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HomeMy Public PortalAbout4928 WILLMONTE AVE_Building__ APPLICATION FOR BUILDING PERMIT FOR.ABPLICANT TO FILL IN (Print or type only) BUIL ING COUNTY OF LOS ANGELES ADC>i ESSOOZE DEPARTMENT OF COUNTY ENGINEER CITY rl zip L) BUILDING AND SAFETY DIVISION NO.OF BLDGS. BUILDING c�y� SIZE OF LOT l ` NOW ON LOT ADDRESS �pC ✓�� TRACT qqj4g BLOCK I LOT NO. al LOCA LIT lam` TEL. NEAREST OWNER NO. CROSS ST. ASSESSOR ADDRESS \ MAP BOOK PAGE L DISTRICT GROUP TYPE FIRE PROCE ED Y CITYTQJPLE0.111 ZIP f� CONST ZONE ARCHITECT OR TEL. .d// ENGINEER NO. STATISTICAL CLASSIFICATION WEER M P ADDRESS CLASS NOv 4�DWELL.UNITS B`K0 PG CONTRACTOR No. USE ZONE MAP -710 LIC. NO. ADDRESS NO. SPECIAL LIC. CONDITIONS CITY CONSTRUCTION LENDER CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ tt NAME AND BRANCH J BL G.SETBACK FROM t TY FR NT PROP.LINE OF (STREET) ADDRESS HIGH AY + YARD = 'TOTAL SETBACK FROM TYPE OF EXISTING SQ. FT. NO. OF NO. OF CHECK FRONT PROP. LINE HIGHWAY WIDTH SIZE p2 STORIES FAMILIES ONE DESCRIPTION OF WORK NEW ❑ + V BLDG.SETB ROM w. ADD SIDE PROP.LINE _ (STREET) ALTER ❑ HIGHWAY + YARD = OTAL SETBACK FROM TYP EXISTING V REPAIR❑ SIDE PROP. LINE HIGHWA WIDTH LULL USE OF _ y EXISTING BLDG. DEMOL 1:1 + Z APPLICANT TEL CORNER CUTOFF YES E3 NO ❑ (PRINT) "ABEDIA4 NO I BY (SIGNATURE) 1- IN OPEN SPACE YES ❑ NO ❑ IN COASTAL PERMIT ZONE YES ❑ NO ❑ VALUATION; ?.--570 I-, G I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION WDX 7- � G- AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- 3� //w, -No?' STRUCTION. 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NO EMPLOY ANY PERSO?I IN VIOLATION OF THE �7 �. / LABOR CODE TH STATE OF -CALIFORNIA IN RELATING TO ? /t�/ rf•CcY�e WORKMEN'S CO PE NSA ION INSURA SIGNATURE OF �'� - Z4 "�t C7 G/)�FS� df- PERMITTEE 1, ADDRESS /"I�I.SO/��Y>r o ,rr9a, /.sszr-rJ FINAL BYE TEL. DATE CITY NO. 1 $ PMT MAKE CHECKS PAYABLE TO: FEE' FEE $ HARVEY T. BRANDT, COUNTY ENGINEER PLAN'CHECK VALIDATION CK. M.O. CASH j. / PERMIT VALIDATION cK. M.O. CASH r -`P NOV 12 1 0 6 9.0 0 ,&-,--.c) 76AGSBA CE*803 5/74 r 4 IOA888A GB rye�B-68 APPLICATION FOR BUILDING PERMIT 1 COUNTY OF LOS ANGELES ADDRESS NG G� / y 'DEPARTMENT OF COUNTY ENGINEER ADDRE .G BUILDING AND SAFETY DIVISION 1=ocALITY ` JOHN A:LAMBIE;COUNTY ENGINEER NEAREST A/�- CASBATT D.GRIFFIN,SUPT OF BUILDING CROSS ST. 06 7 DISTRICT NO. I GROUP TYPEPH CESSE BY FOR APPLICANT TO FILL IN _ coNsr.]v I BUILDING L STATISTICAL CLASSIFICATION I SEWER MAP ADDRESS IV j� yJ/�fj�J/j%J/'�'� [/L'., s K PG ^ J CLASS.NO. DWELL.UNIT LOT NO. It&-,a /� E(/ BLOCK MAP STATE YES NO NUMBER WY. TRACT !?Egg "Pint ;Ptd bA V 4G i USE ZONE SPECIAL SIZE OF LOT t' � _�& NOW ON LOTS Qy / CONDITIONS [. USE OF ��. EXISTING BLDG. BUILDING EXIST. SETBACK YARD HWY STR 7 NAME WIDTH OWNER pS" FRONT MAIL / ' P.L. o ' ADDRESS - SIDE .Jr � TEL. P.L. z CITY 7oll;iv�e_ Chi v NO. INSPECTION RECORD ARCHITECT ORS TEL. ENGINEER ."NO. C_ as ADDRESS TEL. CONTRACTOR �� ''� �`'A- NO. � S? ADDRESS-Z/L Z 5:-.�q:g 2'l&r 3F/046 DESCRIPTION OF WORK NEW ADD ALTER REPAIR DEMOLISH . SQ.'FT. // NO.OF / NO.OF SIZE ��- rb STORIES / FAMILIES / qq USE OF STRUCTURE ems. �k r=' SIGNATURE OF - -!r,a,./lWAPPROVALS. APPLICANT DATE INSPECTORS-SIG ' TURE ADDRESS : FOUNDATION: LOCATION FORMS.MATERIALS P.C. $ FRAME: FIRE STOPS. / /l '� r FEE a. r'^ BRACING,BOLTS / ui" 7 "� . VALUATION + VVD $ FURNACE: LOCATION. GAS VENT,:.DUCTS 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH.IIVT: PLICATION AND STATE THAT THE ABOVE IS CORRECT'AND AGREE TO COMPLY WITH ALL COUNTY ORDINAkICES AND LATH,EXT. STATE- LAWS REMLAG ILDING SCO RUCTION. SIGNATURE OF z� HOUSE NUMBER RECT AND POSTED "%, r, _ 'PERMITTE ` r1 ADORES — /G FINAL J��l `CJ CLYDE N.DIRLAM.PRINCIPAL SThU RAL ENGINEER PLAN CHECS VALIDATION c M.o. CASH PERMIT VALIDATION K. M.O. CASH .�r ..yrea--�=a �.RJ ii:AJ ..G',• M•/'�Y['!' �if17i�_�:,•{ t..JL••!iI 2 1 •...,u _ 2'- x.3_:8::�' AS 2g. � A 4 ,S:'0 O ;Pr WOERS'COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self. APPLICATION FOR BUILDING PERMIT IS insure,or a certificate of Workers'Compenstion Insurance,or a certified copy thereof(Sec. 3800, L Pplicy N0, 7S Comport U� COUNTY OF LOS ANGELES BUILDING AND SAFETY BUILDING Ce ified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS � d Certified copy is filed with th oun buil g ' pe BUILDING Aj/ �/ tion department. ADDRESS Z �� LL I `Ok) d", LOCALITYNEAREST Date rU.. App11 CITY vil ZIP CROSS ST. CERTIFICATE OF EX EM TION FROM WORKERS' r 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 �J 2USE ZONE MAP �d/ hundred dollars ($100)or less.) TRACT p BLOCK LOT O. NO. EL. SPECIAL ®. I certify that in the performance of the work for which this OWNER NO. CONDITIONS O permit is issued, I shall not employ any person•in any manner DISTRICT GROUP TYPE FIRE PRO ESSEDBY V so as to become subject to the Workers Compensation Laws. ADDRESS ) 0 CONST. r ZONEL441zz 0 Date Applicant 99 CITY ZIP 5 STATISTICAL CLASSI ATION T APT. CONDO. V NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR O�TEL. w ` Ls1 Exemption, you should become subject to the Workers' ENGINEER NO. CLASS NO. .� DWELL. UNITS 1A Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP with comply with such provisions or this permit shall be //��"" Ci TELA revoked. CONTRACTOR �'�ET TTEL _ BK. PG, VALIDATION 140 LICENSED CONTRACTORS DECLARATION [ I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS' O 1 4 t aZ NO: ��`Lb0 VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC. �3 $ Professions Code, and my license is in full force and effect. CITY {/ CLASS u License Number f 17,�y��Lic.Class/ SIZE 0 STORIES FAMILIES CHECK Contractor e b DESCRIPTION OF WORK NEW $ I am exempt from the licensing requirem nts as I m a (�` JNft P a L ADD ❑ licensed architect or a registered professional engineer © NALTER ❑ FINAL f acting in my professional capacity (Section 7051, REPAIR ❑ DATE Business and Professions Code). USE OF ? FINAL EXISTING BLDG. J ,3 DEMOL ❑:' BY -1.Q 4 2 4 Lic.or Reg.No. _Date APPLICANT TEL. OWNER-BUILDER DECLARATION (PRINT) NO. #f a o 0 0 21 1 hereby affirm that I am exempt from the Contractor's License - Law for the following reason (Section 7031.5, Business and ADDRESS L� /7 2 o - 5040 Professions Code): PRESENT ❑ BUILDING I, as owner of the property, or my employees with ADDRESS a e cJ G !� C,x wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 0 7 21 -91 El7044, Business and Professiorgs Code). MOVING TEL. 1, as owner of the property,am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). 0 4 2 5 A REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH r o a a o a 1 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. (Sec. 3097, Civ. C.). SIDE 7 ° ° 9 7.C C P.L. Lender's Name r ,, a C 1 Lender's Address P.C. Fee$ Permit Fee G� P, 7.21 —8 1 > I certify that I have read this application and state that the Issuance Fee above informatio ' rrecf. I agree to co ply with all County Investigation Fee ordinances Sta laws relating wilding construction, Total Fee / and he y auf ize representat' of this u y to enter = upo e a e-mentioned rt for ins purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Dote, es 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 0212030018 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST- D R TR: 9848 LT: 21 UN: .002 SQ. FT STORIES TYPE 4928 WILLMONTE AV STRUCTURE: VN TEMP CA 917804044 ASSESSOR 0 0 NEAREST CROSS STREET: LOWER AZUSA 8589-026-002 THOMAS PAGE: 597 GRID: B5 LOCALITY: TEMPLE CITY TENANT: S B G USE: RgSID USE ZONE: R-1 ISSUED 0 --PROCESSED B R S . EXIST OCC GRP: 12/03/02 JK 06/01/03 . OWNER: TEL. N0: BLDGS. NOW ON LOT: VALUATION: FINAL DATE CODE: NAHABEDIAN MICHAEL;PAM L - 3,500 EYAP 4928 WILLMONTE AV TEMP 917804044 FEES PAID RIPTIOl T/0 WOODSHAKE;RESHEET & INSTALL 30YR OWENSCORNING FIBERGLASS FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: COMP P L. 0• BERRY ROOFING (909) 905-5116- AA BLDG PERMIT ISSUANCE 27.75 3165 CENTER ST AC STRONG MOTION RESID 3500.00 VAL 0.50 SPECIAL CONDITIONS: RIVERSIDE 92501 D2 PERMIT W/O EN-HC 3500.00 VAL 115.80 TOTAL FEES 144.05 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE BERRY ROOFING (909) 905-5116- 3165 CENTER ST LIC. NO LOCATION AND SETBACKS RIVERSIDE, CA 92501 691947 SOILS ENGINEER APPROVAL ARCHITECT OR NG L. N0: - FOUNDATION/TRENCH FORMS LIC. NO: SLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION 144H269 3 01 FLOORSHEATHING 0. OF FAMILIES: D I G UNITS: A O : STAT CLASS: NO 21 ROOF SHEATHING SCHOOL WITHIN HA7ARDOUS SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME INSPECTION - REQUIRED RED O L SETBACK FROM- EXIST FIRE SPRINKLER HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- SULATION/WEATHER STRIP SIDE PL- INTERIOR LATH/DRYWALL EXTERIOR LATH RATED FLOOR/CEIL ASSEM. RATED WALL ASSEMBLIES RATED S 0 T-BAR CEILINGS * ADDITIONAL DATA ON FILE LOT DRAINAGE REPORT I0: DPR261 ROUTE TO: BS0508