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Home My Public Portal About5740 RIO HONDO AVE_Building__ t 76A666A CE#608 6-63 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS 574Q N. Rio Hondo BUILDING AND SAFETY.DIVISION LOCALITY Temple Cit JOHN A. LAMBIE. COUNTY ENGINEER NEAREST WILLIAM A.JENSEN,SUP'T OF BUILDING CROSS ST. Live Oak DIST ?NQS GROUP TYPE R E ED Y FOR APPLICANT TO FILL IN (979 CONS . BUILDING STATISTICAL CL�A{� 1FICATION SEWER MAP ADDRESS l}0 N Rio Hondo Tem 3m Cit CLASS. NO. `� DWELL.UNIT�S� B PG LOT NO.' J6_29J - /Q'Q WATER NOT REQUIRED RECEIVED ❑ J / CERTIFICATE: Iv x TRACT MAP HIGHWAY ' / NO.OF BLDGS. NO. /Oa (CIRCLE) STATE MAJOR SECON ,LOCAL SIZE OF LOT �jQ NOW ON LOT USE ZONE IfSPECIAL USE OF CONDITIONS EXISTING BLDG. TEL. OWNER Mrr, N. %11ten NO. BUILDING YARD HWY STREET NAME EXIST. ADDRESS 740 NS Rio HondoI Temple Cit FRONT SETBACK y WIDTH ARCHITECT OR TEL. P. L. ENGINEER NO. SIDE ADDRESS �- CONTRACTOR TEL. 0 f Co No, .28 -0 0 v ADDRESS 600 So. San Gabriel Blvd. S Gabriela 'DESCRIPTION OF WORK ri a NEW ADD ALTER REPAIR DEMOLISH H SQ.FT. NO.OF NO. OF SIZE STORIES FAMILIES USE er000use on # STTRUCRUC Rf honly with 2TURE 35 composition over 572 wood shingles. SIGNATURE OF APPL I CANT VALUATION $ 295°00 APPROVALS DATE INSPECTOR'S SIGNATURE FOUNDATION: LOCATION FEE $ '� FEE $ 6.o0 FORMS, MATERIALS FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY 9fWq"Cb OT EMPLOY ANY PERSON IN VIOLA- LATH, INT: TION OF THE LABOR THE STATE OF CALIFORNIA RELAT- ING TO WORKMEN'S C • LATH.EXT. SIGNATURE OF 11AHOUSE NUMBER COR_ PERMIT RECT AND POSTED ADDRESSeng bect,y r- FINAL JOHN F. LEWIS, PRINCIPALS • RAL ENGINEER PLAN CHECK VALIDATION CK. -M.O. CASH PERMIT VALIDATION CK. M.O. CASH JIG K' 4"3 5,8 JUL 1 1 D 6.0 0~ G 4. r ` WORKE'R`S'CO. PEf NTION AECLAR TION k % I hereby affirm that I have' certificate ofonsent to self APPLICATION ��' BUILDING insure, or a certificat W kof ers'Compensation Insurance, or a certified copy th eof( 3800, Lob. C.) ' COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No.. Company BUILDING 1:1 Certified copy hereby furnished. .► FOR APPLICANT TO FILL IN ADDRESS -44-°,'4O =® 001VO& ❑ Certified copy ii filed with the county building inspec- BUILDING GP)q „ � O bi®w®® g�Aa ®u7 c Ty tion department'.%t ADDRESS/C DiJ / It/700 .y Fd,s!P" �-rY- Date /?Plicant• CITY ( E/ rA Ll rF CA ZIP 1/ /0® LOCALITY e� CERTIFICATE OF EX`=MPTION FROM WORKERS' ,(iY! NO. ON ioT i CROSS ST.NEAREST W®� COMPENSATION INSURANCE SIZE OF LOT (� r (This section need not be completed if the permit is for one TRACT SVSV-7BLOCK ®O (4 v! ASSESSOR " ® 1 hundred dollars($100)or less.) LOT NO. MAp BOOK � ® PAGE 0T PARCELO t C TEL. OWNER�0S�T) O o i AIALf NO.OL �3� USE ZONE MAP I certify that in the performance of the work for which this NO 2-4C. permit is issued, I shall not employ any erson In any ner /��!11 X�r 6 b+0�p �� SPECIAL ] ` so as to become subject to the W Com nsatio aw ADDRESS 6"#)4 a�- ''`` f` CONDITIONS CITY-MP "1 Le1 �j"I ZIP 9 1—no V Date App lica � NO CE TO APPLICANT: If; after makin this er icate of ARCHITECT OR TEL.//��®p .9 P�� DISTRICT GROUP TYPE FIRE CESSED BY O Exemption, you should become subject to the Workers' ENGINEER NO. T /dJ -110FCONSL ZONE t V Compensation provisions of the Labor Code, you must forth- ADDRESS o ? 6.� P-C6 a 8 with comply with such provisions or this permit shall be TEL. STATICAL CLASSIFICATION APT. CONDO. [a/) deemed revoked. CONTRACTOR he NO. LIC LICENSED CONTRACTORS DECLARATION CLASS NO. 2f DWELL UNITS . m I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. SEWER MAP (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 BK VALIDATION SQ.FT. /, NO.OF NO.OF CHECK License Number Lic.Class SIZE STORIES FAMILIES ONE VALUATION Contractor Date DESCRIPTION OF WORK O N NEW $ /�4,y��❑ BNa�.�I am exempt under Sec. r`e+-U ADDALTER B.BP.C. for this reason 3 � S! REPAIR ❑jl $ Date: U E OF DEMOL EXISTING BLDG. Q Signature APPLICANT /� TEL PRINT IG�� NO FINAL OWNER-BUILDER DECLARATION DATE I hereby.affirm that I am exempt from the Contractor's License I" �IjNDO � G� Law for the following reason (Section 7031.5, Business and ADDRESS !�+' f FIN Pro sions Code): PRESENT9 BUILDING 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 LOCALITY hL t C�� 7044, Business and Professions Code). MOVING TEL. z 0 6 7!� ❑ I,as owner of the property,am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS 0 0 0 0 0 tion 7044, Business and Professions Code). REQUIRED TOTAL SETBAC o 00 = CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH 09.1 ,t 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 (863 Lender's Name /'l/ LDMA Ref. q m P.C.Fee$ Permit Fee r Lender's Address I certify that I have read this application and state that the Issuance Fee �O LDMA P/C 6 R above information is correct. I agree to comply with all County Investigation Fee °o ordinances and State laws relating to building construction, Total FeeLDMA Perm.q H and he by authorize repress fives of is County to enter � u abov mentioned p erty fo spection p � m ( SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of App scant or gent Date