HomeMy Public PortalAbout6431 TEMPLE CITY BLVD_Building__ PS'iA CE IRDS 3-69 `
APPLICATION FOR UL IDN PER T
COUNTY OF LOS ANGELES BUILDING `
DEFARYMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBI E, COUNTY ENGINEER
COLEMAN W JENKINS, SUPT OF BUILDING NEAREST
CROSS ST
FOR APPLICANT TO FILL IN DISTRIcr No cR TYPE.t.y PR v
(PRINT OR TYPE ONLY) �/�- r7/
BUILDINGS
� CLASS NO DWELL UNITS BK G PGpCTATISTICAL CLASS FILATION SE ER MAP
ADDRESS T� I0L E CID'T' D �3
�
LOT NO BLOCK USE ZONE I MAP
NO VV
TRACT ��! ISPECAL
NO OF BLDGS ✓\ CONDTIONS
S1ZE OF LOT C NOW ON LOT S
USE OF
EXISTING BLDG ', '.11 . / L BLDG SETBACK FROM
OW NE W EA/ NOI� FRONT PROP LINE OF (STREET)
TYPE OF EKISTI SETBACK HIGHWAY h YARD = TOTAL
ADDRESS (02.0 XI WAV WID H FROM C L
CITY 04LIE
` d = p2_0
ARCHITECT OR TELBLDG SETBACK FROM
ENGINEER C NO SIDE PROP LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY i YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C L
TEL n
CONTRACTOR ( �A NO c
ADDRESS 1T M ' IC
NO CORNER CUTOFF YES ❑ NO ❑
0
CITY ^� CLASS SEE REVERSE SIDE FOR SPECIAL APPROVALS Q
NAME
CONSTANDTBRANCH ION
ADDRESS DER -A O N I DESIGN DMS)ON APPROV
1V N
tLW A E Rtr RED z
SO FT /� NO OF NO OF
SIZE V STORIES FAMILIES NEW /
USE STRUCTURE
- ADD ❑ O )
TER ❑
lizi PAIR ❑ G
SIGNATURE DEMOL ❑
APPLICANT �7 M, - I I.
VALUATION / c' F PMT �/ 7
APPROVALS D TE INS c • s nloN uAK
FEE S / O FEE S /` // �✓ D FOUNDATION N TERIAILS Z
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION FRAME FIRE STOPS,
AND STAT! THAT TME ABOVE 19 CORRlCT AND AGRlE TO COMPLY BRACING, LT
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUC- FURNACE LOCATION,
TION I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I GAS VENT. DUC
WILL NOT EMPLOY ANYPERSON IN VIOLATION OF THE LABOR CODE LATH INT Wl ,
OF THE STAT! OF CALIFORNIA IN RELATING TO WORKMEN'S COM-
PENSATION INNSSypM LATH, EXT SIGNATPERMITTB Lti 4:/ HOUSE NUMBER CORRECT
AND POSTED
AODR ESS�(I -� �yP6 �"-� - FINAL S O
JOHN F LEWIS, PRINCIPAL S79TNURAL ENGINEER
PLAN CHECK 4VALIDATION �+ M o CASH PERMIT VALIDATION cK N S cA•H
J, 27230 76.501 q
I Ar,- 4 4 0 9� APR 9 1 0 12 750~ v
WORKERS COMPENSATION DECLARATION
.N
I hereby affirm that I have a certificate of consent to self
insdi e, or d -APPLICATION FOR BUILDING PERMIT certificate of Workers' Compensation Insurance,or a certi copy thereof (Sec 3800, Lob C )
�p COUNTY OF LOS ANGELES WILDING AND SAFETY
P�cy Compo _zny /T,J —
Certified copy is hereby furnished 7'�`ya' FOR APPLICANT TO FILL IN BUILDING
ADDRESS lv�8i
Ce fl copy is filed unty II g inspec-
t ADDRESS GJ i
CEICATE
rtment
DateApplic CITY 'r ZIP LOCALITY
OF D(EMPTI F ERS' SIZE OF LOT NOWNNO OF&LO CROSS S
COMPENSATION I SURA CROSS 57
(This section need not be completed if the rmit to far one TRACT BLOCK LOT NO MAP BOOKS Z PA Z PARCEL
hundred dollars ($100)or less ) TEL OWNER USE ZONE MAP 5
NO
I certify that in the performance of the work far which this //�� - ,(J �].._
SPECIAL
permit is issued, I shall not employ any person in any manner ADDRESS Ly OC-O CONDITIONS a
so as to become subject to the Workers Compensation Laws CITYP �� Ou
Date Applicant ARCHITECT OR TEL oc
NOTICE TO APPLICANT If, after making this Certrfroate of ENGINEER NO DISTRICT G P CONST ARE E D BY Q
Exemption, you should become subject to the Workers v
Compensation provisions of the Labor Code, you must forth- ADDRESS 4�
to
with comply with such provisions or this TATISTICAL CLASSIFICATION APT CONDO '
p y p permit shall be TEL to
deemed revoked CONTRACTOR NO �• /
LICENSED CONTRACTORS DECLARATION CLASS NO DWELL UNITS_
I hereby affirm that I am licensed under provisions of Chopter 9 ADDRESS SEWER MAP
(commencing with Section 7000)of Division 3 of the Business LIC / '
and Professwm Code,and my Ircar a m full face a�anddd effect CUV A CLASS BK P�b�7 VALIDATION
SO FT NO OF NO OF CHECK
License Nu berZ�/ Lic Class SIZE STORIES FAMILIES I ONE
VALUATION
COniraCl Date DESCRIPTION OF WORK NEW ❑ $ _
❑1 am exempt under Sec ADO ►
�jy. jo8AO ALTER ❑
B BP C for this reason �.-�./ �� REPAIR ❑ $
Date USE OF
DEMOL ❑
EXISTING OF BLDG
Signature APPu FINAL
OWNER-BUILDER DECLARATION (PRINt) _ ,d
I hereby affirm that I am exempt from the Contractor's License DATE
Low'for the following reason (Section 7031 5, Business and ADDRESS FINAL 'O
Professions Code) KADDRESS
BT
❑ I, as owner of the property, or my employees with BUILDING
�' `�•IF
wages as their sole compensation will do the work and
the structure is not intended or offered for sole(Section
7044, Business and Professions Code ) TEL
❑ 1, .'owner of the property,am exclusively contracting OR NO i a
with licensed contractors to construct the project (Sec - 4�_IT.T
tion 7044, Business and Professions Code ) '?.L17 Z,_
CONSTRUCTION LENDING AGENCY vARD IiWY L FROM WIDTH
I whereby offrrm that there ua construction lending agency for he performance of the work for which this permit is issued O(Sec 3D97, Civ C ) TorFL 147 _ 38 Lenders Name y Chtl( 14ti.1' Permit Fee OjiTDMA ser 1 r�AFaUE .CIFI
Lenders Address G!I cemfy that I have read this application and state that theIssuonce Fee G� 7..i LDMA P2 N Poo
above iM2rmcnnon is corn I agree to comply with all County Invengatlon Fee l 1 II�hQ—r]QI i' *]1E yQ�
or inc State I relating to building construction, Total Fea .J LDMP.Perm N
d hereby a hors e r presentatives of this County t en J4c t
tSyJ pan e a nn ad property for inspeclwn p All 7'-',.
n SEE RIVl=FOR EXPLANATOVY LANGUAGE y
./grope scant or Agent Dat
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY Efl
WORKER S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS
I hereby affirm that I have a certificate of consent to self Insure BUI DDRES {� G Cw
or a certificate of Workers Compensation Insurance or a certified `
GDpr thereof
t�.1L.1G Wi ) of �� L L�/I 7S10 LOCAL
Pdlcy o -�T Company v
SIZE OF LOT NO OF BLDGS NOW ON LOT
,??Certified copy Is hereby furnished NEAREST CROSS ST
❑ Certified copy Is filed with the co ly eTspect"On TAT BLOCK LOT NO
Dat2zde/9�art�p/I��n/t/�^� USE ZONE MPP NO
ra L Appllcan ASSESSOR MPP BOOK PAGE PARCEL
/- ! •� SPECIAL CONDmONS
CERTIFICATE OF XEMPTION FROM WORKERS °
COMPE ON INSURANCE WITHIN 1000 FT OF SCHOOL? VES NO
(This section need not be completed If the permit G for one hundred RE
dollars($100) of less)
•. 81, DISTRICT GROUP TYPCONST FIRE ZONE PROCESSED BY
�DaI certify that In the performance of the work for which this permit CRY � ZW
Is issued I shall not employ any person In any manner so as to •_
become subject to the Workers Compensation Laws CHITECT ENGINEER I L NO
STATISTICALCLASSI ICA710N APT CIX
AS
Date Applicant ADDRESS CLS NO DWELL UNITS
NOTICE TO APPLICANT If after making this Certificate Of REQUIRED TOTAL SETBACK FROM E%IST
Exemption you should become subject to the Workers CO S—7Z� SET BACK
COnperlsabon provisions of the Labor Code you must forthwith YARD FM1YY PROP LINE WIDTH
comply with such provisions o this permit shall be deemed revoked ESS n NO FRONT
LICENSED CONTRACTORS D RATION Y2 SIDE
P L
I hereby affirm that I em IK:ensed u rprovrsions of Chapter 9 Cis SEWER MAP
(commencing with Section 7000)of vIRKNI 3 of the Busuess and NO OF STORIES NO OF FAMILIES
Professions Code ns Iii full face and aftr�Ree��ccqq�`� NEW BK PG , }
License Number 0 lags I TION OFA RK N ; ADD ❑ VALUATION d 0
Contractor Date ���� A'/M7 �1� (Ar ` ALTER ❑ $ Sb•
cc
❑ 1 am exempt under Sec S Z REPAIR ❑ $ Q
BBPC for this reason Qpp �,.� �}j. DEMOL ❑ W
LOMA P/C
Date USE OF EXI TING URM ❑ 1 IL
TFj.�ylJpure z
❑ las i mEr of the property, u my ermkryees with wages as APR ICAI�T PIANT '+ _g), LDMA Perm A = A��T.T
their sale conpensahon will tlo the work and the structure is ESS 1/� F �.] 1?7.40
not Intended Of offered for sale (Section 7044 Business and5iz '` FlRAL DATE Q
Professions Lode) W1 THE M UGANT OR FUTURE RULCVq OCCURINT HM'pI.E A HAZAR 51MTERNL — 1 ITEMS
J
❑ I as pWn o OI for property am the project
contracting DR A ,Ts sEE CANWNND A AEpo s TEmALL EQU�WOR TO OR GREATER TIUN THE TOTAL
y
rig Wlth AMOLNTg apECIFlE HE 1U�ZMOOl15 NATET1VL91tFORMATICN GUCE'! FINAL BY � 1 V 11'11 1+�7 -
40
Business
contractors to construct the Project ?Section 7044
Business and Professions Code 1 WUYEs❑ CHECK i.i f•4�I
VAI.L THE MI THE BUIOUNOCONSTRUCTION
RV THE AMOC OR FUTURE TBUILDING
HE
OCCUMM REQUIRE P PERMIT FOR CONBfRIICTION OR EE KI'MiIDN FROM CH TKU SOUTH I'H&3E .qp
CONSTRUCTION LENDING AGENCY COAST AIR ouu-ITv MawuEMENr asmlcr Isc�nj SEE aERunravc c�crcusr FOR fT0DLL11�']]LL
oup7s
1 hereby affirm that there Is a construction lending agency for YES No
a the pertomance of the wok to which this permit Is Issued(Sec
m ?HAVE PFAp T1E RGO ' IFOROATION OODE AND THGiCAOACp PERMW TTTNGE ULFyy V4J1 y,�ip�7J
3097 Cry C I �CxusT i LwDERST uRE VENTS U R THE�ANG
Lenders Name MHTLEATE e o rrapHzzDIAD�IVD AiAaoous �Q¢5 1 11%4E
Lender s Address
o R aR.mrcr
I certify that I have read this application and state under penalty
8 Of perjury that ih bo a mlormation Is correct I agree to comply PC FEE PERMIT FEE S�
With all coon oral noes and State Taws relating to Wading
construction C,I Dnze ffsepre9EYIt8lrvas Of this County ISSUANCE FEE
a to enter upon madp�pPiytlOr InspectI r es
m INVESTIGATION FEE TOTAL FEE
.a....,k 3 . pyo
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 1209170025
PHONE (626) 285-0488 EXT
ILEGAL ID NO OF CONST BUILDING ADDRESS
ON FILE SQ FT STORIES TYPE 6431 TEMPLE CITY BL
ISTRUCTURE V-B TEMP CA 917801435
(ASSESSOR INFORMATION NUMBERNEAREST CROSS STREET
15382-022-053 1 THOMAS PAGE 596 GRID J1 LOCALITY TEMPLE CITY Cl
ITENANT IEXIST BLDG USE RESID USE ZONE R-2 ISSUED ON PROCESSED BY I
I IEXIST OCC GRP 09/17/12 SR I
I I I
OWNER TEL NO IBLDGS NOW ON IAT VALUATION IFI TE FI CODE 1
MECUM SEYMOUR L ISABEL (626) 497-9927- 1 9 880 1 l 2/
6431 TEMPLE CITY BL
TEMP 917801435 FEES PAID ID CRIPTION OF FORK
SOLAR PHOTOVOLTAIC SYSTEM ROOF MOUNTING 16 PANELS
FEE DESCRIPTION QUANTITY UOM AMOUNT 1
APPLICANT TEL NO
IA-1 SOLAR POWER INC (855) 410-4700- AA BLDO PERMIT ISSUANCE 27 80
5632 VAN NUYS BLVD 1AB STATE GREEN BLDG FEE 9880 00 VAL 1 00 ISPECIAL CONDITIONS 1
VAN NUYS CA 91401 1P1 RES PV PC<10KW 153 90 1 1
P2 INSPCT RES PV <10KW 138 00
TOTAL FEES 320 70 1
CONTRACTOR TEL NO 1 APPROVALS DATE INSPECTOR SIGNATURE
IA-1 SOLAR POWER INC (855) 410-4700-
15632 VAN NUYS BL #36 LIC NO 1LOCATION AND SETBACKS 1 1
VAN NUYS CA 91401 493623C-10 '
SOILS ENGINEER APPROVAL
1ARCHITECT OR ENGINEER TEL NO 1 1FOUtiDATION/TRENCH FORMS I I I
LIC NO SLAB/UNDER FLOOR
_ RAISED FLOOR FRAMING 1
MAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP 1UNDERFLOOR INSULATION
1153H265 3 001 -1-1-
I I
(FLOOR SHEATHING
IND OF FAMILIES DWELLING UNITS APP/COND STAT CLASS-1 I
0 NO 21 Ram SHEATHING
I I
SCHOOL WITHIN HATAADOUS ISHEAR PANELS
1AIR QUALITY 1000 FEET MATERIALS
NO NO NO 1FRAME INSPECTION
I I (FIRE SPRINKLER HANGERS 1
INSUTATION/WEATHER STRIP
I
I
INTERIOR LATH/DRYWALL
I 1 I � 1SXTERIOR LATH
RATED FLOOR/CEIL ASSEM
RATED WALL ASSEMBLIES
RATED SHAFTS OPENING$ 1
T-BAR CEILINGS
• ADDITIONAL DATA ON FILE
LOT DRAINAGE
REPORT ID DPR261 ROUTE TO BS0508
I I I I I