HomeMy Public PortalAbout5323-5325 SANTA ANITA AVE_Building__ APPLICATION FOR BUILDING PEI N_IIIT
FOR APPLICANT TO FILL IN (Print or type only) � �, '� V` I� V
BUILDING �COI�NTY OF LOS AAELES
ADDRESS j DEPARTMENT OF COUNTY ENGINEER
CITY Cil ZIP BUILDING AND SAFETY DIVISION
�^�
NO OF BLDGS. ,r� BUILDING
SIZE OF LOTJ6 y c1b NOW ON LOT '/ ;/ [ADDRESS
TRACT BLOCK LOT NIX LOCALITY e
TEL. EAREST
OWNER .71..vC /C Y�+S1� NO. 4J1/6ASSESSOR
•�I� Ross ST.
ADDRESS (�•�0 W ���rr L•j 4 MA BOOK PAGE PARCEL
` DISTRICT GROUP TYPE ESSED BY
-CITY / 1 ZIP d O �a CONS lz!�e.�-
STATISTICAL
ARCHITECT R i L ! 0�ENGINEER / r/6'p sc�/! N 'f l CLASSIFICATION -MER
AAP
ADDRESS CLASS NO. U� DWELL.UNITS t. 7 IBKK,5 D PG
IEL CONTRACTOR r r•v�i �- NO!y Q USE ZONE MAP F
LI
ADDRESS �(� �� vi1 P NCO&q - ' SPECIAL
CONDITIONS
CITY LIC. n
�� CLASS /7 ROAD DEPARTMENT APPROVAL R UIRED YES ❑ NO ❑
CONSTRLrdION LENDER
NAME AND BRANCH rF L BLDG.SETBACK FRO
FRONT PROP.LINE OM ^ ISTREETI
ADDRESS r QQ LU(14/ CITY / TOTAL SETBACK FROM TYPE OF EXISTING
SQ.FT. NO.OF HIGHWAY + YARD NO.OF CHECK - FRONT PROP.LINE HIGHWAY WIDTH
SIZE STORIES FA;ILIES ONE / /r
DESCRIPTION OF WO .;7&Z NEW + � /t� O
ADD ❑ BLDG.SETBACK FROM ex
} Z SIDE PROP.LINE OF (STREET! O
ALTER ❑ HIGHWAY ( YARD = TOTAL SETBACK FROM TYPE OF EXISTING
SIDE PROP.LINE HIGHWAY WIDTH
USE OF REPAIR 13 Z
EXISTING BLDG. �'DEMOL ❑ +
APPLICANT �' ��TEL CORNER CUTOFF YES ❑ NO ❑
(PR NT) Iy- N
IN OPEN SPACE YES ❑ NO ❑
BY ISIGNATUREI '
��—__ �1 OASTAL PERMIT ZONE YES ❑ NO
QQ ❑
VALUATION`P ~ 6-0 ~ a z/0
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES
AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY.ANY PERSON IN VIOLATION OF
THE LABOR CODE OF THE STATE OF CALIFO!�7
NG TO WOR COM-
PENSATION INSURANCE. �
SIGNATURE OF
PERMITTEE
ADDRESS '+ ' ✓ s
t FINALJ j �(�I BY t�l�1 �`•' r
TEL ' r{��J DATE /�"•" ICS} "�,
CITY ve NO.
a
MAKE CHECKS PAYABLE TO: FEE FEET
HARVEY T.BRANDT,COUNTY ENGINEER /C'7 //1 -`U Q - O ,
PLAN CHECK VALIDATION CK.-) M.O. CASH / PERMIT VALI A I ON `J CK. M.O. CASH
4 4 0 r'.:nFD e-,j 3 3 D 1 5 3.0 �yr�
osbL'�-kPP 123D 105.08
®s 76A63BA CE#803 3.75 /�
WORKERS'COMPENSATION DECLARATION
hereby affirm that I have a certificate of consent to self APPLICATION FOR BUILDING PERMIT rIs'
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
Certified co is hereby furnished. BUILDING c� -s► �J
❑ copy y I FOR APPLICANT T FILL IN ADDRESS _
❑ Certified copy is filed with the county buildin�insec- i BUILDINGJ
ff IOU
tion department. ADDRESS 2 J LOCALITY
NEAREST
Date Applican SA CITY ZIP CROSS ST.
CERTIFICATE OF EXEMPTION FROM WORKERS' I NO.OF BLDGS. ASSESSOR
COMPENSATION INSURANCE I SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL
(This section need not be completed if the permit is for one USE ZONE MAP
hundred dollars($100)or less.) TRACT BLOCK LOT NO. NO.
i TEL. �J SPECIAL y
I certify that in the performance of the work for which this OWNER �► NO. / CONDITIONS O.
permit is issued, I shall not employ any person in any manner �^ DISTRICT GROUP TYPE FIRE P ESSED BY O
so as to become subject to the Workers'Compensation Laws. I ADDRESS ��ZS ` CONST. ZONE V
Date Applicant CITY ZIP STATISTICAL C IFICATION PT. CONDO,
NOTICE TO APPLICANT: If, after making this Certificate of i ARCHITECT O t TEL. q
Exemption, you should become subject to the Workers' ENGINEER f Q NO. �S� Z� CLASS NO. �1/ DWELL. UNITS
Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP
with comply with such provisions-or this permit shall be
deemed revoked. CONTRACTOR J NO. BK. PG, VALIDATION
LICENSED CONTRACTORS DECLARATION LIC,
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. VAL ON
(commencing with Section 7000)of Division 3 of the Business and LIC.
Professions Code,,liand my license is in full force and effect. CITY a ��� CLASS t $ ,
License Number`-t'l 1�-� Lic.Class '�� �'�' STONO. IE FA OF CHECK
C SIZE STORIES FAMILIES ONE 01111
�� ]�-Q�Date �Z DESCRIPTION OF WORK NEW $
Contractoc�
❑I am exempt under Sec. U
ADD ❑
ALTER FINAL y
B.$P.C. for this reason REPAIR ❑ DATE
USE OF
Date: EXISTING BLDG. C] By AL
DEMOL
Signature APPLICANT TEL.
OWNER-BUILDER DECLARATION PRINT NO.
I hereby affirm that I am exempt from the Contractor's License
Law for the following reason.(Section 7031.5, Business and ADDRESS
Professions Code): PRESENT
❑ I, as owner of the property, or my employees with BUILD
1 3 7 R.
wages as their sole compensation,will do the work and
the structure is not intended or offered for sale(Section LOCALITY o a o 0 0 1
7044, Business and Professions Code). MOVING TEL.
❑ I,as owner of the property,am exclusively contracting CONTRACTOR NO. a o 4 9 88
with licensed contractors to construct the project (Sec- ADDRESS - z
tion 7044, Business and Professions Code). ° = ° 1,9• Pc. u
REQUIRED TOTAL SETBACK FROM EXIST. 0'4, 1 2-8 3
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH
I hereby affirm that there is a construction lending agency for FRONT
the performance of the work for which this permit is issued P.L.
tSec. 3097, Civ. C.). SIDE
0
P.L.
: Lender's Name
3 P.C.Fee$ Permit Fee
Lender's Address
I certify that I have read this application and state that the Issuance Fee ,.
above information is correct. I agree to comply with all County Investigation Fee Il�
ordinances and State laws relating to building construction, Total Fee }j
and hereby authorize representatives of this County to enter
upon theabove-menti ed property for inspection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Applicantler Agent Date ®s
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 0809090014
PHONE: (626) 285-0488 EXT:
LEGAL ID: NO. OF CONST BUILDING ADDRESS: I
ITR: 13363 LT: 2 SQ. FT STORIES TYPE 5233 SANTA ANITA AV
I ISTRUCTURE: 22 V-B I TEMP CA 917803622 I
ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET:
18574-009-002 I I THOMAS PAGE: 597 GRID: D4 LOCALITY: TEMPLE CITY, Cl
I
TENANT: JEXIST BLDG USE: RESID USE ZONE: R-2 JISSUED ON: PROCESSED BY: EXPIRES ON:
I (EXIST OCC GRP: 109/09/08 SR 03/08/09
I L I
[OWNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: 1F NAL DATE FIq�-(
CODE:
ILIMBA, PAUL (626) 579-3588- I 4,700 I ��5233 SANTA ANITA AV rr
TEMP 917803622 1 FEES PAID ID SCRIPTION OF WORK 73
I [HOUSE & GARAGE REMOVE LAYERS TO WOOD INSTALL 30 FLET PAPER
]FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:IINSTALL 20 YEAR SHINGLES CLASS A
APPLICANT: TEL. NO: I I
1HAYVEN CONSTRUCTION (818) 997-3960- IAA BLDG PERMIT ISSUANCE 27.75 1
17109 GERALD AVE. IAC STRONG MOTION RESID 4700.00 VAL 0.50 ISPECIAL CONDITIONS:
VAN NUYS, CA 91406 ID2 PERMIT W/O EN-HC 4700.00 VAL 132.60
TOTAL FEES 160.85
CONTRACTOR: TEL. NO: I JAPPROVALS DATE INSPECTOR SIGNATURE
1HAYVEN CONSTRUCTION (818) 652-2138-
17109 GERALD AVENUE LIC. NO (LOCATION AND SETBACKS
IVAN NUYS CA 91406 865771 B
I I ISOILS ENGINEER APPROVAL
ARCHITECT OR ENGINEER: TEL. NO: IFOUNDATION/TRENCH FORMS I I I
LIC. NO: (SLAP/UNDER FLOOR
IRAISED FLOOR FRAMING
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: JUNDERFLOOR INSULATION I I I
1147H277 3 O1 I I I
I I ]FLOOR SHEATHING I I
INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I I I
NO 21 I IROO$ SHEATHING I I I
SCHOOL WITHIN HAZARDOUS I SHEAR PANELS I I I
(AIR QUALITY: 1000 FEET MATERIALS i I I I
NO NO NO I FRAME INSPECTION I I I
IREQUIRED TOTAL SETBACK FROM EXIST I (FIRE SPRINKLER HANGERS I I I
ISET BACK YARD: HWY: PROP LINE: WIDTH: I I I I I
IFRONT PL- I IINSbLATION/WEATHER STRIPI I I
SIDE PL-
I I
(INTERIOR LATH/DRYWALL
I I
IE ERIOR LATH I I I
I
RAT*D FLOOR/CEIL ASSEM. I I I
I (RATED WALL ASSEMBLIES I I I
RAT D SHAFTS/OPENINGS
IT-BAR CEILINGS
I I (LOT DRAINAGE I I I
IREPORT ID: DPR261 ROUTE TO: BS0508 I I I I
I I I I I I
L +
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 OS05310004
PHONE: (626) 285-0488 EXT: '
LEGAL ID: NO. OF CONST BUILDING ADDRESS:
TR: 32489 UN: 7 SQ. FT STORIES TYPE 5323 5325 SANTA ANITA AV
STRUCTURE: 18 VN TEMP CA 917803625
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET:
8573-036-025 THOMAS PAGE: 597 GRID: D4 LOCALITY: TEMPLE CITY, C
TENANT: EXIST BLDG USE: RESID USE ZONE: R-2 ISSUED ON: PROCESSED BY: EXPIRES ON:
EXIST OCC GRP: 05/31/05 JK 05/26/06
OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FI DA FIN Y: CODE:
HOUSTON KENNETH W TRUSTEE (818) 579-4111- 3,250
5323 SANTA ANITA AV ei
---------
TEMP 91780362S FEES PAID DESCRIPTION OF WORK
TEAR OFF AND HOT MOP DOWN AND COMPOSITION SHINGLES
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:
APPLICANT: TEL. NO:
GARCIA (626) 453-0972- AA BLDG PERMIT ISSUANCE 27.75
11367 LAMBERT AV AC STRONG MOTION RESID 3250.00 VAL 0.50 SPECIAL CONDITIONS:
EL MONTE, CA 91732 D2 PERMIT W/O EN-HC 3250.00 VAL 115.80
TOTAL FEES 144.05
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
SOUTH COAST AND VALLEY ROOFING (626) 453-0972-
11367 LAMBERT AVE. LIC. NO LOCATION AND SETBACKS
EL MONTE, CA 91732 830059 C39
SOILS ENGINEER APPROVAL
ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION TRENCH FORMS
LIC. NO: SLAB/UNDER FLOOR r
RAISED FLOOR FRAMING
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR—ENSULATION
147H277 3 01 FLOOR
FLOOR SHEATHI t, `
NO. OF FAMILIES: DWELLING UNITS: APT COND: STAT CLASS:
NO 21OOF SHEATHIN q
Z 3
SCHOOL WITHIN HAZARDOUS SHEAR PANEL ��.
AIR QUALITY: 1000 FEET MATERIALS N.
NO NO NO FRAME-INSPECTION
REQUIRED TOTAL SETBACK FROM EXIST FIRE SPRINKLER HANGERS
SET BACK YARD: HWY: PROP LINE: WIDTH:
FRONT PL- INSULATION WEATHER STRIP
SIDE PL-
INTERIOR LATH/DRYWALL
EXTERIOR LATH
RATED FLOOR CEIL ASSEM.
RATED WALL ASSEMBLIES
RATED SHAFTS OPENINGS
T-BAR CEILINGS
LOT DRAINAGE
REPORT ID: DPR261 ROUTE TO: BSO508
COUNTY OF LOS ANGELES I 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 0301090007
PHONE: (626) 285-0488 EXT:
LEGAL ID: . 0 S:
TR: 32489 UN: 7 SQ. FT STORIES TYPE 5323 SANTA ANITA AV
STRUCTURE: VN TEMP CA 917803625
ASSESSOR NUMBER: NEAREST CROSS STREET: FREER
8573-036-025 THOMAS PAGE: 597 GRID: D4 LOCALITY: TEMPLE CITY
TENANT: R SID USE—LONE: R-2 ISSUED0PROCESSED
EXIST OCC GRP:• 01/09/03 JK 01/04/04
NE TEL. N0: !BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL—BY: CODE:
HOUSTON KENNETH W TRUSTEE - 2,300
5323 SANTA ANITA AV
TEMP 917803625 FE P NEWT o_N OF WORK
REROOF TILE SECTION WITH 3OYR CLASS A SHINGLES OVER EASTERN
FEE DESCRIPTION: QUANTITY: LION: AMOUNT: HALF OF BUILDING
APPLICANT:
DAVID SANDOVAL (626) 794-2101- AA BLDG PERMIT ISSUANCE 27.75
768 HIGHLAND ST AC STRONG MOTION RESID 2300.00 VAL 0.50 SPECIAL CONDITIONS:
PASADENA 91104 D2 PERMIT W/O EN-HC=�23OO.O0 VAL 99.00
E LE�rdet-4FEES 127.25
CONTRACTOR: TEL. NO: � \� APPROVALS TEINSPECTOR-SIGNATUR
DAVID SANDOVAL ROOFING (626) 794-2101- �®
768 HIGHLAND ST. LIC. NO ` LOCATION S
PASADENA, CA 91006 36661SC39
tu 0 1
SOILS ENGINEER APPROVAL
i
ARCHITECT OR ENGINEER: E O: % / ` 0 /TRENCH
J L.,
LIC. NOL L. I SLABANDER FLOOR
L RFLOOR FRAMING
MAP 0: SEWER MAP BOO PAGE: FIRE ZONE: C�P rl J �) ���g �l GLV UNDERFLOOR INSGLATION
L (CFLOOR 147H277 3 01:J 1
0. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS•:- —
YES 21 - — �/ ROOF SHEATH G
SCHOOL WITHIN RDO
/ ❑ T,: r ! EAR PANELS-
AIR
LS
AIR QUALITY: 1000 FEET MATERIALS NO NOF— /� FRAME INSPECTION
REQUIRED 0 SETBACK ROM E IST �� 1 , ' ? FIRE SPRINKLER HANGERS
SET B ��ACK YARD: HWY: PROP LINE: WIDTH: jL, _ +
FRONT PPL _ `�y Vic a ���/ INSULATION/WEATHER STRIP
�_ -- INTERIOR LATH75MALL
I
EXTERIOR LATH
RATER FLOOR/CEIL ASSEM.
RAT D WALL ASSEMBLIES
RATED P S
-BA CEILI GS
LOT DRAINAGE
REPORT ID: DPR261 ROUTE TO: BSO5O8