HomeMy Public PortalAbout6320 TEMPLE CITY BLVD_Building__ APPLICATION FO,R COUNTY OF LOS ANGELES
EPARTMENT OF COUNTY
BUILDING PERMU DBUILDING AND SAFETY DVSIONR
FOR APPLICANT TO FILL IN BUILDING
ADDRESS
BUILDING /�zD y /
ADDRESS (O pi LOCALITY
CITY y NEAREST
4/ ZIP CROSSST
O OF BLDGS ASSESSOR
SIZE OF LOT NOW ON LOT MAPBOOK PAGE PARCEL
TRACb Z ����/�J" DISTRICT GROUP TYPE FIRE ESSED BY
ACIP Q LOOjTL NO O CONS ZONE
OWNER�/ 6�a4v6�/ 17Q��G
STATISTICAL CLASSIFICATION CLASSIFFIICAATION SEWER
ADDREV4*1!; X13, -;iF //VO CLASS NO 0(5) DWELL UNITS , BK PG
CITY eo*7:: ZIP 7�IOp U/S�)ZONE �P ' ^�
ENGINEARCHITEP OR TEL
/ Y_ SPECIAL/'T/
L/� CONDITKKJS
ADDRESS ' / ROAD DEPARTMENT APPROVAL REWIRED YES ❑ NO 1:1®
CONTRAREO.P6G {'//b4-W-,4b BLDG SETBACK FROM
LIC FRONT PROP LINE OF [STREET)
ADDRESS NO HIGHWAY + YARD TOTALSETBACKFROM TYPEOF EXISTING
LIC FRONT PROP LINE HIGHWAY WIDTH
CITY CLASS
CONSTRUCTION LENDER y+ + >.
NAME AND BRANCH I- �-C BLDG SETBACK FROM a
ADDRESS CITY SIDE PROP UNE OF (STREET) U
SO FT NO OF NO OF CHECK HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING
SIZE STORIES FAMILIES ONE SIDE PROP LINE HIGHWAY WIDTH 0
U
DESCRIPTION OF WORK +
NEW
ADD CORNER CUTOFF YES ❑ NO ❑ d
ALTER
IN OPEN SPACE VES ❑ Np ❑ Z
REPAIR
USE OF IN COASTAL PERMIT ZONE YES ❑ NO ❑
EXISTING BLDG DEMOL
TEL
L:c wiE6s4.✓d NO_sS284�
BYI
I HEREBY AC LEDGE TH HAVE APRICATKkI MID SLATE
iHAi THE ABOV CORRECT AGREE O Y WITH ALL ORDINANCES T I , T
AND LAWS REGULATING BUILDING CONSTRICTION I CERTIFY THAT IN DOING THE
WORT(AUTHORIZED HEREBY I WILL NOT EMPLOY My PERSON IN VIOLATION OF
THE LABOR CODE OF THESTATE OF CALIFORNIA IN RELATING TO WOR[ EN SCOM
PENSATION INSURANCE
SIG"ATERMITTU p.� FINAL L'J' BY
GATE o
ADDRESS
TEL PC Fee$ Permlt Fee ,3 a
CITY NO
VALUATION$
6/ 'p� 29 020 Issuance Fee
/ ..._ 7
Ti,ml Fee 3.3
PLAN CHECK VALIDATION c G o C"H PERMIT VALIDATION c1R -o cAsH
8 9 n H A R G7 2 3 'D 11 8-U.0 Q baa
819�JUN . 8g $ o eg20A— 88O� 8 1 0 331.U0 �'
76"36A OE/ A ene -
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
WORKER S COMPENSATION DECLARATION : FOR APPUCANT TO FILL IN _I BDILIXNG 2 V
1 hereby affirm that I have a certificate of consent to self Insure &ALD G E O I ' L.
a a certdcale of Workers Compensation Insurance or a cerblleofT' ,p� V
copy trema (Sec 31 7 V
LOCALITY
Paps No AA
-WFOF LCT O OF MODS NOW ON LOT
❑�, Certified copy S hereby furnished NEAREST CROSS ST
17'Gartmed Copy IS fled with the County bund..Inspectpn TRACT BLOCK LOT NO
' daps/gyp'gr/I"nUSE ZONE MAP NO
Dated/ IOant ASSESSOR MAP 8001( PAGE PARCEL
Ll
SPECIAL CONDITIONS
CERTIFICATE OF EXEMPTION F WORKERS' TEL NO
COMPENSATION INSURANCE IL WITHIN 1000 FT OF SCHOOL+ `'ES NO
(Thus section need not be completed d the permit M for one hundred ADDFJEW �/� �?. '1'
Idalara w(5100) less)
V \ V DISTRICT GROUP Ty ST FlRE ZONE PROCESSED BY
T
I candy that m the performance of the work for which this CMV ZIP permit �0� J
is leaded I Shea rptt employmploy arty person airy manner ea as to ARCHITECT NG+tEE TEL NO •l
zd
DBCOrOa subject f0 the Workers Compensation 1� STATIST gA1 CLTSSIFICATgN APT CONDO
Dafe Applicant CLASS NO —2&,L— DWELL UNITS
NOTICE TO AP'PLCAW If after making this Certificate of
Exempton you should became seol ubtt0 the Workers 1 TEL REQUIRED TOTAL SETBACK FROM IST
SET BACK yARp HVlV PROP LINE
COITPOrosbOn PrOWtOnS Of the LabM Code you must forthwith FRONT
comply with such provisions or this permit shall be deemed revoked SS .J
I PL
LICENSED CONTRACTORS DECLARATION SIL DE
C S P
I hereby affirm that I am licensed uderprovslors of Chapter 9 r' SEWER MAP
(connrterlang with Section 7000)of DrvsOn 3 0l the Business and SO FT SIZE NO OF S NO OF FAMILIES
NEW , 911.
BK PG O
Professions Code ppd license,s In full face erld eff t 'I--
LOense Number Ix C� DESCav OF WORK ADD ❑ VALGA N U
Contract �y�T— Date $
AlR7ER ❑ ��n Q
❑ I aexempt udder Sec , x IR ❑
m $ O
BaPC for this reason DEMOL ❑ LDMA P/C jUjj
E OF E BLDG
Gate URM ❑ L H
Signature APPLICANT(PRINT) TEL NO LDMA Perm• 2
❑ 1 as owner of to property M my employees with wages as Z 3303 140.�r
It'" $ae CORpaYlatlal writ do the work and the Structure Is ADDRESS F 1 ITEMS
Intended w offered for sale (Section 7044 Business and FINAL DATE Q y9
Profession Code) WILL THE MPLpWT ai FUTURE BUILDING OCcUPi I IMNOLE A IN2AfSdIS WIERML !D-( � TOT
1
L 4 . 85
❑ 1 as Owner a the property am exclusmely Contracting with OR A M%TUFE CANRNNlNG A HAZAiDpUS WTEREQUALL EOL TO OR OEATER TIMN THE Q
ANOINTS SPEORED ON THE HAZMVOUS WTERMLS lFOPIAmON GIAEt
cent contractors to caslruct the Protect (Sectlm 7044 YES❑ ND❑ FINALar > -HE
Sluurles149.5
a end PraessNOns Code) MGL THE INTENDED LSE a THE eU0.RD eV THE APPJCAM OR FUTURE BULDfD i HANGE .05
OCCUPNm REOURE A P RIAr FOA C(xLR11iUGTON On MODFICATON FROM THE souTH 7
CONSTRUCTION LENDING AGENCY Guoa�ITy HEENT DISTRICT ISGMIGI SEE FERWTNG CIECKLL4T FOR n(,pa O eZ
1 hereby affirm that there s a construction IenldaV agency for /
N the performance of the work for which this parmrt s osued(See �s❑ N0❑ ll , 13000-0001
m 3097 Cr, C) IIVYE nEAD TIE HAZMDOISWTERALSKO4MTpNOUDE AND THE SUp10 PERITTNG VV
(y CHECKLIST I UIDER3TMD My REO TEMENTS UNDER THE LOS ANGELES COUNTY COVE 159° 1 RM J.3�
Lender a Nagle TITLE 2 C TER 220 SECTIONS t 20100 THROUGH 2 20 IAD ' En IMZAfOCIIs
WTERMW REPORTNG AND FOR 01 l 140 A PERWT FROM THE 9LAOSD
Lenders Address
0 GMrEF Cn.E T
I cerUty that I have read the appkcatOn and este under penally
of perplry that the above mformartor,Is Correct I apse l0 Cm* PC FEE PERMIT FEE 11
with all county Ordinances and State laws relating to blllldng d'
contstru n and hereby authorize representatives of this County ISSUANCE FEE
to On the abov n, tided Property forge ��1 ',^
m E� INVESTIGATION FEE TOTAL FEE /
SEE REVERSE FOR EXPLANATORY LANGUAGE
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1308200021
PHONE (626) 285-0488 EXT
LEGAL ID NO OF CONST BUILDING ADDRESS
TR 33529 ON 10 SQ FT STORIES TYPE 6320 TEMPLE CITY BL
(STRUCTURE V-B TEMP CA 917801432
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET LONGDEN
15383-015-043 THOMAS PAGE 596 GRID J2 LOCALITY TEMPLE CITY CAI
TENANT EXIST BLDG USE RESID USE ZONE R-2 ISSUED ON PROCESSED BY
IEXIST OCC GRP 08/20/13 SR 1
(OWNER TEL NO IBLDGS NOW ON LOT VALUATION FULkL DATE FINAL BY CODE 1
ILONGDEN AVE HOA, DONALD DAVIS (626) 285-9410- 6 270 (J 'j,� .�(/h
16320 TEMPLE CITY BL qw/�'/ Y
ITEMP 917801432 FEES PAID ]DESCRIPTION OF WORK
I REMOVE RIDGE INSTALL 30 YR CLASS •A• COMP OVER 1 LAYER OF
IFEE DESCRIPTION QUANTITY DOM AMOUNT (EXISTING COMPOSITION 1
(APPLICANT TEL NO I
(GRATER GUY (626) 355-2755- IAA BLDG PERMIT ISSUANCE 27 80 1
11407 FOOTHILL BLVD IAB STATE GREEN BLDG FEE 6270 00 VAL 1 00 ISPECLILL CONDITIONS 1
LA VERNE CA 91750 IAC STRONG MOTION RESID 6270 00 VAL 0 60
ID2 PERMIT W/O EN-HC 6270 00 VAL 166 20
(CONTRACTOR TEL NO I 'TOTAL FEES 195 60
(APPROVALS DATE INSPECTOR SIGNATURE
ID AND G ROOFING INC (909) 593-4982-
1407 FOOTHILL BLVD #307 LIC NO VACATION AND SETBACKS
ILA VERNE CA 91750 534986 1
ISOILS'ENGINEER APPROVAL 1
(ARCHITECT OR ENGINEER TEL NO (FOUNDATION/TRENCH FORMS I I
)
LIC NO (SLAB/UNDER FLOOR
(RAISED FLOOR FRAMING
(MAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP , IUNDERF,OOR INSULATION I
3 OOII I
IFLOOR SHEATHING
IND OF FAMILIES DWELLING UNITS APT/GOND STAT CLASS 1
I I
IYES 21 IROOF S4EATHING
I SCHOOL WITHIN HAZARDOUS SHEAR`PANELS
(AIR QUALITY 1000 FEET MATERIALS I
NO NO NO 1 FRAME INSPECTION
FIRE SPRINKLER HANGERS
INSULATION/WEATHER STRIP(
I INTERIOR LATH/DRYWAr.r,
I
II EXTERIOR LATH i 1
1 IRATED rLOOOR/CEIL ASSEM
I I I
RATED WALL ASSEMBLIES
RATED SHAFTS/OPENINGS
I
II IT-BAR CBILING9 1
LOT DRAINAGE
I 1
IREPORT ID DPR261 ROUTE TO BS0508
I