HomeMy Public PortalAbout8609 WORTHINGTON DR - Building - 1960-04-01 A ROAD 'DEPT. PERMIT' IS ~�I
FOR ANY MATERIAL �;••f;,;�, OR WORK _
DONNE lfd THE ROAD RIGri7 OF -WAY.
Im.Ac6#.osa." APPLICA'TI-ON IrOq 'BUILDING 'PI~:RMI ' . 1.
COUNTY OF LOS ANGELES BUILDING "
AD°REss
DEPARTMENT OF COUNTY ENGINEER '
BUILDING AND SAFETY DIVISION' :. LOCALITY
JOHN A. L•AMBIE, COUNTY ENGINEER NEAREST
CASSATT
D. GRIFFIN SUPT OF BUIL DING CROSS ST.
DISTRICT NO. GROUP . TYPE P ESSED BY
FOR APPLICANT TO FILL IN
BUILDINC�q/ STATISTICAL CLASSIFICATION. S ER MAP
ADDRESS�'!y p BK• PG
CLASS.NO. DWELL.UNIT
LOT NO. 2 BLOCK MAP 4STATE
NUMBER HWY. YES NO
TRACT '25541 USE ZONE - SPECIAL
NO.-OF BLDGS. /� I CONDITIONS A
SIZE OF LOT I NOW ON LOT
USE OF
EXISTING BLDG, 'e-ve BUILDING EXIST.
SETBACK YARD. HvfY STREET AME WIDTH
OWNER. Jack Kileen FRONT
MAIL P.L.
ADDRESS SIDE '
P.L. V.
CITY Tu junga
TEL : /If ECTION• RECORD
ARCHITECT OR TEL. ^
ENGINEER NO.
ADDRESS.. TL
rNE).FL •882`
CONTRACTOR 11.Jaok Kll@8
ADDRESS 10227
DESCRIPTION OF WORK _.N_490 . T/J I°o ty /_a/J/J r/ [�oar
NEW z ADD ALTER REPAIR DEMOLISH 47
SQ. FT. NO. OF NO. OF
SIZE 14�� STORIES FAMILIES
USE OF
STRUCTURE R6S1denoe and Two '-Car
Detached Garage
SIGNATURE OF
APPLICAN APPROVALS DATE INSPECTOR'S SIGNATURE
ADDR 3 27. Fairgrove A,Ve TUjUnga FOUNDATION:LOCATION-
FORMS,MATERIALS C7
VALUATION $ le
p „J FRAME:FIRE STOPS, DJ��p
BRACING,BOLTS 1/A I/,'
ty FURNACE:LOCATION,
F E I FEE S I GAS VENT,DUCTS
IER BY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH,INT. nfitl� 'j�
PLICATION AND STATE THAT THE ABOVE IS-CORRECT AND
AGREE TO'COMPLY WITH COUNTY ORIPINANCES AND
STATE LAWS REG TI BUILDI STRUCTION. LATH,EXT.
SIGNATURE OF HOUSE NUMBER COR-
SIGNATURE
RECT AND POSTED .
ADDRE FINAL
CLYDE N. DIRLAM, PRINCIPAL STR RAL ENG EER
'. PLAN CHECK VALIDATION- �H M.O. CASH PERMIT VALIDATION M.O. CASH
L;�6 7 5 4 51 RAR 2 3 A' 2 4.0 0 M ®P
6 3-52 APR 1 A 5.1--0 0
WORKERS'COMPENSATION DECLARATION
hereby affirm that I have certificate of consent to self APPLICATION FOR BUILDING PERMIT
insure, or a certificate of Workers'Compensation Insurance,
�orocertified opy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY
y Company
Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING )
ADDRESS (f
Certified copy is filed with the county building inspec- BUILDING `
tion department. /' ADDRESS _.
Date/,/ Applicant CITY SAO b,2.rrL ZIP LOCALITY
CERTIFICATE OF EXEMPTION FROMWORKERS, NO.OF BLDGS. NEAREST
COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST.
(This section need not be completed if the permit is for onenn (C�' ASSESSOR
hundred dollars($100)or less.) TRACT oZS 3 BLOCK LOT NO. MAP BOOK PAGE PARCEL
OWNER TE USE ZQNE MAP
I certify that in the performance of the work for which this //++ — NO + /) / NO.
permit is issued, I shall not employ any person in any manner ADDRESS G 0�2T id s SPECIAL
so as to become subject to the Workers'Compensation Laws. CONDITIONS O
CITY CA+%) "01, ZIP 1
Date Applicant
ARCHITECT OR TEL.
NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. DISTRICT GROUP TYPE FIRE PROCESSED BY O
Exemption, you should become subject to the Workers' CONST.` ZONE (--
Compensation provisions of the Labor Code, you must forth- ADDRESS t/ W
with comply with such provisions or this permit shall be t].
deemed revoked.
TEL STATISTICAL C SIFICATION APT. CONDO. fn
CONTRACTO h�� GN �/ Z_
LICENSED CONTRACTORS DECLARATIONCLASS NO. DWELL UNITS
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS/ L)AJ4-_S '10Q.NLICO. 3 33 SEWER MAP
(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 BK PG VALIDATION
3� SQ.FT. NO.OF NO.OF CHECK
License Number G ?32 Lic.Class 1 SIZE STORIES FAMILIES ONE
/ff��� �L` ,,�r/^ ,''n VALUATION
Contractorhik esu J�tS'r!�%r.J�ttfgate d 'J DESCRIPTION OF WORK�� cid-- OVY9 CS NEW ❑ i ;
679
I am exempt under Sec. GOor 1 ADD ❑
�.,/ ALTER •❑ ,
B.BP.C. for this on _ It S S AA-G EPAIR ❑ $
Date: USE OF DEMOL
EXISTING BLDG. C]
Signet f °9?Z— APPLICANT `�� 1 TEL. FINAL
6 Ek-BUILDER DECLARATION PRINT J P-M 9084V b-W IML Ol� DATE — �9 9 9.3 A
I hereby affirm a am exempt from the Contractor's License �11 � �
Law for the following reason (Section 7031.5, Business and ADDRESS L/�'S�f)�rrS .o� S4v 19 FIN # 0 0 0 0 0
Professions Code): PRESEMT B
BUILDINGa - 87,38
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 ® 0 0 0 8 7.3 8 5
7044, Business and Professions Code). MOVING TEL.
I, as owner of the property, am exclusively contracting CONTRACTOR NO. 0 b 2 7;-i 8 8
with licensed contractors to construct the project (Sec- ADDRESS
tion 7044, Business and Professions Code).
REQUIRED TOTAL SETBACK FRO
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP.LINE WIDTH
I hereby affirm that there is a construction lending agency for FRONT
the performance of the work for which this permit is issued i P.L.
(Sec. 3097, Civ. C.). SIDE
P.L.
Lender's Name ,
LDMA Ref. #
Lender's Address P.C. Fee$ Permit Fee !
I certify that I have read this application and state that the Issuance Fee .LS L/ LDMA P/C N
! above information is correct. I agree to comply with all County ! Investigation Fee
i
ordina—aces aft State laws relating to building construction, Total Fee LDMA Perm. q
an ereby ou orize representatives of this County to enter
( on th e- entioned perty for inspection purposes. ,
` SEE REVERSE FOR EXPLANATORY LANGUAGE
i pplicant or Agent Dat
D
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 0210180027
PHONE: (626) 285-0488 EXT:
LEGAL ID: 0• OF CONST BUILDING ADDRESS:
TR: 25341 LT: 2 SQ. FT STORIES TYPE 8609 WORTHINGTON DR
STRUCTURE: VN SGAS CA 917752646
ASSESSOR0 NEAREST CROSS STREET: BURTON
5386-007-044 THOMAS PAGE: 596 GRID: G2 LOCALITY: TEMPLE CITY
TENANT: EXIST BLDGRESID U E - SU 0 : PROCESSED BY: EXPIRES 0 :
EXIST OCC GRP: 10/21/02 JK 04/19/03
OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: 4FINALDAT ' B : CODE:
LEDWITZ MARTIN W;ELIZABETH A TRUSTE ( 10,100 Z8609 WORTHINGTON DR i�SGAS 917752646 N 0STALL TILE
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:
A NO:
RICH SWATMAN ( AA BLDG PERMIT ISSUANCE 27.75
D1 PLANCHECK W/0 EN-HC 10100.00 VAL 198.39
D2 PERMIT W/O EN-HC 10100.00 VAL 233.40
TOTAL FEES 460.55
CONTRACTOR: TEL. NO: APPROVALS DATE -- INSPECTOR SIG AT RE
ROYAL ROOF CO. (800) 400-7692-
996 E PRICE ST LIC. NO LOCATION AND SETBACKS
SAN GABRIEL, CA 91767 413067 C39
SOILS'ENGINEER APPROVAL
ARCHITECT OR ENGINEER: FOUNATIONPRENCH
LIC. NO: SLAB/UND R FLOOR
i
IS D 00 G
i
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION
15OH261 3 01
FLOOR SHEATHING
NO. OF NG UNITS: APT/C : STAT-CLASS:
NO 21 ROOF SHEATHING
SL'HOOL WITHINHAZARDOUS ME-ATIPTNEES !/ ��•��C
AIR QUALITY: 1000 FEET MATERIALS
NO NO NO FRAME INSPECTION O
REQUIRED TOTAL SETBACKR S SPRINKLER'HANGERS
SET BACK YARD: HWY: PROP LINE: WIDTH:
FRONT PL- NSULA ON/ FATHER STRIP
SIDE PL- I
INTERIPR LXTR73RMLL
EXTERIOR LATH
RATED Ot C
RATED WALL ASSEMBLIES
RATED i
H S 0
RC 5 IL G
0 G
REPORT ID: DPR261 ROUTE TO: BS0508
I