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HomeMy Public PortalAbout9836 WENDON ST_Building__ • APPLICAT, N FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUIL D ESS I hereby affirm that I have a certificate of consent to self insure, FBUILDINGJyjS., GWOON &V6-or a certificate of Workers'Compensation Insurance,or a certified ('�copy thereof(Sec.3800,Lab.C.) nC-1-9 _�/ ZIP I I ISAI PLIS C-1 / q,7s v LOCALITY Policy No. Company SIZE OF LOTNO.OF BLDGS NOW ON LOT /• ❑ Certified copy is hereby furnished. �(10.02 x i 7-5- 1 L NEAREST CROSS Sf ' TRACT BLOCK LOT NO. ❑ Certified copy is filed with the county building inspection // USE ZONE MAP NO. department. 6 Date Applicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL NO. YES NO COMPENSATION INSURANCE , 1WITHIN 1000 FT OF SCHOOL? (This section need not be completed if the permit is for one hundred ADDRESS _I1 r dollars($100)Or less.) t/v, ARI r, Ilia, vG rFRONT GROUP . FIRE ZONE PROCESSED BY I certify that in the performance of the work for which this permit CITY n��dl� C� ZIP cl 16, 6, ©- is issued, I shall not employ any person in any manner so as t0 ARCHITECT OR ENGINEER TEL NO. _ ��� become subject to the Workers Compensation Laws. L CLASSIFICATION APT CONDO Date Applicant ADDRESS 4 DWELL UNITS NOTICE TO APPLICANT.' If, after making this Certificate of D TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CONTRACTOR TEL NO. K YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith xwe✓comply with such provisions or this permit shall be deemedrevoked. ADDRESS LIC.NO.LICENSED CONTRACTORS DECLARATION CITY LIC.CLASS I hereby affirm that I am licensed underprovisions of Chapter 9 SEWERMAP (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO,OF STORIES I NO,OF FAMILIES Professions Code,and my license is in full force and effect. !;-0d NEW 11 BK PG ® a ' License Number Lic.Class DESCRIPTION OF WORKADD n ❑ VALUATION 1 X E 1 SFIN $ Q U 0 Contractor Date E ALTER ❑ oG61- 'fbuSC ttA7-412 °C ❑ I am exempt under Sec. REPAIR ❑ $ BAP.C.for this reason a--TA A W. DEMOL ❑ LDMA P/C# uJ Date: USE OF EXISTING BLDG. URM ❑ E- - co Signature APPLICANT(PRINT) TEL NO. LDMA Perm I, as owner of the property, or my employees with wages as Z their sole compensation, will do the work and the structure is ADDRESS F not intended or offered for sale (Section 7044, Business and FINAL DATE atoo. _ Professions Code.) WILL HE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL ❑ I, as owner of the property, am exclusively contracting with AMOUNTS S ECIFED ON HE HAZARDOUS MATERIALS INFORMATION A HAZARDOUS MATERIAL EQUAL TO OR GUIRDE9 EATER THAN THE > licensed contractors t0 construct the project (Section 7044, FINAL BY > 9 2'5 Business and Professions Code.) YES❑ NO❑ :;- c WILL THE INTENDED USE OF HE BUIDLING BY THE APPLICANT OR FUTURE BUILDING -''f--'I` - OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM HE SOUTH CONSTRUCTION LENDING AGENCY COAST OA TAIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMIPERMITTING3, RMITG CHECKUST FOR s/hGL/� y—i� I:�'!Y!'�;:' o_I ES I hereby affirm that there is a construction lending agency for YES❑ NO❑ y_ W the performance of the Work for Which this permit Is Issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND HE SCAOMD PERMITTING .^�.. 3097,CIV.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE Il IL;:,•^1� sL:.*-..� a 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. C3 Lender's Address y -i O OWNER OR AGENT o I certify that 1 have read this application and state under penalty of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE / N with all county ordinances and State laws relating to building �"2• constructipn, and hereby authorize representatives of this County ISSUANCE FEE �/ co to BIT u n the abo e-mentioned rty for inspection purposes. p. T" a 10fj INVESTIGATION FEE TOTAL FEE wom dun Agan o.w Y' SEE REVERSE FOR EXPLANATORY LANGUAGE 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 1202230096 PHONE: (626) 285-0488 EXT: ILEGAL ID: I NO. OF CONST I BUILDING ADDRESS: I ITR: 11386 LT: 6 BL: B I SQ. FT STORIES TYPE 1 9836 WENDON ST I ISTRUCTURE: 17 V-B I TEMP CA 917801726 1 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 1 15385-025-006 I I THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY, Cl (TENANT: (EXIST BLDG USE: RESID USE ZONE: R-1 IISSUED ON: PROCESSED BY: 1 EXIST OCC GRP: 102/23/12 SR 1 10WNER: TEL. NO: ]SLOGS. NOW ON LOT: VALUATION: IF TE F Y: CODE: 1 IBRONDOLILLO, JOHN - 1 4,000 1 19836 WENDON ST. 1 I ITEMPLE CITY CA 91780 1 FEES PAID IDESCRIPTION OF WORK v1 I I IMAIN HOUSE TEAR OFF WOOD SHINGLE & COMP ROOF. INSTALL 15/32"1 1 IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:IOSB PLYWOOD WITH RADIANT BARRIER 30 LB ASTM FELT & 30 YR 1 (APPLICANT: TEL. NO: I ICLASS A FIBERGLASS SHINGLES 1 FABER, JOHN (909) 949-4397- IAA BLDG PERMIT ISSUANCE 27.80 1 I I IAB STATE GREEN BLDG FEE 4000.00 VAL 1.00 ISPECIAL CONDITIONS: 1 IAC STRONG MOTION RESID 4000.00 VAL 0.50 1 I ID2 PERMIT W/O EN-HC 4000.00 VAL 115.80 1 I I I TOTAL FEES 145.10 1 I ICONTRACTOR: TEL. NO: 1 (APPROVALS LATE INSPECTOR SIGNATURE 1 IROOFING PLUS CONSTRUCTION (909) 949-4397- I 1 I 118 N. CENTRAL AVE. LIC. NO ILOCATION AND SETBACKS I I I ]UPLAND, CA 91786 708020 1_ 1-1 I I ISOILS ENGINEER APPROVAL 1 ] I (ARCHITECT OR ENGINEER: TEL. NO: 1 (FOUNDATION/TRENCH FORMS 1 I 1 LIC. NO: 1 (SLAB/UNDER FLOOR I 1 I I (RAISED FLOOR FRAMING 1 I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( ]UNDERFLOOR INSULATION I I I 1153H269 3 001 1 I I I I IFLOOR SHEATHING I I I INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I- 0 0 NO 21 1 IROOF SHEATHING 1 (1 SCHOOL WITHIN HAZARDOUS �I ISHEAR PANELS 1 I AIR QUALITY: 1000 FEET MATERIALS 1 NO NO NO I IFRAME' INSPECTION I 1 (FIRE SPRINKLER HANGERS 1 1 1 ]INSULATION/WEATHER STRIP!(( 1 I I (INTERIOR LATH/DRYWALL I 1 1 1 ]EXTERIOR LATH I I I IRATED FLOOR/CEIL ASSEM. I I I ] IRATED. WALL ASSEMBLIES I I I I I I I � IRATED. SHAFTS/OPENINGS I I I ] II I I IT-BAR. CEILING3 1 1 I I ]LOT DRAINAGE I I I IREPORT ID: DPR261 ROUTE TO: BS0508 I I I I I I 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 1202230097 PHONE: (626) 285-0488 EXT: ILEGAL ID: I NO. OF CONST I BUILDING ADDRESS: I ITR: 11386 LT: 6 BL: B I SQ. FT STORIES TYPE J 9836 WENDON ST I I ISTRUCTURE: 17 V-B I TEMP CA 917801726 I (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: J 15385-025-006 I I THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY, Cl (TENANT: IEXIST BLDG USE: DETAC USE ZONE: R-1 JISSUED ON: PROCESSED BY: 1 (EXIST OCC GRP: 102/23/12 SR J (OWNER: TEL. NO: JBLDGS. NOW ON IAT: VALUATION: IFINAL DATE FINAL BY: CODE: J IBRONDOLILLO, JOHN - 3,000 J I 19836 WENDON ST. ! I I ITEMPLE CITY CA 91780 J FEES PAID IDESC117PTION OF WORK I I 1 IDETACHED GARAGE WITH ATTACHED GUEST ROOMS TEAR OFF WOOD SHINI I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:JGLE & COMP ROOF INSTALL 15/32" OSB PLYWOOD WITH RADIANT BARRI (APPLICANT: TEL. NO: I IIERS 30 LB ASTM FELT & 30 YR CLASS A FIBERGLASS SHINGLES 1 IFABER, JOHN (909) 949-4397- IAA BLDG PERMIT ISSUANCE 27.80 1 I I JAB STATE GREEN BLDG FEE 3000.00 VAL 1.00 ISPECIAL CONDITIONS: I I JAC STRONG MOTION RESID 3000.00 VAL 0.50 I ID2 PERMIT W/O EN-HC 3000.00 VAL 99.00 ! I I TOTAL FEES 128.30 1 I ICONTRACTOR: TEL. NO: 1 JAPPROVALS DATE INSPECTOR SIGNATURE J ROOFING PLUS CONSTRUCTION (909) 949-4397- I 1 I 118 N. CENTRAL AVE. LIC. NO 1 VACATION AND SETBACKS J I !UPLAND, CA 91786 708020 ! (SOILS ENGINEER APPROVAL J I I JARCHITECT OR ENGINEER: TEL. NO: J IFOUNDATION/TRENCH FORMS I ! I LIC. NO: JSLAB/UNDER FLOOR I I I IRAISED FLOOR FRAMING I I I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:J (UNDERFLOOR INSULATION I I I 1153H269 3 001 1 I I I I I IFLOOR SHEATHING I I I INO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: I I I I 1 0 NO 21 1 IROOF SHEATHING 1 ! I SCHOOL WITHIN HAZARDOUS 1 JSHEAR PANELS J 1 JAIR QUALITY: 1000 FEET MATERIALS ! ! J I 1 NO NO NO FRAME INSPECTION ! !FIRE SPRINKLER HANGERS ! 1 ! !J JINSULATION/WEATHER STRIPI I I (INTERIOR LATH/DRYWALL I J I ! I I JEXTERIOR LATH I I I J I IRATED FLOOR/CEIL ASSEM. 1 1 I ! !RATED WALL ASSEMBLIES I I ! ! !RATED SHAFTS/OPENINGS I ! ! IT-BAR CEILINGS I I I 1 I (LOT DRAINAGE I I I IREPORT ID: DPR261 ROUTE TO: BS0508 I I I I I I I I I I