HomeMy Public PortalAbout5117 ROSEVALE DR_Building__ 76A839 CF 879 8 62 11
APPLICATION FOR RELOCATION BUILDING RMIT ILII
COUNTY OF LOS ANGELES I BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DMSION
LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST
WILLIAM A JENSEN SUPT OF BUILDING CROSS ST
FOR APPLICANT TO FILL IIQ DIST O R C SE KSR MAPP CE Y
PROPOSED /�
ADORES BUILDING,1. 117 Rosevale Dr. WATER
pI
/� Calif. CERTIFICATE NOT REQUIRED RECEIVED
LOCALITY TV
Temple it CafMAP HIGHWAY
PRESENT NO 19 CIRCLE) STATE MAJOR SEGO LOCAL
SU
ADDRESG QI 2 Ba/l�dwin Ave• f USE ZO E SPECIAL -� r / / �J
LOCALITY Tem le Cit Calif. CONDITION,-AK �iL6_ %
�,.y / A
OWNER .TO RQASU MAIL SETBAICK YARD WY STREET NAME WIDTH
ADDRESS 10107 La Rosa Dr.
FRONT
CITY Temple Cit NO 017Q P L
SIDE l
MOVING TEL p L
CONTRACTOR NO BYRPrF� A
ADDRESS e f I ¢ BY
BUILDINGTEL C ¢ Ta RIc y
CONTRACTOR A. Amoroso NO 3 7018 DEPOSIT f ILe '?� Y O
I APPR ALS DATE INSPECTO 5 SIGNATURE
ADDRESS
PRESENT FOUNDATION LOCATION
USE OF FORMS MATERIALS
BUILDING Vacant
acant FRAME FIRE STOPS
PROPOSED BRACING BOLTS d
USE OF
BUILDIN O11S@ FURNACE LOCATION Z
GAS VENTS DUCTS
SO FT 16A,A9�EE22 NO OF LATH INT
SIZE ROOMS STORIES 1
WALL
COV RINGplaster ROOF COVVLEGALQERING shingles LATH EXT
NUMBER
DESCRIPTION LOT NO J BLOCK HOUSE
AND POSTEDR
TRACT 2933:6 JJ{{QQ FINAL
SIZE OF LOT iJ�W ON LOTS none SURETY BOND DISTRICT ENGINEER
USE OF NO
RELEASED
OP
EXISTING BLDG L.NILIEB I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
I HEREBY STATE TH T TH INFORM T ON GIVEN S AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
CORRECT v'v WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
SIGNATURE OP BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
APPLICANT AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA
ADDRESS D TION OF THE LABOR CODC OF THE STATE OF CALIFORNIA RELAT
ING TO WORKMEN S COMPENSATION INSURANCE
VALUATION $ P C $ 5 SIGNATURE OF
FEE J PERMITTEE . I
FEE $ ADDRESS
VMMATI N cx rG -GBH JOHN F LEWIS PRINCIPAL STRUCTURAL GINE
PERMIT VALIDATION — m G cuH
LAGO5805z8 NOV1425 D 25.0 QG6,9851 NOv23 6 D 1.8/.5Ov 9
Lila y R 4L llfZat/�v
( �� �
NBSo-��
V- '
YHORRERS-CQMPENSATION DECLARATION
r affirm shot I hove certificate of consent to self APPLICATION FOR BUILDING PERMIT
insure or a certificate of Workers Compensation Compenaoon Insurance
or a certthed cdby thereof (Sec 3800 Lab C )
COUNTY OF LOS ANGELES BUILDING AN AFETY
Policy No Company
Certified copy is hereby furnished FOR APPLICANT TO FILL IN WILVINU
ADORES
Certified copy is filed with the county budding inspecBUILDING
hon department ADDRESS /T D3,E
Date Applicant CITY CIT zip �449TLOCALITY
CERTIFICATE OF EXEMPTION FROM WORKERS NO OF BLDGT NEAREST
COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT S
(This section need not be completed if the permit is for one -2ASSESSOR
hundred dollars ($100)or less ) TRACTfiIOCK LOT NO MAP BOOK PAGE PARCEL
TEL U ONE MAP
I certify that in the performance of the work for which this OWNER NO 0� NO off-
permit is Issued, 1 shall not employ any person in any manner ADDRESS 6149'q
ZA RMA —' SPKIAL 6
so as to become subject to the Workers'Compensation Law COFDITIOM1LS O
Date 1y_ he t CITY ZIP 917 0
lJ
APP aO
NOTICE TO APPLICANT If, ah making ilia Certificate of ENGINEER NOR O DISTRICT GROUP TYPE FIRE DNY
Exemption you should beco a subject to the Worken CONST ZONE
Compensation provisions of the Labor Code, you must forth ADDRESS d
with comply with such provisions or this permit shall be TEL STATISTICAL CLASSIFICATION APT CONDO
deemed revoked CONTRACTOR NO
49
LICENSED CONTRACTORS EC
TRACTORS OASS NO - DWELL UNITS_
I hereby affirm that I am licensed under provismns of Chapter 9 ADDRESS NO
(commencing with Section 7000)of Dwivon 3 of the Business andLIC SEWER MAP
Professions Code, and my license is in full force and effect CITY CLASS VALIDATION
SO FT NO OF NO OF CHECK PIG
License Number Lic ClassSIZE STORIES FAMILIE ONE
//p vALl1ATION Ciro
Contractor Dote DESCRIFTIONCIF WORK NEW
$ l
r_11 am exempt under Sec 4, ,
ALTER
B dP C for this reason REPAIR $
Date USE OF
EXISTING BLDG DFMOL
Signature APPLICANT TEL FINAL DECLARATION PRINT NO DATE
I hereby affirm that I am exempt from the Contractor z License
Low for the following reason (Section 7031 5 Business and ADDRESS
Professions Code)
0 1 as owner of the property or m employees Ywith ABDunMG
UDDING
wages o t their sole compensation wil l do the work and ,
the structure is not intended or offered far sale(Section LOCALITY
7041 Business and Professions Code) MOVING TEL
F11, as owner of the property am exclusively contracting CONTRACTOR NO
with licensed contractors to construct the project (Sac- ADDRESS —4 4 0 9 3 A
tion 7044 Business and Professions Code)
CONSTRUCTION LENDING AGENCY SET REQUIRED
YARD H1YYTOTAL LINE WIDTH
I hereby affirm that there is a construction lending agency for FRONT
the performance of the work far which this permit is issued PILL ( • ' 49, 88
(Sec 3097 Civ C ) SIDE
Lender s Name P L • • 4 9 8 8
a 3 DMARef 0224-86
Lender is Address PC Fee f Permit Fee �l '
I certify that 1 have read this application and state that the Issuance Fee LDMA P/C N
above information is correct I agree to comply with all County Inveatpoeon Fee
ordinances and State jaws relating to building construction T=ee
v and hereby outhortze representatives of this County to enter Lam`P•rin R
upon the above-mentio ed property for inspection purposes
.&ZkZ � � SO REVERSE FM EXPLANATORY LANGUAGA
$igreiare of Apti or Xgerit �--DdIte 8 i
COUNTY OF LOS ANGELES TEMPLE CITY 0 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY LA 91780 BL 0508 0503140016
PHONE (626) 285-0488 EXT
LEGAL 10 -m. ur---eugr-- BUILDING ADDRESS
TR 29316 LT 5 SQ FT STORIES TYPE 5117 ROSEVALE DR
STRUCTURE: 2800 VN TEMP CA 917803308
ASSESSOR INFORMATION NLP48ER 8585-007-052 NEAREST CROSS STREET- LA ROSA
THOMAS PAGE. 597 GRID 84 LOCALITY: TEMPLE CITY, C
TENANT: EXIST BLDG USE RESID USE 7W—W-�F— ISSUED ON PROCESSED BY EXPIRES ON:
EXIST OCC GRP: 03/14/05 JK 03/09/06
OWNER' No ULDGS. NOW ON LOT' VALWMTM-- FINAL DATE FINAL sY- CODE
CHAN, PETER (818) 444-5019- 5,000
5117 ROSEVALE DR \ - Z 3 -
TEMP 917803308 FEES PAID DESCRIPTION
1/0 THE SHINGLE COVER UP OSB PLYWOOD 30 YEARS ASPHALT
APPLICANT: --rrr NO: FEE DESCRIPTION QUANTITY: LION AFAXMT SHINGLES HOUSE AND GAVAGE
FIMG'S CONSTRUCTION CO (626) 287-8075- AA BLDG PERMIT ISSUANCE 27.75
8K9 ELM AVE AC STRONG MOTION RESID 5000.00 VAL 0.50 SPECIAL CONDITiDNS:
SA GABRIEL CA 91775 D2 PERMIT W/O EN-HC 5000.00 VAL 132.60
TOTAL FEES 160 85
CONTRACTOR: TEE--VF— APPROVALS DATE INSPECTOR SiGNATUAr—
FUNG'S CONSTRUCTION CO , INC. (626) 625-7048-
8449 ELM AVENUE LIC NO LOCATION AND SETBACKS
SAN GABRIEL, CA 91775 753441 B
SOILS ENGINEER APPROWAr-
LIC. RD 9M7aflFMF-)'166F—
RAISED FLOOR FRAMING
MAP NO: SEWER MAP BOOK. PAGE TrRr-2NE---UV amrqrluo"
147H273 3 01 1
40. OF FAMILIES DWELLING UNITS: APT/C0NDr-§TXr-00%T-- FLOOR SHEATHING
NO 21 ROOF SHEATHING
AIR QUALITY SCHOOL WITHIN —1909RD50T-
1000 FEET MATERIALS
NO NO NO FRAKF INSPECTION
REQUIRED TOTAL SETBACK FROM EXIST
1T1��
SET BACK YARD HWY PROP LINE WIDTH
FRONT PL- INSULATION/WEATHER STRIP
SIDE PL-
REPORT 10: DPR261 ROUTE TO: BS0508