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Home My Public Portal About8624 WORTHINGTON DR - Building - 1960-04-01 A ROAD DEPT. KR' 1I IS-s RcC,';; ZD Plan 3 FOR ANY MATT- !/,L O,t V'JOI:K DONE IN TiyE RUAD 'RiGo i `Or MAY; 7BAeeeA CE OBB-OY APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS !L BUILDING AND SAFETY'DIVISION LOCALITY _ r JOHN A. LAMBIE. COUNTY ENGINEER NEAREST / CASSATT D.GRIFFIN SUPT OF BUILDINGCROSS ST. DISTRICT NO. GROUP TYPE PROCESSED BY FOR APPLICANT TO FILL IN I CONST.I BUILDING STATISTICAL CLASSIFICATION SEWER MAP ADDRESS - r .� I BK PG Irthineton Dre 18-G. ' CLASS.NODWELL.UNITS LOT NO. BLOCK MAP STATE YES NO NUMBERHWY. TRACT 25.41 USE ZONE COSPECIAC NDITIONS NO.OF BLDGS. �j7 SIZE OF LOT I NOW ON LOT 1 k USE OF --- s m i• EXISTING BLDG. BUILDING EXIST. SETBACK YARD HWY STRE T NAME WIDTH OWNER _ FRONT ` MAIL P.L. s° , ADDRESS SIDE CITY TE F1 38273 P.L. ' „ SPECTION RECORD ARCHITECT OR TEL. ENGINEER _ NO. �.r �j ��, ��t,� _•) ADDRESS Jack Kiloen TELF138273 '�>` inns A11(6 "x tura �'!,�rr• CONTRACTOR NO. ADDRESS _bfE§bMfff0JN OF WORK NEW X ADD ALTER REPAIR DEMOLISH !' SQ. FT. NO. OF NO. OF (• SIZE STORIES FAMILIES STE OF UCTURE Residen.00 and two Car Detach 4994 Gara eo SIGNATURE OF APPLIC FOUNDATION: MATERIALS ION - -e�O 4W , > VALUATION $ dd Qa ,[� �` (� FRAME:FIRE STOPS, BRACING,BOLTS' _ P. 4 C. �r PMT. ,IJ - FURNACE:LOCATION, FEE S� "' FEE S+� GAS VENT,DUCTS i i HEREBY ACKNOWLEDG THAT 1 HAVE READ THIS AP- LATH.INT. /_D •,• PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH COUNTY OR ANCES AND �. I n// rr� STATE LAWS REG TI BUILDI STRUCTION. LATH.EXT. '/I SIGNATURE O C HOUSE NUMBER COR- PERMITTE RECT AND POSTED ADDRE FINAL. _//-/74o ✓�O� CLYDE N. DIRLAM. PRINCIPAL STORAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIONM.O. CASH DEC)7 5 "0.4%=o I A 2 2.5 0 A M OP I�j�,`j F3 0 3 G APR - 1 A L 8.n v e WORKERS'' COMPENSATION DECLARATION insurebor a certifiaffirm hAatte of Wof corent to sel orkers'tCompensat on APPLICATION Insurancef FOR BUILDING PERMIT or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company ❑ Certified co is hereby furnished. FOR APPLICANT TO FILL IN BUILDING Dr PY Y ADDRESS : •�{f� ;4_n ❑ Certified copy is filed with the county building inspec- BUILDING ,� - C tion department. ADDRESS ul-_•Z4 !,( r /' (1 ,.Q(i (. � - _AJ �ll�75 Date Applicant CITY^ ,, /,.� Ge ZIP `�ir� 1�� LOCALITY NO. OF BLDGS. 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.) , `t r ��tl�,` TEL. �•. �, USE ZONE MAP OWNER �c.C,I, L_ nj NO. I certify that in the performance of the work for which this C +' SPECIAL >_ NO. permit is issued, I shall not employ any.person in any manner ADDRESS p jty tyla ! ;•1. D CONDITIONS a- so as to become subject to the Workers'Compensation Laws. rq O CITY . _-r.! ZIP ��I 1 (r U Applicant ARCHITECT OR TEL. Date . 1. � NOTICE TO APPLICANT: If, after making this Certificate of ; ENGINEER NO. DISTRICT GROUP IE PROCESSED BY Q Exemption, you should become subject to the Workers' w Compensation provisions of the Labor Code, you must forth- ADDRESS with comply with such provisions or this permit shall be TEL. ?STATISTICAL CLASSIFICATION APT. CONDO. /+ r to deemed revoked. CONTRACTOR LOQ t _ F�J t NO. s Z LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. (commencing with Section 7000)of Division 3 of the Business LIC. SEWER MAP and Professions Code,and my license is in full force and effect. CITY CLASS BK PG VALIDATION SQ. FT. _ NO. OF NO. OF CHECK License Number Lic. Class SIZE I STORIES FAMILIES ONE VALUATION Contractor DESCRIPTION OF WORK ��; (:� NEW ❑ `J `•: El Date �I am exempt under Sec. 6M ) � L IV, r', ADD E] $ i` C ALTER ❑ B.BP.C. for this reason v h' t� ( - Ii REPAIR ❑ $ Date: USE OF EXISTING BLDG. DEMOL ❑ Signature ,APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION (PRINT) NO DATE I hereby affirm that I am exempt from the Contractor's License Fofeons he following reason (Section 7031.5, Business and ADDRESS FINAL Code): a.PRESENT By BUILDING as owner of the property, or my employees with `;ADDRESS wages as their sole compensation,will do the work and �Q, �.,_ the structure is not intended or offered for sale(Section .LOCALITY ® 330", 7044, Business and Professions Code.) MOVING TEL. t I,as owner of the property,am exclusively contracting CONTRACTOR NO. s ITEi tr with licensed contractors to construct the project (Sec- ADDRESS I i-1(({L I T 3 o 63 tion 7044, Business and Professions Code.) REQUIRED TOTAL SETBACK FROM EXIST. 1� �1'ff +i CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT 41 h the performance of the work for which this permit is issued P.L. C HA �- (Sec. 3097, Civ. C.). SIDE P.L. iF �'-;->��U� 1fi �l'4 Lender's Name Tri.! $ P.C. Fee$ Permit Fee tJ �(� LDMA Ref. # 6354 °C� Lender's Address t> 1 ATE I I°c-1`• I certify that I have read this application and state that the Issuance Fee � LDMA P/C# 3 above information is correct. I agree to comply with all County Investigation Fee e / r ordinances and State laws relating to building construction, Total Fee (o ; LDMA Perm. # and hereby authorize representatives of this County to enter o upon the above-mentioned property for inspection purposes. uy' 12- � , t:��L �u � _ �` SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or-Agent Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTEP,ATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0406070040 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING DRESS: TR: 25341 LT: 5 SQ. FT STORIES TYPE 8624 WORTHINGTON DR STRUCTURE: VN SGAB CA 917752647 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: BURTON 5386-007-047 THOMAS PAGE: 596 GRID: G2 LOCALITY: SAN GABRIEL, C TENANT: EX T BLDG USE: R SID USE ZONE: R-1 ISSUEON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 06/07/04 VG 06/02/05 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: — FINAL DATE -' CODE: KIM EUNICE ( 2,000 A p�n 11 . 8624 WORTHINGTON DR. //�\II � J TEMPLE CITY 91780 FEE PAID DESCRIPT ON YF 0 �! REMOVE AND REPLACE 10 WINDOWS (SAME SIZE) FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. NO: SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RESID 22000.00 VAL 0.50 SPECIAL CONDITIONS: D2 PERMIT W/O EN-HC 2000.00 VAL 82.20 TOTAL FEES 110.45 CONTRACTOR: TEL. NO: APPRCVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - LIC. NO LOCATIFiN AND SETBACKS SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOLI AT ON/TRENCH FORMS LIC. NO: SLABi•UNDER FLOOR RAI9j0 FLOOR FRAMTHG (MAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE: CMV UNDEk.FLOOR INSULATION XX 3 Oi _ GL OR SHEATHING NO.--OF FAMILIES: DWELLI G UNITS: APT/GOND: STAT CLASS NO 21 ROOF SHEATHING SCHOOL WITHIN HAZARDOUS I SHEARPANELS AIR QUALITY: 1000 FEET MATERIALS _ NO NO NO FRAME INSPECTION EQUIRED TOTAL SETBACK FROM EXIST FIRE SPRINKLER HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- INSULATION/WEATHER STRIP - SIDE PL- _ INTERIOR LA H/DRYWA L (EXTERIOR LATH RATED LOOR/CEIL ASSEN. RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508 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 0706200007 PHONE: (626) 285-0488 EXT: LEGAL ID: N0. OF CONST BUILDING ADDRESS: ITR: 25341 IT: 5 SQ. FT STORIES TYPE 8624 WORTHINGTON DR I ISTRUCTURE: 293 VN I SGAB CA 917752647 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: BURTON 15386-007-047 1 THOMAS PAGE: 596 GRID: G2 LOCALITY: TEMPLE CITY, Cl 1TENANT: JEXIST BLDG USE: RESID USE ZONE: R-1 (ISSUED ON: PROCESSED BY: EXPIRES ON: I (EXIST OCC GRP: 106/20/07 SR 06/14/08 1 OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: E AL BY: CODE: IKIM, EUNICE ( I 5,880 i 18624 WORTHINGTON DR. ISAN GABRIEL 91775 FEES PAID IDESCRIPT ON OF WORK PATIO COVER 293.8 S.F. I FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:( I IAPPLICANT: TEL. NO: I I 1SAME AS OWNER - IAA BLDG PERMIT ISSUANCE 27.75 I I IAC STRONG MOTION REBID 5880.00 VAL 0.59 ISPECIAL CONDITIONS: I IAX BUILDING REVIEW FEE 54.70 I I 1 ID2 PERMIT W/O EN-HC 5880.00 VAL 149.40 I I TOTAL FEES 232.44 (CONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE ISAME AS OWNER LIC. NO I 1LOCATION AND SETBACKS 1 I I ISOILS ENGINEER APPROVAL I (ARCHITECT OR ENGINEER: TEL. NO: I 1FOUNDATION/TRENCH FORMS I I y I 1 LIC. NO: I 1SLAB/UNDER FLOOR 1 (RAISED FLOOR FRAMING I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( (UNDERFLOOR INSULATION 1 I150H261 3 Oil I I I I FLOOR SHEATHING I I I INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I I I I NO 21 I IROOF SHEATHING SCHOOL WITHIN HAZARDOUS I I I I I SHEAR PANELS (AIR QUALITY: 1000 FEST MATERIALS I I �I I I NO NO NO I (FRAME INSPE CTION � REQUIRED TOTAL SETBACK FROM EXIST 1 IFIRE SPRINKLER HANGERS I 1 I ISET BACK YARD: HWY: PROP LINE: WIDTH: I I I I I 1 FRONT PL- I IINSULATION/WEATHER STRIPI I I SIDE PL- I -1-1 IINTERIOR LATH/DRYWALL I I I I I (EXTERIOR LATH I I I 1 I (RATED FLOOR/CEIL ASSEM. I I I I I (RATED WALL ASSEMBLIES I I I I I 1RATED SHAFTS/OPENINGS 1 I 1 I I I I IT-BAR CEILINGS I I I (LOT DRAINAGE I I I I I I I IREPORT ID: DPR261 ROUTE TO: BS0508 I I I I I I I I I I