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Home My Public Portal About4449 TEMPLE CITY BLVD_Building__ WORKERS' COMFiNSATION DECLARATION ' hereby affirm that I have certificate of consent o nto self APPLICATION FOR BUILDING PERMIT insure, or a certificate of Workers kers Compensation Insurance urance or a certified copy thereof (Sec 3800 Lab C) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy N�1�Companyi ��[/�d ❑ Certified copy is hereby furnished FOR APPLICANT TO FILL IN ADDRESS Certified copy is filed with the county building inspec- - ,ooh G Bd r _ hon deportment /�,/� Date Applicant ""`NOm AVP'/��L CITY Lam" I ZIP /� Q LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS _ NO _ NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW O ON LOT CROSS ST ASSESSOR (This section need not be completed if the permit is for one TRACT &O(D: - - - LOT NO MAPBOOK _ 1PAGE pggCEl hundred dollars ($100)or less ) L� /`{ P4LOS, TEL O-�4 USE ZONE MAP II OWNER NQL I certify that in the performance of the work for which this W_ SPECIAL permit is issued, I shall not employ any person in any manner ADORF55 - CONDITIONS a so as to become subject to the Worker Compensation Lows O CTIY ZIP - Ll Dote Applicant ARCHITECT OR TEL NOTICE TO APPLICANT_,If, after making this Certificate of _ ENGINEER NO DISTRICT GROUP TYPE- ZONE PROCESSED BY rO Exemption, you should become subject to the Worker _ 7 �O V Compensation provisions of the Labor Code, you must forth- ADDRESS �� `7 with comply with such provisions or this STATISTICAL C IFICATION APT CONDO py p permit shall be TEL IwcS N deemed revoked CONTRACTOR NOu O� _ .4 . Z LICENSED CONTRACTORS DECLARATION UC /c.7�. 3 CLASS NO DWEl1 UNITS_ I hereby off rim that I am licensed under provisions of Chapter 9 ADDRESS NO /c7 SEWER e- (commencing with Section 70DO)of Division 3 of the Business UC �j MAP and Professions Code,and my license is in full farce and effect CITV�M CLASS -c7 VALIDATION �7O p �F �p SQ FT NO OF INC) OF CHECK BK PG License Nu'mbe--r,,''/: :?_A O Lic,Class SSSIZE STORIES FAMILIES ONE VALUATION Co�tractorll�6k" .PQa4✓6 Date /—P�--93 DESCRIPTION OF WORK &I - ❑ $ L1 I am exempt under Sec s AC TRU ADD Li ► ALTER ❑ B 8P C for this reason -REPAIR 11M $ USE OFDate /-,p/- EXISTING BLDG Ls*sS /9-S •✓ [� DEMOL ❑ Signa turt) APPLIC TT !' TEL .YO FINAL-- .�"" OWNER-BUILDER DECLARATION DATE I hereby affirm that I am exempt from the Contractor's License _ f Law for the following reason (Section 7031 5, Business and ADDRESS FINAL 1 ' Professions Code) _ - _ _Br _- ❑ I, as owner of the property, or my employees with BUILDING � AL.GT•V wages as their sole compensation willdotheworkand - polo - - -- -- 330' 113e67 44 the structure is not intended or offered for sale(Section LOCALITY - - rrc 70Business and Professions Code ) MOVING _ _ TEL - -- --- -- - -1 ITEMS ❑ I as owner of the property,am exclusively contracting CONTRACTOR NO I with licensed contractors to construct the project (sec- Aamu TOTAL 113.-6'3 hon 7044, Business and Professions Code ) CONSTRUCTION LENDING AGENCY SET 91A� YAR tIWY TAT LONEFROM I i - -HECK 113.63 j hereby affirm that there is a construction lending agency for FRONT -- - UWE .00 ' the performance of the work for which this permit is issued Pt (Sec 3097, Civ C ) SIDE _ Lender's Name P L 1 1/21/93 17,fDMA Ref x 7740 — 1 AM 8:Su Lender s Address P C Feet Permit Fee {t a I ave i that I have read this application and state that the Issuance Fee 7.S LDMA P/C R above nformation's cortect I agree to comply with all County _ Inverhgal'on Fee / ord' a Statelaws relating to building tonstrudion, Total Fee . IO 3 LDMA Perm p a ereb ay tor' ze repro ntatives of this County to enter y Pon ai - enhon roperty for rnspecJtion purposes SEE REVEM FOIL EXPLANATORY LANGUAGE a re of APPI'can,or Agent Date r - • COUNTY OF LOS ANGELES TEMPLE CITY 9 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0306180026 PHONE (626) 285-0488 EXT LEGAL ID NO OF CONST NEW RUILDImu AUUKtbb TR 12998 SO FT STORIES TYPE OCCRP GROUP 4449 TEMPLE CITY BL \ STRUCTURE 430 1 VN U1 TEMP CA 917804231 XWOMMMUTiON NUMBER GARAGE NEAREST CROSS STREET LOWER AZUSA 8592.002.041 OTHER THOMAS PAGE- 597 GRID 'A5 LOCALITY TEMPLE CITY, C TENANT EXIST BLDG USE USE ZONE. ISSUFO ON PROCESSED BY EXPIRES ON EXIST OCC GRP 06/18/03 VG 06/12/04 OWNER TEL NO oLDGS NOW ON LOT VALU07M— FINAL DATE FINAL BY CODE AIKEN, KURT (626) 444-2445- 19,300 a n ,0.4 4449 TEMPLE CITY SL ` I TEMPLE CITY 91780 FEES PAID DESCRIPTION OF WORK CONSTRUCT FRONT PORCH 190 S F , DE)O AND BUILD NEW REAR FEE DESCRIPTION QUANTITY UOM AMOUNT PORCH 240 S F., ADD 2 BAY WINDOWS AND REPLACE 6 WINDOWS APPLICANT- TEL. NO HOCCOM (626) 286-7119- AA BLDG PERMIT ISSUANCE 27 75 AC STRONG NOTION RESID 19300 00 VAL 1 93 SPECIAL CONDITIONS' D1 PLANCHECK W/O-EN-HC---19300 00 VAL 326 91 D2 PERMIT W/0'EN-HC.— -- 19300 00 VAL 384 60 �j—%GELE$ TOTAL FEES 741 19 CONTRACTOR TEL 90 APPROVALS DATE I NSFFETM_§rQU7UWff'_ - L D H CONSTRUCTION (626) 286-7119- 9634 OLIVE ST LIC NO ✓� ` LOCATION AND SETBACK$ TEMPLE CITY, CA 91780 562071 8 SOILS ARCHITECT OR ENGINEER TEL NO k y FOUNDATION/TREWCF-FORIM- LIC iii _ �\ SLAB/UMoER FLOOR RAISED FLOOR FRAMIN -- MAP NO SEWER MAP BOOK PAGE FIRE ZONE CRP_ UNDERFLOOR IW990ffrW— NO. OF FAMILIES DWELLING LIMITS APT/COND STAT CLASS NO 21� r - - — 1ST LEVEL FLOOR SHEATW SCHOOL WITHINTn HAZARDOUS V i AIR QUALITY 1000 FEET MATERIALS 'A`• � � �/ NO NO NO TIRE DEPT. FRAME INSPECT BLDG DEPT FRAME INSPECT SET BACK YARD HWY PROP LINE WIDTH' �� i' /-io� �(n 3 FRONT PL- SHEAR G �C� SIDE PL- v[Ce_F �_ � os REPORT ID DPR261 ROUTE TO BS0508