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HomeMy Public PortalAbout5723 ROWLAND AVE_Building__ � 3I�'SA63PCE#80B ILDIN PERMIT APPLICATIOOR fl r COUNTY OF LOS.ANGELES ASSESSOR A DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAG PARC L BUILDING AND SAFETY DIVISION BUILDING , ADDRESS COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST '7 Print or . e onl CROSS ST. /L1 r DIST..ICT N0. GROUP TYP.E�� P ESSED BY ADDRESS BUILDING Y7� ®�OVAGi/�D �pS COWS3' LOT NO. yY03 BLOCK STATISTICAL C •ASSIFICATION SEWER MAP CLASS NODWELL.UNITS 9K)^PC'�/ TRACT USE ZONEI MAP NO.OF BLDGS. ` NO. SIZE OF LOT NOW ON LOT W / SPECIAL USE OFIFCONDITIONS EXISTING LDG. iF�/A/C Amt ff OWNER 'V� y' r^/ TEL ' . 6 l,-� NOpZ S BLDG.SETBACK FROM E ! ADDRESS -7�3 !.✓!�/�/D, FRONT PROP.LINE OFNft 41 (STREET) �6M/�L� G/7' TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL CITY HIGHWAY WIDTH FROM C.L: ARCHITECT OR TEL. + = 4 ENGINEER NO. BLDG.SETB CK FROM ADDRESS SIDE PROP. INE OF (STREET) TEL TYPE OF EXISTIN SETBACK HIGHWAY + YARD = TOTAL d CONTRACTOR /AIDSO,d(. ( / 0, a/� y'0 HIGHWAY WIDTH FROM C.L. CC.'. ADDRESS—1rZ y3O QwA ( ( NO. Z�(o3b + = C F` CITY//A /!AA/ LIC. dS s. CLASS FS"P CORNER CUTOFF YES ❑ NOLL CONSTRUCTION LENDER CL NAME ANDBRANCH L CO_ SEE REVERSA SIDE FOR AECIAL APPROVALS ADDRESS kyN #X Del T. SQ. FT. NO. OF NO. OF ❑ SIZE O STORIES Q FAMILIESOdC NEW �Z USE OF ADD STRUCTURE 8576/Z00 -,I/ ALTER ❑ Z REPAIR❑ SIGNATURE OF 7� APPLICANT DEMOL ❑ , z- VALUATION S Ooo r APPROVALS DATFF INS�PECTOR'915,1 GNA TU RE P.C. PMT. FOUNDATION: LOC_ FEE$ FEE$ 06 s 97 FORMS, MATERI L FRAME:' FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION IS BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALLORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS STRUCTIO,N. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY .ANY PERSON IN VIOLATION OF THE LATH, INT. LABOR CODE OF THE STATE OF -CALIFORNIA IN RELATING TO WORKMEN'S COMPENSATI N NS RANCE. Ir LATH, EXT . SIGNATURE OF HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS �O FINAL p JOHN F. I EWIS. PRI 11 CIP EI STR- RAL ENGINEER MI PLAN CHECK VALIDATION CK: M.O. CASH PERT VALIDAT N . CK. M.O. CASH Z LAI.6,aa. 8A.-JUL. , 6, .• D 2.00- v W%RKERS'COMPENSATION DECLARATION �• " I ue;ay affirm'that I havecertificate of consent to self APPLICATION FOR BUILDING P E RM I T 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. Company BUILDING El Certified /A-a Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS .07Z q/` F- ❑ Certified copy is filed with the county building inspec- BUILDING Li q„� tion department. ADDRESS )W CITY T M PIP- C1 ZIP LOCALITY Date Applicant NO.OF BLDGS. NEAREST / CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST. O COMPENSATION INSURANCE J� ASSESSOR ,(� (This section need not be completed if the permit is for one TRACT �D I BLOCK LOT NO.`Z'©3 MAP BOOK PAGE Q Z PARCEL `=”V hundred dollars ($100)or less.) OWNER —VAMCk OAA' Np•bl Z USE ZONE MAP I certify that in the performance of the work for which thisy� i NO. ?�r permit is issued, I shall not employ any person in any manner ADDRESS �7 iCEVI& A-v2 CONDITIONS so as to become subject to the Workers'Compensation Laws. t n O CIN•TP., Q M C � ZIP l �b Date Applicant ARCHITECT OR TEL De NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO DISTRICT GROUP OPE ZONE PRO ED O Exemption, you should become subject to the Workers' ` Compensation provisions of the Labor Code, you must forth- ADDRESS �� © ut �' CIo N with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATIONAPT. DO. Z deemed revoked. CONTRACT NO. , _ LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. ENV DWELL. UNITS I hereby affirm that I am licensed under provisions 6f Chapter 9 ADDRESS NO. (commencing with Section 7000)of Division 3 of the Business LIC SEWER MAP and Professions Code,and my license is in full force and effect. CITY CLASS BK PG VALIDATION SQ. FT. NO. OF NO. OF CHECK License Number Lic. Class SIZE I STORIES I FAMILIES ONE VALUATION Contractor Date DESCRIPTION OF WORK NEW ❑ s /©� ❑I am exempt under Sec. NEW WALL- b RpNT • PFRC%A ADD (Q ► ALTER ❑ B.BP.C. for this reason REPAIR ❑ $ Date: USE OF ,,.... pp EXISTING BLDG. ff_& DEMOL ❑ Signature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION (PRINT) NO. I hereby affirm that I am exempt from the Contractor's License DATE �, Law for the following reason (Section 7031.5, Business and ADDRESS FINAL ro essions Code): PRESENT BY ACCT.•a BUILDING I, as owner of the property, or my employees with ADDRESS 3303 r r0 wages as their sole compensation,will do the work and ! ■ the structure is not intended or offered for sale(Section LOCALITY , 1 7044, Business and Professions Code.) MOVING TEL. ❑ I,'as owner of the property,am exclusively contracting CONTRACTOR NO. ACCT a a8 with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code.) 3303 75.08 REQUIRED TOTAL SETBACK FROM EXIST. ITEMS CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH 1 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. TOTAL :125 a 5p_3 (Sec. 3097, Civ. C.). SIDE CHECK � �. P.L. Lender's Name Q �P LDMA Ref. # CHANGE .00 8 P.C. Fee$ 99,43Permit Fee Lender's Address , I certify that I have read this application and state that the Issuance Fee �� LDMA P/C# '- above information is correct.I agree to comply with all County Investigation Fee 0000-0001 7/ 1/96 ordinances and State laws relating to building construction, Total Feed/ if LDMA Perm. # 7201Ate $ and hereby authorize representatives of this County to enter upon thq above-mentioned roperty for inspection prurposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date 'Aw COUNTY OF LOS ANGELES TEMPLE CITY # 0'p8 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS i ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA SL 0508 9801060011 PHONE: (818) 285-0488 EXT: GAL D: NO. OF CONSTBUILDING ADDRESS: TR: 6561 LT: 403 UN: .002 SQ. FT STORIES TYPE 5723 ROWLAND AV STRUCTURE: 0 VN TEMP CA 917802617 ASSESSOR INFORMATIONBER: NEAREST CROSS STREET: 8587-029-005 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY TENANT: G USE: RESID USE ZONE: R- TS—SUE-D-0-97 PROCESSED BY: EXPIRES N: EXIST OCC GRP: 01/06/98 UT 01/06/99 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY CODE: CHANG CHWANG-FANG;SHU-MEI LIN (626) 285-7239- 1 1,600 1-21 5723 ROWLAND AV TEMP 917802617 FEES PAID DESCRIFTIONF WORK CHANGE 3 WINDOWS AND ADD DRYWALL TO GARAGE-NOT TO BE USED APPLICANT: TEL. 0: FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: FOR HABITABLE SPACE SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RESID = ,1600.00 VAL 0.50 SPECIAL CONDITIONS: AX BUILDING REVIEW FEE 54.70 B2 PERMIT• W/ENERGY,, _ _' 1'600.00:VAL 90.42 TOTAL'.FEE9-t 173.37 CONTRACTOR: TEL. N0: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO -' �� LOCATION SETBACKS SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: L. 0: '� `. �' U D RE R LIC. N0: i ___ ' - I I ` SLAB UNDER FLOOR RAISED FLOOR FR NG MAP 0: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: ;i, �` �Ij ., i., UNDERFLOOR I SOLATION 150H269 3 '01 - FLOOR SHEATHING 0. OF F S: NG D: STAT C S - - -- -- -- ----- - NO 21 , F ROOF SHEATHING SCHOOL WITHIN HAZARDOUS a ` ':�' SHEAR-PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO NO ;�� RAME INSPECTION RE Q L SETBACKR S R SPRINKLER S / l8 SET BACK YARD: HWY: PROP LINE: WIDTH: 20 -_---- - FRONT PL- ``'�. • '!. : ?' rINSULATION/WEATHER S RIP SIDE PL- --- - - - INTERIOR LATHIDRYWALL EXTERIOR LATH RATED FLOOR/CEIL ASSEM. RATED WALL-ASSEMBLIES RATEDSHAFTS/OPENINGS T-BAR­CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508