICENSED CONTRACTORS DECLARATION L SIDE TY LI LAS PL I hereby affirm that I am licensed underprovisions of Chapter 9 S. SEWER MAP > (commencing with Section 7000)of Division 3 of the Business and SO.FT.SIZE NO.OF STORIES NO OFrMILIE NEW ❑ BK PG a Professions Code,and my license is in full force and effect. , C ��Z C - DESCRIPTION OF WO ADD ❑ VALUATION fi p V License Number Lic.Class `� FJ Contract Date _ ALTER ❑ $-zz, O ❑ 1 am exempt under Sec. REPAIR $' H BAP.C.for this reason �� DEMOL ❑ LDMA P/C# W Date: USE OF EXISTI DG. URM ❑ - Signature "=)='- (` `� LDMA Perm# G ❑ I, as ow of the property, or my employees with wages as Z 1 s 1"1- theirs compensation, will do the work and the structure isA /� O _ —, , ,— not intended or offered for sale (Section 7044, Business and ��`� -lT FINAL DATE a .tl I �- -�-� _ �� Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL i I ri•i' x.1 L� OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE v J � HECA + s r ❑ 1, as owner of the property, am exclusively contracting With AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY licensed contractors to construct the project (Section 7044, ^ ' E'iC IFS •j-) YES 1:1 NO Business and Professions Code.) L..� WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY I COAST AIQUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FORGUIDELIN S. I hereby affirm that there is a construction)ending agency for YES❑ No a :�A'+!1'i -4 _ C11 the performance of the work for which �ermit is issued(Sec. _�: 1 , O) ]HAME READ THE MATERIALS TTING 3097,Civ.C.) I CHECKLIST I UN ERSTANNDUMY REQUIREMENTS UNIDER ON T EELOS ANGEAND THE LES IVID (CODE, a TITLE 2,CHAPTER 2 20 SECTIONS 2 2JnOO THROUGH 2 20 140 CONCERNING HAZARDOUS Lender's Name MATERI EPORn G AND FOR OBC A 'ERMIT FROM THE SCAOMD o Lender's Address 0 OWNER OR AGENT o I certify that I ve read this application and state under penalty c of perjury th the above information is correct.I agree to comply P•C.FEE PERMIT FEE �q' CIA with all county ordinances and State laws relating to building construction,and hereby authorize representatives of this Count ISSUANCE FEE �� I CO toe er upon the ab o -mentioned property for inspection rpos G) ( m INVESTIGATION FEE TOTAL FEE Ap cq ? —{V � :mua m Ao��,u WeM DM SEE REVERSE FOR EXPLANATORY LANGUAGE