Loading...
HomeMy Public PortalAbout5611 TEMPLE CITY BLVD_Building__ T G - WORKERS'COMPENSATION DECLARATION ` n hereby affirm that I have a certificate of nt to ,elf insure, - APPLICATION FOR ,BUILDING PERMIT JISI re, or a certificate of Workers'Compensationtion Insurance I or a certified copy thereof (Sec 3800, Lab CCOUNTY OF LOS ANGELES BUILDING AND SAFETY Polity No Company BU1IDING Certified copy a hereby furnished FOR APPLICANT TO FILL IN ADDRESS �/ Certified copy Is filed with the county building mspec- UILDING / jj�� pp tion department _ ADDRESS 6// %^APIIE /TY rJLUc/• LOCALITY Date Applicant C (•E AC07-Y R ZIP V1780 �5T CERTIFICATE OF EXEMPTION FROM WORKERS NO OF&DGS ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit Is for one TRACT LOT NO USE ZONE �r NO - 0 hundred dollars ($100)or Ion I - ,E I certify that in the perform a of work or whtch t s WNE '��' A/t '�/ �'^"""-�3 CONDITIONS d permit is Issued, I shall not ploy y in any mann �j t DISTRICT P TYPE FIRE PROCESSED BY O �f so as to become subject to he W Co nsanon La ADDRESS�IO1 /!-6 �`/7Y^ /O")D`I' � CONST ZONE V Date�/�Applcant CII�/NP44 l�i C/•I z,P 1 STAAJTICAL CLASSIFICATION 3 Do O / NOTICE TO APPLICANT If after maks this Certificate of ARCHITECT OR TEL V Exemption, you should become subject to the Workers' ENGINEER NO CLASS NO DWELL UNITS_ UJI d Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP N with comply with such provisions or this permit shall be TEL - Z deemed revoked CONTRACTOR NO BK b PG /�,� VALIDATION , LICENSED CONTRACTORS DECLARATION UC I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO Icommencing with Section 7000)of Division 3 of the Business and VALUATION Professions Code, and my license is in full force and effect LIC Cm CLASS $ SO NO OF / NO OF CHECK ► License Number Lic Class SIZE STORIES FAMILIES ONE _ Contractor late DESCRIPTION OF WORK 145D/P/O $ NEW ❑ ADO p I am exempt under Sec 07AXW AWA ALTER FINAL/ DATE I B 8P C for this reason REPAIR ❑ Data USEMMOL- ❑ FINAL NAL �Cr EXISTITT NG BLDG T Signature APPLICANT TEL OWNER-BUILDER DECLARATION RUNTNO I hereby affirm that I am exempt from the Contractor's License ► = Low for the following reason (Section 7031 S, Business and - - Professions Cade) - ❑ I, as owner of the property, or my employees with BUILDING wages ct their sole intended or on will fa the work and the structure is not intended or offered far sale(Section LOCALITY 7041, Business and Professions Code) TEL MOVING 1, as owner of the property, am exclusively contracting CTOR NO - - . 9 1 5.5 P, with licensed controctors to construct the project (Sec- ADDRESSnon 7041, Business and Professions Code) #'• • • • • 1 REQUIRED TOTAL SETBACK FROM EXIST CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP LIM WIDTH I hereby affirm that there iso construction lending agency for FROM r J b ► _ 2 - 26550 the performance of the work for which this permit Is Issued P L iSec 3097, Civ C ) SIDE *'- 26a503 PL Lender s Name �+ 0117-83 Lender's Address PC F.$ Permit Fee'Certify that I have r s 'cation and state that the Issuance Fee cd oboy armation t txrect I 9 to comply gwitfi all Count' Investgvnon Fee r o I and S re Iowa rel lin to bw Wm consnvction, Total Fee J .J rid eby o th nze repr vas of ilio County to anter P. a_bo e- entioned ojaerty f insj>ecnon / SNI REVERE FOR EXKANATORY LANGUAGE - - `- Sig otvre of Applimnt or Agent para E11 COUN1Y OF LOS ANGEL'• Trr.'1C ;I1Y P u1Dd BUILDING PERMIT i DEPARThENT OF PUBLIC q 1 Ll' TUNAS RESIDENTIAL AD- BUILOINC AND SAFETY / LAND DEVELOPMENT ;;;PIE C fY CA 91780 BL 0508 04100800 = PFIAE t-26) 285-0488 EYT I- , — ON FILE SO FT STORIES TYPE _ OLCUP GROUP 5611-TEMPLE CITY BL j STRUCTURE 0 0 VN R3 "t^ LA 917802532 1 �"" n H., GARAGE 882 1 VN Ul NEA-EST LROSS STREET BROADS 1 8588-007-0114 OTHER TtO�AS oAGE 597 GRID Azo �OCAIITY TEMPLE CITY TENANTEiiET HC6LTG€ $l "TuMUED ON PROCESSED - EXIST OCC CR° 10/08/04 JK _ _ 10IU3/05 I OWNER — TEL NJ p. L'Ji V4LUAf,oNA - _ PENG LORI - 5611 TEMPLE CITY B! 26'107 ` _ TEMP 917802532 „Ip 1 ,1,,, O L N 1 DENO EXT°TYNG GARAGE AND BUILT DETAC,ED 2 CAR GARAGE 882 SF APPLICANT FEE DESCRIOT .V QUANTITI - ' AMOUNT TEI NO Cd EMP (213) 400-1841- AA BLDG PL" C SSUPNCE 27 75 _ I 2626 BERKLEY AJ. AC STRONG M,ION FESID 26107 00 2 61- PUNAS_wn�1�bNS ,OS ANGELES LA 90025 D2 PERMIT ;;Io E9-.'C 26107 Z, 497 55 1 TOTAL FEES 527 91 ON TOR --- FELNU , -- P AI`. `PCI Q S,GZtATOU— i C S CONTRACTCR 13-190<- ,� 2026 BERKELLY LIC NO — LOS ANGELES C, Y002n 3aw936 6 IS�L'JG,NrrR APPROVAL 1 AfFCHTTn-T u—'c1 Uh n�=� - -- -__-'J- ---- 1 - LHEN, JASOJFEFIZ�+TiPITS-- , - /� C/0 1139 GLC L 4 COViNA, Cl IZ- aJ FL O0T7kAw1 NU --I MAP-NOSELIEP �9PP d .�1: ACS E 1 IRE ZON -- -CMP-. -------- 3 01 T97-UPtiT-FLOWO+F -- Av�FAil"i�,�S—dGELCt�..�CiN7T��PT7coFt�STAB cCAS`�- _ I NO 21 7N7Fr-EJff FI MR-FIFA HH SCHOOL WITHIN HAZARDOUS AIR QUALITY 1000 FEET MATERIALS NO No ,HO Tiff j Fo N SET RACK YAr-- -WIDTH HL6L E i-c FE�A56ECT /�SET BACK YAf:O HNY PROP LINE WIDTH `-I< FRONT PL- FANELS SIDE PL- IU EA7VLR STRIP TATUM LAT I DRY ACS �2I7y L M-WRAGE -I i OH FIRE DEPARTMENT REPORT ID UPR261 ROUTE TC BS0508 COUNTY OF LOS ANGELF- -Fr4PLE CITY k 0508 BUILDINC or%MST IDEPARTMENT OF PUBLIC WORKS 901 LAS TUNAS RESIDFNTIH. ADD/A,.T/REP NU,IDING AND SAFETY / LAND DEi ELOPMENT TEBPLE CITY CA 91780 BL 0508 0312100004 P,IONE (626) 285-0488 EXT LEGAL D NO OFO1 —BLr,. ADDRESS ON FILE SO FT STORIES TYPE OCCUP GROUP 5611-TEMPLE CITY BL STRUCTURE O 1 VW R3 TF-'P rA 917802532 BM'MF-Mr0�IAjION NUMBER GAR^GC 832 1 VP U1 NEAREST CROSS STREET CROAD"AY 8588-007-01- OTHER T90.'AS PAGE 597 GRiO A3 LOCALITY TEMPLE TENAAT—" ERIST tiLOG USE 0 EXIST OCC GRP 10;08/04 JK 10/03/05 -EL -- 9LD�`.$ WN N JPLUATION t1V•_ D IE FINAL BY CODE PENG LOPI - 40,000 � 5611 E CITY BL 91780 [p� TEMP 917802532tL b'€��7Fi ICT6FWTi5QlK " —� REMODEL INTERIOR OF UNIT TO C°EATE 2 (AHTS (UNIT A 2BR/1 75 i FEE DESCRIDTiON QUAMT1TY U04 AMOUNT Bn -275 W/120SF ENCL PTIO, (,MIT 5 2RR/1 25 BA) CHEMP (215) 400-1841- D1 PIAhCHECK W/0 EN-HC 4C'I,0 CO Jni 567 11 2626 BtRKLE) AVE AA BLDG PERMIT ISSUANCE 27 75 ��U AL COHOI LOS ANGELGS C" 90026 AC STRONG 9CTION RESID 40000 JO VAL 4 00 I� 82 PEP� IT N/ENERGY 4OCC9 79 A. 733 92 FR I 13R, «/0 PERMIT 23" OG DG. -257 00 T6t7Tk1CLT: i -L NO TOTAL F FS 11589 78 T"_ S E S GN...0 C S COHTHACTC'n (213) 413-1904- , n 2626 BCNKELEY LIL NO IECZATION S[T8ACKS LOS AMGFLES C4 0'1926 386936 B �t(ILS _°rf R APPROVAL ICHEN JAS1N m) sir-n9bo- C/O 3 15: GL L. '-TC NO W COV`NA CA 91790 0040159 MAT-NU -:oNC FIA E009 PAct----F7RL-zb;; — CMP I.. G-RFLOU TNsutaTM— "-- 3 01 ua�x-�zarrrE�-ro�r�T�c-uarrs-��csD �a�s— l�, s NO 21 2h I L VLL FLOOR SRPATH -- SC>(60LplTffii� FCJF S-FEATATNIi — --- AIR GUA_ITY 1000 FEET MATERIALS NO NO NO 911RE DEOT FkAME MMRRV- _ETsa 'T-RjAW--E7rSI— BL �EPT�RAAETAS1sECT —_ — SET BACA YARD HWY PROP ZINE WIDTH FRONT PL- $ALAN PAAET� SIDE F_- IWS -- — IN .R R LATH/DRYWALL UT RUM"IT17 LO1 DRAINAGE ?;r'FckL-6C� FIRE DEPARTMENT REPORT ID DPR261 POLITE 10 BS0508 t J -�