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HomeMy Public PortalAbout9729 VAL ST_Building__ APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN (p,.m Gr IVOR GDIv) BUc JZ COUNTY OF LOS ANGELES ADOR DEPARTMENT OF COUNTY ENGINEER CITY zlp BUILDIN AND SAFETY DIVISION O OF BLDGS BUILDING SIZE OF LO^^T '' '` C OW ON LOT 10 ADDRESS �pp ���� TRACT Ny � LOT NO LOCALITY il�tA.Ati Z. OW NE / NE CRCSS ST ASSESSOR ADDRESS MAP BOOK PAGE PARC EL (STRICT I GROUP ITYPE FIRE ROC ESSED BY CITY ZIP �1D� �+ CONS ZO[IE ARCHITECT OR TEL YV J1N/'�"' �lJ ENGINEER NO STATISTICAL CLASSIFICATION V SEWER MAP ADDRESS CLASS NO O I DWELL UNIT J_BK CKLPG CONTRACTOR54 TEL USE ZONE OP ()� ADDRESS NO R PECIAL �. CITY LIC 1 _ CONDITIONS CONSTRUCTION LENDER CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO C NAME AND BRANCH L BLDG SETBACK FROM v FRONT PROP LINE OF - ` (STREET) ADDRESS CITY HIGHWAY } ARD TOTAL SETBACK FROM TYPE OF EXISTING SQ NO OF NO OF CHECK FRONT PROP LINE HIGHWAY WIDTH SIZ F STORIES FAMILIES ONE I } DESCRIPTION OF WORK / DO BLDG SETBACK FROM [e C SIDEPROP LINEOF (STREET) LER HIGHWAY } YARD TOTAL SETBACK FROM TYPE OF EXISTING U REPAIR SIDE PROP LINE HIGHWAY WIDTH d USE OF } = Z EXISTING BLDG EMOL 111 FM AN TE CORNER CUTOFF YES ❑ NO ❑ T) N NATURE) IN OPEN SPACE YES ❑ NO ❑ ' IN COASTAL PERMIT ZONE YES ❑ NO ❑ TION EBY ACKNO LEDSK THAT I HAVE READ TH f APPLICATION TE THAT THE ABOVE 10 CORRECT AND AGREE TO COMPLY ` LL ORDINANCES AND LAWS REGULATING BUILDING CON- ONI CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN S COMPEM TION INSURANCE SIGNATURE OF PERMITTEE ADDRESS FINAL '2 BY TEL / VA. CITY NO DATE MAKE CNEC&S P.11AULtPC PMT 10 FEE $ FEE b�� HARVEY T BRANDT, COUNTY ENGINEER /17. PLAN CHECK VALIDATION K M O CASH _ PERMIT VALIDATION CK M O CASH 397PAUG 2923117.00 7 0 9 P SEP 17 2 3 0SG1(�/�"A- 1/�^.yp�1 2-52 0 • ♦ (gy TSAS,GA CK* S E/T1 A ' "'"�W`-g , 7 1 OPSEp 17 2 3 7.0 0 •96 APPLICATION FOR BUILDING PERMIT F(JIAPPLICANT TO FILL IN (P,,o et type mly) U LDING COUNTY OF LOS ANGELES ADDRESS DEPARTMENT OF COUNTY ENGINEER cl eoqY zip BUILDING AND SAFETY DIVISION O OF BLDGS BUI LDIN Q SIZE OF LOT OW ON LOT ADDRESS C roee TRACTOA/ 460gyE LOT NO LOCA LIT � T NEAREST OWNER N CROSS ST ASSESSOR ADDRESS r MAP BOOK PAGE PARCEL /� DISTRICT GROUP TYPE FIRE ,SSED BY CITY ZIP V IC NST_ ZONE ARCHITECT OR TEL t Q� .I! ENGINEER NO STATISTICAL CLASSIFICATION SEWER MAP ADDRESS CLASS NCr,A_-DWELL UNITS I_BKFDPG CONTRACTOR TEL USE ZONE NOP O LIC D ADDRESS NO �1 D SPECIAL CITY LIC CONDITIONS CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ CONSTRUCTION LENDER NAME AND BRANCH BLD SETBACK FROM FRO TPROP LINEOF (STREET) ADDRESS CITY - TOTAL SETBACK FROM TYPE OF EXISTING SO FT NO OF NO OF CHECK RIGH Y } YARD - FRONT PROP LINE HIGHWAY WIDTH SIZE STORIES FAMILIES ONE } DESCRIPTION OF WORK EW V G O OO ❑ SIDEGSETBACK PROP L NEOF M (STREET) PC If O ALTER ❑ HIGHWAY } YARD = TOTAL SETBACK FROM OF EXISTING E~j REPAIR SIDE PROP LINE HIG WIDTH G USE OF } = Z EXISTING BLDG EMOL A PP L I CA EL CORNER CUTOFF YES ❑ NO ❑ (PRINT) ND BY (SI O NA TURF / IN OPEN SPACE YES ❑ NO ❑ t( [�o IN COASTAL PERMIT ZONE YES ❑ NO ❑ VALUATION Y O I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCE! AND LAW! REGULATING BUILDING CON- STRUCTION C[RTIfY THAT IM DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION Of THE LABOR CODE C THE STAT[ OF CALIFORNIA IN RELATING TO WORKMEN'S COMP TION INSURANCE SIGNATURE O PERMITTEE ADDRESS TEL FINAL BY CITY NO DATE 9,.,;-) 9� /� '�7� 1 ,ifAAE CHECKS PASAULE !O F C t / PMT P FEE Y FEE 7 HARVEY T BRANDT COUNTY ENGINEER PLAN CHECK VALIDATION CK M D CASH PEIMUT VALIDATION cK IN oo �CABX 3 9 5:AUG 29 1 D 3.0 0 Azla 76AGIBA CC*K3 ATA APPLICATION FOR BUILDING PERMIT COUNTY OFLOS ANGELES BUILDING AND SAFETY 1 B SS C WORKER'S COMPENSATION DECLARATION FOR APISUCAUT FILL IN �- I hereby affirm that I have a certdcate of consent to self uaure BUILDING ADDRESS �- Q or a certificate of workers Compensation Insurance a s certified Vl copy thereof(Sec 3800 Lab C) CtTv ZIP LOCALITY Policy No Company SIZE OF LOT NO CF BLDOS NOW ON LOT ❑ Certified copy a hereby furnished DEME CROSS 3T ❑ Certified copy rs filed with the county bulldog Inspection TAT BLOCK LOT NO department USE ZONE k1AP NO Date Applicant ASSESSOR MPP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS OV44ER� c� II YES NO COMPENSATION INSURANCE J wm+IN 1000 Fr OF SCHOOL? (This section need not be completed If the permit a f«ane hundred ADDRESS dd1am, ($100)or less) �� DISTRICT GROUP CWST FIRE GONE SSED BY I certify that in the performance of the work f«which this permit CTry a Issued I shall not employ any person In ary manner so as to •/ Sill to I Workers Compensa ARCHITECT OR ENGINEER TEL NO /pm STAPSTICAL 1/FICATON APT CONDO DBtO Applicant // _ ADDRESS CLASS NO SC's DWELL WITS NOTICE TO APPLr-W If alter making this Cerfifrrate of RECURRED TOTAL SETBACK FROM EXIST Exemption you should become subhect to the workers CONTRACTOR " TEL NO /� SET BACK YARD MYY PROP LINE WIDTH Compensation prrnnsnns of the Labor Code you must forthwith Df pC,l FRONT comply with Such prOwerona or the permit shall be deemed revolted ADDRESS /�7 1 DC P L LICENSED CONTRACTORS DECLARATION a �� � _ CfTV L LIC CLAS3 P L I hereby affirm that I em Icerlsed underpnwacns of Chapter B SEWER MAP (Commencing with Section 7000)of DNaron 3 of the Business and 50 FT SIZE NO OF STORES NO OF FAM0JE3 Pmfessens Code and my Igense Is In full 1«ce a9dveUGpt N ❑ BK �' , /`,}�[ License NumbersZ&ql Lc Class DESCRIPTION OF WORK A ADD ❑ $ p�oO V Contract Date A ALTER ❑ cc I ❑ I am exempt underSac REPAIR ❑ $ C.7 BBPC for this reason Q DEMOL ❑ LOMA P/C A W Date USE OF EXI NG BLDG URM ❑ Q. Slpnature APPLICANT(PRW7) TEL NO LDMA Perm♦ 1 11I as owner m the property « my employees a wager as = AGGT.: Z their SOIB not intended or offered for persatim will (SectKin 7044 Busmess and ADDRESS FINAL DATE CC er Profesaens Code) H ITEMS 158.85 vwLL THE APPLIC.Wi OR FaA ARDO o oCCIfMNi HUN-T A R GREATER lAA1Efl HE ID^ — 1 ITE Is ❑ I BS OWrlef Of Ih10 property em a%C OR A IA%nXE LONTNNNla A HAZAI>OW0I.MTEPYL EWAL TO OR GREATER TWN THE USotec contracting n 44 ANq{Anb SPECIFIED ON THE HALV S WTERWS NFORMNTICN OUDE'r FlNAL BY bcensed contractors to construct the protect (SeaUa, 7D44 YEs❑ No❑ TOTAL 15$ . $rJ s neva and Professions cede) C11ECK 158.85 041 THE RIZ ro USE OF THE BIlIXNO BY THE MODFINT OR FUTURE E SOUTH aecuPurR REaumE A FESMT FOR CONIC?(SC ON OR EEa IRMT N FROM THE s OR CONSTRUCTION LENDING AGENCY OOAm NR ouAury rwwaENENr Dlsrr4cT IscAouDl SEE PERAfRNO pEakusr FOR CHANGE .00 puoELUEs I hereby affirm that there a a construction lending agency for YES 1:1 NO❑ the performance of the work for which this permit a asued(Sec HAVEREAD<MT I JNDERS D IAIMTERwLSn60nAUNDER T DE AND THE LES CO PERNTT NO OOOE 3097 CN C) CHECKLaT UNDERerM'D TAY REOIAREI.ENir UNDER THE L09 ANGELES COUNTY CODE Lender a Nae a� ���, R F��; 1 9/26/95 Lenders Address 2504 1 PM 5:18 0 PwEn W,Mx, g I certify that I have read this application and state under penalty PC FEE PERMIT FEE of perjury that the above mformatxm Is correct I agree to comply rr R with all county ordmences and State laws relating to budding .7✓ construction and hereby aulllome representatives of the County ISSUANCE FEE Q er n thgl�ove-mentanetl property tar Iy C� RIVESRGiV10N FEE TOTAL FEE SEE REVERSE FOR EXPLANATORY LANGUAGE I WORKERS'COMPENSATION DECLARATION ll hereby affirm that I have r certificates Come of tionconsent to-self ., ARPLICATION FOR BUILDING PERMIT JISI I insure 'or o certificate of Workers' Compensation Insurance t or a certified copy thereof (Sec 39DO Lob C ) ., COUNTY OF l05 ANGELES BUILDING AND SAFETY I Policy No Company Certified copy is hereby furnished FOR APPLICANT TO FILL IN BUI DING ADDRESS C71 Certifieddepartment copy a filed with the county building tmpec- ABUILDING DDRESS LFJ bon depanmant ADDRESS LOfp,UTy Q Dote Applicantj%itln Ji9.!/NJ/O qtt ZIP NEAREST CERT�EXEMPTION FROM WORKERS' NO OF BLDGS ASSESSOR COMPENSATION INSURANCE SIZE OF LOT m NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed If the permit Is for one BLOCK LOT NO USE ZONE NO •? 7 hundred dol lam (flop)or less ) J TEL CONDITIONS Y I certify that In the performance of the work for which this OwNFRSPECIAL NO CONDITIONS n• permit Is Issued, I shall not employ any person In any manner DISTRICT GROUP TYPE FIRE PROCESSED BY O so as to become subject to the Workers'Compensation Lows ADDRESS CONST / ZONE 74.& V O Vim/ 0 Date Applicant ITYARCHITECT ZIP TEL STATISTICAL KATION CONDO V NOTICE TO APPLICANT If, after making this Certificate of - Exemption, you should become subject to the Workers ENGINEER NO CLASS NO DWELL UNITS_ d Compensation provisions of the Labor Code you must forth- ADDRESS SEWER MAP N with comply with such provisions or this permit shall be TELZ deemed revoked CONTRACTOR j, RK VALIDATION LICENSED CONTRACTORS DECLARATION UC I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NOWo VALUATION (commencing with Section TODD)of Division 3 of the Business and Professions Code, and my license Is In full force and effect CITY CUSS -00�J/ 50 FT NO OF NO OF CHECK , License Number -X952 Lic a. gL/ _ SIZEUC STORIES FAMILIES ONE Contractor .� y 0&0 Date DESCRIPTION OF WORK NEW C1 � O O O ❑ I am exempt under Sec .94V0 O ADD ALTER FINAL B 8P C for this reason O REPAIR DATE USE OF Date EXISTING BLDGOEMOL FI Signature APPLICAM TEL By OWNER-BUILDER DECLARATION PRIM NO I hereby affirm that I am exempt from the Contractor's License Law far the following reason (Section 7031 S Business and Professions Code) ❑ I, as owner of the property, or my employees with BUILDING .� 2 3 b A wages as � their sole compensation,will do the work and the structure Is not Intended or offered for sole(Section LOCALITY 7044, Business and Professions Code) MOVING TEL f( • I, as owner of the property am exclusively contracting CONTRACTOR NO - 2 • 2 1 8 b.3 with licensed contractors to construct the project (Sec ADDRESS hon 7044, Business and Professions Code) �pLt� CONSTRUCTION LENDING AGENCY SET BAQW( YARD HWY TOTAL SETBACK FROM INE WIDTH • ' 2 1 8631 I hereby affirm that there Is a construction lending agency for FROM pop. Q 8 06-840 the performance of the work for which this permit Is Issued P L (Sec 3097, Civ C ) SIDE - PL - Lender s Nome - Lender s Address P C Fee f Permit Fee I certify that I have read this application and state that the I.i,.Fee > , above Infarnaiion Is correct I agree to comply with all County Investigation Fee ordinances and Sate jaws retailing to building construction, Twal Fee D and hereby authorize representatives of this County to enter Upon above-men oned operty for Inspection purposes SEE EFVUW FOR EXPLANATORY LANGUAGE Signature o Applicant m Agent Os WORKERS COMPENSATION DECLARATION s insure, o affirm that I have a certificate of consent to self APPLICATION FOR BUILDING PERMIT inwre, or a certificate of Workers Compenstion Insurance or �. certified copy thereof (Sec 3800 Lob C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company pi Certified copy Is hereby furnished FOR APPLICANT TO FILL IN ADDREBUIWISS R 7! 1 �/p S �-• Q�,p ' Certified copy Is filed with the county building inspec BUILDING /I�� [� (� tion department ADDRESS r/-- I `4 �• LOCALITY T-i--l"'NEARE i' Date Applicant CITY V" Cl T ZIP 0 CROSS STGoIdtKWe sxc —j'enE RC1' ` CERTIFICATE OF EXEMPTION FROM WORKERS NO OF BLDGS 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 USE ZONE MAP a O� hundred dollars ($100)or less ) TRACT BLOCK LOT NO NO r I I ♦ TEL 1 7 SPECIAL y W 'L q LVt / ,I Q YI I certify that in the performance of the work for which NO .f CONDITIONS h this p r7 DISTRICT GROUP TYPE FIRE PR SSED BY 0 permit is Issued I shall not employ any person In any manner ADDRESS 1 7< q V q CYPE ZONE (' so as to become subject to the Workers Compensation Laws op /` �y.J O g ZO cc ata Cpf ' �� Applicant ` �� CITY {. L'LL� l CA � ZIP TEL!1 ' •+ D STATISTICAL IFICATION P7 CONDO NOTICE TO APPLICANT If after makIrIlly this Certificate of ENGINEER NOto ARCHITECT OR Exemption you should become subject to the Workers C1.455 NO DWELL UNITS_ d N Compensation provisions of the Labor Code you must forth ADDRESS SEWER MAP Z with comply with such provisions or this permit shall be deemed revoked TEL CONTRACTOR I KI NO BK LPG &FQ VALIDATION LICENSED CONTRACTORS DECLARATION V LIC I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESSNO VALUATION (commencing with Section 7000)of Division 3 of the Business and UC Professions Code and my license is in full force and effect CITY LJC = License Number I Class SIZEFT Q STORIIEES FAMILLIIES CHE ONE /1 ;2 1 6 1 6A Contractor Dote DESCRIPTION OF WORK NEN' 1J O"tl # • • • is • 1 ❑ ADO am professional exempt from the licensing men as I am o -�� prC� 2 • • 3 Q,O Q licensed architect or a registered professionall engineer ALTER FINAL / acting in my professional capacity (Section 7051 i REPAIR DATE S •i• . 3 &00cam, Business and Professions Code) USE OF EXISTING BLDG DEMOL FINAL Lic or Reg No Date APPLICANT TEL BT ( 0 2 —81 OWNER BUILDER DECLARATION PRINT NO I hereby affirm that I am exempt from the Contractor s License Law for the following reason (Section 7031 5 Business and ADDRESS Professions Code) I PRESENT ❑ BUILDING I as owner of the property or my employees with ADDRESS wages as their sale compensation will do the work and the structure is not intended or offered for sole(Section LOCALITY 7044 Business and Professions Code) MOVING TEL 1 A I as owner of the property am exclusively contracting CONTRACTOR NO with licensed contractors to construct the project (Sec lion 7044 Business and Professions Code) ADDRESS • • • 1 REQUIRED TOTAL SETBACK FROM EXIST CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP UNE WIDTH Z • 52 00 I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued PL is, • 5 2 0 0 6 (Sec 3097 Civ C ) SIDE Lender s Name PL 1020-81is Lender s Address PC Fee S Permit Fee j w I certify that I have read this application and state that the Issuance Fee 7 above information is correct I agree to comply with all County Inveoigaeon Fee ordinances and State jaws relating to budding construction VI and hereby authorize representatives of this County to enter Total Fee upon the abo re mentioned property for inspection purposes n SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Appli nt or Agent Dore ms 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 1202270021 PHONE (626) 285-0488 EXT LEGAL ID NO OF CONST BUILDING ADDRESS ON FILE SQ FT STORIES TYPE 9729 VAI, ST (ASSESSOR INFORMATION NUMBER (STRUCTURE 3300 V-B I TEMP CA 917800000 NEAREST CROSS STREET GOLDEN WEST 15383-017-011 I I THOMAS PAGE GRID LOCALITY TEMPLE CITY Cl (TENANT (EXIST BLDG USE REBID USE ZONE R-1 (ISSUED ON PROCESSED BY FIST OCC GRP 02/27/12 SR (OWNER TEL NO IBLDGS NOW ON LOT VALUATION JFINkL DAT& FPUA BY CODE ICHING HSID, KETTY (626) 641-6115- 8,770 I "') 19729 VALLEY ST ITEMP 917800000 FEES PAID N OF WORK TEAR OFF RE ROOF WITH 30 YR TIMBERLINE UNDERLAYMENT 30 LB FEE DESCRIPTION QUANTITY UOM AMOUNT PAINT FASIA BOARD FRONT FOOD AND REPAIRS (APPLICANT TEL NO I I (CARDENAS, APOLIMAR (626) 375-9842- IAA BLDG PERMIT ISSUANCE 27 80 1 I IAB STATE GREEN BLDG FEE 8770 00 VAI, 1 00 ISPECIAL CONDITIONS AC STRONG MOTION RESID 8770 00 VAL 0 90 D2 PERMIT W/O EN-HC 8770 00 VAL 199 80 TOTAL PEES 229 50 ICONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATVRE 1CARDENAS GENERAL CONSTRUCTION (909) 469-6285- I 1 4 1652 LORRAINE AVENUE LIC NO (LOCATION AND SETBACKS 1 POMONA, CA 91767 926051 ] SOILS ENGINEER APPROVAL ]ARCHITECT OR ENGINEER TEL NO I (FOUNDATION/TRENCH FORMS LIC NO SLAB/UNDER FLOOR (RAISED FLOOR FRAMING (MAP NO SEWER MAP BOOR PAGE FIRE ZONE CMP1UVDERFLOOR INSULATION 1153H269 3 001 I IFLOOR SHEATHING I ] ING OF FAMILIES DWELLING UNITS APT/COND STAT CLASS I I .( ] 0 NO 21 1 IROOF SHEI SCHOOL WITHIN HAZARDOUS ISHRAR PANELS 1AIR QUALITY 1000 FEET MATERIALS NO NO NO FRAME INSPECTION ] FIRE SPRINKLER HANGERS _IINSUTATION/WEATHER 51RIPI ] I{ 11NTERIOA (ATH/DRYWALL I 1 I ] 1 ]EXTERIOR LATH I I I ] (RATED FLOOR/CEIL ASSEM (RATED PALL. ASSEMBLIES ] I Iw+TED SHAFTS/OPENINGS IT-BAR CEILINGS \ ' ADDITIONAL DATA ON FILE ] I I II,CF DRAINAGE I I IREPORT ID DPR261 ROUTE TO BS0508 1 I I I I I I I I