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HomeMy Public PortalAbout9750 VAL ST_Building__ ' .APPLICATION FOR COUNTY OF LOS ANGELESOF COUNTY �1 ` " BUILDING PERMIT DEPARTMBUILDNGANDSAFETYDIIVSIONR !! UI FOR APPLICANT TO FILL IN ADDDRESS R�O BUILDING ADDRESS .7 LOCALITY CITUNEAREST J _ �,• C T ZIP CROSS ST NO OF BLDGS ASSESSOR SIZEOFLOT NOW ON LOT MAP BOOK PAGE PARCEL DISTRICT GRO TYPE FIRE ESSE Y TRACT BLOCK LOT NO ,� C r ZOpIE OWNER NO .� �TtSi�LCLASSIFICATION SEW ER MAP ADDRESS CLASS NO a" DWELL UNITS � BK97 vPG CITY ZIP j1rSE jONE OP O O� ARCH( ECT OR TEL K•l ENGINEER NO 'Z EDITIONS ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ TEL CONTRACTOR NO BLDG BA FROM LIC FRONT PROP UNEOF (STREET) ADDRESS ti� NO TOTAL SETBACK FROM TYPE OF EXISTING LIC HIGHWAY + YARD FRONT PROP LINE HIGHWAY WIDTH CITY CLASS CONSTRUCTION LENDER + NAME AND BRANCH BLDG SETBACK FROM �/ /� ADORESS CITY SIDE PROP LINE OF ��y ISTREET) O SQ FT NO OF NO OF CHECK HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING r SIZE STORIES FAMILIES ONE �ySIDE PROP LINE HIGHWAY WIDTH a DESCRIPTION OF WORK S Q NEW + a V r Le ,e r— V 9 aV ADD CORNER CUTOFF YES ❑ NO ❑ 44!2r, owg ALTER IN OPEN SPACE YES ❑ NO Cl REPAIR USE OF IN COASTAL PERMIT ZONE YES ❑ NO ❑ EXISTING BLDG DEMO APPLICANT TEL PRINT) NO BY ISIGNATUREI I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLIZATON AND STATE THAT THE ABOVE tS CORRKT AND AGREE TO COMPLY WITH ALL ORIXNANCE5 AND LAWS RMI.&ATING BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORX AUTFIDRIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN S COM PEFEATION I Q SIGNATURE r FINAL �L 7 BY PERMITTEE DATE (J ' / ADDRESS C TEL P C Fee S Permit Fee J CITY NO �• Isxance Fee VALUATION �V V� Total Fee y PLAN CHECK VALIDATION cK M o CAeH PERMIT VALIDATION cK r o c iH 176 7 J D 52.00Aw WORKERS'COMPENSATION DECLARATION . R - Z / 1 hereby affirm that I have certificate of consent toself- APPLICATION FOR BUILDING--PERMIT 1'SI insure or a certificate of Workers'Compensation I n nsurance «acertified copy thereof (Se�3800 tab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY 0 rf Policy No#J-AL-2?--IS-arompany FFt✓h OvV T SN/!o`/YhT Certified co Ia hereby furnished BUILDING Pr Y FOR APPLICANT TO FILL IN ADDRESS r0 - �— Certified copy is filed with the county building inspec- tion department V iii LOCALITY 1 I - - ' _ NEAREST Date $—r O- �{ Applicant � &Am 11... 1-I�-+Y CITY 2IP !15 CROSS ST OF BIDGS CERTIFICATE OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE SIZE OF LOT ZVO NOW ON LOT \ MAP [PAGE PARCEL (This section need not be completed if the permit is f«one USE ZONE TRACT BLOCK L73 hundred dollars ($100)or less ) TEL NO NO I certify that in the performance of the work for which this OWNER ' NO O DS'T'I�/ CONCDITIONS IAL A. permit Is issued, I shall not employ any person in any manner DISTRICT GROUP TYPE FIRE BY O so as to become subject to the Worken'Compensation Laws ADDRESS ' CONST ZONE U 91 s r ae X-3 3 0 Date Applicant CIN .m Zr ZIP D STATISTICAL CLASSIFICATION OFDO NOTICE TO APPLICANT If, after making this Certificate of ARCHITECT 4 N TEL (� ri Exemption you should become subject to the Worker ENGINEER tJ0 —I CLASS NO DWELL UNITS_ W Compensation provisions of the Labor Code, you must forth- ADDRESS N SEWERµqp N with comply with such provisions or this permit shall be TEL 2 deemed revoked CONTRACTOR OLS -/ BK VAUDATLON LICENSED CONTRACTORS DECLARATION ! IC I hereby affirm that I am hcemed under provisions of Chapter 9 ADDRESS O.� !' NO331522 7 VALUATION (commenting with Stolon 7000)of Dlvlvotl 3 of the Bumn aril UC O O D Professions Code, arid my license Is In full force and effect CITY iJ C 01.455 1 f HECK License Number 33I Z-7 LIc Clow SIZE DRIES I FAMIFT NO OF NO LIES ' CONE ► f Contract«( J76$WO LT Date S-/&-V DE j OF WORK N OEW ❑ Fit am exempt under Sec - A A jr4 ,900ADD �J B 8P C f«this reaREPAAIR son ALTERFINAL❑❑ DA EIII ��'/ SE CF Date EXLSTING BLDG DFMOL ❑ FINAL /J BT Signature [,��r G ( APRICA _ TEL OWNER$UILDER DECLARATION PRIM NO 1 hereby affirm that I am exempt from the Contractors License _ , /�J' Law f« the following reason (Section 7031 5, Business and �'7 Professions Code) RE55 / 1, as owner of theo y employees BUILDING pr jxrty, « m em to ees with ADDRESS wages as their sole compensation,will do the work and LOCALITY Ll 4 3 b A the structure Is not Intended or offered for sale(Section ' 7044 Business and Professions Code) MOVING TEL jl • . • • . 1 I as owner of the property, am exclusively contracting CONTRACTOR NO with licamied contractors to construct the project (Sec- i - 15300 hon 7044, Business and Professions Code) ADDRESS CONSTRUCTION LENDING AGENCY MACK C YARD HWY TOTALPS�CK FROM INE DTH • - 15 3 0 0 j M hereby affirm that there Is a construction lending agency for FRO ► 0 F1 1 —8 3 the performance of the work for which this permit Is Issued P L iSec 3097, Civ C ) SIDE PL Lenders Name Lenders Address PC F"$ Permit Fee S0 1 certify that I have rood this application and state that the Issuance Fee /0' s-0 above inform is cortex I agree to comply with all County Invesagetion Fee ordinances and State jaws relating to building construction, - Total Fee S � and hereby authorize representatives of this County to enter ///upon three above-mentionedd property far Inspection purpotas "'Op" /o. SSI/"47 SU RFV[i FOR EXPLANATORY LANGUAGE /_ Sgrwtun of Ap"'com or Agent T Date 03 WORKERS'COMPENSATION DECLARATION hereby affirm that I haver cit' Come of tion Int ra self APPLICATION FOR BUILDING PERMIT insure, or a certrficate of Workers' Compensation Insurance , (S or a c Now certified copy thereof vitec 3 39 80D Lab C ) or ��•tf47 f COUNTY OF LOS ANGELES BUILDING AND SAFETY NG Certified copy is hereby furnished FOR APPLICANT TO FILL IN ADDDRESS 5;4- Certified copy is filed with the county building mspec- BUILDING tion deportment ADDRESS D IZ g9L LOCALITY NEAREST Date,, ApplicantC._.IIJ ..L CITY ZIP CROSSST G CERTIFICATE OF EXEMPTION FROM WORKERS SIZE of LOT Z NOW F EILDGS ASSESSOR BooK PAGE PARCFL COMPENSATION INSURANCE (This section need not be completed if the permit is for one SPECIAL QQ hundred dollars($100)or less ) #RACY I BLOCK I LOT NO USE ZONE I certify that in the performance of the work far which this OWNER ,) r NO , CONDITIONS 6 permit a issued, 1 shall not employ any person in any manner DISTRICT GROUP TYPE FIRE PROCESSED BY O se as to become subject to the Workers Compensation Laws ADDRESS O r7� CONST ZONE � O —, Oc Date Applicant CITY ZIP STATISTIUL CIASSIFIUTIONAPT CONDO H NOTICE TO APPLICANT If, after making this Certificate of ARCHITECT OR TEL V Exemption, you should become subject to the Workers' f1iiis"W" rLJA Tel "7_ NO y C1A55 NO DWELL UNITS_ W Compensation provisions of the Labor Code, you must forth- ADDRESS , l OI/s/ - SEWER MAP with comply with such provisions or this permit shall be / z deemed revoked CONTRACTOR L— NO BK //PG (l VALIDATION LICENSED CONTRACTORS DECLARATION Ll I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS Gis/ NO 92-7 VALUATION (commencing with Section 7000)of Dtvaion 3 of the Business and LIC B-) $ Professions Code, and my licenseisis in full force and effect CITY CLASS V (/ IND NO CHECK License Number 31� •+ � / Lic Class g"'�1 SIZESO S © STORIES FAAV�S ONE ► Contractor DotDESCRIPTION OF WORK !�Q NEW C] $ e ❑ I am exempt under Sec fe, y ADD ALTER ❑ FINAL B 8P C for this reason REPAIR ❑ DATE —144S USE OF MOL ❑ /� �° EXISTING BLDG By AL 4 Signature % LLQ . `� APPLK'AsdT TEL OWNER-BUILDER DEC ION PRIM O NO J _ I hereby affirm that I am exempt from the Contractor's LicenseH Q^ _ Pit, Law for the following reason (Section 7031 5 Business and Professions Code) 1, m owvatr of theo y employees BUILDING pr party, or m em o ass with ADDRESS wages as their sole compensation will do the work and the structure Is not Intended or offered for sets(Section LOCALITY 70d, Business and Professions Code) MOVING TEL 1, as owner of the property, am exclusively contracting CONTRACTOR NO with licensed contractor to construct the project (Sec- ADDRESS tion 70", Business and Professions Code) CONSTRUCTION LENDING AGENCY TOSETBACK FROM SET BACK YARD HWY L �pTN I hereby affirm that there is a construction lending agency for FROM ► the performance of the work for which this permit is Issued PL E 4 4 9 8 A (Sec 3097, Civ C ) SIDE # • . . e PL Lender's Name s 12 • • 3,300 Lender'.Address P C Fee f Permn Fee • • • 33005 I certify that I have read this application and state then the Invone Fee < above information is correct 1 agree to comply with all County Invesngatwn Fee © e 1 5-19 3 H$ ordinances and State lows relating to building construction, and hxeby outhorize representatives of this County to enter Total Fee upon the above-mentioned property for Inspection purposes ci.sn�4- F. d �"� " 111111 REVERES FOR EXPLANATORY LANGUAGE Signature of Applicant or ngem Dole COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 IAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1108010010 PHONE (626) 285-0488 EXT LEGAL. ID I NO OF CONST BUILDING ADDRESS BK 118 PG 72 PC 2 SQ FT STORIES TYPE ] 9750 VAL ST 1 STRUCTURE 1500 V-B I TEMP CA 917800000 1 (ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET 15383-018-030 1 THOMAS PAGE GRID LOCALITY TEMPLE CITY Cl TENANT 1fiRIST BLDG USE RESID USE ZONE R-1 ISSUED ON PROCESSED BY 1 IECIST OCC GRP 108/01/11 SR OWNER TEL NO JBLDGS NOW ON LOT VALUATION FI DATE FINAL BY CODE LANE RONALD - i- 9 900 ��1 9750 VALLEY ST �Df TEMP 917800000 FEES PAID IDESCRIPTION OF WORK I IREMOVE ONE LAYER WOOD OVER APO% 1200 SQFT INSTALL PLYWOOD IFEE DESCRIPTION QUANTITY UOM AMOUNT ]AND 30 YEAR COD@ ROOF OVER MISTING COMP ADDITION APROX I 1APPLICANT TEL NO 1 300 SOFT WITH COMP HOUSE ONLY NOT GARAGE 1 IKEEFERS BRIAN (909) 608-0622- 1AA BLDG PERMIT ISSUANCE 27 80 1 ]AS STATE GREEN BLDG FEE 4900 00 VAL 1 00 ]SPECIAL CONDITIONS 1AC STRONG MOTION RESID 4900 00 VAL 0 50 ] ID2 PERMIT W/O EN-HC 4900 00 VAL 132 80 ] TOTAL FEES 162 10 CONTRACTOR TEL NO ] 1APPROVALS DATE INSPECTOR SIGNATURE 1KEEFER'S ROOFING (909) 608-0622- 1 ] 11216 BEGONIA COURT LIC NO I 11.0CATION AND SETBACKS I UPLAND CA 91784 760903 C39 ISOILS NGINEER APPROVAL (ARCHITECT OR ENGINEER TEL NO I (FOUNDATION/TRENCH FORMS I I LIC NO ISL.AB/urmER FLOOR I 1RAISED FLOOR FRAMING I I 1MAP NO SEWER MAP HOOK PAGE FIAE ZONE CMP UNDERFLOOR INSULATION I I I 1153x269 3 001 1 I I I IFLOOR HEATHING I IND OF FAMILIES DWELLING UNITS APT/GOND STAT CLASS I I 0 NO 21 1 ]ROOF S,i ATHING I I ] scxooL wITxIN xnzAADous 1 1sxeAR PANELS I I 1AIR QUALITY 1000 FEET MATERIALS I ] ] I NO NO NO FRAME INSPECTION I (FIRE S,RINKLER HANGERS INSULATION/WEATHER STRIPI I I INTERICR LATH/DRYWALL I EXTERIOR LATH I (RATED FLOOR/CEIL ASSEM I I IAATED WALL ASSEMBLIES I I I IRATED SFATS/OPFININGS ] 1 I IT BAR CEILINGS I ] LAT DRAINAGE IRFPORT ID DPR261 ROUTE TO BS0508 I I1 1