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Home My Public Portal About9653 WOOLLEY ST_Building__ 78A639A DHH•S 12•S4 •. APPLICATION- FOR",- BUILDING PERMIT ]. DIVISION OF BUILDING AND SAFETY BUILDING r Department Of County Engineer ADDRESS 4. County of Los Angeles LOCALITY WM.J.FOX. COUNTY ENGINEER NEAREST / I CASSATT D.GRIFFIN,SUPT OF BUILDING NEARECROSS'ST. FOR'APPLICANT TO FILL IN DISTRI�T NO. GROUP I TYPE SEWER MAP ,- � e .�. BK PG BUILDING / . - CONST. ADDRESS X053 �rJ�G�('L'C.I_•I- MAP �J DO STATE, 4gRS ®- Sl y ISO�t 07L W1Y`�•'3�i O�-•��f1. �o NUMBER /t ✓ HWY L07 NO.0_ �^ 440010-0 ` /� -�-± BLO K US ZONE SPECIAL TRACT 34ft704 ,qn/ l�.400 0-0 /f-� d,� � CONDITIONS' NO:OF BLDGS. I �� SIZE OF LOT 53 LS I NOW ON LOT DIV. BUILDING YARD. .HWY STREET NAME EXIST. USE OF SETBACK WIDTH EXISTING BLDG. FRONT 91D OWNER 1 M (_IC'u/'/C SIDE MAILC� P. L. ADDRESS #03,9/ //� t NO. C�/l�'Io6 I t'' DWELL. 1 UNIT 5 INDUSTRIAL Zi •DUPLEX_UNIT 6 PUBLIC BLDG.. ARCHITECT OR - TEL ! ENGINEER NO. 31 APT. UNITS 7 ADDN.,ALT.,ETC. ADDRESS ^^ Ate' Qi COMMERCIAL 8 MISCEL. � TEL CONTRACTOR .A./!�IArJ -/Y NO. INSPECTION RECORD - ADDRESS �J�G•-.n. Ji�:I1vU� ' DESCRIPTION SOF WORK NEW AD.D ALTER REPAIR DEMOLISH r A'.'/7•14 7Xenilep ex SQ: FT / NO. OF NA OF _SIZE �•'J STORIES FAMILIES USE OF STRUC URE • _ f41 Al;t'971 A9,- AAI ,FAIT,-F. R_ - ��X A,o , SIGNATURE OF APPLICANt,�T'_+� �j�I C�.S APPROVALS ADDRESS /i 7!1 T,� �t(�'ir?�c ? -r 1-C! f DATE INSPECTOR'S SIGNATURE FOUNDATION: LOCATION �/ O oe •P.C. S• Ya",�� C� .FORMS. MATERIALS �" )S ( �I ar C - FEE / FRAME: FIRE STOPS. -BRACING.BOLTS FEE Y fi -�11 �i fMC4f VALUATION O FURNACE: LOCATION, � 1 HEREBY ACKNOWLEDGE THAT 1• HAVE READ THIS +o;GAB VENT,DUCTS 7-ZOzSrf APPLICATION AND STATE THAT rTHE.ABOVE IS CORRECTW, t'; ! AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH. INT. •//v� AND STATE LAWS REGULATING BUILDING CONSTRUC- TION. I LATH.EXT. SIGNATURE OF 1 HOUSE NUMBER COR- PERMITTEE i RECT. AND POSTED 1. 3. /� ADDRESS .FINAL Zo �7l v WLL-- J. FOX. CouxTy ENGINEER VALIDATION BY °' 2 1 1 e ,'MAR'3. 1.6 1 4'� 3 5 61`�."APR. 6 �- 3.0-00 !tt - - -- DEPUTY^ - ry( "DEPUTY . BY BY ` DEPUTY DEPUTY APPLICATION FOR BUL INC PERMIT C ' COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN W_�ES BUILDING ADDRESS I hereby affirm that I have a certificate of consent to self insure, 9653 WOOLLEY or a certificate of Workers'Compensation Insurance,or a certified CITY ZIcopy thereof(Sec.3800,Lab.C.) STATE FUND TEMPLE CITY 91780 Polley No. 10 10 Company SIZE OF LOT NO.OF BLDG&NOW ON LOT❑ Certified Copy iS hereby furnished. Certified copy is filed with the county building inspection TRACT BLOCK LOT NO department. I I USE ZONE MAP NO Date 11-1-95 Applicant RANDOL ROOFING ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS .7 CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL NO I // CHARLENE S'_I11i YES NO COMPENSATION INSURANCE 446-25 WITHIN 1000 FT OF SCHOOL? (This section need not be completed if the permit is for one hundred ADDRESS dollars($100)or less.) 9653 WOOLLEY DISTRICT GROUP TYP CONST FIRE ZONE PROCESSED BY CITY ZIP I certify that in the performance of the work for which this permit TEMPLE CITY 91780 3 � 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. STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT. If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become Subject t0 the Workers' CONTRACTOR TEL NO. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith RANDOL ROOFING 288-4040 FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC NO. PL LICENSED CONTRACTORS DECLARATION X5129 E. VALLEY SIDE I hereby affirm that I am licensed underprovisions of Chapter 9 AN GABRIEL CA 91776 LICCc 39 P L (commencing with Section 7000)of Division 3 of the Business and SO.FT SIZE NO OF STORIES NO.OF FAMILIES SEWER MAP Professions Code,and m license is in full force and effect. NEW ❑ BK PG a License Number 41937 Lic.Class C-39 DESCRIPTION OF WORK ADD ❑ VALUATION C REROOF HOUSE & GARAGE WITH 4,000.00 L ContractorRANDOL ROOFING Date 1-31-9h ALTER ❑ � 25—YEAR CLASS A FIBERGLAS REPAIR ❑ C ❑ I am exempt under Sec. BAP.C.for this reason SHINGLES. TEAR OFF ONE LAYER DEMOL El $ LL LDMA P/C# Date: ODC F EXISTING BLDG. URM ❑ TyTr�+ U Signature APPLICANT(PRINT) TEL NO. LDMA Perm# L—g—llvI 1 Eat A Wo tl_ 2 ❑ I, as owner of the property, or my employees with wages as RANDOL ROOFING 2$$— Z y_�I! their sole compensation, will do the work and the structure is ADDRESS O - �i'ItsE �"—• not Intended or offered for sale (Section 7044, Business and 2 FINAL DATE a Professions Code.) VVILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL ._l L� OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE ❑ I, as Owner of the property, am exclusively contracting with AVOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GU.DE9 licensed Contractors to construct the project (Section 7044, FINAL BY Business and Professions Code.) YES 11 NO ❑ Q� —QQ01 iQ/ 2/9S WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REOU'RE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH �y CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKUST FOR 1 Alll o-2p GUIDEUNES 2575 1 hereby affirm that there is a construction lending agency for YES❑ NO❑ CY W the performance Of the Work for which this permit IS ISSUed(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDEAND THE SCAQMDPERMITTING a 3097,CIV.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE TITLE 2,CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERN'NO HAZARDOUS 3 Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERVIT FROM THE SCAOVD oLender's Address C OANER OR u=YT Z; I certify that I have read this application and state under penalty of perjury that the above information is correct.I agree to comply P.0 FEE PERMIT FEE $ with all count o I ances and State laws relatin to uilding 114.90 m construction, by authorize representatives f this County ISSUANCE FEE 27.30 Cl) to enter u� ove- entio d party for in oses. W INVESTIGATION FEE TOTAL FEE ar_I n••I A rt _ IlAq 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 0810280003 PHONE: (626) 285-0488 EXT: ID: NO. OF CONST BUILDING ADDRESS: ILS ON FILE I SQ. FT STORIES TYPE I 9653 WOOLLEY ST ISTRUCTURE: V-B I TEMP CA 917801444 (ASSESSOR INFORMATION NUMBER: I i NEAREST CROSS STREET: VAL I 15383-013-021 I THOMAS PAGE: 596 GRID: J1 LOCALITY: TEMPLE CITY, Cl I 1TENANT: (EXIST BLDG USE: RESID USE ZONE: R-1 (ISSUED ON:. PROCESSED BY: IRXIST OCC GRP: 110/28/08 SR JOWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: JFINAL DAT FIN BY: CODE: I SMITH CHARLENE J (626) 446-4187- 10,000 1`-)" IAnNj 1 9653 WOOLLEY ST 1 IM 4 ITEMP 917801444 FEES PAID1DESCRIPTIO OF WORK 1KITCHEN, • (2) BATHROOMS A13 LAUNDRY REMODEL J I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:( JAPPLICANT: TEL. NO: I I IL & W KITCHENS & BATHS (626) 287-1131- JAA BLDG PERMIT ISSUANCE 27.75 1 18812 LAS TUNAS DR. IAC STRONG MOTION RESID 10000.00 VAL 1.00 ISPECIAL CONDITIONS: [ SAN GABRIEL CA 91775 JB2 PERMIT -W/ENERGY 10000.00 VAL 238.26 TOTAL FEES 267.01 I j (CONTRACTOR: TEL. NO: I [APPROVALS DATE INSPECTOR SIGNATURE I IL AND W KITCHENS AND BATHS (626) 287-1131- I [ 18812 LAS TUNAS DRIVE LIC. NO I (LOCATION AND SETBACKS I I (SAN GABRIEL CA 91776 205344 B', I [ [ I I I (SOILS ENGINEER APPROVAL I [ (ARCHITECT OR ENGINEER: TEL. NO: - I I (FOUNDATION/TRENCH FORMS I I LIC. NO, I JSL"/UNDER FLOOR I I (RAISED FLOOR FRAMING [ IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION I 1153H269 3 00� L�+ 1 [ Lk d V+ A r FLOOR SHEATHING INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I NO 21 ROOF SHEATHING I 1 1 J 1 SCHOOL WITHIN HAZARDOUS , J Sr !SHEAR PANELS I [ JAIR QUALITY: 1000 FEET MATERIALS bkl� Cp�ct L �Le`,Ef� �'� ,�r�% I NO NO NO 1FRAME INSPECTION / f I [ REQUIRED TOTAL SETBACK FROM EXIST • I � [FIRE SPRINKLER HANGERS I I I (SET BACK YARD: HWY: PROP LINE: WIDTH: [ �1Q�.� 0 FRONT PL- 1 JINSULATION/WEATHER STRIPI I [ SIDE PL I (INTERIOR LATH/DRYWALL 1 I IERTERIOR LATH I I J I [RATED FLOOR/CEIL ASSEM. I 1 1 RATED WALL ASSEMBLIES I I I (RATED SHAFTS/OPENINGS I J I I [ I T;gM MILINGS 1 LOT DRAINAGE ID: DP : BS0508 [ (REPORT R261 ROUTE TO