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Home My Public Portal About8726 WENDON ST_Building__ WORKERS'COMPENSATION DECLARATION i� have a certificate oconsent to sef insurebor afcertificatelof Workers'Compenstion Insurance,olr APPLICATION FOR BUILDING PERMIT ✓ .a certified copy thereof(Sec. 3800, Lob. C.) 15 qp �rer•+c.� COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy NO N 92— �ompany T Pty^nib ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILIN ADDRDESSG ZA Certified copy is filed with the county building inspec- FADD7 ) /J tion department. LOCALITY Date 3 X32 Applicant NEAREST / pp - ZIP CROSS ST. CERTIFICATE OF EXEMPTION FROM WO KERS' SIZE OF LOT IL*))(J MI5 Y &%8.OF BLDGS. ASSESSOR COMPENSATION INSURANCE NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one USE ZONE MAP TRACT 3 BLOCK LOT NO. �� NO. r U O hundred dollars ($100)or less.) �i / SPECIAL � � � TEL. 1 certify that in the performance of the work for which this OWNER J V NO. S1 ' CONDITIONS permit is issued, I shall not employ any person in any manner nD DISTRICT GROUP TYPE FIRE PRO ESSED BY U (s A v (� so as to become subject to the Workers'Compensation Laws. ADDRESS 0 In CONST. ZONE�"t U �c / J J V Iv Date Applicant CITY a ` ZIP STATISTICAL CLASSIFICATION APT. CONDO. U NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. UJ � ENGINEER NO. CLASS NO. ! DWELL. UNITS Exemption, you should become subject to the Workers' u) Compensation provisions of the Labor Code, you must forth- F. with comply with such provisions or this permit shall be ADDRESS SEWER MAP deemed revoked. TEL• BK. PG a' VALIDATION CONTRACTOR , NO. S�L 7 LICENSED CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS C, V1 NO. �� VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC �'• Professions Code, and my license is in full force and effect. CITY 1 pn CLASS aej SQ. FT. NO.OF NO.OF CHECK License Number 401,01 Lic.Class_ SIZE c�--STORIES FAMILIES ONE /� 1 DESCRIPTION OF WORK % J e r NEW ❑ $ Contractor IAWN wr ( Q Date ❑ 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, REPAIR ❑ DATE — u "b Z Business and Professions Code). USE OF DEMOL ❑ FINA B EXISTING BLDG. y Lic.or Reg.No. _Date APPLICANT , ,. TEL. OWNER-BUILDER DECLARATION (PRINT) NO. I hereby affirm that I am exempt from the Contractor's License I /J' Law for the following reason (Section 7031.5, Business and ADDRESS 5 o 6.V i I, r Professions Code): PRESENT ❑ BUILDING I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and LOCALITY 5 3 7 Q the structure is not intended or offered for sale(Section 7044, Business and Professions Code). MOVING TEL. 1 0 0 0 o a ❑ I, as owner of the property,am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS o - 26-00 tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH o 062L0.0060 I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P L LC S C 3—8 2 (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name Lender's Address P.C. Fee$ Permit Fee rI certify that I have read this application and state that the Issuance Fee �• S C = above information is correct. I agree to comply with all County Investigation Fee d ordinances and State laws relating to building construction, Total Fee �f d and hereby authorize representatives of this County to enter o upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature la f Applicant or Agent Date es I_ i APPLICATION FOR BUILDING PERMIT s _ COUNTY OF LOS-ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDI DDRE S Q BUILDING ADDRESS d tp 2 I hereby affirm that I have a certificate of consent to self insure, 8726 HENDON ST. or a certificate of Workers'Compensation Insurance,or a certified copy thereof 1046140Lab.C.) STATE FUND CITY TEMPLE CITY ZIP 91775 LO IT Policy No. Company SIZE OF LOT NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. NEAREST CROS ST. Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. USE ZONE MAP NO. Date 11-1-95Applicant RANDOL ROOFING ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS � Q/ CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL NO. YES NO COMPENSATION INSURANCE TOM RICE 285-7801 WITHIN 1000 FT.OF SCHOOL? (This section need not be completed if the permit is for one hundred ADDRESS DISTRICT GROUP TY CONST. FIRE ZONE PROCESSED BY dollars($100)or less.) 8726 HENDON ST. I certify that in the performance of the work for which this permit CITY TEMPLE CITY CA ZIP 91775 -J is issued, I shall not employ any person in any manner so as to Ile become subject to the Workers'Compensation Laws. ARCHITECT OR ENGINEER TEL NO. STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO. 94/ DWELL UNITS NOTICE TO APPLICANT If, after making this Certificate Of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CONTRACTOR TEL NO. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith RMOL ROOFING 288-4040 FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL LICENSED CONTRACTORS DECLARATION 529 E. VALLEY BLVD 451937 SIDE CITY LIC.CLASS P L I hereby affirm that I am licensed underprovisions of Chapter 9 —11 9 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORIES I NO.OF FAMILIES Professions Code,an my license is in full force and effect. ? NEW 11 BK PG d License Nyuv'er Lic.Class �7/ DESCRIPTION OF WORK ADD ❑ VALUATION 000.00 ® U Contr�p#6Ti" Date ALTER El 25—YEAR CLASS A FIBERGLAS REPAIR IN $ O ❑ I am exempt under c. B.BP.C.for this reason V SHINGLES OVER EXISTING COMP- DEMOL ❑ LDMA P/c# W Date: USE OF EXISTING BLDG. URM ❑ CO 0- Signature A NT(PRINT) TEL NO. LDMA Perm# ��eFD�41T ' 1 ❑ I, as owner of the property, or my employees with wages as RANDOL ROOFING 288-4040 O TOTAL their sole compensation, Will do the work and the structure is ADDRESS not intended or offered for sale (Section 7044, Business and I L FINAL DATE a CHECK j,2ti5.75f Professions Code.) �,'Z�J G �'^ WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL lI ❑ 1, 8S owner of the y y g OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE n 00 property, am exclusive) contracting With AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY licensed contractors to construct the project (Section 7044, YES❑ NO❑ b CHANGE Business and Professions Code.) WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH �O �f��}i 6,�'fL!G� CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKUST FOR 001 7 LO!7 GUIDELINES 1 hereby affirm that there is a constriction lending agency for YES El No 112490 1 AM11-0 11 Cq the performance Of the Work for which this permit IS ISSUed(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING 1 3097,CIV.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. o Lender's Address C OWNER ORAGENT oI certify that I have read this application and state under penalty O of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE N with all cou ty 1 noes and State Taws relati to b ilding 98.2 construction, auth ize representatives f this ounty ISSUANCE FEE "o to enter u•0 a anti a perty for in n p es. 27.30 m a INVESTIGATION FEE M TOTAL FEE 125.55 Sgmwm m e SEE REVERSE FOR EXPLANATORY LANGUAGE r 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 1112140013 PHONE: (626) 285-0488 EXT: ILEGAL ID: I NO. OF CONST I BUILDING ADDRESS: [ ITR: 17963 LT: 12 BL: .001 I SO. FT STORIES TYPE [ 8726 WENDON ST [ I ISTRUCTURE: 16 V-B I SGAB CA 917752629 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 15386-007-022 1 1 THOMAS PAGE: 596 GRID: G2 LOCALITY: TEMPLE CITY, Cl I [TENANT: IIEXIST BLDG USE: RESID USE ZONE: R-1 ISSUED ON: PROCESSED BY: [ (EXIST OCC GRP: 112/14/11 SR (OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: (FINAL DATE FINAL BY: CODE: 1 IRICE THOMAS E;JUDITH K (626) 285-7801- 1 4,000 1 I8726 WENDON ST SGAB 917752629 I FEES PAID IDESCRIPTION OF WORK ITEAR OFF EXISTING ROOF APPLY 30 YR CLASS °A" SHINGLES HOUSE 1 IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:(+ GARAGE 1 (APPLICANT: TEL. NO: I I I ILANSFORD ROOFING INC. (626) 390-3480- IAA BLDG PERMIT ISSUANCE 27.80 I I IAB STATE GREEN BLDG FEE 4000.00 VAL 1.00 ISPECIAL CONDITIONS: I IAC STRONG MOTION RESID 4000.00 VAL 0.50 1 1 D2 PERMIT W/O EN HC 4000.00 VAL 116.00 [ 1 [ TOTAL FEES 145.30 [ I ICONTRACTOR: TEL. NO: [ [APPROVALS DATE INSPECTOR SIGNATURE ILANSFORD ROOFING, INC. (626) 390-3480- 1 13535 LANDFAIR RD LIC. NO (LOCATION AND SETBACKS 1 [ I IPASADENA, CA 91107 775436-C39 I i ISOILS ENGINEER APPROVAL (ARCHITECT OR ENGINEER: TEL. NO: - 1 IFOUNDATION/TRENCH FORMS I [ LIC. NO: I ISLAB/UNDER FLOOR I I I I [ IRAISED FLOOR FRAMING [ I I I I I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( 1UNDERFLOOR INSULATION I I I I I I XX 3 00 I I (FLOOR SHEATHING [ I I INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I I 1 0 NO 21 I IROOF SHEATHING ISI SCHOOL WITHIN HAZARDOUS I ISHEAR PANELS 1 1 I (AIR QUALITY: 1000 FEET MATERIALS 1 I I I I NO NO NO [ IFRAME INSPECTION I I I I [FIRE SPRINKLER HANGERS [ 1 I [ (INSULATION/WEATHER STRIPI I I I I (INTERIOR LATH/DRYWALL [ [ I I I I I �{ (EXTERIOR LATH I I [ I I I [ RATED FLOOR/CELL ASSEM. [ [ I (RATED WALL ASSEMBLIES [ ! I[ IRATED SHAFTS/OPENINGS FFF IT-BAR CEILINGS 1 [ �* ADDITIONAL DATA ON FILE I [ [ I [ I ILOT DRAINAGE [ I [ IREPORT ID: DPR261 ROUTE TO: BS0508 [ [ I [ I I I I I I