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Home My Public Portal About5003 SERENO DR_Building__ k ORKERS' COMPENSATION DECLARATION fflrrn (fiat 6f W r as' Come of do neat to selfAPPLICATION FOR BUILDING PERMIT certificate of Workeri Compenwtlon Insurance,d copy thereof (Sec 3800, Lab C ) CAUNTY OF LOS ANGELES , - BUILDING AND SAFETY Company _fied copy is hereby furnished FOR APPLICANT TO FILL IN =RFS , 3 E ' ❑ C rrfled copy u filed with the county budding Impec- :Z,0R�o03 b ' hon department pp q U /- CITY Cz-21 ZIP /17p O I LocAu V G Dote Applicant �+ NO OF CERTIFICATE OF EXEMPTION FROM WORKERS SIZE OF LOT De7O NOW ON LOT r- NEAREST CROSS ST COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit Is for one - TRACT - BLOCK LOT NO MAP BOO( PAGE PARCEL hundred dollars ($100)or leu ) OWNER�1 S POAk.Ka (•-S4/ USE ZONE, MAP I certify that in the performance of the work for which this INO SFIECLAL >_ permit In issued, I shall not employ any person in any manner ADDRESS.-62003 SEREAlo Die - OONDInONS Q. O so as to become sublect to the Workers Compensation Laws CITY - ��t ZIP /7.'V V Data_ ApplicantARCHITECT ORTEL DISTRICT_ ROUP TYPE IRE BY aC NOTICE TO APPLICANT If after making this Certificate of ENGINEER N _ NO CONST ZONE O Exemption, you should become subject to the Workers 1� Compensation provisions of the Labor Code you must forth- ADDRESS •C/ � j with comply with such provisions or this permit shall ber TEL STATISTICAL CLASSIFICATION APT CONDO Z deemed revoked CONTRACTOR NO LICENSED CONTRACTORS DECLARATION UC CLASS NO DWELL ;NITS _- 1 hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO SEWER MAP (commencing with Section 7000)of Division 3 of the Business DC and Professions Code,and my license is in full force and effect - CITY CLASS BK PG VALIDATION License Number Lic Class S�IZEFJF ORIES FAMILIES ONE VALLIAT1191i �s Contractor Date DESCRIPTION OF WORK019e do APIP INEW ❑ + o ❑I am exempt under Sec ADD poll �, 'I _ ALTER ❑ B 8P C for this reason T -AA.r' 4�.J REPAIR ❑ S - Mte USE OF S REMIX ❑ EXISTING BLDGVe Signature APPLICANTTEL FINAL �iC'' OWNER BUILDER DECLARATION PRINT) C NO I DATE/Ow- /� rip I hereby affirm that I am exempt from the Contractor's License ADDRESS - 7 199.EE - Law for the following reason (Section 7031 5, Business and Q FIN foot, trrc Pro ions Code) - NT - BY (moi%N (� 1 ITEMS' I, as owner of the property, or my employees with WILDING 5 S "o wages os their sole compensatan,will do the work and LOCALITY ,t� +s L Ixt TATA. 199 .S$ the structure is not intended w offered for sale(Section poolIDECK 7044, Business and Professions Code ) MOVING -TEL LsASat� ❑ I as owner of the property, am exclusively contracting CONTRACTOR NO ONE e00 with licensed contractors to construct the project (Sec- ADDRESS hon 7044 Business and Professions Cade ) IR RED TOT CONSTRUCTION LENDING AGENCY - SET BACK YARD HWY AL SEOF TBAL�NK E WIDTH FROM -EXIST \ 1 9� 6/89I hereby affirm that there in a construction lending agency for FROM - The performance of the work for which this permit a issued P L - 5518 1 A9 8:51 (Sec 3097 Civi ) 1 SIDE - PL Lender's Nome 11 LDMA Ref Y ' Lender's Address I P C Fees Permn Fee 1 I I certify that I have read this application and state that the Issuance Fee 1045 to"F/C Y polo above Information is correct I agree to comply with all County nInvesigoiin Fee ' ordinance° and Stq! laws relating to building conetrucllon, Total Fee • LDMA Perm an meby auth I repreaentatrvea of thin County to enter "u the abov phoned property for aspectlon purposes LJ0S111111 UVOW FOR 1)(P ANATOITY LANGUAGE Date 'i COUNTY OF LOS ANGELES 'r TEMPLE CITY 9 0508 BUILDING PERMIT , DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT ` TEMPLE CITY CA - BL 0508 9611270023 PHONE (818) 285-0488 EXT LEGAL To NO OF CONST JOUILDING ADDRESS ON FILE SO FT STORIES TYPE 5003 SERENO DR STRUCTURE 0 VN TEMP CA 917803038 ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET 5388-016-001 1THOKAS PAGE 596 GRID- H5 LOCALITY TEMPLE CITY TENANT. EXIST BLDG USE RESID USE Z59E.—F-f— ISSUED ON PROCESSED BY EXPIRES ON EXIST OCC GRP 11/27/96 LC 11/27/97 OWNER. TEL NO BLDGS NOW ON LOT VALWTrdF— FINALjDATE FINAL BY CODE DAHBOUR PAUL S - 4,000 5003 SERENO DR TEMP 917803038 FEES PAID 6ESCRIPIIGN UF WURK RE-ROOF HOUSE AND GARAGE TEAR JFF EXISTING ROOF, SHEETING FEE DESCRIPTION QUANTITY LOO AMOUNT EXISTING, INSTALL COMPOSITION SHINGLE APPLICANT: TEL NO BEST CONSTRUCTION (213) 487-2121- AA BLDG PERMIT ISSUANCE 27 75 AC STRONG MOTION RESID 4000 DO VAL 0.50 SPECIAL CONDITIONS' D2 PERMIT W/0 EN-HC. 1 E 04000.00 YAL 116 10 ` OLa.- TOTAL �S^� 144 35 CONTRACTOR. TEL NOAPPROVALS DATE INSPn7M_flWKMNE__ BEST CONSTRUCTION (213) 487-2121-� 5902 MARSHALL AVENUE LIC NO LOCATION�61�i BUENA PARK, CA 90621 C-33,B,C39 SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER- FOUNDATION/TRENCH FOR" LIC NO RAISID FLOUR FRAMING MAP XX 3 O1 PUBLIC Off/ _ 111 - NO. OF FAMILIES- DWELLING UNITS: APT/COND STAT CLA 0� FLOUR SHEATHING NO 2,2 a +o Yd ( ) ROOFISKEATHING rZ-SCHOOL WITHIN HAZARDOUSSHEAP PANELS 3� AIR QUALITY- 1000 FEET MATO IALS . ` QrtJ n �O NNO FRAME INSPECTION REQUIRED TOTAL SETBACK FROM EXIST FIRE SPRINKLER HANGERS SET BACK YARD HWY PROP LINE WIDTH ''((,,JJ ^ �� LJ FRONT PL- `- � 1Ce TRIP SIDE PL- LATH I " T-BAR CEILINGS I I I I ADDITIONAL DATA ON FILE r REPORT ID DPR261 ROUTE TO BS0508 I COUNTY OF LOS ANGELES ' TEMAE CITY-- # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9706090028 PHONE (818) 285-0488 EXT LEGAL ID NO OF CONST BUILDING ADDRESS ON FILE SQ. FT STORIES TYPE 5003 SERENO DR STRUCTURE 0 VN TEMP CA 917803038 ASSESSOR INFORKATMUNWER. NEAREST CROSS STREET: ACASO 5388-016-001 THOMAS PAGE 596 GRID H5 LOCALITY TEMPLE CITY TENANT EXIST BLDG USE RESiD USE ZONE R-Z ISSUED ON: PROCESSED BY EXPIRES ON EXIST OCC GRP 06/09/97 TC 06/09/98 DAHBOUB PAUL S - i 1 10,ODO �/� 5003 SERENO DR 1)-?:j A� .� TEMP 917803038 FEES PAID DESCRIPTION of WORK REMOVE EXISTING PREFABRICATED BE60CH WALLS A BRING BEDROOM FEE DESCRIPTION QUANTITY U1M- AMOUNT: UP TO CODE WITH NEW WALLS 8 ELECTRICAL APPLICANT. TEL NO SUNSET CONSTRACTORS (818) 791-1250- AA BLDG PERMIT ISSUANCE - 27 75 AC STRONG MOTION RESID 10000.00 VAL 1 00 m _ AX BUILDING REVIEW.FEE 54 70 D2 PERMIT W/O EM-HC- L E.10000-00 VAL 217 80 ✓ TOTAL FEES 0 301 25 CONTRACTUN; TEL. NOSUNAPPROVALS DATE INSPECTOR SIGNATURE SET CONTRACTORS 818 791125 -0 \� v P 0 BOX 661705 LIC NO LOCATION AND SETBACKS ARCADIA, CA 91066 693770 BARCHITECT OR ENGINEER. TEL NO T6MMkTM/TRENCH FOR 7 , 1 O4/141 LIC NO ', S�UNOER FCS , nn � rz RAISED FLOOR FRAMING _ `A _ 1MAP NO: SEWER MAP BOOK PAGE' FIRE ZONE- CMFCOR INSULATION 44H265 3 61 PUBLIC WORKS FLOOR SHEATHING NO OF FAMILIES- DWELLING LIMITS APT/EMff._3rXr_MJffF_ No 21 �_ O / O A)A, k'06F-SHEATHING SCHOOL WITHIN HAZARDOUS /� SHFhh P7IAEC� AIR QUA0 QUALITY: 1000FEET MATO IALS y� Q O� 1• T�F �� REQUIRED TOTAL SETBACK FROM EXIST Trlr3pmKLER HANGERS - a SET BACK YARD HYY• PROP LINE WIDTH FRONT PL- 1 a„ SIDE PL- INSULATION/WEATHER UM rvi INTERIOR LATH/DRYWALL RATED SHAFTS/OPENINGS (364' kol RATED WALL ASSEMBLIES i LOT DRAINAGE 'i REPORT ID DPR261 ROUTE TO BS0508