HomeMy Public PortalAbout6403 TRELAWNEY AVE_Building__ TSw�aul"S s•u 1
APPLICATION FOR BUILDING PERMIT 1
DIVISION OF BUILDING AND SAFEPY BwooR®Bu1LOINa
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DspomuEnl of Comp Enffh T erzo
County of Loa Angela LOCALITY
WM J FOX COUNTY ENGINEKR NSARKST
CASSATT O GRIFFIN SY T OF BUII.DINa CROSS BY
DISTRICT j�0 GROUP ,n,PK [ HK MAP
FO//B APPLICANddT A�TO FILL IN JG/ ad
BUILDSBUILDING CD O / /V. ,/I I MAP 1 STATE
NUMBER GJ HWY -�
LOT NOZ�BLOCK USE ZONR SPECIAL
/ CONDITIONS
TRACT I15000
NO OF IGLOO
SIZE OF LOT S7 L NOW ON LOTS O BUILDING YARD Hwr BrRKKr NAM[ EXISTSETBACK WIDTH
US[OF FRONT
EXISTING BLDG P L /
OWNER SIDE _
L P
ADDS®S (r MAIL - iQS�7� .sT O TRACT DWELL 1 UNIT
Lf INDUSTRIAL
S ,¢ N� DWELL I UNIT B PUBLIC BLDG
ARCHITECT OR TEL 2 DUPLEX I UNIT 7 ADDN ALT ETC.
ENGINEER NO S APT _UNITE
B MISCEL
ADDRESS TEL 4 COMMERCIAL e�wr �c�
CONTRACTOR Q10'�✓F� INWEC ION RECORD
NO ,/
ADD S J,,,I,
DFSCRIMON OF WORK
NEW L-'ADO ALTER REPAIR DEMOLISH / F
NO YSTORIES
ZH FAM�PES
UBE OF STRUCTURE
`+
SIGNATURE OF �
APPLICANT APPROVALS
ADDRESS DATE INSPECTOR$SIGNATURE
FOUNDATION LOCATION
i ► C. S �O FORMS. MATKAIALS
2 ✓ � FEs , /�'n RACING FIRE
VALUATION _
m FVFURNACE LOCATION
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GAS VENT DUCTS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH INT �� A
AND STATE LAWS REGULATING SUI NG CONSTRUC-
TION LATH EXT
SIGNATURE OFy HOUSE NUMBTED
ER COR- S� f 'l
PERMITTEE RECT AND POS
ADDRESS FINAL Z'Z
WM J FOX.COUNTY ENGINEER VALIDATION C. N DIRLAM CHIEF BLDG INSPECTOR
W L0 5 0 7 11S JUN 2 1 6 1. 5.Q T1.61110 7 2 S juN 2 4 1 3000 0
m
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56;'6ieA CEReDD [-°°APPLICATION FOR BUILDING PERMIT J
COUNTY QF LOS ARGELES BUILDING �
t D �403
EPARTMENT.OF COUNTY ENGINEER ADDRESS /'gyp` W/4 e
BUII.DING AND SAFETY DIMION LOCALITY
JOHN A LAMBIE, COUNTY ENGINEER NEAREST /
COLEMAN W JENKINS, SUP T OF BUILDING CROSS ST O e/Y) 1%, S T•
FOR APPLICANT TO FILL IN DISTRICT NO GROUP TYPE / PROCESSED BY
(Print ort a .1 (f CONST j /.D_ 5wC /
BUILDING STATISTICAL CLASSIFICATION G—�-_ 67-SK
MAP !��
ADDRESS Q.3 e_iA I L floe , CLASS NO--t--DWELL UNITS_ G SK PGI
LOT NO 16 BLOCK WE ZONE MAP Q 2
TRACT • SPECIAL 7
f NO OF SLOGS CONDITIONS
SIZE OF LOT J NOW ON LOT
USE OF
EXISTING BLDG / BLDG SETBACK FROM
OWNER UCG QW NOL�A 'SIfr4 FRONTPROP LINEOF (STREET)
TYPE OF QI STING SETBACK HIGHWAY + YARD = TOTAL
Y WIDTH FROM C L
ADDR=S 6vu /� a ue XIGHWA66
CITY7e_,,, /Q `I O NI BLODG SETBACK FROM +� ,
ARCHITECT OR / TEL SIDE PROP LINE OF (STREET)
ENGINEER / P_ NO TYPE OF EXISTING SETBACK HIGHWAY + YAM = TOTAL
ADDRESS HIGHWAY WIDTH FROM C L
CONTRACTOR TEL + _
N Pi N LI
ADDRESS NO CORNER CUTOFF YES ❑ NO C
CITY
LIC
SEE REVERSE SIDE FOR SPECIAL APPROVALS
CONSTRUCTION LENDER a
NAME AND BRANCH L 2
6
ADDRESS
SO FT NO OF NO OF
06
SIZE .0 STORIES FAMILIES NEW Lj
USE OF ADD
STRUCTURE
ALTER ❑ r-i��I O` D Y - -••� l"�1 \
SIGNATURE OF '17 REPAIR❑ � � \ .
APPLICANT Q (� DEMOL ❑ /// G 0 /- , 1_-
VALUATION $ OO APPROVALS DAT (HSP c on e n N TURK
P C PMT FOUNDATION LOCATION
FEE S FEE S FORMS MATERIALS
FRAME FIRE STOPS // //��
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS - 7Y 19" SLI/
AND STAT[ THAT THE ABOVE la CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT DUCTS
STRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT EMPLOY ANY PERSON IM VIOLATION OF THE LATH INT
LABOR COOS OF THE STAT[ OF CALIFORNIA IN RELATING TO
WORKMEN B COMPENSATION INSURANCE
LATH EXT r
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED Ej I
ADDRESS 4qP3 FINAL 6
JOHN F LEWIS PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION Cl M O GASH _ PERMIT VALIDATION CK NO CAE
t IAC,9 1 7 8 Am 7 1 D 1 725-
-
l
WORKERS COMPENSATION DECLARATION a hereby affirm certificate
that I hove r certificate of consent to self APPLICATION"FOR BUILDING PERMIT
insure, or a certificate of Workers' Compensation Insurance,
or a certified copy t21re f (Sec 3&70, Lob C COUNTY OF LOS ANGELES - BUILDING AND SAFETY
Policy No a- 2Z Company
❑ Certified copy is hereby furnished FOR APPLICANT TO FILL IN ADDRE�I�I 2
ified copy is filed with the county building inspec- BUILDING GVD3 T e5 �, (/
11vvv✓�� tion department ADDRESS p
Date S-/'2-;P2Applicant 1/ ^�c^i�O CITYCE L' T zlv LOCALITYMY\ G
NO OF BLDGS NEAREST IO
CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST
COMPENSATION INSURANCE - ASSESSOR
(This section need not be completed if the permit is for one TRACT BLOCK LOT NO MAP BOOT( PAGE PARCEL
hundred dollars ($100)or leu ) r
OWNER D E— L//G4 6- S/a ZONE MAP
I certify that in the performance of the work for which this L//�
SPE
permit is issued, I shall not employ any person in any manner ADDRESS T .4J ���'• f INQ
CONCDIITTIONS
so m to become subject to the Workers'Compensation Laws O
-/1 -9�, ,/ '/ CITY 9i !o L)
Dale pphcant z~_�O�! ry �Q ARCHITECT OR 6 C T ZIP TEL - 04
O
NOTICE TO APPLICANT If after making this Certificate of ENGINEER NO DISTRICT GROUP TYPE FI PROCESSED BY
_ CONST ZONE rr
Exemption, you should become subject to the Workers
Compensotion provisions of the Labor Code, you mum forth- ADDRESS F 1 �" V
with comply with such provisions or this permit shall be TEL STATISTICAL CLASSIFICATION APT CONDO in
deemed revoked _ CONTRACTOR /►/ �NO 1dy 90/� Z
LICENSED CONTRACTORS DECLARATION !/,�1 .✓. T✓.9C UC CLASS NO DWELL UNITS_
ADDRESS I hereby affirm that I am licensed under provisions of Chapter 9 TILL` NO ys1_ X -
(commencing with Section 7000)of Division 3 of the Business LIC SEWER MAP t..,
and Professions Code,and TTmy license is in full force and effect CITY �'� < < CLASS C� 3✓ VALIDATION
Me PG
License Number 7�0✓—F CJ'/ � O ST � - FA OF CHECK
Lic Class SIZE STORIES FAMILIES ONE� rll
q VALUATION
Contractor. &4!%%W ��/jf Date 11—/Z DESCRIPTION OF WORK �ArF L'iMJOis ❑ N.L'' j,I�Q y�'i + iiSN
Li
El am exempt under Sec y 3 /(l/T/l ADD ► �/J3-
ALTER ❑ —
B 8P C for this reason da0f ,IB AW f/86e"&,/Q.f,s REPAIR ❑ f
Oeste USE OF
EXISTING BLDG cSPCrC'/`/GAT.hI.rJS DEIAOL ❑
Signature APP
TENALL
OWNER-BUILDER DECLARATION WRINTI �yC�roNO -� '9D DATE �L(` �2/
I hereby affirm that I am exempt from the Contractor's License ADDRESS N T` E / r �x
Law for the following reason (Section 7031 S, Business and FINAL I /
Professions Code) Y _
El 1, as owner of the o BUILDING Y
property, or my employees with ADDRESS
wages as their tole compensation,will do the work and
the structure is not intended or offered for sole(Section LOCALITY
7044, Business and Professions Code) MOVING TEL
❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO
with licensed contractors to construct the project (Sec- CRESS
tion 7044, Business and Professions Code )
CONSTRUCTION LENDING AGENCY I YARD HWY TOTAL BA INEFRO,M M
wiDTH
I hereby affirm that there is a construction lending agency for FRONT i
the performance of the work for which this permit is issued P L
(Sec 3097 Gv C ) SIDE
PL
Lender's Name
LDMA
PC Fee f Permit Fee Ref N
Lender's Address ,
I certify that I have read this application and state that the Issuance Fee TDMA PIC N
above mformot ect I agree to conpply with all Count' Inveaepotion Fee
ordinance State la relating to bwlding construction, Total 13, LDMA Perm N
Q and h uthori prasentanves of thn County to enter
YA u t bove- oned pr rty for inspection purposes
� 3 ia9.z SEE RIVERU FOR l%PLANATOIIY LANGUAGE
&g Lure of Applicant w Agent Dote
aebWORKERS COMPENSATION DECLARATION i
o affirm that I have certificate of consent to .elf APPLICATION FOR BUILDING PERMIT
insure or a certificate of Workers'Compensation Insurance
or a certlfqtFlcopy thereof (Sec 3800 Lab C )
COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No 30 Company F7fftdV:.Ei �Nr i
❑ Certified copy is hereby furnished FOR APPLICANT TO FILL IN BUILDING ?
ADDRESS
[7T Certified copy Is filed with the c unity bu l g 'n c- BUILDING
Ia flan deportment ADDRESS A. p /Ht
Dora / L/P' Applicant Cm ZIP 7/-/Oo LOCALITY
CERTIFICATE OF EXEMPTION ROM NO OF BLDGS NEAREST
COMPENSATION ROAM
SIZE OF LOT NOW ON L ST
(Thu section need not be comp) ed if the permit is for one ASSESSOR
hundred dollars ($100)or leu ) TRACT BLOCK LOT NO // MAP BOOK PAGE PARCEL
I certify that in the performance of the work for which this OWNER
TEL
115E ZONE NO
SPECIAL
permit is Issued I shall not employ any person in any manner ADDRESS /�K I CONDITIONS
so as to become subject to the Workers'Compensation Lows ��p O
U
CITY T C zIP q// • o
pore Applicant ARCHITECT OR TEl 0
NOTICE n, APPLICANT If, cher making this Certificate rs NGINEER NO DISTRICTS GROUP TYPE ZONE SSED BY
Exemption, you should become subject to the Workers 3(//IQO' � �T Z�
Compensation provisions of the Labor Code, you must forth ADDRESS
with comply with such provisions or this permit shall be L7.
deemed revoked TEL STATISTICAL CIASSIF TION APT N
CONTRACTOR 7T —023 Z
LICENSED CONTRACTORS DECLARATION '080 -/ LiC CLASS NO DWELL UNITS_
I hereby affirm that I am licensed urder provisions of Chapter 9 ADDRESS /V i NO
(commencing with Section 7000)of Division 3 of the Business and LICy SEWER MAP
Professions Code and my license is in full force and affect CITY U C1A55 N SK PG VALWATTON
SO NO OF NO
HECK
License Nutilber 2MIIPVS Lic Class ^r SIZE STORE Ag
FAOLIES / CONE
V TION
Contractor Date /Z ��8 DESCRIPTION OF WORK NEW $ /17 00
ADO Q J / Pilo
am exempt under
ALTER
B BPC for this r 9.49 �yT— REPAIR $
SE I!
EXISTING BLDG
Signature n ` NNAL
OW ER-BUILDER TION
APPLICANTAct
61,17 AJ 'NO 7 '-0LV�/ DATE �i
I hereby affirm th t I am exempt the Contractor's License
Law for the foll ing reason (Section 7031 S, Business and ADDRESS Al wW d k RN 8$ 1 4 A
Professlons Code) YTZd
OBUILDING
I g owner of the property, or my employees with ADDRESS 4 • • • • •t1
wages ct their Bole intended
droff will do the work and
the structure is not intended or offered for sob(Section LOCALITY ,) • • 4 9 8 8
7041, Busmen and Professions Code) MOVING TEL
F1 I as owner of the property am exclusively contracting CONTRACTOR NO • • - 49 886
with licensed contractors to construct the project (Sec-
tion 7011 Business and Profewon Code) ADORE 01.21 -88
L SETBACK Hirum
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP LINE IDTH
I hereby affirm that there is o construction lending agency for FRONT
the performance of the work for which this perms a issued P
(Sec 3D97, Cor C ) SIDE
PL
Lenders Name
LDMA Ref N
P C Fes$ Permit Fes
Lender s Address
I certify that I ha read this application and state that the Issuance Fes IDMA P/C•
above InfarmatI correct I
o comply with all County In~.gatwn Fee
adirwnns an Stats I ro building construction,
R and hereby a h ze reps b this County r enter Total Fee LDMA Perm e
upon the obo s onedfor inspection purposes
_
—M $0 REVERSE FOR EXPLANATORY LANOLIAGE
`97s
i of Apptico t I Dau -10-rG C �0/ /-s%2 aZ
COUNTY OF LOS ANGELES TEMPLE CITY 6 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVRLoPINIT TEMPLE CITY CA 91780 BL 0508 0513080078
PHONE (636) 385-0488 EXT
LEGAL ID NO OF CONST BUILDING ADDRESS
TR 17706 LT 30 BL 001 SQ FT STORIES TYPE 6403 TRELAMHEY AV
STRUCTURE 3600 VN TEMP CA 917801314
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET LEMON
5383-010-063 THOMAS PAGE 596 GRID J1'" LOCALITY TEMPLE CITY C
TENANT EXIST BID(; USE REBID USE ZONE R-1 ISSUED OB PROCESSED BY EXPIRES ON
EXIST OCC GRP 17/08/05 Jt 11/03/06
OWNER TEL NO BLDGS NOW ON IAT VALUATION FINAL DATE FINAL BY CODE
GILLILAND GEORGE M TR (616) 818-9716- 6,000 ��
6403 TRELAWNEY AV / IL V-
TENP 917801314 FEES PAID DESCRIPTION OF WORK
TRAR-OFF AND REROOF COMPOSITION SHINGLES HOUSE AND GARAGE
FEE DESCRIPTION QUANTITY VOM AMOUNT
APPLICANT TEL NO
URBAN HOME CONSTRUCTION (676) 677-7069- AA BLDG PERMIT ISSUANCE 77 75
6373 LIVIA AVE AC STRONG MOTION REBID 6000 00 VAL 0 60 SPECIAL CONDITIONS
TEMPLE CITY CA 91780 D7 PERMIT W/O ZM-HC 6000 00 VAL 149 40
TOTAL FRES 177 75
CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE
DREAM HOME CONSTRUCTION (676) 185-4471-
6373 LIVIA AVE LIC NO LOCATION AND SETBACKS
TEMPLE CITY, CA 91780 744854B
BOIL9 HNOI11EYit APPROVAL
ARCHITECT OR ENGINEER TEL NO FOUNDATION TREE® FORME
LIC NO SLAB UNDER FLOOR
RAIEED FLOOR FRAMING
MAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP UNDERFLOOR INSULATION
153H165 3 01
FLOOR SHEATHING
NO OF FAMILIES DWELLING UNITS APT COND STAT CLASS
NO 71 ROO SHEATHING
SCHOOL WITHIN HAZARDOUS SHEAR PANELS
AIR QUALITY 1000 PRET MATERIALS
NO NO NO FRAME INSPECTION
REQUIRED TOTAL SETBACK FROM EXIST FIRE SPRINKLER HANGERS
SET BACK YARD HWY PROP LINE WIDTH
FRONT PL- INSULATIOB WEATHER STRIP
SIDE PL-
INTERIOR LATE DRYMALL
EXTLRIOR LATE
RATED FLOOR CBIL ASSRM
RATED MALL ASSWLIES
I
RATED SB&FT8 OPBNIWGS
T-BAR CEILINGS
ADDITIONAL DATA ON PILE
LOT,DRAINAGE
REPORT ID DPR761 ROUTE TO RB0508
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