HomeMy Public PortalAbout9509 WEDGEWOOD ST_Miscellaneous__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MISCELLANEOUS PERMIT
s r DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS MP 0508 0610060002
BUILi.ING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: NO. OF CONST NEW BUILDING ADDRESS:
ON FILE SQ. FT STORIES TYPE OCCUP GROUP 9509 WEDGEWOOD ST
_ STRUCTURE: 1 VN TEMP CA 917802517
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: CLOVERLY
8588-006-003 EXIST BLDG USE: f THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY, C
EXIST OCC GRP: USE ZONE: R-1
TENANT: ISSUED ON: PROCESSED BY: ERPIRE3 ON:
BLDGS. NOW ON LOT: VALUATION: 10/06/06 JK 04/04/07
0
OWNER: TEL. NO: FINAL DATE CODE:
PARKER RONALD E;MONICA J ( LIST ITEMS: �7 J
9509 WEDGEWOOD ST —�
TEMP 917802517 DEbCRIPTION OF WORK
TO FINALIZED EXPIRED BUILDING, ELECTRICAL AND PLUMBING
OCCUP LOAD EXIST: PEPMITS FOR BEDROOM, BATHROOM 208 S.F. &
APPLICANT: TEL. NO: OCCUP LOAD NEW:
SAME AS OWNER - Family Room.
PARKING SPACES REQUIRED., SPECIAL CONDITIONS:
PARKING SPACES PROVIDED:
_ EXIT HARDWARE: _
CONTRACTOR: TEL. NO: LIMITSD TIME USE
SAME AS OWNER - NBR OF EXITS: FROM TO
LIC. NO
FEES PAID
APPROVALS DATE INSPECTOR SIGNATURE
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: J
ARCHITECT OR ENGINEER: TEL. NO: T1,AILER USE
- OA PERMIT ISSUANCE 27.75
LIC. NO: 01 R/M OCC/USE INSPECT 145.95 SAFETY PERMIT
TOTAL FEES 173.70
TEMP. STRUCT. APPROVED
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: TL4P. STRUCT. REMOVED
i
NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: _
NO
SCHOOL WITHIN HAZARDOUS
AIR QUALITY: 1000 FEET MATERIALS _
NO NO NO
REQUIRED TOTAL SETBACK FROM EXIST
SET BACK YARD: HWY: PROP LINE: WIDTH:
FRONT PL-
SIDE PL-
REPORT ID: DPR267 ROUTE TO: BSO508
WC'. 1!RS'COMPENSATION DECLARATION 76M444 MISCELLANEOUS APPLICATION
CE 875 (11-84)
I lierehy a cert that I have a certificate of consent nc self COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION
insdre, br a certificate of 1'1'orkers'Compensation Insurance,or
a certified copy thereof(Sec. 3800,Lab.C.).
Policy No:--_ Company FOR APPLICANT TO FILL IN ADDRESS )
112c...�D
Certified copy is hereby furnished. BUILDINGQ 1 LOCALITYADDRCSS -41 EMP G�
0 Certified copy is filed with the county building inspection LOCALITY NEARC,T
department. — CROSS ST.
Date —Applicant — _ NEARCST DIS7gIC NO. I rOUP
ITYPEj P ESS' BY
CROSS ST. (�(�I,r� �, CONST.
— ' .
CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL
COMPENSATION INSURANCE DCSCRIPTI ON LOT NO. BLOCK NOP MIG ICIRC STATE MAJOR SECON LOCAL
NO. OF SLOGS. LE)
(This section need not be completed if the work involved TRACT NOW ON LOT USC ZONESPECIAL CONDITIONS
by the permit is for one hundred dollars ($100) or less.) USE OF
SIZC OF LOT EXISTING BLDG.
I certify that in the performance of the work for which this o
permit is issued, I shall not employ any person in any manner OWNER
so as to become subject to the Workers' Compensation Laws. �'
MAIL OCCUPANCY GROUP o
ADDRESS ~'"
Date Applicant uI
NOTICE TO APPLICANT: If, after making this Certificate of clrY (, OCCUPANT LOAD Cl-
Exemption, you should become subject to the Workers' APPLICATION FOR EXIT HARDWARE:
Compensation provisions of the Labor Code,you must forth-
with comply with such provisions oI this permit shall be TRAILER USE GEOLOGY INSPECTION ❑ No Spec. Knowl. El
deemed revoked.
LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION Panic Devices El
I hereby affirm that I am licensed under provisions of Chapter SAFETY PERM,Ifi ❑ (LIST ITCMS BELOW)
9 (commencing with Section 7000) of Division 3 of the Busi- NO. OF EXITS
ness and Professions Code,and my license is in full force and
effect. SPACESG REq D r� PROVIDED
License Number302.94� Lic. Class j&7 A TI '°"- CiJ L LL��JJ
"��y LIMITED TIME USE
Contractor&MA4b jute �Z�fIEL r f OAT6 OATG
ffFROM: TO:
I am exempt from the licensing requirements as I am a
licensed architect or a registered professional engineer SIZE OF NO. OF INSPECTOR'S
g 1? � � SIGNATURE
acting in my professional capacity (Section 7051, Bus- EXISTING BLDG. STORIES
iness and Professions Code).
PRESENT USE OF BUILDING FINAL APPROVAL
Lic.or Reg.No. Date
IIOME OWNER-BI:ILDER DECLARATIONNO. OF EXISTING BUILDINGS
ON LOT AND USE "171 r
I hereby affirm that I am exempt from the Contractor's F
License Law for the following reason (Section 7031.5, Busi- TOT PL 9"3 010
ness and Professions Code): NO. PARKING
tti.r-1 ,
❑ 1, as owner of the property, will do the work and the SPACES PROVIDED sh=ut 9 ,,:_
structure is not intended or offered for sale (Section
7044,Business and Professions Code). °
CONSTRUCTION LENDING AGENCY PROPOSCD USE OF BUILDING
I hereby affirm that there is a construction lending agency 7011 '-_l ti 11 =�����"'_
for theerformance of the work for which this permit is - [�
issued(Sec. 3097,Civ.C.). ~� i
Lender's Name _— ----- --- ---
PROPOSCD MAX. OCC.
Lender's Address -- -- - yI-I`
I certify that I have read this application and state that the PERMIT FEE
above information is correct.1 agree to comply with all County ISSUANCE FEE 31 0-
ordinances and State laws relating to building construction,
and hereby authorize representatives of this County to enter TOTAL FEE r
upon tllc above-mentioned Prop ty for inspection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
J& Ai' �'—e;�gl
O gnature of a nittee Date