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Home My Public Portal About9448 WOODRUFF AVE_Building__ WORKERS'COMPENSATION DECLARATION �! • ' APPLICATION FOR BUILDING -PERMIT %I •hereby;affirm that I have a certificate of consent to self • insure, or a,certificate of Workers' Compensation Insurance, or a certified copy thereof(Sec. 3800, Lob. C.) Y r b COUNTY OF LOS ANGELESO:� BUILDING AND SAFETY Policy IVo. Company BUILDING ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS �d ❑ Certified copy is filed with the county building inspec- A RIFs p,r tion department. E •^ Date Applicant CITY / ZIP LOCALITY ' NO. OF B,DGS. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST. COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL hundred dollars ($100)or less.) TEL. OWNER ' y NO. USE ZONE MAP I certify that in the performance of the work for which this NO. permit is issued, I shall not employ any person in any manner ADDRESS o ✓ /'-�' SPECIAL a- so as to become subject to the Workers'Compensation Laws. ems/ C� CONDITIONS O CITY C ZIP // U Date Applicant ARCHITECT OR• _ � NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER i (/� DIS RIOT• GROUP TYPE FIRE PROCESSED BY O Exemption, you should become subject to the Workers' a CONST_. /' ZONE 15 Compensation provisions of the Labor Code, you must forth- ADDR O , r� EV/ f G j.�t�-� CL with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATIONJAXTI. COzNDO. to deemed revoked. CONTRACTOR NO. LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. vZ DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. SEWER MAP I-'°�'�•' (commencing with Section 7000)of Division 3 of the Business LIC. and Professions Code,and my license is in full force and effect. CITY CLASS BK PG 1 VALIDATION SQ. NO.OF NO.OF CHECK tL•L I°F License Number. Lic. Class SIZE I STORIES FAMILIES ONE Contractor Date DESCRIPTION OF WORK NEW La VALU TION 3;017 515°15 Q ADD 1TENS ❑I am exempt under Sec. eia.S _ 9 ALTER ❑ $ TOTAL 605- 26 B.&P.C. for this reason REPAIR ❑ 26. Date: EXISTING BLDG.4 V,L DEMOL ❑ CHANGE �CHECK1�_ �t F"t° 4 Signature APPLICANT TEL• CHANGE all (PRINT) N 2 FINAL I. OWNER-BUILDER DECLARATION DATE tj' )Z- I hereby affirm that I am exempt from the Contractor's License ®!t� Law for the following reason (Section ADDRES 7031.5, Business and FINAL 0I00-1301,31 -4/2-0/933 Professions Code): PRESENT B ❑ I, as owner of the property, or m employees with BUILDING Y Iryy�a PM 4%IS P P Y. YADDRESS ACG1.TO wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY3,307j 7044, Business and Professions Code.) MOVING TEL. �,r 26_.16 I, as owner of the property,am exclusively contracting CONTRACTOR NO. 1 1TEti` l � with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code.) TOTAL ' o , REQUIRED TOTAL SETBACK FROM EXIST. �r7G4 CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH 4 260.aLL, 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. CHANGE (Sec. 3097, �1RCiv. C.). � � � �� A I� SIDE c-►KL-c �.—, QrM/TR_ P.L. Lender's Name �� n �ryr 4 f P.C. Fee$ • Permit Fee O .�-•� Lender's Address LDMA Ref. 5098 1 AN 9:18 I certify that I have read this application and state that the Issuance Fee 45 {DMA P/C# , 3 above information is correct. I agree to comply with all County Investigation Fee / ordinances and State laws relating to building construction, ITotal Fee LDMA Perm. # and hereby authorize representatives of this County to enter upon hebove entioned property for inspecti Cur oses. SEE REVERSE FOR EXPLANATORY LANGUAGE ° na ure of plicant r Agent at WORKERS'COMPENSATION DECLARATION 1 hereby affirm that I have certificate of consent to self APPLICATION FOR BUILDING PERMIT insure, or a certificate of Workers'Compensation Insurance, , or a certified copy thereof(Sec. 3800, Lob. C.) , COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished. I FOR APPLICANT TO FILL IN BUILDING QU ADDRESS Certified copy is filed with the county building inspec- tion department. ADDRESS Date "' Applicant ,,rJa�w U CITY ZIP LOCALITY NO.OF BLDGS. NEAREST } CERTIFICATE OF EXEMPTION FROM WORKERS' � Jr 5 COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. (This section need not be completed If the permit Is for one ASSESSOR hundred dollars($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL TEL. SE ZONE O I certify that'in the performance of the work for which this OWNER NO ! J permit is Issued,I shall not employ any person in any manner �� SPECIAL 9f so as to become subject to the Workers'Compensation Laws. I ADDRE CONDITIONS V Date Applicant CIT ZIP NOTICE TO APPLICANT: If, after makin 'this Certificate of ARCHITECT R TEL. 5DISTRICT6bOUP NST. FIRES PROCESSED BY V g ENGINEER NO. Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forth- ADDRESS 13 a / with comply with such provisions or this permit shall be' deemed revoked. TEL, STATISTICAL CIASSIFICA 10 APT. DO. T)' CONTRALTO LICENSED CONTRACTORS DECLARATION LIC CLASS NO. DWELL. UNITS "t I hereby affirm that I am licensed under provisions of Chapter 9 ADDRE NO. SEWER MAP i (commencing with Section 7000)of Division 3 of the Business and LIC. Professions Code,and my license is in full force and effect. CI CIA " BK PG VALIDATION SQ.FT. NO.OF NO.OF CHECK License Numbers Lic.Clas ,'r SIZE STORIES IFAMILIES ONE VALUATION _ ContractoraV4Q= ��,�Datp--�� DESCRIPTION OF WORK NEW ❑ $ ADD ❑ ❑I am exempt under Sec. ALTER ❑ i B.BP.C. for this reason REPAIR l $ USE OF Date: EXISTING BLDG. DEMOL ❑ Signature APPLICANT TEL. FINAL T 91 Q 2 A PRINT – OWNER-BUILDER DECLARATION DATE 1 hereby affirm that I am exempt from the Contractor's License ADDRESS FI # 0 0 0.0 Oil Law for the following reason (Section 7031.5, Business and e Professions Code): ' ❑ BUILDING ,1 . 05925 I, as owner of the property, or my employees with ADDRESS o 0 0 5 9'2 5'v wages as their sole compensation,will do the work and the structure is not Intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. 073, 03 -88 ❑ 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). FIRARER CONSTRUCTION LENDING AGENCY SPBACK YARD HWY TOTAPROPLINE WIDTH 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 P.L. Lender's Name LDMA Ref. N P.C.Fee$ Permit Fee Lender's Address I certify that I have read this application and state that the Issuance FeeItV T/ LDMA P/C M 'o above information is correct. I agree to comply with all County Investigation Fee } v :. q ordinances and State laws relating to building construction, :` ' ' •" R and hereby authorize representatives of this County to enter ' Total Fee LDI111A,Perm.q upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of pp ent Date 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 0601180001 PHONE: (626) 285-0488 EBT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: TR: 6561 IT: 328 SQ. FT STORIES TYPE 9448 WOODRUFF AV STRUCTURE: 22 VN TEMP CA 917802039 // ASSESSOR INFORMATION NUMBER% NEAREST CROSS STRHOAK 8587-006-014 THOMAS PAGE: 596 RID: J3 LOCALITY: TEMPLE CITY, C TENANT: EXIST BLDG USE: REBID USE ZONE: R-2 ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 01/18/06 JK 01/13/07 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE: ANGELA CHEN (626) 288-1278- 5,800m 9448 WOODRUFF AVE TEMPLE CITY CA 91780 FEES PAID DESCRIPTION OF WORK T/O OLD ROOF, INSTALL OBS PLYWOOD INSTALL CLASS A FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: COMPOSITION SHINGLES APPLICANT: TEL. NO: ALFRED LAU (626) 285-9016- AA BLDG PERMIT ISSUANCE 27.75 4533 SHIRLEY AVE AC STRONG MOTION REBID 5800.00 VAL 0.58 SPECIAL CONDITIONS: EL MONTE, CA 91731 D2 PERMIT W/O EN-HC 5800.00 VAL 149.40 TOTAL FEES 177.73 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE GOLDEN KEY INC. (626) 285-9016- DBA NEVADA GOLDEN KEY LIC. NO LOCATION AND SETBACKS 4533 SHIRLEY AVENUE 775115 C39 EL MONTE, CA 91731 SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS LIC. NO: SLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDER?LOOR INSULATION 150H265 3 01 FLOOR SHEATHING NO. OF FAMILIES: DWELLING UNITS: APT GOND: STAT CLASS: NO 21 ROOF SHEATHING SCHOOL WITHIN HAZARDOUS SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME INSPECTION REQUIRED TOTAL SETBACK FROM EXIST FIRE SPRINKLER HANGERS SET BACK YARD: NNY: PROP LINE: WIDTH: FRONT PL- INSULATION WEATHER STRIP SIDE PL- INTERIOR LATH DRYWALL EXTERIOR LATH RATED FLOOR/CEIL ASSEM. I RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508 COUAYTY OF LUS 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 1310230060 PHONE: (626) 285-0488 EXT: (LEGAL ID: I NO. OF CONST BUILDING ADDRESS: 1 ITR: 6561 IT: 328 I SQ. FT STORIES TYPE I 9448 WOODRUFF AV J STRUCTURE: V-B TEMP CA 917802039 I (ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 1 18587-008-014 I THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY CAI I I I_ I TENANT: (EXIST BLDG USE: RESID USE ZONE: R-1 ISSUED ON: PROCESSED BY: (EXIST OCC GRP: 110/23/13 SR I I I I IOWNER: TEL. NO: IJBLDGS. NOW ON LOT: VALUATION: JFIN TE FI Y: CODE: 1 KA, ANGELA - I 3,900 1 1 19448 WOODRUFF AVE 1 I r ITEMPLE CITY CA 91780 I FEES PAID IDE RIPTIOS OF WORK 1 I I IREPLACE 7 WINDOWS TO VIN RETRO-FIT WINDOWS 1 IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:1 J JAPPLICANT: TEL. NO: I I 1 1WU, BRYAN (714) 990-9988- JAA BLDG PERMIT ISSUANCE 27.80 1 1 545 W LAMBERT RD #E JAB STATE GREEN BLDG FEE 3900.00 VAL 1.00 (SPECIAL CONDITIONS: 1 IBREA CA 92821 JAC STRONG MOTION RESID 3900.00 VAL 0.50 1 1 ID2 PERMIT W/0 EN-HC 3900.00 VAL 115.80 1 1 -1 TOTAL FEES 145.10 1 1 (CONTRACTOR: TEL. NO: I JAPPROVALS DATE INSPECTOR SIGNATURE I IBRYAN WU (949) 701-8714- 1 1_ 1 1545 W LAMBERT ROAD #208 LIC. NO 1 1LOCATION AND SETBACKS I I I IBREA CA 92821 899265 Bi I I 1 1 I 1SOILS ENGINEER APPROVAL I 1 1 I I I I I I JARCHITECT OR ENGINEER: TEL. NO: 1 IFOU_NDATION/TRENCH FORMS I I I LIC. NO: 1 ISLAB/UNDER FLOOR 1 1 1 IRAISED FLOOR FRAMING I 1 1 I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: JUNP.ERFLOOR INSULATION 1 I 3 OG 1_ 1 I IFLOOR SHEATHING 1 1 1 [NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I I I I NO 21 [ROOF SHEATHING 1 1 1 I I I I I I 1 SCHOOL WITHIN HAZARDOUS 1 ISHF.AR PANELS I I I JAIR QUALITY: 1000 FEET MATERIALS 1 I_ 1 I 1 1 NO NO NO I 1FUME INSPECTION 1 1 1 I I I I I I I I 1FIRE SPRINKLER HANGERS 1 1 JINSULATION/WEATHER STRIP( I 11 11N4'ERIOR LATH/DRYWALL J 1 1 JEXTERIOR LATH 1 1 1 (RATED FLOOR/CEIL ASSEM. I 1 1 1 1 IRATED WALL ASSEMBLIES 1 1 1 (RATED SHAFTS/OPENINGS 1 1 IT-BAR CEILINGS I 1 1 1 ILOT DRAINAGE 1 1 1 1 1REPORT ID: DPR261 ROUTE TO: BS0508 1 1 1 1 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 • BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS 7 ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0101040001 PHONE: (626) 285-0488 EXT: EGL D: NO. OF CONST BUILDING ADDRESS: TR: 6561 LT: 328 SQ. FT STORIES TYPE 9448 WOODRUFF AV STRUCTURE: 0 VN TEMP CA 917802039 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: OAK 8587-008-014 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY TENANT: ST BLDG E: RESID USE ZONE W-2 ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 01/04/01 UT 07/03/01 OWNER: TEL. N0: BLDGS. NOW ON LOT: VALUATION: FINAL D TE FINAL Y CODE: KA-DEWNNIS OODRUFF (626) 288-1278- 1 20,000 2 2 UVB TEMPLE CITY, CA EES PAID DESCRIPTION 0 WORK CHANGE FROM COMMERCIAL UIL ING BACK TO RESIDENCE (NEW BATH APPLIT: TEL. N0: FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: CREATED IN EXISTING SQUARE FOOTAGE) SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RESID 20000.00 VAL 2.00 SPECIAL CONDITIONS: AX BUILDING REVIEW--FEE 54.70 Cou".k_: '3 beriv`vutnn,sy ,3 �pc��{� K.64",I,OLS D2 PERMIT W/0--EN-:HC . 20600.00 VAL 384.60 ray ?,1"�•: = :TOTAL-,FEES .. 469.05 i' J¢L, 5 CONTRACTOR: TEL. N0: * • - APPROVALS I +DATE INSPECTOR SIGNATURE SAME AS OWNER - :� V• A r' -� LIC. NO LOCAT-ION AND SETBACKS SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: +" '- O� UNDO N/ R C FORMS LIC. NO: f L' - SLAB/UNDER -FUO-OR RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: - , UNDERFLOOR INSULATION 150H265 3 1100,1 FLOOR SHEATHINC 0. OF FAMILIES: DWEL I G TS: AP COND: STAT CLASS;:. NO 21 + - ROOF SHEATHING J SCHOOL WITHIN HAZARDOUS SHEAR PANELS ; AIR QUALITY: 1000 FEET MATERIALS NO NO NO '�� FRAME INSPECTION REQUIRED TOTAL SETBACK FROM EXIST y �I FIRE SPRINKLER HANGER- SET A G RSET BACK YARD: HWY: PROP LINE: WIDTH: - _ ,• ' FRONT PL- INSUL TION/WEAT ER STRIP SIDE PL- ��- - • .,�„ ��' ioL Zi 2 v NTERIOR LATH/DRYWALL -- - - i 2 EXTERIOR`LATH RATED FLOOR/CEIL ASSEM. RATED WALL ASSEMBLIES TED S AFTS/OPE UlNGS T-BAR CEILINGS 0 DRAIN GE REPORT ID: DPR261 ROUTE TO: SS0508