HomeMy Public PortalAbout5318 WELLAND AVE_Building__ 76A638A CE1803 5-65 APPLICATION FOR BUILDIN PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER A D D R E S
BUILDING AND SAFETY DIVISION LOCA LIT
JOHN A. LAMBIE. COU arY ENGINEER NEAREST
COLEMAN W JENKINS.SUP T OF BUILDING CROSS ST
:- DISTRI�r NOS GRA P TYPE PRO ESS BY
FOR APPLICANT TO FILL IN _L CONST
BUILDING !�/(j /� STATISTICAL SSIFICATION SEWER MAP
ADDRESS !� /d C.^ CLASS NO. DWELL UNITS B KF PG//,
s
LOT BLOCK USE
'�ZONE MAPS 06 ,jZ
TRACT /'az' SP
�r SPECIAL
y N0. BLOGS. CONDITIONS
SIZE OF LO �1 N LOT
+ USE OF
EXISTING BLDG. BLDG. SETBACK FROM D/
TEL. a FRONT PROP. LINE OF `� — (STREET)
OWNER NO. J TYPE OF EXISTING SETBACK HIGHWAY + YARD — TOTAL
ADDRESS HIGHWAY WIDTH FRO?4 C L.
zO f — LIQ f
CITY 1
ARCHITECT TEL. - BLDG 5 BACK FROM
ENGINEER NO. SIDE PROP. LINE OF (STREET)
_TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C L
TEL. + _
CONTRACTOR NO O
LIC V
ADDRESS LINO CORNER CUTOFF YES NO
OG
CITY
LIC SS SEE REVERSE SIDE FOR SPECIAL APPROVALS G
DESCRIPTION OF WORK
a
ADD ALTER REPAIR DEMOLISH H
Q.FT. / NO OF I NO. OF
SIZE C! STORIF_S / FAMILIFS =
USE OF jol
• STRUCTURE
SIGNATURE OF ,A
APPLICANT fL4/
.. VALUATION$ (JOV• APPROVALS DATE INSPECTOR'S SIGNATURE
P C. ,Ff ✓ MT. FOUNDATION,
O
FORMS, MATERIALS
FEE S •r FEE$
FRAME, FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS
9UILDI NG CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT.
TION OF THE LABOR CODC OF THE STATE OF CALIFOR IA RELAT.
ING TO WORKMEN S COM ENSATIONWANCE.
LATH. EXT.
SIGNATURE O HOUSE NUMBER COR-
PERMITTEE � RECT AND POSTED a f
ADDRESSL _ Fl NAL `{+ f' %, •.c r _
JOHN
PLAN CHECK VALIDATION CK M O. CASH _ PERMIT VALIDATION TRCK ►URAL EN C CASH
1 D
-
'GA638A CE0809 8_o3 APPLICATION FOR BUILDING PERM
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A.JENSEN, SUPT OF BUILDING CROSS ST.
DI,§TR4. 1�7 N GR YPE Y
FOR APPLICANT TO FILL IN ; CONST.
BUILDING STATISTICAL CLA IF ATION SEWER MAP
ADDRESS _ wl� � BK G//
CLASS. NO. DWELL.UNITS
LOT NO. , cW 17 BLOCK WATER
CERTIFICATE: NOT REQUIRED ❑ RECEIVED
TRACT MAP HIGHWAY
NO.OF BLDGS. / NO. (CIRCLE) STATE MAJOR SECON LOCA
SIZE OF LOT NOW ON LOT USE ZONE SPECIAL
USE OF CONDITIONS
EXISTING BL G. kv
TEL.�/
OWNEleff� . NO!J LDING YARD HWY TREE NAME EXIST.
� pp ETBACK WIDTH
ADDRESS, 12 (J<rr/� ' FRONT �® �
ARCHITECT OR TEL. P. L.
pj
ENGINEER NO. SIDE
P. L.
ADDRESS
TE 0
CONTRACTOR E N e U
ADDRESS 0
DESCRIPTION OF WORK r)
• W
AL
NEW ADD ALTER REPAIR DEMOLISH z
SQ.FT. NO.OF NO.OF
SIZE STORIES. FAMILIES
USE OF
ST CTURE
SIGN URE OF t r
APPL I CANT
VALUATION $ OG Pv
APPROVALS DATE INSPECTOR'S SIGNATURE
P C. PMTqFOUNDATION: LOCATION
F E $ FEE $ (/ 'V FORMS, MATERIALS
FRAME: FIRE STOPS, g
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING. BOLTS ��`� •� ✓'�
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION.
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS
BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA-
TI
IOLA- LATH. INT.
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT-
ING TO WORKMEN'S C EN,SAATTION INSURANCE. LATH.EXT.
SIGNATURE OF- LL/ HOUSE NUMBER COR-
PERMITTEE �V RECT AND POSTED
ADDRESS FINAL (/ C/rte,C p—•
JOHN F. LEWIS. PRINCIPAL STRUcTURAT ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. GASH
.9 2 4 3� -JJN23 1 D 9.00- 17
•
IEA633A CE 980310-1. - APPLICATION FOR BUILDING PERMIT 1
COUNTY OF LOS ANGELES BUILDING /7ilir
DEPARTMENT OF COUNTY ENGINEER ADDRESS c C.,/�
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A.LAMBIE,COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST.
DISTRICT NO, GROUP I TYPE SSED BY
53/ FOR APPLICANT TO FILL IN CONST.
BUILDING ' - ��`v STATISTICAL CLASSIFICATION SE fR MAP
ADDRESS K PG
CLASS.NO. DWELL. UNITS /` 1/ 7
LOT NO. BLOCK MAP STATE YES
>�±LNUMBER HWY.
TRACT aUSE ZONE SPECIAL ..
/ I NNO.OF OW ON LOTS Q / CONDITIONS
SIZE OF LOT d
U S E O F
EXISTING BLDG. BUILDING YARD HWY STREET NAME EXIST.
SETBACK WIDTH
OWNER '-• ..�cL FRONT
MAIL P. L.
ADDRESS SIDE
TEL. P.L.
ARTY
v rr u No. INSPECTION RECORD
ARCHITECT OR' / �, TEL. q
ENGINEER p, I t
ADDRESS
CONTRACTOR (� TE 7%1-5 1 l/.7 -i r i �O
ADDRESS 2_I�.LI /1'�f•"Q1(� "t'/,`�R. V�i(�1
DESCRIPTION OF WORK
NEW ADD ALTER REPAIR DEMOLISH
SO.FT. NO.OF NO.OF
SIZE t� STORIES FAMILIES
USE OF STRUCTUR r __
U
446
SIGNATUREt OF APPROVALS -
APPLIC T
D E INSPECTOR'S SIGNA-TUOE
ADDRESS, FOUNDATION: LOCATION
$ _FORMS.MATERIALS
P.C. S (,T6 FRAME: FIRE STOPS.
FEE BRACING, BOLTS
VALUATION S �.i FURNACE: LOCATION.
FEE GAS VENT,DUCTS
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ HIS AP- LATH,INT.
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORD ANCES AND
STATE LAWS GU NG B L G-"ICTIFN, LATH.EXT. '
SIGNATUgg OF +++ddd���0'//J HOUSE NUMBER COR-
PERmler.rE RECT AND POSTED
C
ADDRESS FINAL1
L-_' I — CLYDE N.DIRLAM, PRINCIPAL STR AL GINEER
PLAN CHECK VALIDATION M.O. H PERMIT VALIDATION CK. M.O. CASH
®F
;��5 2 0 5 a.gAY 5 1 A 4 2.00
r
WORKERS'COMPENSATION DECLARATION ,
hereby' affirm that I have a certificate of const to self ` APPLICATION F OR BUILDING PERMIT
insure, or a certificate of Workers'Compenstion Insurance, or
a,certified copy thereof(Sec. 3800, Lab. C.) j COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. Company t . BUILDING 3
EJ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS ��
EJ Certified copy is filed with the county building inspec- BUILDING Q '7— /� /1 -4-S, G
tion department. ADDRESS (� v@ . LOCALITY 1= l l �A. !/
NEAREST
Date Applicant ,_- CITY M ��- C ZIP / p CROSS ST. L W
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
hundred dollars ($100)or less.) TRACT BLOCK L NO. ,� NO.
nn G EL. Z SPECIAL
I certify that in the performance of the work for which this � lvr O.� -O ,` CONDITIONS
permit is issued, I shall not employ any person in any manner ADDRE AS'.1f a vLp DISTRICT GROUP TYPE FIRE PROC SED BY U
so as to become subject to the Workers'Compensation L ws. lD� � CONST. `ZONE
�( �� o t �/
ate -� 1 Z Appli ��
CITY C,41ZIP 7 �o STATISTICAL CLASSIFICATION V APT. CONDO. tU
ARCHITECT OR TEL.
NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. o� LU
Exemption, you should
be subject to the Workers' CLASS NO. DWELL. UNITS IL
Compensation provisions of the Labor Code, you must forth-
p p y ADDRESS SEWER MAP �
with comply with such provisions or this permit shall be TEL.
deemed revoked. CONTRACTOR NO. BK. pG �a VALIDATION
LICENSED CONTRACTORS DECLARATION LIC.
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. VALUATION
(commencing with Section 7000)of Division 3 of the Business and
LIC. ; QljO
Professions Code, and my license is in full force and effect. - CITY CLASS $
SQ.FT NO.OF NO.OF CHECK
License Number Lic.Class SIZE STORIES FAMILIES ONE
Contractor Date DESCRIPTION OF WORK t NEW ❑ $
I am exempt from the licensing requirements as I am a ADD
licensed architect or a registered professional engineer ALTER FINAL
acting in my professional capacity (Section 7051, REPAIR DATE
Business and Professions Code). USE OF
EXISTING BLDG. DEMOL FINAL
By
Lic.or Reg.No. Date APPLICANT TEL.
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): PRESENT
❑ BUILDING 2 6 6.0 AI, as owner of the property, or my employees with ADDRESS )
Wages as their sole compensation,will do the work and
the structure is not intended or offered for sale(Section LOCALITY a U ' 0 0 0 0 0 1
7044, Business and Professions Code). MOVING TEL.
1, as owner of the property, am exclusively contracting CONTRACTOR NO. 2 o 0 5 2 0 0
with licensed contractors to construct the project (Sec-
tion 7044, Business and Professions Code). ADDRESS o 0 0
REQUIRED TOTAL SETBACK FROM EXIST.
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH B-82
1 hereby
eby affirm that there is a construction lending agency for FRONT J
the performance of the work for which this permit is issued P L. cx)0 !O
(Sec. 3097, Civ. C.). SIDE
P.L.
Lender's Name
Lender's Address P.C. Fee$ Permit Fee X3,10
I certify that I have read this application and state that the Issuance Fee O
above information is correct. I agree to comply with all County Investigation Fee
ordinances and State laws relating to building construction, del
1.1 and hereby authorize representatives of this County to enter Total Fee
� upon
-bo e-
erty for inspecti purp s
SEE REVERSE FOR EXPLANATORY LANGUAGE
0
gnature of Applicant or Agent Dote ®s
I
WORKERS'COMPENSATION DECLARATION , l�
` r ~ 1�
I hereby affirm that I have a certificate of consent to self J
insure, or a certificate of Workers'Compenstion Insurance, or � APPLICATION FOR BUILDING PERMIT
a,certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. Company BUILDING / I
• Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS �.?f �� f a ( ✓� .
• Certified copy is filed with the county building inspec- `� BUILDING Q �� ' /^ G
tion department. ADDRESS p v� . LOCALITY C /tom l� `f1.
n n NEAREST
Date Applicant CITY 1M ��- ` r ZIP / CROSS ST. el
CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. ASSESSOR
COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL
USE ZONE MAP
hundred dollars ($100)or less.) TRACT BLOCK
(This section need not be completed if the permit is for one ^7
L NO. / /f NO. y
G EL. t"r 1- SPECIAL d
1 certify that in the performance of the work for which this O r O..S -O ,` CONDITIONS
permit is issued, I shall not employ any person in any manner — DISTRICT GROUP TYPE FIRE PROC SED BY V
ADDRE CONST. ZONE
so as to become subject to the Workers'Compensation L ws. �3 ✓P d S/ } OC
�( � . ZIP
� Date/—If 1Z Appli 4 CITY • STATISTICALCLASSIFICATION APT CONDO. V
NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. IW
Exemption, you should becom subject to the Workers' ENGINEER NO. CLASS NO. a DWELL. UNITS N
Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP Z
with comply with such provisions or this permit shall be TEL.
deemed revoked. CONTRACTOR NO. BK PG � VALIDATION
LICENSED CONTRACTORS DECLARATION LIC.
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. VALUATION
(commencing with Section 7000)of Division 3 of the Business and LIC ��Cl
Professions Code, and my license is in full force and effect. CITY CLASS S
SQ. FT NO. OF NO. OF CHECK
License Number Lic.Class f SIZE STORIES FAMILIES ONE
Contractor Date DESCRIPTION OF WORK NEW $
ADD
I am exempt from the licensing requirements as I am a
licensed architect or a registered professional engineer ALTER FINAL
acting in my professional capacity (Section 7051, DATE
REPAIR
Business and Professions Code). USE OF
FINAL
EXISTING BLDG. DEMOL
By
Lic.or Reg. No. Date APPLICANT TEL
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): PRESENT
BUIMING 4 !� ,. 2 2 6 0 A
D
I, as owner of the property, or my employees with ADDRESS I'llewages as their sole compensation,will do the work and # 0 0.0 0 1
the structure is not intended or offered for sale(Section LOCALITY
7044, Business and Professions Code). MOVING TEL
F1I, as owner of the property, am exclusively contracting CONTRACTOR NO 2 005200-
with
• 520Qwith licensed contractors to construct the project (Sec- ADDRESS
tion 7044, Business and Professions Code). 5 20 0 v
REQUIRED TOTAL SETBACK FROM EXIST.
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH 1, 1 8-82
1 hereby affirm that there is a construction lending agency for FRONT )�
the performance of the work for which this permit is issued P L. 0, V CJ
(Sec. 3097, Civ. C.). SIDE
P.L
Lender's Name )
P.C. Fee S Permit Fee ,,J , S O
Lender's Address
' I certify that I have read this application and state that the Issuance Fee O
above information is correct. I agree to comply with all County Investigation Fee
ordinances and State laws relating to building construction, dv
Total Fee
and hereby authorize representatives of this County to enter
jC_7p_0n-*e
above-mentioned erty for inspecti purp s tL SEE REVERSE FOR EXPLANATORY LANGUAGE ,
'•
Os
gnature of AppHwnt or Agent Dore
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 Buiii.i^G PERMIT
DEPARTMENT OF PU9L1C WORKS 9701 LAS TUNAS A'-"'-:iTON/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BI. 1508 0408110004
PHONE: (626) 285-0488 EXT:
LEC1L ID: -r NO. OF CONST r— BUILDING ACCRECC:
T!?: 10898 LT: 17 BL: .001 SQ. FT STORIES TYPE 5318 WELLAND AV
_ STRUCTURE: 28 VN TEMP CA 91780_i507
ASSESSO. INFORMATION NUMBER: NEAREST CROSS :TFEET: FREER
8573-035-018 THOMAS PAGE: 597 GRID: D3 LOCALITY: TEINDLE CITY, C
TE ANT: X15) BLDG USE: RESID USE ON - TSS ED 0PROCESSED BY: EXPIRES ON:
EXIST OCC GRP: 08/11/04 JK 08/06/05
01WNER: — TEL. NO: 6LOGS-NOW ON LOT: y VALUATION: ii'I11L DQTE� F57A'L BY: CODF:
HUYNH VI T;STEPHANIE C (626) 401-2992- 4,900 JUJ6(�
5318 WELLAND AV _
TEMP 917803507 FEES PAID ! ESCRIPTION OF WORK
T/O OLD ROOF REPAIR ROTIED WOOD INSTALL CLASS "a" 30 YEAR
IFEE DESCRIPTION: QUANTITY: UOM: AMCLINT: COMPOSITION SHINGLES
APPLICANT: EL. NO:
LAI.( (626) 285-9016- IAA BLDG PERMIT ISSUANCE x'7.;5 _
4533 SHIRLEY AVE AC STRONG MOTION RESID 4900.00 VAL 0.50 )SPECIAL CONDITIONS:
EL MONTE, CA 91731 ID2 PERMIT W/O EN-HC 4900.00 VAL 132"60
� TOTAL FEES 760. 5
CONTRACTOR: TEL. NO: I IAPP1i0VALS DATE INSPECTOR bIGNAIURt:
GOLDEN KEY INC., 6262859016 (626) 285-9016-
4533 SHIRLEY AVE LIC. NO LO ON AND SHACKS
EL MONTE, CA 91731 775115039
STS ENGINEERAPPY0V�1L �I
P.RC I 'EL'T OR ENGINEER: TELCO: I FOU.IDA d! Rl ENCH 4GRw:S —)
LIC. NO: ISLis.:/UFIDER FLOOR
�T2A!SVD FL03R FRAt.ING — i `—
MAr NO: SEWER MAP BOOK: NAGN FIRE ZONE: 1"oOffFE-001i 1NSULATJOU
XX 3 03�
aR S
II—THING
X17. OF FAMILIES: DWELLING UNITS:S:A!•'i/ OWD: STA CLA53:
NO ^-1 IF.0O� SHEATHING
SCHOOL I N_ HAZARDOUS SS!.E R P LS ')
FAIR QUALITY: 1000 FLET MATERIALS I
NO NO NO :RA!tiE INSPECTION---
REQUIRED TOTAL SETBACK FROM EXIST SPRINKLER AN9F!?5 -
SET BACK YARD: HWY: PROP LINE: WIDTH:
FRONT PPL-L- IINSJLATION/WEATHER STRSIDE
rP
NT ER OR LATH/DRY ALC.
(EXTERIOR LATH
)
RAT D F OOR/C IL ASSEM. —�—
RARTED WALL ASSEMBLIES
I --
RATED SHAFTS/OPENINGS -`�—
IT-B R CEILINGS
(LOT DRAINAGE
REPORT ID: DPR261 ROUTE TO: BS0508 I —�
i I