The URL can be used to link to this page

Home My Public Portal About9735 WOODRUFF AVE_Building__ WORKERS'COMPENSATION DECLARATION 14i51 hereby affirm that I have a certificate of consent to self APPLICATION FOR BUILDING PERMIT insure, or a certificate of Workers'Compenstion Insurance, or a certified copy thereof(Sec. 3800, Lob. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company ElCertified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING S— P o?-L,E ADDRESS 97 WU ❑ Certified copy is filed with the county building inspec- BUILDING Of , v tion department. ADDRESS ') Q �J LOCALITY }xe" t Ci 1 s NEAREST / Date Applicant CITY j T R q/ zip IIS/ 7 � CROSS ST. 62d!ra C/l/ W t-rP T'p CERTIFICATE OF EXEMPTION FROM WORKERS' NO OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK �Sv3 00 PARCEL (This section need not be completed if the permit is for one 9. USE ZONE MAP a D 7 hundred dollars ($100)or less.) TRACT ,7 .� , BLOCK LOT NO. / �y NO. } EL. r� p f i— SPECIAL p, OWNER - 63p; ty / 0A/ NO.r20 b.3S, 0 CONDITIONS I certify that in the performance of the work for which this O permit is issued, I shall not employ any person in any manner p `` DISTRICT GROUP TYPE FIRE PROC SF�D BY U ADDRESS % 1 R ~af- Ave—. CONST. ZONE so as to become subject to the Workers'Co pensation Laws. p� .tet -PI Pp CITY i/T ZIP f d V Date A lica� STATISTICAL CLASSIFICATION A CONDO. NOTICE TO APPLICANT: If, after making his Certificate of ARCHITECT OR TEL. LU Exemption, you should become subject to the Workers' ENGINEER NO. CLASS NO. DWELL. UNITS N Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP with comply with such provisions or this permit shall be deemed revoked. CONTRACTOR NO.TEL. BK / VALIDATION LICENSED-CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS afzNO. 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 CLASS $ !�7 S-00oo SQ. FT. NO.OF NO.OF CHECK License Number Lic.Class SIZE STORIES FAMILIES ONE Contractor Date DESCRIPTION OF WORK NEW $ ElI am exempt from the licensing requirements as I am a Z)Z 3/ At�j ADD licensed architect or a registered professional engineer ALTER ❑ FINAL acting in my professional capacity (Section 7051, REPAIR DATE C+3 O Business and Professions Code). USE OF' . DEMOL `rye EXISTING BLDG. L{plb y.f/C� FINAL Lic.or Reg.Nd. Date APPLICANT e� TEL. , p y OWNER-BUILDER DECLARATION (PRINT)JOS ��C�/f�f4.�i ' NO.olO Cc3�1O I hereby affirm that I am exempt from the Contractor's License ADDRESS l3 J~ VV�Q -e it l'r- 427.�r I ' Law for the following reason (Section 7031.5, Business andC Professions Code): PRESENT BUILDING 1C� I, 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 7044, Business and Professions Code). MOVING TEL. � 1 1 4,3 A I, as owner of the property, am exclusively contracting CONTRACTOR NO. 0 0 0 0 0 1 with licensed contractors to construct the project (Sec- ADDRESS ' tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK FROM EXIST. Z ° ° 4 a O O CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT x the performance of the work for which this permit is issued P.L. .10 0' � D 60 0 0 0 (� 3,� Q CJ (Sec. 3097, Civ, C.). SIDE Q �1 0 9. 1 4 -8 1 P.L. Lender's Name 7/ d P.C. Fee$ Permit Fee c.3& Lender's Address I certify that I have read this application and state that the Issuance Fee above information is correct. I agree to comply with all County Investigation Fee 2 3 ordinances and State laws relating to building construction, Total Fee J / and hereby authorize representatives of this County to enter upon the above-m Homed property for inspection purposes. , r - µ�`,q`�J SEE REVERSE FOR EXPLANATORY LANGUAGE a �t7 ture of ,pplicant or Agent Date i ®s COUNTY OF LOS ANGELES TEMPLE CITY i # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 9905170029 PHONE: (626) 285-0488 EXT: LEGAL D' No. OF CONST BUrLDrWG SS: TR: 6561 LT: 95 SQ. FT STORIES TYPE 9735 WOODRUFF AV STRUCTURE: 0 VN TEMP CA I NEAREST CROSS STREET: ASSESSOR I 0 ON ER: 5385-019-012 THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY EAT: EXIST BLD S SD USE ZONE: - ISSUED 0 : PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 05/17/99 UT 11/13/99 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE / FIMAL BYr CODE: GARCIA EULALIO G;GARCIA MARY A (626) 285-8339- 1 2,000 9735 WOODRUFF AV TEMP 917801752 FEES PAID D SC 'IP 10 DF WORK REMOVE AND RECOVER OVER ISTING ROOF WI ELOTEX CLASS A APPLICANT: TE FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: COMP. SHINGLES 25 YR. N WEATHERITE ROOFING (626) 287-0669- AA BLDG PERMIT ISSUANCE 27.75 4016 TEMPLE CITY AC STRONG MOTION RESID 2000.00 VAL 0.50 SPECIAL CONDITIONS: ROSEMEAD, CA D2 PERMIT W/O,EN-HC"-- -- 2000.00 VAL 82.20 a� -- ,_70TA1-FEES• 110.45 CONTRACTOR: TEL. 0: r• APPROVALS DATE INSPECTOR SIGNATURE WEATHERITE ROOFING (626) 287-0669- �Of 4016 TEMPLE CITY BLVD LIC. NO i• �'. �` LOCATION AND SETBACKS ROSEMEAD CA 91770 423177C39 s SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: r `•�`' i FO A IO C ORMS LIC. NO:p i -___—a' i __ _ -- SLAB/.UNDER FLOOR RAISED FLOOR FRAMING 150H269 SEWER MAP B00 PAGE: FIRE ZONE: CMPO ,; UNDERFLOOR INSULATION FLOOR SHEATHINF 0. OF IES: DWELLING S: T/ 0 : STAT CLASS:- NO L NO 27 � ; - �' - - ROOF SHEATHING SCHOOL W R 0 + �` -' r _ SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS � �• _'f NO NO NO ��•1 FRAME INSPECTION %" REQUIRED TO AL SETBACK FROM S r - k�� ' ,.��• FIRE SP HANG RS SET BACK YARD: HWY: PROP LINE: WIDTH: ��a�A�� - --' .•-. �i�:�� `� FRONT PL- - % INSU ATION/ EA HER STR P SIDE PL- INTERIOR A WA EXTERIOR LATH TED FLOOR/CELL ASSE . RATED WALL ASSEMB IES RATED SHAFTS/OPENINGS-- T-BAR P NT-BAR CE LINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508