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Home My Public Portal About4968 SERENO DR_Building__ WORKERS COMPENSATION DECLARATION^ #880343 SB n hereby affirm fica I have r certificate of can.nsuta .elf APPLICATION FOR BUILDING PERMIT ,ul Insure, or a certificate of Workers'Compensation Insurance ora certified copy thereof(Sec 3800, Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Ocy No W0007146Compony Beaver Ins. N Certified copy is hereby furnished FOR APPLICANT TO FILL IN BUILDING IL RESS ® Ciii copy is filed with the county building Inspec. BUILDING non department I ADDRESS 4968 Sereno Dr. Date 7-1-89 Applicant Virgin Roof Co. Cm Tpmplp rfty zip 91780 LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO OF BIDGS NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON PT ST - (This`section need not be completed if the permit Is for one ASSESSOR hundred dollars($100)or leu ) TRACT BLOCK LOT NO MAP BOOK PAGE PARCEL TEL I certify that In the performance of the work for which this OWNER W. P NO USE ONE NO - permit Is Issued, 1 shall not employ any Person In any manner - I SPECIALt so in to become subject to the Workers Compensation Lows ADmss 496i Sereno Dr. CONDITIONS - Date Applicant CITY Temple City ZIP 91780 NOTICE TO n, APPLICANT If, cher making this the W rk of ENGINEER OR TEL DISTRICT UP TYPE FIRE D BY O. Exemption, you should become subject to the WakertC ENG0F3 Compensation provisions of the Labor Code you must forth with comply with such provisions or this permit shall be ADDRESS V`a a` deemed revoked TEL CONTRACTOR Virgin Rnnf Co- _ STATISTICAL C1A5511 TION APT DO to LICENSED CONTRACTORS DECLARATION LIC CLASS no DWELL UNITS_ Z I hereby ofhrm that 1 am licensed under provisions of Chapter 9 ADDRESS P.O. BOX J NO 160650 (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 CLASS C39 SK PG VALIDATION FT License Number 16065" Lic Clan C39 SIZE STORIES FAMINO LIES Co E VALUATION Contractor` Virgin Roof Cote 6-30-89 DESCRIPTION OF WORK Tear off onp I ityel NEW $ 2833.00 , ❑I am exempt under Sec of roof then apply #30 and ADD ALTER B&P C for this reason Class "A" Fiberglass Shingles REPAIR i 201 7 4 A Date USE OF EXISTING BDG DiiiiellinlZ DEMO Signature APPLICANT TEL e e e e 1 OWNER-BUILDER DECLARATION PRINT Virgin Roof Co. IJO 287-0507 FINAL - DATE 'I,e • 59, 25 74 I hereby affirm that 1 g r exempt from the Contractors License ADDRESS P.0. BOX. J San Gabriel 9177 Law for the following reason (Section 7031 5 Business and ETNA Professions Code) ERROR 6'-L- 59255 , ❑ BUILDING — I as owner of the property, or my employees with _ ADDRESS ¢ o 7 d 3-88 wages as re is sole compensation,will f o the work and LOCALITY ,E //� -�j�O /a,//I S� the structures not intended or offered for sale(Semon /V J YC i;//C/ 70", Business and Professions Code) MOVING TEL ❑ I as owner of the property, am exclusively contracting CQIHTRACTOR NO with licensed contractors to construct the project (Sec- tionADDRESS Y 70" Business and Professions Code) CONSTRUCTION LENDING'AGENCY M CK YARD HWY TO PROPBACKF LINE WND7H 1 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 PL Lendm s Name 8 LOMA Ref B gg' Lender s Address PC I"& Permit Fee $48.75 ' 8 I certify that I have read this application and state that the hawnce Fee 10.50 LDMA P/C e ' above information is correct I agree to comply with all County Investigation Fse $ ordinances and State lows relating to building construction, Total Fee- 59.25 IDMA Perm • ,Q and hereby outhorize representatives of this County to enter upon the above mentioned roperry for Inspection purposes sPj?6W 7-12-88 $0 ftVIEI a FOR EXPLANATORY LANGUAGE SrKdris of Applicant or Agent Data I I COUNTY OF LOS ANGELES TALE CITY OSOB BUILDING PERMIT DEPARTMENT OF PUBLIC NOM 9701 LAS TOLULS BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 // BL40500810608030057 1 PHONE (676) 785-0488 -EXT ` LEGAL ID NO OF CONST NEN BUILDING ADDRESS ON PILE Sp PT STORIES TYPE OCCUP GROUP 4968 SLRINO DR STRUCTURE 497 1 VN R3 TEMP CA 919803036 ASSESSOR INFORMATION IMMURE! GARAGE NEAREST CROSS STREET ROSEEAD 5368-017-015 . OTHER 85 1 VN R3 THOMAS PAGE 596 GRID HS LOCALITY TIDIPLE CITY, C I TENANT MIST BLDG USE USE SONE ISSUED ON PROCESSED BY BIPIREB,ON EXIST OCC GRP 10/03/06 TK 09/78/09 ONNBR TEL NO SLUGS NOW ON LOT V UATION FINAL DATE FINAL BY CODE AVID 68, D (676) 861-9579- 59,659 49 1968 SERINO DA 170E 911803036 PIES PAID 063 IPTI N OF WORK ADD BEDROOM, BAIRR00 499 19 9 ➢ AND REMODEL EXISTING HOUSE Fn DESCRIPTION QUANTITY UGH AMOUNT 85 8 F APPLICANT TEL NO TSUI/KARVIS FONG i ASSOCIATES (676) 594-1430- 111 PLANCRECX M/ENERGY 57659 00 VAL 877 84 1111 1/7 HIGHLAND OX AA BLDG PERMIT ISSUANCE 77 75 SPECIAL CONDITIONS ARCADIA CA 91006 AC STRONG MOTION RESID 57659 00 VAL 5 77 B7 PERMIT M/ENERGY 57659 00 VAL 960 06 TOTAL FSE4 1 814 47 CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE A L R CONSTRUCTION CO (313) 711-9106- 066 N GARFIELD AVENUE LIC NO LOCATION AND SETBACKS MONTEBELLO CA 90640 509116 B SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER TEL SO - FOUNDATI04 TR CB FOBMB LIC NO SLAB UNDER FLOOR RAISED FLOOR PEAKING MAP NO 36MBR MAP BOOK PAGE FIRE ZONE CKP UNDERFLOOR INSULATION 3 01 1 !tl -�� tl0 OF FAMILIES DWELLING LEVEL FLOOR BREATH UNIiB APT GOND 9iAT CLASS NO 71 - 2ND LEVE. FLOOR SHEATH 60000E MITHIB MATERIALS ROOF BH6ATHINO AIR pIIAI.ITR 1000 PEST MATBtIAL4 NO NO NO FIRE DEPT FRAME INSPECT REQUIRED TOTAL SETBACK FROM MAST - - _ BLDG DEPT FAAKE INSPECTD(J SST BACK YARD RMY PROP LINE WIDTH ' Y� FRONT PL- SHEAR PANELS SIDE PL- INSULATION NKATHSB STRIP INTERIOR LASE DRYWALL �' F EXTERIOR LATE LOT DRAINAGE SKOKE DETECTION DEVICES ` PINS DEPARTMENT APPROVAL RRPORT ID DPR761 ROLT78 TO 880508 • COUNTY OF LOS ANGELES TEMPLE CIT! i 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD/ALT/REP BUILDING AND SAFETY / LAND DEVEL0PMENT TEMPLE CITY CA 91780 BL 0508 0606030051 PHONE (616) 105-0488 HIT LEGAL ID _ .. _ NO OF CONST NEW BUILDING ADDRESS ON PILE SQ FT STORIES TYPE OCCUP GROUP 4968 SHREWD DR STRUCTURE 0 1 VU R3 TEMP CA 911803036 ASSESSOR INFORMATION NUMBER GARAGE SB8 1 VV U1 VRIVRCT CROSS STREET ROSEMEA0 5388-012-015 - ' OTHER ' THOMAS PAGE 596 GRID H5 LOCALITY TEMPLE CITY, C TENANT - EXIST BLDG USE USE HONE ISSUED ON PROCESSED BY MIRES ON MIST OCC GRP 10/03/06 GK 09/28/07 OWNER TEL NO BLDGS VON ON LOT VALUATION P AL DATA AL BY CODE CERE DAVID (626) 062-7529- 17,430 �I' Ii 4968 SERENO D8 V�-Y{ TEMP 917803036 FEES PAID D SCHIPTIOa OF MORN EXISTING GARAGE TO BE DEMOLISHED AND BUILD DETACHED 2 CAR FEE DESCRIPTION QUANTITY DOM AMOUNT GARAGE SBE 82 S P APPLICANT TEL NO TSUI/MARVIN FONG A ASSOCIATES (626) 574-7430- D1 PLANCEECE W/O EN-HC 17430 00 VAI, 298 35 1111 1/2 HIGHLAND OH AA BLDG PERMIT ISSUANCE N 27 75 SPECIAL CONDITIONS ARCADIA, CA, 91006 AC STRONG NOTION REBID 17430 00 VAL 1 74 _ D1 PLANCRECK W/O EN-HC 17430 00 VAI, 290 35 TOTAL FESS 626 19 CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE A L N CONSTRUCTION CO (323) 721-9206- 866 N GARFIELD AVENUE LIC NO LOCATION AND BBTBACXS MONTEBELLO CA 90640 509276 B SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER TEL NO YOUVDATIOa TREKS FORMS �1 LIC NO SLAB UNDER FLOOR RAISED FLOOR FRAMING MAP NO SEWER MAP BOOK PAGE FIRE ZO9E CMP UNDERFLOOR INSULATION 3 01 IST LEVEL FLOOR BREATH NO OF FAMILIES DWELLING UNITS APT GOND STAT CLASS _ i NO 21 2ND LEVEL FLOOR BREATH SCHOOL WITHIN HAZARDOUS ROOF SHEATHING AIR QUALITY 1000 FEET MATERIALS NO NO NO FIRE DEPT PEAKS INSPECT REQUIRED TOTAL SETBACK FROM EXIST BLDG DEPT F8AM8 INSPECT SET BACK YARD HWY PROP LIRE WIDTH FRONT PL- BEHAR PANELS SIDE PL- INSULATION WEATHER STRIP INTERIOR LATH DRYWALL EITHPIOR LATH LOT DRAINAGE SHOES DETECTION DEVICES PIRG DEPARTMENT APPROVAL REPORT ID DPR261 ROUTE TO BSO508