HomeMy Public PortalAbout5707 ROWLAND AVE_Building__ GASSM CE#6089.09 APPLICATI®N FOR BUILDINC+��./PERMIT .
COUNTY OF LOS ANGELES ADp ESS �/ V ) /9, +ou eaw-L
DEPARTMENT•OF COUNTY ENGINEER �,, `'
BUILDING AND SAFETY DIVISION LOCALITY ( �-11�..[•
JOHN A.LAMBIE,COUNTY ENGINEER NEAREST / OAK K
CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST. C+r''+-1
DISTRICT NO. GROUP TYPE PROCESSED BY
FOR APPLICANT TO•FILL IN „y I CONST. I &A/C'C�
BUILDING .ti SEWER MAP.
STATISTICAL CLASSIFICATION
ADDRESS � BK . 'PG
w� CLASS.NO.1—DWELL.UNIT
L07 NO.. O SO DF Ev419)BLOCK MAP STATE
YES �NO
/ NUMBER `✓fe! HWY.
TRACT USE ZONE SPECIAL
NO OF SIZE OF LOT rS � p+J I NOW ON LOTS/!'6$ CONDITION
USE OF
EXISTING BUILDINGEXIST.
YARD HWY STREET NAME
` SETBACK WIDTH
OWNER 'k P FRONT /1 �� `: � I e�•
MAIL• P.L.
ADDRESS I
TEL. P.L."
cITY .'47t�to v. EL.NO.,1:2L INSPECTION RECORD
ARCHITECT OR TEL
ENGINEER Dw.�a N NO.
ADDRESS
TEL !" I-A')
CONTRACTOR NO. ,
DD SES
DESCRIPTION OF WORK
NEWv'ADD 'ALTER REPAIR • DEMOLISH
SQ.FT. NO.OF NO.OF '�• �" % ( Yl f L^Ip� f?�/S
SIZE / S 6 STORIES o FAMILIES
USE OF STRUCTURE
r 7- cP Ie -�__ll��
SIGNATURE OF AP — YVAr to /;',E/��/f��f/
APPLICANT -
ATE INSPECT0R'S==NA7'URE
ADDRESS J+ d FOUNDATION: LOCATION
FORMS,MATERIALS /
$ P.C. $ (c� FRAME: FIRESTOPS.
'FEE �` BRACING,BOLTS
VALUATION j CLQ'
FEE $ FURNACEKLOCATION.
GAS VENT.DUGT8 2yG
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH,INT.
PLICATION AND STATE'THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL'COUNTY ORDINANCES D
STATE LAWS REG LATI, BUILD ro, N. LATH,EXT.
SIGNATURE OF / HOUSE NUMBER COR_
PERMITTER RECT AND POSTED
ADORES f1'�t FINAL '2 2 S� Cip7!/l'�'�CG�LNP
CLYDE N.DIRLAM,PRINCIPALST RAL ENGINEER
-PLANCHECK VALIDATION k CK. M.O. CASH PERMIT VALIDATION CK. M.O. . CASH
L 2.�2 3 3;:u;:FEB 5 2 3 A co:(Y. r '
. _ _ -LCD 2:3 7 3 M 'FEB 11 1 A 48
.00 �.
760.83 BA CEVBD3 9
'67APPLI•CATIO FOR BI!�'ILDING PERMIT LJ
i COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF'COUNTY ENGINEER ADDRESS �7 O
BUILDING AND SAFETY DIVISION LOCALITY
JQHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPT OF BUILDING NEAREST
CROSS ST.
FOR.APPLICANT TO FILL IN
DISTRICT T N ROU TYPiE P c S D BY
Print or type only)
4_
BUILDING (^ �) STATISTICALCLIFICATIO SEWER MAP
ADDRESS tJ e /, '). CLASS NO. DWELL.Ut4ITS B
LOT NO. S�, / o' �fSCK USE ZONE MAP
NO.
TRACT �� SPECI
CONDITIONS
AL
NO.OF BLDGS.
SIZE OF LOT d NOW ON LOT
USE OF
EXISTING BLDG. BLDG.SETBACK FROM
TEL. FRONT PROP.LINE OF (STREET)
OWNER JNO. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
f HIGHWAY WIDTH FROM C.L.
ADDRES
+
CITY BLDG.SETBACK FROM
ARCHITECT OR TEL. SIDE PROP.LINE OF (STREET)
ENGINEER NO. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C.L.
ELL - r
CONTRACTOR N0!;;L. e 3 + a
O
ADDRESS 3d �I/ NO. CORNER CUTOFF YES ❑ NO ❑aojKv
CIT CLAS SEE REVERSE SIDE FOR SPECIAL APPROVALS
DESCRIPTION OF WORK oW
Cn
Z_
NEW ADD ALTER REPAIR DEMOLISH
SQ. FT. NO. OF NO. OF
SIZE STORIES FA ILIES
USE OF
STRUCTURE
SIGNATURE OF
APPLICANT
VALUATION$ d APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. PMT. FOUNDATION: LOCATION
FEES FEE Sp?-. t FORMS, MATERIALS
FRAME: FIRE STOPS,
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS
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 1 WILL NOT EMPLOY ANY PERSON IN VIOLA-
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RE T• LATH, INT.
ING TO WORKMEN'S COMPENS I SURANCE.
• LATH, EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS FINAL
JOHN F. LEWIS. PRINCIPAL ST RAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH
o-3 6 .0-7 HIR 1 925
'"
ZJ
76 p'g A q.g-VOS.9.67
y "". APPLICATION FOBUILDI PERMIT
OUNTY OF LOS ANGELES
BUILDING �g , ,i`
D8PARTMENT OF'CO.UNTY.ENGINEER ADDRESS. 7(a° .r{ f$'s ��'�I S•L
,;''BUILDING AND SAFETY DIVISION LOCALITY "z " ;.,,ai
_40HP A. LAMBIE, COUNTY ENGINEER _
COLEMAN W. JENKINS, SUPT OF BUILDING NEAREST �' �•
CROSS ST.
FOR APPLICANT TO FILL IN DISTRICTjJI GUP TYPE P. � C f
L� .L CONST.
Print ort a only) / ./«
BUILDING / STATISTICAL C ASSIFICATION SEWER MAP
ADDRESS Ej� // / f/' L/�® ,7 :�¢"�- - CLASS NO, -DWELL.UNITS
LOT NO. • ,� ! j;T� Bt�OCK USE ZONE MAP
/' NO.
TRACTyr- fp CONDITIONS
AL
NO.OF BLDGS. /
SIZE OF LOT +� w,• i j_� % NOW ON LOT r
USE OF
EXISTING BLDG, BLDG.SETBACK FROM
TEL. : r"= FRONT PROP.LINE OF (STREET).
OWNER/'.r r1`� /il // NO• 'TYPE OF EXISTING SETBACK HIGHWAY JRD = TOTAL
ADDRESS -%/i %'�%, ' ,t.�w•_��w-:.� HIGHWAY WIDTH FROM C.L. �f
lI +
CITY T -� BLDG.SETBACKFRO
ARCHITECT OR TEL. =SIDE PROP.LINE Q —(STREET)
ENGINEER NO. TYPE OF EXISTIN " •E �K HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTH F C.L.
CONTRACTOR f f-r ��'%IVO + p
LIC. Cl
ADDRESS," 5 �/' •'� NO. CORNER CUTOFF YES ❑ NO ❑
LIC. C3
CITY .� ` �—.�� CLASS =—/ SEE REVERSE SIDE FOR SPECIAL APPROVALS
DESCRIPTION OF WORK L`I
NEW ADD- ALTER REPAIR DEMOLISH
SQ. FT. NO. OF NO. OF
SIZE STORIES FAMILIES f
USE OF �' deo✓�,, �fe ..+1,!G�r
STRUCTURE• — °
x .c��a
SIGNATURE OF
APPLICANT i�� / '!"/'`."� ,l._-• -� •
VALUATION
$ {
APPROVALS DATE INS CTOR`S SIGNATURE
P.C. PMT, rte- �D FOUNDATION: LOCATION
FEE S FEE$ �� FORMS, MATERIALS
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE:WLOCATION,
ITH 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- LATHINT
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT , .'- :( -
ING TO WORKMEN'S COMPENSATION INSURANCE. 1'
/� -^ LATH, EXT.
SIGNATURE OF � � HOUSE NUMBER.COR-
PERMITTEE _ _` RECT AND POSTED '
ADDRESS '" ) � '�r' , '�- FINAL
JOHN F. LEWIS. PRINCIPAL ST R U AL ENGINEER
PLAN CHECK VALIDATION CK. M.C. CASH — PERMIT VALIDATION CK. M.O. CASH
►0.3-m5-- 8-:&:G -M.14.- Ik A 1 8 5':E}N �
WORKERS'COMPENSATION DECLARATION 9 ` O 3F 9/ T 7/ �f
hereby affirm that I have certificate of consent to Self APPLICATION FOR BUILDING PERMIT �
insure, or a certificate of Workers'Compensation Insurance,
or a certified copy thereof(Sec. 3800, lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY'
Policy No.I V84.-22515Ampany_ Fremont Indemnity
r_1NG
copy y FOR APPLICANT TO FILL IN ADDRESS
7
Certified co is hereby furnished. ADDRESS
Certified copy is filed with the county building inspec- BUILDING
IIJJ tion department. ADDRESS 5707 N. Rowland
Date 8/11/84 Applicant V i rg i n Roof Co. CITY Tem 1 e Cit - ZIP :LOCALITY
CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. NEAREST
COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST.
(This section need not be completed if the permit is for one ASSESSOR
hundred dollars($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL
TEL.
I certify that in the performance of the OWNER M r. & Mrs. Go s swe i n work for which this NO. USE ZONE MAPNO. 49 7 916ermit is issued,I shall Aot em to an person in an manner 1 SPECIAL
so as to become subject to the Workers'Compensation Laws. ADDRESS 5707 N. Rowland CONDITIONS U
CITY Temo 1 e City ZIP oe
Date 'Applicant ARCHITECT OR TEL. O
NOTICE TO APPLICANT: If, after making'this'Certificate of DISTRICT GROUP TYPE FIRE PRO ESSED BY CONST. ZONE I.,,
'� U
Exemption, you should become subject to the Workers' ENGINEER NO. -
Compensation provisions of.the Labor Code;you must forth- ADDRESS i H
with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION AW I CONDO. Z
deemed revoked. CONTRACTOR Virgin Roof Co. NO. 287-05
LICENSED CONTRACTORS DECLARATION LIC, CLASS NO. . a, DWELL. UNITS
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS P Q sox J NO. 16
(commencing with Section 7000)of Division 3 of the Business and LIC. SEWER MAP
Professions Code, and my license is in full force and effect. CITY San Gabriel 91776 CLASS 1 q BK PG VALIDATION
-
SQ.SQ.FT. NO.OF NO.OF CHECK
License Number 160650 Lic.Class C39— SIZE STORIES FAMILIES ONE
1 VALUATION
Contractor V�i rg i n Roof CO;Dote 8/1/84 DESCRIPTION OF WORK -Re-roof house -& NEW ❑ $ 8821 -00
❑ ,
❑ ADDIamexemptunderSec. garage with Class ACal-Shakes ❑ -•
ALTER
B.BP.C. for this reason 25 S s. REPAIR. ❑ $,
USE OF ❑
Date: EXISTING BLDG. dwelling DEMOL
'Signature APPLICANTT . 28 —0 0 EL. FINAL /
OWNER-BUILDER DECLARATION (PRINT) Virgin Roof Co. NODATE
1 hereby affirm that I am exempt from the Contractor's License ADDRESS P• 0. sOX J San Gabriel 91776 FIN
Law for the following'reason (Section 7031.5, Business and
Professions Code): PRESENT By -E-328 1 A
❑ BUILDING
I, as owner of the property, or my employees with ADDRESS ' { 0 0 0 0 0 1
wages as their sole compensation,will do the work and ,
the structure is not intended or offered for sale(Section LOCALITY 2 0 1 1550
7044, Business and Professions Code). MOVING TEL.
❑ I, as owner of the property,am exclusively contracting CONTRACTOR NO. o 0 1 1 5 E 0 u
with licensed contractors to construct the project (Sec- ADDRESS Q 8 0 %—84
tion 7044, Business and Professions Code).
REQUIRED TOTAL SETBACK FROM' T.
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH
I hereby affirm that there is a construction lending agency for FRONT
the performance of the work for which this permit is issued P.L.
(Sec. 3097, Civ. C.). SIDE
g P.L.
Lender's Name LDMA Ref. #
3 P.C. Fee$ Permit Fee 105.00 '
Lender's Address
I certify that I have read this application and state that the Issuance Fee 10.50 LDMA P/C#
above information is correct. I agree to comply with all County Investigation Fee
ordi antes and State laws relating to building construction, Total Fee 11115-.50 LDMA Perm. #
and hereby authorize representatives of this County to enter
( up the above-mentioned pr erty f 'ns ection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
a
5' ture of Applicant or Agent Date i Oo
-" I
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 1302040066
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I NO. OF CONST I BUILDING ADDRESS: I
ITR: 6561 IT: 401 I SQ. FT STORIES TYPE 1 5707 ROWLAND AV 1
ASSESSOR INFORMATION NUMBER: ISTRUCTURE: V-B I TEMP CA 917802617
8587-029-003 I I NEAREST CROSS STREET: LIVE OAK
I I I THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY CAI
TENANT: EXIST BLDG USE: RESID USE ZONE: R-1 ISSUED ON: PROCESSED BY:
1 (EXIST OCC GRP: 102/07/13 SR
(OWNER: TEL. NO: IBLDGS. NOW ON IAT: VALUATION: IFINAL DATE FINAL BY: CODE: 1
ITRIEU, MAI (626) 315-6902- 1 15,000 I I
15707 ROWLAND AV I I �3 1
ITEMP 917802617 1 FEES PAID 1D SCR PT ON OF WORK 1
I I 1(1) REMODEL (E) KITCHEN (2) REMODEL (E) 2 BATHROOMS 1
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:I (3) REPLACE 7 (E) WINDOWS WITH RETRO-FIT WINDOWS 1
(APPLICANT: TEL. NO: I I I
ILO, GILBERT (626) 234-4118- IAA BLDG PERMIT ISSUANCE 27.80 1
12200 S FREMONT AVE IAB STATE GREEN BLDG FEE 15000.00 VAL 1.00 ISPECIAL CONDITIONS: 1
ALHAMBRA CA 91803 AC STRONG MOTION REBID 15000.00 VAL 1.50
I IB2 PERMIT W/ENERGY 15000.00 VAL 330.70 I
1 I TOTAL FEES 361.00 1
ICONTRACTOR: TEL. NO: 1 1APPROVALS DATE INSPECTOR SIGNATURE 1
IG & YONG CONSTRUCTION INC (626) 234-4118- 1 I
12200 S FREMONT AVE #200 LIC. NO 1 ILOCATION AND SETBACKS I
1ALHAMBRA CA 91803 795058 1 1 1 I
I [ ISOILS ENGINEER APPROVAL I [ I
(ARCHITECT OR ENGINEER: TEL. NO: - I IFOUNDATION/TRENCH FORMS I I I
LIC. N0: I ISLAB/UNDER FLOOR I I I
I I IRA SED FLOOR FRAMING I I [
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( (UNDERFLOOR INSULATION I I
1150H269 3 001 I1 [
I I IFLOOR SHEATHING I I
INO. OF FAMILIES: DWELLING UNITS: APT/CONDI STAT CLASS: I I I I I
I 0 NO 21 1 IROOF SHEATHING
I I I
SCHOOL WITHIN HAZARDOUS 1 ISHEAR PANELS 1 I I
(AIR QUALITY: 1000 FEET MATERIALS I I I I
1 NO NO NO I IFRAME INSPECTION
I IFIRE SPRINKLER HANGERS
I (INSULATION/WEATHER STRIP I I
I I I I I
I [INTERIOR LATH/DRYWALL 1
I [ IEXT^cRIOR LATH I [
I I IRATED FLOOR/CEIL ASSEM. I I I
1 I RATED WALL ASSEMBLIES I I I
(RATED SHAFTS/OPENINGS
[ IT-BAR CEILINGS 1 I I
I [
I [ [LOT DRAINAGE [ [
IREPORT ID: DPR261 ROUTE TO: BS0508 I 1 1
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