HomeMy Public PortalAbout9148 WOOLLEY ST_Miscellaneous__ '' -'y'
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 MISCELLANEOUS PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS MP 0508 0003130001
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
EGA ID: NO. OF CONST NEW BUILDING ADDRESS:
TR: 12115 LT: 16 SQ. FT STORIES TYPE OCCUP GROUP 9148 WOOLLEY ST
STRUCTURE: 1 VN R3 TEMP CA 917801349
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: ENCINITA
5382-023-008 EXIST BLDG USE: RESID THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY, C
EXIST OCC GRP: R3 USE ZONE:
TENANT: ISSUED ON: PROCESSED B EXPIRES ON:
BLDGS. NOW ON LOT: VALUATION: 03/13/00 VG 0999100
2 0
OWNER: TEL. NO: FINAL DATE FINAL BY: CODE:
PRICE KENNETH D;JEANNINE L (626) 287-4665- 1ST EMS: . ,f_
9148 WOOLLEY ST FOUNDTN FOR GAR, BEDRM & BATH, RMDL KITCH/ELEC,MECH, PL
00 P-UVI
TEMP 917801349 DESCRIP ION OF WORK 1/
TO FINAL BLDG PERMITS, #0p96& 097, ELEC PERMIT #556 &8819"
OCCUP LOAD EXIST: PLUMBING PERMITS #099'&8820'/AND MECH PERMITS 265 & 8818✓
APPLICANT: TEL. 0: OCCUP LOAD NEW:
SAME AS OWNER -
PARKING SPACES REQUIRED• SPECIAL CONDITIONS:
PARKING SPACE O. -6-1-ED:
CsELE$
CONTRACTOR: TEL. NO: EXIT H/ Co LIMITED TIME USE
SAME AS OWNER LIC. NO NB F A� FROM TO
` � � FEES PA'I.
EE DES� I TION: QUA ITY: UOM: AMOUNT: APPROVALS DATE INSPECTOR SIGNATURE
ARCHITECT OR ENGINEER: TEL. N0: TRAILER USE
0 PERMIT IS A C 27.75
LIC. NO /0 /IOC E N§P , 45.95 SAFETY PERMIT
L T P L FEES 73.70
TEMP. STRUCT. APPROVED
MAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE: C 1 n n D ��C
���O rn1 n/J s TEMP. STRUCT. REMOVED
0. 0 FAMILIES: DWELLING UNITS: APT/CO : STAT CLAS U ILJ,�L{llu�`v
NO O _
SCHOOL WITHIN HAZAR 0 S
AIR QUALITY: 1000 FEET MATERIALS Q ❑
�'� �'•�
NO NO NO El
REQUIRED TOTAL SETBACK OM EXISTSET
FRONTAPL- YARD: HWY: PROP LINE: WIDTH: /L. Serv1Ce.�33
SIDE PL-
REPORT ID: DPR267 ROUTE TO: BS0508
WORKERS'G01lPENSATION DECLARATION CE 875(11-84) MISCELLANEOUS APPLICATION
I herebycruffirm.iat I have a certificate of consent tself COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION
insure, or a certificate of Workers'Compensation Insurancc e,or
a certified copy thereof(Sec.3800,Lab.Q.
Policy No. Company FOR APPLICANT TO FILL IN BUILDING
ADDRESS
Certified copy is hereby furnished. BUILDING L LOCALITY
ADDRESS
Certified copy is filed with the county building inspection LOCALITY /' �/^ NCAR sT.
department. /.�f/1 e t l a
Date Applicant NEARESTDISTRICT NO. OUP TYPE PROC SS BY
CROSS ST. T_S 5_ ♦1 CONST.
CERTIFICATE OF EXEMPTION FROM LEGAL
LEGAL -J (J
COMPENSATION INSURANCE DESCRIPTION LOT NO. BLOCK MAP HIGHWAY
No. (CIRCLa STATE MAJOR S OND LOCAL
NO. OF SLOGS. /I
(This section need not be completed if the work involved TRACT r `� NOW ON LOT USE ZONE SPECIAL C
by the permit is for one hundred dollars ($100) or less.) USE OF
I certify that in the performance of the work for which this SIZC OF Lor EXISTING BLDG.
permit is issued, I shall not employ any person in any manner OWNER K ?^ GC
so as to become subject to the Workers' Compensation Laws. MAIL - OCCUPANCY GROUP Ea]
a
47/ �` Gv c Z e_
Date ADDRESS Applicant
NOTICE TO APPLICANT: If, after making this Certificate of CITY1"14 _ dZ, rETM `ti/fr 4�s OCCUPANT LOAD
Exemption, you should become subject to the Workers' APPL CATION FOR EXIT HARDWARE:
Compensation provisions of the Labor Code, you must forth-
with comply with such provisions Or this permit shall be TRAILER USE ❑ GEOLOGY INSPECTION ❑ No Spec. Knowl.
deemed revoked.
LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION Panic Devices
I hereby affirm that I am licensed under provisions of Chapter SAFETY PERMIT ❑ (LIST ITEMS BELOW)
9 (commencing with Section 7000) of Division 3 of the Busi- NO. OF EXITS
ness and Professions Code,and my license is in full force and
effect. O
LOOP PARKING REOD pR OY1DED
SPACES
License Number Lic. Class LIMITED TIME USE
Contractor Date DATE DATE
El I am exempt from the licensing requirements as I am a L
FROM: TO:
licensed architect or a registered professional engineer SIZE of NO. OF I PECTO R'S
acting in my professional capacity (Section 7051, Bus- EXISTING BLDG. STORIES IGNATURE
iness and Professions Code). FINAL APPROVAL _
PRESENT USE OF BUILDING
Lic.or Reg.No. —Date
HOME OWNER-BUILDER DECLARATION NO. OF EXISTING BUILDINGS
ON LOT AND USE
I hereby affirm that I am exempt from the Contractor's
License Law for the following reason (Section 7031.5, Busi-
ness and Professions Code): NO. PARKING
I, as owner of the property, will do the work and the SPACES PROVIDED are 9 1 Q 9 A
structure is not intended or offered for sale (Section
7044,Business and Professions Code). o D o o -4 Q
CONSTRUCTION LENDING AGENCY PROPOSCD USE OF BUILDING I D D 8 Q 5 0
I hereby affirm that there is a construction lending agency
for the performance of the work for which this permit is o - 8Q503
issued(Sec.3097,Civ.Q.
Lender's Name 03,04-88
PROPOSED MAX. OCC.
Lender's Address
I certify that I have read this application and state that the PERMIT FEE c
above information is correct.I agree to comply with all County ISSUANCE FEE .�
ordinances and State laws relating to building construction,
and hereby authorize representatives of this County to enter TOTAL FEE
upon tl above-mentioned property for inspection purposes.
/ nSEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Permittee Date