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Home My Public Portal About5331-5333 SANTA ANITA AVE_Building__ APPLICATION FOR BUIkDING f FR-MlT FOR APPLICANT TO FILL IN (Print or type only) I ,?j '7 FBUILDING COON OF LOS ANGELES S DEPARTMENT OF COUNTY ENGINEER ''^ ZIP C BUILDING AND SAFETY DIVISION NO.OF BLDG . BUILDIN SIZE OF LOT NOW ON LOT ADDRESS _, TRACT BLOCK LOT NO. LOCAUT TEL NEAREST OWNER �� div NOSL/T/ •-,V✓'30 CROS ST. OR ADDRESS /df' MAASSP BOOK PAGE PARCEL LAl J v CITY �� ZIP ��r/� / DISTRICT GROUP TYPE FIRE ESSED BY b �` p CONS. ZONE ARCHITE R TE J . s Du ENGINEER '� Pop jl NO. �l4 STATISTICAL CLASSIFICATION O E P ADDRESS / : r TEL. CLASS NO. 6�� DWELL.UNITS BK J "PG CONTRACTOR BIZ p, E ZONE �NM P 4c—), z C. .ADDRESS y r O. 7 —3 CIAL LICNDITIONS CITY CLASS CONSTRUCT( N LENDER ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ NAME AND BRANCH �7( . BLDG.SETBACK FROM VOL) Py" FRONT PROP.LINE OF (STREET) ADDRESS (J TOTAL SETBACK FROM TYPE OF EXISTING SO.IT.—., I NO.OF NO. LF /I CHECK HIGHWAY + YARD = FRONT PROP.LINE HIGHWAY WIDTH SIZE STORIES FAMILIES ✓' ONE } DESCRIPTION OF WORK ��8Zp NEW + - O BLDG.SETBACK FROM ad y _fes a DD ❑ SIDE PROP.LINE OF (STREET) O r�c�� ALTER ❑ HIGHWAY + YARD = TOTAL SETBACK FROM TYPEOF EXISTING USEOF REPAIR [3 SIDE PROP.LINE HIGHWAY WIDTH Z EXISTING BLDG. DEMOL ❑ + APPLICANT r—TEL �J CORNER CUTOFF YES ❑ NO ❑ (PRINT) _ �� \ : '�[3,y' NO. Y y .+ IN OPEN SPACE YES ❑ NO ❑ BY(SIGNATURE) v IN COASTAL PERMIT ZONE YES ❑ NO ❑ VALUATION$ (� /s Q 0 i J 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 RELATING TO WORKMEN'S COM- PENSATION INSURANCE. .'",1/.F)t• �� ti r SIGNATURE OF q PERMITTEE ADDRESS TEL DATEL� �C?�' BY �� CITY NO. 40 o f f �✓ PM MAKE CHECKS PAYABLE TO: P.C.EFET" HARVEY T.BRANDY,COUNTY ///ENGINEER > 53 /D-5' 65o,/� PLAN CHECK VALIDATION /GIC M.O. CASH — PERMIT VALID ON CK. M.O. CASH 437inFG �� 23 D (`_. 3. � � 1 5 U 0 ��G . 0 6 0 E P. 1 2 3 0 :L U :).C) ®s 76A638A CE#803 3.75 V p 0 6 4 N APR 1 1 U 4 3 0-1 ';s G 3 #900322 PB WORKERS' COMPENSATION.DECLARATION 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. PC997500 Company Republic Indemnity BUILDING ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS ® Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS 5333 & 5331 Santa Anita Ave 7-1-91 Virgin Roof Co. CITY Temple Cit ZIP LOCALITY T�j,%J,_4Lc Gam/ Date Applicant NO.OF BLDGS. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST. COMPENSATION INSURANCEASSESSOR (This section need not be completed if the permit is for one TRACT BLOCK LOT NO. MAP,BOOK PAGE PARCEL hundred dollars ($100)or less.) TEL. USE ZONE MAP OWNER Sung, Bolivar & Ramivsz NO. 47-/,/•- 77 1 certify that in the performance of the work for which this permit is issued, I shall not employ' FEEIAL person in any manner ADDRESS 5333 & 5331 Santa Anita e `� CONDITIONS 1A' CL so as to become subject to the Workers'.Compensation Laws. I O CITY Tem le City ZIP 91780 U Date Applicant ARCHITECT OR TEL. Od NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. DISTRICT GROUP TYPE FIRE ZONE PROCESSED BY O Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forth- ADDRESS CONST�� a with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. CONDO. N deemed revoked. CONTRACTOR Virgin Roof CO. NO. 287-0507 Z LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS P.0. BOX J NO. 160650 (commencing with Section 7000)of Division 3 of the Business LIC. SEWER MAP CITY San Gabriel CLASS 'L and Professions Code,and my license is in full force and effect. C39 BK. PG. 1(AUDATION SQ. FT. NO. OF NO OF CHECKACC' License Number 160650 Lic. Class C39 SIZE 15 Sq STORIES 2 FAMILIES ONE VALUATION .3307 82.[1t1 Contractor Virgin Roof CO-Date 6-30-91 DESCRIPTION OF WORK Sweep rock insta 14Ew 0' $ 2920.00 1 !TENS El I am exempt under Sec. Ca sheet, type IV and base. ADD poll TOTAL 8�`m DID ALTER I� B.BP.C, for this reason 15 S S. REPAIR $ CHECK 82.00 Date: USE OF ❑ CHANGE .1111 EXISTING BLDG. Dwelling IDOL Signature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION (PRINT) Virgin Roof Co. NO. 287- DATE i 1 hereby affirm that I am exempt from the Contractor's License 0(3100-0001 10/ 2/90 Law for the following reason (Section 7031.5, Business and ADDRESS P.O. BOX J San Gabriel 91778 FINA t4lV_CY Professions Code): . PRESENT By 308-1 1 AI� 9:34 BUILDINGEl I, as owner of the property,Y� 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 7044, Business and Professions Code.) MOVING TEL. ❑ I,as owner of the property,am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS -tion 7044, Business and Professions Code.) CONSTRUCTION LENDING AGENCY SETT BACK YARD HWY TOTAL PROP LINE FROM 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 P.L. Lender's Name g $69.00 LDMA Ref. # P.C. Fee$ Permit Fee , � Lender's Address I certify that I have read this application and state that the I Issuance Fee 13.00 LDMA P/C# above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, Total Fee LDMA Perm. # c and hereby authorize representatives of this County to enter u on the abo -mentioned property for inspection purposes. 0 10-1-90 SEE REVERSE FOR EXPLANATORY LANGUAGE ' ignature of Applicant or Agent Date APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUI DING AND SAFETY WORKER'S COMPENSATION DECLARATIONFOR APPLICANT TO FILL IN BUILDING ADDRES I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS 3 5331 Santa Anita or a certificate of Workers' Compensation Insurance,or a certified CITY ZIP Cit copy thereof Sec.3800,Lab.c.> T 91780 LOCALIT Policy r ?710598 Company Cal Comp p y SIZE OF LOT NO.OF BLDGS,NOW ON LOT 11 Certified copy is hereby furnished. i NEAREST CROS ST. $i Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. I USE ZONE MAP NO. Date 7/1/93 Applicant Virgin Roof Co. ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL NO. Y S NO COMPENSATION INSURANCE Carlos Ramirez 444-2336 WITHIN 1000 FT.OF SCHOOL? (This section need not be completed if the permit is for one hundred ADDRESS dollars($100)or less.) 5331 Santa Anita DISTRICT GROUP PE(7J NE PROCESSED BY GUY ZIP 1 certify that in the performance of the work for which this permit 'temple City, CA 91780 ,(� _3 3 is issued, I shall not employ any person in any manner so as to v become subject to the Workers'Compensation Laws. ARCHITECT OR ENGINEER TEL NO. STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO. CA-4 DWELL UNITS NOTICE TO APPLICANT If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CONTRACTOR TEL NC SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith Virgin Roof CO. 87-0507 FRONT comply with such provisions or this permit shall be deemed revoked. 1 ADDRESS LIC.NO. PL LICENSED CONTRACTORS DECLARATION PO Box 5010 160650 SIDE °b I hereby affirm that I am licensed underprovisions of Chapter 9 an Gabriel, CA 91778-501 LIC.CLIVSS. SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORIES NO.OF FAMILIES (;i`1 Professions Code,and my license is in full force and effect. 800 2 NEW ❑ BK PG a License Number. 160650 Lic.Class C39 DESCRIPTION OF WORK ADD ❑ VALUATION C ContractolVirgin Roof CO•Date 6/30/93 Remove tile, lay one layer #40 ALTER ❑ $ 2000.00 C: felt and re-lay tile. 8 sqs. REPAIR C ❑ I am exempt under Sec. $ 17- BAP.C.for this reason DEMOL ❑ C CDMA P/C# Date: USE artmentLDG. URM ❑ . U Signature APPLICANT(PRNT) TEL�tO. y LDMA Perm# 1 Z ❑ I, as owner of the property, or my employees with wages as Virgin Roof Co. 81 2ti7-0507 Z ACCT.a their sole compensation, will do the work and the structure isADDRESS - 0 „e� not intended or offered for sale (Section 7044, Business and P 5010, San Gabriel, CA 91780-5010 FINAL DATE y ( a 3 307 �q c Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL ^`�?'9 1TE11S ❑ 1, as owner of theproperty, am exclusive) contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE �� Y 9 AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY 135®-g-57 licensed contractors to construct the project (Section 7044, YES El No�j . � Business and Professions Code.) WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING— OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH �, k' CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR CHANGE .01 GUIDELINES I hereby affirm that there is a construction lending agency for YES 11 NOg W the performance of the work for which this permit is issued(Sec. I I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING (} {��— Z // i� 3097.Cq ,CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, j v Lender's Name MATERITITL '�REPORTING HAPTER 2.20 SECTIONS 2 20ANG OR OBT�ITHPOU 20.140 THE SCAOMD. HAZARDOUS _ 8051 F1 1 i AMIOO-22 $ Lender's Address - 0 OWNER OR AGE oI certify that I have read this application and state under penalty O of perjury that the above information is correct.I agree to comply ' P.C.FEE PERMIT FEE N with all county ordinances and State laws relating to building 110'82 m con truction, and hereby authorize representatives of this County ISSUANCE FEE ter upon the above-*)M y for inspe�ti p s. 24.75 m INVESTIGATION FEE TOTAL FEE 135.57 m4lre plifdnt a A,.re 13 e SEE REVERSE FOR EXPLANATORY LANGUAGE „ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS I 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT I TEMPLE CITY CA 91780 BL 0508 0307100056 PHONE: (626) 285-0488 EXT: LEGAL ID” -110 CONST BUILDrWADDRESS:-- - TR: 32489 UN: 3 SQ. FT STORIES TYPE 5331 5333 SANTA ANITA AV STRUCTURE: VN TEMP CA 917803626 ASSESSOR NEAREST CROSS STREET: FREER INFORMATION 8573-036-021 THOMAS PAGE: 597 GRID: D4 LOCALITY: TEMPLE CITY TENANT: EXIST BLDGUSEi- RESID ISSUED0 SEXPIRES EXIST OCC GRP: 07/10/03 JK 07/04/04 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: F NAL'DATE FINAL BY: CODE: N/A - 4,995 '7 Y'03 STC fI� OF WORK FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: STRIP EXISTING PITCH 3/12;INSTALL DOUBLE 15ASTM 30YR COMP APPLICANT: L. 0: KEN SMITH - AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RESID 4995.00 VAL 0.50 SPECIAL CONDITIONS: D2 PERMIT W/O EN-HC 4995.00 VAL 132.60 TOTAL FEES 160.85 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE A - OK ROOFING & RENOVATIONS (714) 891-3754- 11691 LUZON STREET LIC. NO LOCATION A C CYPRESS, CA 90630 6394478C39 SOILS ENGINEER APPROVAL ARCHITECTOR ENGINEER: OU D 0 CH ORMS LIC. NO: SLAB UNDER FLOOR RAISEDFLOOR FRAMING P NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR NS ATI N 147H277 3 01 FLOOR-SHEATHING 0. OF F D E LING S: CO D: STAT C : NO 21 ROOF SHEATHING SCHOOL WITHIN HAZARDOUS S R S AIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME INSPECTION REQUIRED 0 L SETBACK FROM EXISTSPRINUER RINGERS SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- INSULATION/WEATHER STRIP SIDE PL- ER EXTER OR LATH RATED-FLOOR/CEILASSEM. RATED-WALL ASSEMBLIES RATED-SllAFTS/OPENINGS T-BAR-CEILINGS LOT DRAYNAGE REPORT ID: DPR261 ROUTE TO: BS0508 f. a 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 0505310007 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: TR: 32489 UN: 3 SQ. FT STORIES TYPE 5331 5333 SANTA ANITA AV STRUCTURE: 18 VN TEMP CA 917803626 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 8573-036-021 THOMAS PAGE: 597 GRID: D4 LOCALITY: TEMPLE CITY, C TENANT: EXIST BLDG USE: REBID 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: FINAL DATE FINAL BY: B r' ROBIN DORIS T (818) 443-9161- 3,250 Y 5331 SANTA ANITA AV 6z -( TEMP 917803626 FEES PAID DESCRIPTION OF WORK TEAR OFF AND HOT MOP DOWN COMPOSITION SHINGLES FEE DESCRIPTION: QUANTITY: DOM: 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 RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION 147H277 3 01 FLOOR SHEATHING NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: NO 21 ROOF SHEATHING SCHOOL WITHIN HAZARDOUS SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS 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: BS0508