HomeMy Public PortalAbout6316 TEMPLE CITY BLVD_Building__ APPLICATION FOR COUNTY OF LOS ANGELES
BUILDING PERMIT DEPARTMENT
ENGINEER
BUILDING
ING
FOR APPLICANT TO FILL I ADDRSS
BU
ADIDRIESS (NG O/3/e/-
LOCALITY
NEAREST
CITY ZIP CROSSST
NO OF BLDGS A55ES50R
SIZE OF LOT NOW ON LOT MAP BOOK PAGE PAL
TRA / DISTRICT GROUP TYPE FIRE SS D By
SL7 BLOCK LOyTTl�NNO�� L�O� — CONST ZONE
OWN T/O�✓ T$y J�� J
STATISTICAL CLASSIFICATION SEWER MAP
ADD � a-L�i7/Y 6 L b CLASS NO -.LIG—DWELL UNITS BK PG
CITU ZIP USE ZONE MAP 20ARCHITECT OR TEL NO SPECIAL
NO !� CONDITIONS
ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO❑
CONT p.P B W EL BLDG BACK FROM
LIC FRONTPROP LINEOF (STREET)
ADDRESS NO TOTAL SETBACK FROM TYPE OF EXISTING
LIC HIGHWAY + YARD FRONT PROP LINE HIGHWAY WIDTH
CITU CLASS
CONSTRUCTION LENDER + }
NAMEAN0 BRANCH d
BLDG SETBACK FROM 0
ADDRESS CITY SIDE PROP LINE OF (STREET) U
SOFT NO OF NO OF CHECK HIGHWAY + YARD TOTAL SETBACK FROM TYPEOF EXISTING
SIZ STORIES FAMILIES l ONE SIDE PROP LINE lHIGHWAYI WIDTH O
+ H
DESCRIPTION OF WORK NEW U
ADD ❑ CORNER CUTOFF YES ❑ NO ❑ a
N
ALTER ❑
IN OPEN SPACE YES ❑ NO ❑ Z
REPAIR
USE IN COASTAL PERMIT ZONE YES ❑ NO
EXIST( ❑
EXISTING BLDG DEMOeL
APPLI � E %�,yi.vfp TNp I/'Y./Jzp�
BYI
I HEREBY A FLXiE T I HAV 5 APPLICATION D STATE
THAT THE ABOVE 15 CORRECT DAG TO Y WITH ALL ORDINANCES
AND LAMS REGUTATING BULDI NG CONSTRUCTION I CERTIFY THAT IN DOING THE
WORK AUTHORIZED HEREBY WILL NOT EMPLOY ANY PERSON IN VIOLATION OF I
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKALEN 5 COM
PENSAiION INSURANCE
SlE ATURE O ` FINAL /i/ '�9 BY
PERMITTE DATE
ADDRESS
TEL P C Fee 5 o, o-� Perma Fee
CITY NO
ZO Issuance Fee
VALUATIONOrJT7 -3G./ Q�
Total Fee 331
PLAN CHECK VALIDATION all w O CAgH PERMIT VALIDATION w o CASH
288r-f*K a% 25-M 0.0.0
A"
8 1 7ajm, 8 8 1 BnJIIN 8 1 D 1.0
�7 92 0'"
76"MA Ce/e01A ene m
`T
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
WORKER S COMPENSATION DECLARATION -FOR APPLICANT TO FILL IN ELI ss u
I hereby affirm that I have a certificate of consent to setl uisure eul
a a certificate of Workers; Compensator Insuranc or a certllled
copy theraof�(Sec 3f? C) LOCAUTY
��No`��3 C'�P SIZE OF LOT NO OF BLOBS NOW ON LOT
❑ Certified copy is hereby furnished NEAREST CROSS ST
SJ-O Espy is filed with the county building Inspection TRACT BLOCK LOT NO
de �a� /� USE ZONE MAP NO
Date'-"icanl ASSESSOR ANP BOOK RAGE PARCEL
SPECIAL CONDITIONS
CERTIFICATE OF EXEMPTION FR RKERS OWNER TEL NO
COMPENSATION INSURANCE WITHIN 1000 FT OF SCHOOL? YES NO
(This section need not be completed if the permit o for one hundred �AcI J
01 pSTRICT GROUP TV ST FIRE ZONE PROCESSED BY
dollars($100)or lase)
I certify that In the performance of the work fa which this Permit LP
is issued I shall not employ any person in any manner so as to ✓
become subject t0 the Workers Compensation Laws C ECT OR ENGINEER TEL NO
STATISTICAL CL/�$SIFlCATION APT CONDO
Date Applrant pppRES3 CLASS NO DWELL UNITS
NOTICE TO APPUGANT If after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST
Exemption you should become subject t0 the Workers CO TOR SET HACK YARD HWV PROP UNE MOTH
Contperteahorl prows+ons Of the Labor Code you must forthvath T
FRONT
comply with such prov sons Or thin permit shall be deemed revokedV P L
LICENSED CONTRACTORS DECLARATION TM SIDE
I hereby affirm that I am licensed underprowsxe xOf Chapter 9 lJ( u B P L }
(COrrmlBrNaing w4h Section 7000)of DNaon 3 0l the Business arid SO FT NO OF STORIES NO OF FAMILIES SEWER AMP y
Professore Code a myjico�7000) is In full force Nect
NEW BK PG O
License Number�� � C= DE OF WOHK ADD ❑ VALUATION rJ
Cantrector�yS1)T Date ALTER ❑ $ v _•+ r
I• O
❑ 1 am exempt under Sec !001REPAIR ❑ U
BAPC for thm reason : EMOL ❑ $ W
LDAN P/C. d
Date u OF RaSING BLDG URM ❑ _
Sgrature1
APPLICANT(RmYT) TEL NO CDMA Perm
�11:iT
❑ I as owner of the Property or my employees with wages as = 'T
their sole compensation will do the work and the structure Is ADDRESS
not intended or offered fa sale (Sechon 7044 Busmesa and FINAL DATE F x,03 149.85
professions Code) I
WILL LTE APPLICANT OR FUTURE BUILDING CCCWANi HANDLE A HWIUWa M/REI M Q -`g. -� 3 M 1 ITEM
❑ I as Wrier Of true Property em exclusively contract) with OR A IAIxTUfE CONTNANG A IMZMDOUa MATERYL EDUAL TO OR GREATER THAN TLE Q C
contracting A UMTS SEEMED ON THE H•ZMDOUS ANTERMLS INFCRvWnON GUIXI 8+
licensed contractors to construct the Project (Sector 7044 YES FINAL B'' Q._ > TOTAL 1$9 _ +�
Easiness and Profession Cade) WILL NG❑ d" CHECK 149.E`
TALL THE REOU Ea USE 6 THE BULYIA BY 11E AVON OP FUTURE E SOLI G
oCCUPAM RE0.WE A PERMIT FOR LONSTPUCTgN OR MODIFICATION FROM RLE SIXRH y-�(
CONSTRUCTION LENDING AGENCY �Ba TY^MANAGEMENT DtSIRICT(sc^ouD)SEE PER WTTNG CHECnL14T FOR li,W{wA&645' CHANGE •C0
I hereby eHem that there Is e wnslh this p rmitlis agency for vEs❑ w❑ I O ���
,N the performance of the work for which this genre a issued(Sec
m IHIECfEJ➢REWSAf✓Opll9IMTEPLL9INFORMUNDN MEANS TFE LES PEFMCODE
3097 CN G 1 cuEcucusr u R 2 MND Arc REouR l W UNDER THE Ice�waEL co cooE l l /9?
Lender a Name TE PORTNGµ��Gam MING A� F HEC "A� �0 e n GQ 30—I.OL 1 9! 7
Lenders Address 1502 1 AM v:4'!
Q MMCF fN YEHT
I cerhty that I have read Mo application and state under penally
$z� of penury that the above Information a correct I agree to Comply PC FEE PERMIT FEE
ry wrth all county ordinances and Stale Tawe relah g to building
construction and hereby authorize representatives of the Canty ISSUPtaCE FEE / D
to r upon the above-mentioned Property forInspec pu as �(�
m INVESTIGATION FEE TOTAL FEE
dAW a jJ ✓
SEE REVERSE FOR EXPLANATORY LANGUAGE
COO= OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS I ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVEL/JPMENI TEMPLE CITY CA 91780 BL 0508 1308200020
PHONE (626) 2B5-0488 EXT
LEGAL ID NO OF CONST BUILDING ADDRESS
TR 33529 ON 11 I SQ FT STORIES TYPE
6316
CAM CITY
STRUCTURE V-B I TEMP A917BL
901432
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET LONGDEN
15383-015-044 THOMAS PAGE 596 GRID J2 WcALITY TEMPLE CITY CAI
TENANT EEIST BLDG USE REBID USE ZONE R-2 ISSUED ON PROCESSED BY
EXIST OCC GRP 08/20/13 SR
TOWNER TEL NO BLDGS NOW ON LOT VALUATION
FINAL BY CODE
ILONODEN AVE HOA, DONALD DAVIS (626) 285-9410- 6,270
6316 TEMPLE CITY BL
TEMP 917801432 FEES PAID DESCRIPTION OF YORK
REM(3VE RIDGE INSTALL 30 YR CLASS -A• COMP OVER 1 LAYER OF
APPLICANT TEL NO IFEE DESCRIPTION QUANTITY DOM AMOUNT EXISTING COMPOSITION
IGRATER GUY (626) 355-2755- IAA BLDG PERMIT ISSUANCE 27 80
11407 FOOTHILL BLVD AB STATE GREEN BLDG FEE 6270 00 VAL 1 00 SPELIAL CONDITIONS
LA VERNE CA 91750 AC STRONG MOTION REBID 6270 00 VAL 0 60
ID2 PERMIT W/O EN-HC 6270 00 VAL 166 20
_ TOTAL FEES 195 60 _
CONTRACTOR TEL NO 1APFROVALS DATE INSPECTOR SIGNATURE
D AND G ROOFING INC (909) 593-4982 1
11407 FOOTHILL BLVD #307 LIC NO LOCATION AND SETBACKS
LA VERNE CA 91750 534986
j ISOI..S ENGINEER APPROVAL
(ARCHITECT OR ENGINEER TEL NO I F
jJO�-DATION/TRENCH FORMS
LIC NO (SLAB/UNDER FLOOR
_I RAI-,ED FLOOR FRAMING I
MAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP OND,-RFLOOR INSOLATION
3 0, (FLOOR SHEATHING
IND OF FAMILIES DWELLING UNITS APT/COND STAT CLASS
Yes 21 IROO• SHEATHING I
SCHOOL WITHIN HAZARDOUS
SHEAR PANELS
1AIR QUALITY 1000 FEET MATERIALS 1I I
NO NO NO FRAME INSPECTION
FIRD SPRINKLER HANGERS
INSULATION/WEATHER STRIP
I I-d
INTMIOR LATH/DRYWALL
E%TLRIOR (.ATH
I_
(RATED FLOOR/CEIL AS SEM
(RATED WALL ASSEMBLIES
RATED SHAFTS/OPENINGS
1 I
IT-BPR CEILINGS
(
LOT DRAINAGE
j IREPORT ID DPR261 ROUTE TO BS0508
I I