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HomeMy Public PortalAbout10504 KEY WEST ST_Building_6/8/2015_A COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC WORKS BUILDING AND SAFETY / LAND DEVELOPMENT LEGAL ID: TR: 11290 LT: 1 ASSESSOR INFORMATION NUMBER: 8585-024-001 SCHULZE, ANN 10504 KEY WEST ST TEMP 917803462 A, MANUEL EUCLID CRESCENT D CA 91784 CONTRACTOR: B X D CONSTRUCTION 2509 EUCLID CRESCENT E UPLAND CA 91784 ARCHITECT OR ENGINEER: TEL. NO: TEL. NO: (626) 786 -2347 - TEL. NO: (626) 786 -2347 - LIC. NO 627142 TEL. NO: LIC. NO: MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 3 00 NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: NO 21 SCHOOL WITHIN HAZARDOUS AIR QUALITY: 1000 FEET MATERIALS NO NO NO PERMIT EXPIRES 6 MONTHS DATE OF ISSUANCE OR DATE OF LAST VALID INSPECTION. TEMPLE CITY # 0508 9701 LAS TUNAS TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: NO. OF CONST SQ. FT STORIES TYPE STRUCTURE: -1525V-B� EXIST BLDG USE:' RESID USE ZONE: R-1 EXIST OCC GRP: BLDGS. NOW ON LOT: VALUATION: 4,800 FEES PAID FEE DESCRIPTION: QUANTITY: DOM AA BLDG PERMIT ISSUANCE AS STATE GREEN BLDG FEE 4800.00 VAL AC STRONG MOTION RESID 4800.00 VAL D2 PERMIT W/0 EN -HC 4800.00 VAL TOTAL FEES BUILDING PERMIT ALTERATION/REPAIR BL 0508 1506080015 BUILDING ADDRESS: 10504 KEY WEST ST TEMP CA 917803462 J NEAREST CROSS STREET: FAIRFAX •.r� THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY CA ]ISSUED ON: PROCESSED BY: 106/08/15 SR I F DATE /7}/ FINBd, Tjj': CODE: I�PTIONJOF WORK G�/JUL) IAEMOVE EXISTING 3 TAP ASPHALT SHINGLES, NEW 1/2 OSB RADIANT AMOUNT:ISHEATHING, INSTALL NEW CLASS -A- GAF ARCHITECTURAL ROOF JASPRALT SHINGLES 27.80 1.00 ]SPECIAL CONDITIONS: 0.50 I 132.60 ] 161.90 ] APPROVALS LOCATION AND SETBACKS ] ]SOILS ENGINEER APPROVAL IFOUNDATION/TRENCH FORMS SLAB/UNDER FLOOR i l ,\ '} •.;� 'IRATSED FLOOR FRAMING �! / `` I / ^ iUNDERFL00A INSULATION \ne L�1LJ (_ 1 ]FLOOR SHEATHING I_ ]ROOF SHEATHING I SHEAR PANELS +iiil \`��i�"iFRAME INSPECTION ���l OF ` FIRE SPRINKLER HANGERS I .. ��\SZ. •.'�/�l� ` INSULATION/WEATHER STRIP] INTERIOR LATH/DRYWALL LIXI \J EXTERIOR LATH RATED FLOOR/CEIL ASSEM. (RATED WALL ASSEMBLIES I IRATED SHAFTS/OPENINGS I I IT -BAR CEILINGS IAT DRAINAGE PORT ID: DPR261 ROUTE TO: ES0508 ] DATE INSPECTOR SIGNATURE OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) (Section 7031.5, Business and Professions Code): Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): U I, as owner of the property, or my employees with wages as their sole compensation, will do (J) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner - Builder will have the burden of proving that it was not built or improved for the purpose of sale.). U I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contre?tor pursuant,to the Contractors' State License Law). (_) I am exempt from licensure under the Contractors' State License Law for the following reason: By my signature below I acknowledge that, except for my personal residence in whicf I must have resided for at least one yearpriorlto completion of the improvements covered by this permit, I cannot legally sell a structure that I have built as an owner -builder If it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law. Section 7044 of the Business and Professions Code, is available upon request when this application is submitted or at the following Web site: htto://www.lecinfo.ca.00v/calaw.html. Date: Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. -7 / License Class _ License No.62 / ` ntractor Signature WORKERS' COMPENSATIO WARNING: FAILURE TO SECUREARCNSATION COVERAGE IS UNLAWFUL, ANDCT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I. JOB ADDRESS LOCALITY I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self - insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Policy No. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My wi r e s' Carrier pJeAAII n.insumnce c r�aanopoliyirc�pPolic Num ationon'ba�tte Name of Agent Phone Number I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to b4aagree je to the workers' compensation laws of California, t, if I should become subject to the workers' cvisions of Section 3700 of the Labor Code, I shampl r h those provisio Signature f Date QBBYIST RDINANCE CERTIFICATION omp ete this section for permits in Unincorporated Los Angeles County only This is to certify that I, as permit applicant, am familiar with the requirements of Los Angeles County Code Chapter 2.160 at seq., (relating to the Los Angeles County Lobbyist Ordinance) and that all persons acting on behalf of myself complied and will continue to comply therewith through the application process. Applicant (Print Name) Applicant Signature Company Name Date HAZARDOUS MATERIAL DECLARATION Will the applicant or future building occupant handle a hazardous material or a mixture containing a hazardous material equal to or greater than the amount specified on the hazardous materials information guide? Yes ❑ N o ❑ Will the intended use of the building by the applicant or future building occupant require a permit for construction or modification from the South Coast Air Quality Management District (SCAQMD)? See permitting checklist for guidelines. Yes ❑ No ❑ j I have read the hazardous materials information guide and the SCAQMD permitting checklist, I understand my requirements under the Los Angeles County Code Title 2, Chapter 220' Sections 220.100 through 220.140 concerning hazardous material reporting and for obtaining a permit from the SCARMD. ASBESTOS NOTIFICATION ❑ Notification letter sent to AQMD and/or EPA ❑ I declare that notification of asbestos removal is not applicable to addressed project. DECLARATION REGARDING CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a Construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lenders Name Lender's Address By my signature below, I certify to'each of the following: I am the property owner or authorized to act on the property owner's behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances and stat laws relating to building cons Wction. I authorize rept iv of this county to enter the above-identifi rty fo inspection purposes. Signature otjPrp Qy�orized Agent Date COUNTY OF RAS ANGLES DEPARTMENT OF PUBLIC WORKS BUILDING AND SAFETY / LAND DEVELOPMENT LEGAL ID: TR: 11290 LT: 1 ASSESSOR INFORMATION NUMBER: 8585-024-001 TEL. NO: SCHULZE, ANN 10504 KEY WEST ST TEMP 917803462 NPPLICANT: TEL. NO: ORREA, MANUEL (626) 786-2347- 2509 EUCLID CRESCENT JPLAND CA 91784 JONTRACTOR: TEL. NO: 3 X D CONSTRUCTION (626) 786-2347- 2509 EUCLID CRESCENT E LIC. NO JPLAND CA 91784 627142 4RCHITECT OR ENGINEER: TEL. NO: LIC. NO: NAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 3 00 HO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: NO 21 SCHOOL WITHIN HAZARDOUS NIR QUALITY: 1000 FEET MATERIALS NO NO NO PERMIT EXPIRES 180 DAYS IF 1) WORK DOES NOT COMMENCE, OR 2) WORK IS SUSPENDED OR ABANDONED, OR 3) FAILS TO OBTAIN CODE REQUIRED INSPECTION TEMPLE CITY # 0508 9701 LAS TUNAS TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: BUILDING PERMIT ALTERATION/REPAIR BL 0508 1509020012 FEE DESCRIPTION AA BLDG PERMIT ISSUANCE AS STATE GREEN BLDG FEE AC STRONG MOTION REBID D1 PLANCHECK W/O EN -HC D2 PERMIT W/O EN -HC NO. OF CONST BUILDING ADDRESS: �MVv $�. F'[ STORIES TYPE 10504 KEY WEST ST STRUCTURE: _ V -B TEMP CA 917803462 `--" INSTALL (RETROFIT) 9 WINDOWS, 1 PATIO DOOR VINYL IOW E NEAREST CROSS STREET: FAIRFAX UOM: AMOUNT:1DOUBLE GLASS THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY 27.80 1 1 EXIST BLDG USE: RESID.- USE ZONE: R-1 JISSUED ON: PROCESSED BY: EXIST OCC GRP: ` 0.50 09/02/15 SR SLUGS. NOW ON LOT: VALUATION: I IFINAL DA F NAL BY CODE: FEE DESCRIPTION AA BLDG PERMIT ISSUANCE AS STATE GREEN BLDG FEE AC STRONG MOTION REBID D1 PLANCHECK W/O EN -HC D2 PERMIT W/O EN -HC REPORT ID: DPR261 ROUTE TO: BS0508 LOCATION AND SETBACKS SOILS ENGINEER APPROVAL FOUNDATION/TRENCH FORMS SLAB/UNDER FLOOR RAISED FLOOR FRAMING UNDERFLOOR INSULATION FLOOR SHEATHING ROOF SHEATHING SHEAR PANELS FRAME INSPECTION FIRE SPRINKLER RANGERS INSULATION/WEATHER STRIP INTERIOR LATH/DRYWALL EXTERIOR LATH RATED FLOOR/CEIL ASSEM. RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T -BAA CEILINGS IAT DRAINAGE j���c�5 9,100 ©q% � �MVv FEES PAID DESCRI IO ff R INSTALL (RETROFIT) 9 WINDOWS, 1 PATIO DOOR VINYL IOW E QUANTITY: UOM: AMOUNT:1DOUBLE GLASS 27.80 1 1 4100.00 VAL 1.00 SPECIAL CONDITIONS: 4100.00 VAL 0.50 4100.00 VAL 112.70 4100.00 VAL 132.60 TOTAL FEES 274.60 JAPPROVALS DATE INSPECTOR SIGNATURE REPORT ID: DPR261 ROUTE TO: BS0508 LOCATION AND SETBACKS SOILS ENGINEER APPROVAL FOUNDATION/TRENCH FORMS SLAB/UNDER FLOOR RAISED FLOOR FRAMING UNDERFLOOR INSULATION FLOOR SHEATHING ROOF SHEATHING SHEAR PANELS FRAME INSPECTION FIRE SPRINKLER RANGERS INSULATION/WEATHER STRIP INTERIOR LATH/DRYWALL EXTERIOR LATH RATED FLOOR/CEIL ASSEM. RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T -BAA CEILINGS IAT DRAINAGE j���c�5 OWNER -BUILDER DECLARATION LICENSED CONTRACTOR'S DECLARATION JOB ADDRESS I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) (Section 7031.5, Business and Professions Code): Any city or county that requires a permit to construct, alter, Improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): U I, as owner of the property, or my employees with wages as their sole compensation, will do (✓) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement Is sold within one year of completion, the Owner - Builder will have the burden of proving that it was not built or improved for the purpose of sale.). U I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contrkctor pursuant to the Contractors' State License Law). U I am exempt from licensure under the Contractors' State License Law for the following reason: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior) to completionof the improvements covered by this permit, I c'nnot legally sell a structure that I have built as an owner -builder If it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of'the Business and Professions Code, Is available upon request when this application is submitted or at the following Web site: htto://www.leainfo.ca.aov/calaw.html. Date: Signature of Property Owner or Authorized Agent I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. -4Ioense Class License No. 2% d ZL7 .fat —2 1 Contractor Signature 44- 77 WORKERS' COMPENSA CLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self - insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Policy No. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit its riissued. My worke 'corn a allontipsurance ca 'er d�9licypnmJber a artier Po is Num erNum Expiration D eD e Name of Agent Phone Number I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensa n provisions of Section 3700 of the Labor Code, I shall fo with those provisions o9.y IS — Dale ure scant Da e LOBBYIST ORDINANCE CERTIFICATION Complete this section for•permits in Unincorporated Los Angeles County only This is to certify that I, as permit applicant, am familiar with the requirements of Los Angeles County Code Chapter 2.160 at seq., (relating to the Los Angeles County Lobbyist Ordinance) and that all persons acting on behalf of myself complied and will continue to comply therewith through the application process. Applicant (Print Name) Applicant Signature Company Name Date LOCALITY HAZARDOUS MATERIAL DECLARATION Will the applicant or future building occupant handle a hazardous material or a mixture containing a hazardous material equal to or greater than the amount specified on the hazardous materials information guide? Yes ❑ N o ❑ Will the intended use of the building by the applicant or future building occupant require a permit for construction or modification from the South Coast Air Quality Management District (SCAQMD)? See permitting checklist for guidelines. Yes ❑ No ❑ / I have read the hazardous materials information guide and the SCAQMD permitting checklist, I understand my requiremBents under the Los Angeles County Code Title 2, Chapter 220' Sections 220.100 through 220.140 concerning hazardous material reporting and for obtaining a permit from the SCAQMD. ASBESTOS NOTIFICATION ❑ Notification letter sent to AQMD and/or EPA ❑ I declare that notification of asbestos removal is not applicable to addressed project. DECLARATION REGARDING CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a Construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lenders Name Lenders Address By my signature below, I certify to,each of the following: I am the property owner or authorized to act on the property owners behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. I authorize re ativ of this county to enter the above-idenf Whl erty r inspection purposes.