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HomeMy Public PortalAbout5300-5302-5304-5306 VILLAGE CIRCLE DR_Building__ APPLICATION FOR BUILDING PERMIT F.ORAPPIICANTTOFILL IN (Print ortype only) BUILDING COUNTY OF LOS ANGELES ADDRESS ._� L[-[�3 �C� G�l�.NLCr ��• DEPARTMENT OF COUNTY ENGINEER CITY L 7ZIP ) O BUILDING AND SAFETY DIVISION NO.OF BLDGS. BUILDING SIZE OF LOT NOW ON LOT ADDRESS (p TRACTpZ �O7/ BLOCK i LOT NO. / LOCALITY Q TEL. NEAREST. OWNER t', , U NO. CROSS ST. ADDRESS ASSESSOR L (tl L b MAP BOOK PAGE EL DISTRICT G UP TYP FIRE PROC D BY -CITY �" ,4 F C! ZIP -7ENGD ZONE ARCHIT ER ECT OR NO. 17 !l STATISTICAL CLASSIFY TjON SEWER M, ADDRESS CLASS NO. DWELL.UNITS BK PG CONTRACTOR VI NCJ L 00,$�//�tNO. ZIy7- USE ZONENOP :I� LIC. SPECIAL ADDRES l fvVr L3- NO. CONDITIONS CITY CLASS / CONSTRUCTION LENDER ROAD D;IRARTMENT APPROVAL REQUIRED YES ❑ NO ❑ NAME AND BRANCH BLDG..AETBACK FROM FRON, PROP.LINE OF (STREED ADDRESS CITY If TOTAL SETBACK FROM TYPE OF EXISTING SQ.FT. / NO.OF NO.OF CHECK HIG AY + YARD = FRONT PPP.LINE HIGHWAY WIDTH SIZE < STORIES FAMILIES ONE DESCRIPTION OF WORK NEW + O _ BLDG.SETBACK FROMfolr,rg + o U NS'�� �T� ADD ❑ SIDE PROP.LINE OF '--t5`REETI O ALTER ❑ HIGHWAY + YARD = TOTAL SETBACK FROM TYPE O XISTING a USE OF REPAIR ❑ SIDE PROP.LINE HIGHWAY DTH Z EXISTING BLDG. DEMOL ❑ + APPLICANT NO Y�7 CORNER CUTOFF YES ❑ NO ❑ (PRINT) f IV& T VY ,,D D a IN OPEN SPACE YES ❑ NO ❑ BY(SIGNATURE) IN COASTAL PERMIT ZONE YES ❑ NO ❑ VALUATION Q G� I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION.I 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 COM- PENSATION INSURANCE. SIGNATURE OF PERMITTEE �� �• �v"` a ADDRESS { g I -Al. `` FINA CIN ` lid —NO.���^ Z DATEL BY MAKE CHECKS PAYABLE TO: P.C.E `P FET P HARVEY T.BRANDT.COUNTY ENGINEER J 1 PLAN.CHECK VALIDATION' cK., M.o. cAsH .6 PERMIT VALIDATION CK. M.O. GC-ASH 5 5. 8 JUL 1 S 1 1 2..0 0 a-,a ®s 76A63BA CE#803 3.75' APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN (Print or type only) COUNTY OF LOS ANGELES BUILDING ADD �� ,_ DEPARTMENT OF COUNTY ENGINEER RESS._JJ (/ CITY ZIP BUILDING AND SAF Y DIVISION OF BLDGS. BUILDING SIZE OF LOT OW ON LOT ADDRESS a z�z ` c'iGL TRACT BLOCK LOT NO. LOCALITY L o c TEL. NEAREST OWNER J NO. CROSS ST. ASSESSOR ADDRESS q S ) „ 1� MAP BOOK PAGE I PARCEL DISTRICT GROUP TYPE FIRE PRO ED BY a- -CITY - IP L.—. CONST. ZOO // ARCHITECT R TEL. c U it / I B G ENGINEER NO. STATISTICAL CLASSIFICATION SEWER M9P ADDRESS {, CLASS NO. DWELL.UNITS BK PG CONTRACTOR TEb. ZONE MAP 7 NO. ADDR h NO�j SPECIAL LIC CONDITIONS CITY CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ CONSTRUCTION LENDER NAME AND BRANCH BLDG.SETBACK FROM FRONT PROP.LINE OF (STREET) -ADDRESS CITY TOTAL SETBACK FROM TYPE OF EXISTING SQ.FT. NO.OF NO.OF CHECK HIGHWAY + YARD = FRONT PROP.LINE HIGHWAY WIDTH SIZE STORIES FAMILIES -ONE D � ION OF WORK NEW ❑ + ADD ❑ BLDG.SETBACK FROM )STREET) O SIDE PROP.LINE OF ALTER ❑ TOTAL SETBACK FROM TYPE OF EXISTING G ;Z HIGHWAY + YARD = SIDE PROP.LINE HIGHWAY WIDTH - cn JJSEOF REPAIR ❑ _ Z EXISTING BLDG. DEMOL El + APPLICANT TEL CORNER CUTOFF YES C] NO ❑ IPRINTI NO. IN OPEN SPACE YES ❑ NO ❑ BY ISIGNATUREI IN COASTAL PERMIT ZONE YES ❑ NO ❑ VALUATION D© IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE WPRK-AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF TFH LABOR CORIQL,.E STATE OF CALIFORNIA INFbTITIV TO WORKMEN' •OM- / PE URA SIGNATURE OF PERMITTEE' / ADDR 17 FINAL BY TEL. DATE CITY NO. MAKE CHECKS PAYABLE TO: F E C. $ FET HARVEY T.BRANDT.COUNTY ENGINEER Zo PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH 246-L Fw 1023 25.20 ®s 76A638A CE#803 3.7A- APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN (Print or type only) 1 1 / LJ BUILDING BU}}��•DING ADDRESS 5300-02—OA.—or)d.- AD{� 63 00-02- _ CITY Temple City ZIP 91180 LOCALITY Temple City NO.OF BLOGS. NEAREST SIZE OF LOTT4re�5 AcreSNOW ON LOT 1 CROSS ST. Baldwin TRACT 29000 Bld • LOT NO 1 ASSESSOR MAP BOOK PAGE PARCEL TEL. DISTRICT GROUP TYPE I FIRE 7 ED BY OWNER I NO. - CONST. ZONE / ADDRESS 61 SO. Lake Ave. STATISTICAL CLASSIFICATION SEWER eAP CITY Pasadena ZIP ll CLASS NO.AQ__3 _DWELL•UNITS BK PG ARCHITECT OR TEL. ENGINEER NO.964-001 - US�ZONE� MA NOP ADDRE5317231 E. Railroad Cit of Ad, SPECIAL CONTRACTOR Noel Baldwin NOL448-390CONDITIONS -1 ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO 1QQ1 Gree ❑ ADDRESS n St NO. BLDG.SETBACK FROM FRONT PROP.LINE OF (STREET), CITY Temple City C ASS B-1 CONSTRUCTION LENDHIGHWAY + YARD = TOTAL SETBACK FROM HIGHWAY TYPE OF EWSD IHG NAME AND BRANCH erial Savin S FRONT PROP. LINE ADDRESS CITY + } SQ. FT. NO. OF NO. OF CHECK BLDG,SETBACK FROM v SIZE �h' STORIES FAMILIES41 ONE SIDE PROP.LINE OF (STREET) NEW HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING C DESCRIPTION OF WORK SIDE PROP. LINE - HIGHWAY WIDTH C~D ADD ❑ + _ W ALTER ❑ C0 aur l7level op r EPAIR❑ CORNER CUTOFF YES ❑ NO ❑ Z USE OF EXISTING BLDG.Single Family Re WOL ❑ IN OPEN SPACE YES ❑ NO ❑ APPLICANT Noel Baldwin N01.448-390 IN COASTAL ZONE YES ❑ NO ❑ BY (SIGNATURE) ENVIRONMENTAL CATEGORICAL EXEMPTION YES❑ NO ❑ 4 p IMPACT EXEMPTION DECLARATION SIGNED (DATE) VALUATION$ 128 9 600.QQ IMPACT REPORT PROCESSED (DATE) 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTIO CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREB WILL NOT EMPLOY ANY PERSON IN ATION OF T,F(•E LABOR CODE OF STATE OF CALIF A IN RELAT Ta WORK MPENS TION INSUR C . SIGNATURE OF FINAL J�J� J BY f PERMITTEE DATE !// j ADDRESS 10017 G 'P.C. PMT, FEE 192.6� FEE ` L TEL /Wis CITY T m 1 NO.�. - PLAN CHECK VALIDA7 CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH ��- 8 9 5 FEB 20 2 U 9 2.6 0 Bea 76p638B CEil803A 5/73 1 2 4ti9CT 14 1 D 6 4 2.0 0 ,60 KERS' COMPENSATION DECLARATION irrrt fica I have r certificateoof consent to self APPLICATION F R BUILDING P E RM I T �.. ur a certificate of Workers' Compensation Insurance, or a cern i d copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Po icy No. Company 5T-qTl% BUILDIN Certified copy is hereby furnished. - A DRESS ,❑ FO''R A'P`PLI/CAANT TO FILL INaGf Certified copy is filed with the county building inspec ADDRESSBUILDING 3O^f' tion department. �q;�� � �• f Date_ -q �,� � (}' ' `lA, CITY zip : LOCALITY 9?L L Applicant �� CIV NO.OF BLDGS. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST. CIU COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one TRACT BLOCK LOT NO. hundred dollars ($100)or less.) MAP BOOK PAGE PARCEL OWNER I1� TEL•. USE ZONE MAP VI C- � k NONO. �7 F 1 certify that in the performance of the work for which this nr/ r� n SPECIAL permit is issued, I shall not employ any person in any manner ADDRESS �A'!� � CiC 7"�� CONDITIONS a so as to become subject to the Workers'Compensation Laws. n ^/��� O CITY do✓lJUa- ZIP y V Date Applicant ARCHITECT OR TEL. ix NOTICE TO APPLICANT: If, after makingthis Certificate of ENGINEER — NO •-� DISTRICT GROUP TYPE FIRE PROCESSED BY CONST. ZONE Exemption, you should become subject to the Workers' �, �� �,,(( U Compensation provisions of the Labor Code, you must forth- ADDRESS '� �- !t�-rL��� a with comply with such provisions or this permit shall beTEL. STATISTICAL CLASSIFICATION APT. CONDO. 0 deemed revoked. `• CONTRACTOR •a NO. j Z LICENSED CONTRACTORS DECLARATION /�1� LIC. �y CLASS NO.�DWELL. UNITS — ADDRESS hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS Z E lry NO• (commencing with Section 7000)of Division 3 of the Business LIC. SEWER MAP CITY ►'�-�F✓� CLASS and Professions Code,and my license is in full force and effect. ; BK. PG VALIDATION License Number "i []3 1 Lic. Class SSQ1i1E noo I TORIES .z FAMILLIIES ONEK �y/�� ,, 1�1� VALUATION ContracTorlj"�D^-� O to 1�� DESCRIPTION OF WORK ��F}� F ST(t(d NEW ❑ $ ay. � ElI am exempt under Sec. Z (tX t<<j(.j•ErA.-7W1(L(6 t �Iq� �. ADD ❑ I ALTER 1113BAP.C. for this reason r W; REPAIR $ Date: USE OFDEMOL ❑ EXISTING BLDG. r I �� Signature APPLICANT TEL• FINAL OWNER-BUILDER DECLARATION (PRINT) NO. f -/,D DATE I hereby affirm that I am exempt from the Contractor's License ADDRESS /52 8)t/b ryc!/U• ' Law for the following reason (Section 7031.5, Business and FINAL Professions Code): PRESENT BBUILDING y AUT as A F/s �:"•f•" � ❑ I, as owner of the property, or my employees with = ADDRESS wages as their sole compensation,will do the work and Lu)_? =~a i4 the structure is not intended or offered for sale(Section LOCALITY _ 7044, Business and Professions Code.) H MOVING TEL. CONTRACTOR NO. I, as owner of the property,am exclusively contracting T�-•i• ,�• with licensed contractors to construct the project (Sec- ADDRESS t 1_I r AL. 187 � �-4 tion 7044, Business and Professions Code.) j �i.� �_;,�c REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT tlE�{'tai =I��' the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE Lender's Name F.L. [1cloo-til;;,o 1 sr1 x IL 3'L 3 LDMA Ref. # P.C. Fee$ Permit Fee :t� -,01~ t: Lender's Address I certify that I have read this application and state that the Issuance Fee 13 LDMA P/C# 00 above information is correct. I agree to comply with all County Investigation Fee Q ordinances and State laws relating To building construction, Total Fee U LDMA Perm. # and hereby authorize representatives of this County to enter u on the a -me coned p perty for' pe tion purposes. 1-11�I SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applican r Agent Date 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 0004030008 PHONE: (626) 285-0488 EXT: EGA ID: 0. OF CONST I BUILDING ADDRESS: TR: 29602 LT: 3 UN: 56 SQ. FT STORIES TYPE 5302 VILLAGE CIRCLE DR STRUCTURE: 0 VN TEMP CA 917803358 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: BALDWIN 8585-001-126 THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY TE EXIST BLDG SE: RESID USE E: RPD ISSUED ON: PROCESSED BY: EXPIRES . EXIST OCC GRP: 04/03/00 UT 09/30/00 . OWNER: TEL. N0: BLDGS. NOW ON LOT: VALUATION: FINAL DAT Epp INA BY: CODE: HEARD LYNN - 1 1,130 1808 CEDAR BEND DR FEES PAID DESCRIPTION OF OR TEAR OFF AND RECOVER GARAGE WITH ROCK FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. 0: BRONCO ROOFING (714) 632-1057- AA BLDG PERMIT ISSUANCE 27.75 811 E. LINCOLN AVE. AC STRONG MOTION RES D 1130.00 VAL 0.50 SPECIAL CONDITIONS: ORANGE, CA D2 PERMIT W/0 EN� 110.00 VAL 82.20 110.45 CONTRACTOR: TEL. NO: �0�9 ��/A� APPROVALS DATE INSPECTOR SIGNATURE BRONCO ROOFING (714) 632-1057- 811 E LINCOLN AVE LIC. NO LOCATION AND SETBACKS ORANGE, CA 92665 344837 C39 { SOILS ENGINEER APPROVAL ARCHITECT OR E G EER: TEL. J0: FOUNDATION/TRENCH FORMS LIC. NO 1111111 SLAB/UNDER FLOOR RAIS--- -FLOOR FRAMING MAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE: MP�� n (� O n ��© n� UNDERFLOOR INSULATION 147H269 3 0��=�U II I� lUU^Suu luj FLOOR SHEA H NG NO. OF FAMILIES: DWELLING UN TS: APT COND: STAT CLAS YES 21 Q ROOF SHEATHING y[�� O ❑ k�11. SCHOOL WITHIN HAZARDOUS i,.'fi�'�, t., SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS Q ❑ NO NO NOC1�fy���y FRAME INSPECTION REQUIRED TOTAL SETBACK FROM EXIST 46 l -n10i FIRE SPRINKLER HANGERS El SETBACK YARD: HWY: PROP LINE: WIDTH: /L+ Service ,��a�tt11VV INSULATION/WEATHER STRIP FRONT PL-SIDE PL- INTERIOR LATH/DRYWALL EXTERIOR LATH RATED OOR/CEI ASSE . RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508