HomeMy WebLinkAbout2171 PACIFIC AVE - Building PermitsOWNER
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DATE
BUILDING PERMIT N0. �
LOT 30 TRACT ti53 FIRE ZONE VAWE
ROUGM PLUMBING
PROP. SWR. LINE n HOl15E CON.
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UNOERGROUNO � POWER
ROUGH WIRING
BOND BEAM [] STEEL
SMERTNING
N FqAME AND FLASHING
� �ATHING - IN n i
�(]a P ER, BROWN COAT
O 5'� _TURAL, FINAL
'.7.� HEATING, VENT., REFR
BWLOING. FINAL
SUBCONTRACTOR
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GOS�TBoxE,zoo CIOSDTIAM SAFCALIFoaNAws2szsT . �PL TION�FOR��TRUCTURA�PERMIT-2a��
RECEI E PERMIT
For Applicant to Fill in Completely - Use Ink Only ��
BUI�DING21 1PgC�µ� AY ` A.P.NO. �—
ADPAESS E� D /units —
OWNEROR BUILDING / �^/� �
TENANT Surf View TI�1C. ADDRE55 �
MAILING UNITOR � �
ADDRE55161 1 E. �9hittier BZVCl. SPACENO.
TR LOT� BLK.
CITV ' ' L. . NpL �,�.'�_�.j. 0
pp(�STRUCTION • NEW ADD LTER REPAIR MOVING OEMOLISH
LENDER
BRANCN
OWNE �
ADDRESS V LUE
AflCr71TECT TEL. VSE D E/
pR NGINEER
ADORESS ZONE TVPE GROUP
APPROVED
CONTRACTOP Ti-Mar TI7C. e� DATE
ADDAE55 161 1 E. Whittier Blvd.
TEL.1' 1I
CITY Whittiea �i`d. NO. `✓7—`�'7�2
APPROVEOSETBACKS
LIC. NO. '�SOO7O LICVNO.
SIZE NO.OF BlDGS. (FROM C/L STREET)
OF 40T NOW ON LOT 3 FR NT FT.
USE OF
EXISTING BLOG.
Separate permits are required for L. SIDE
electric, plumbing and heating work:
REAR FT.
USE OF BUILDING AND WORK TO BE PERFORMED PLqN ING C N
DATE
Demolish ,eT/Y��.n/T qPPppVEO
Gc�� •�rRo — �-
I heYeby eeknowledBe thei I have reatl this appllcation entl staia
that tha ebova information is corract antl a8�ee to comply wfth
ell laws rapulatinB builtlin9 construction, antl I shell not employ - .
eny parson in vfolation of the workmen's companzation laws oi
Me Stata of Calitornla.
I haraby cenify t�at I em properly licensed as a contracior under SQ. FT.
ihe 5taia ot California 8usiness and Vrotess(ons Cotle, Division 3, THE AMOUNT SHOWN UNDEfi VALUATION IS FOR
Chapter 9, antl that such licansas are In full forca and eftxt, or I THE PUFiPO6E OF 6TABLISHING A PERMIT FEE ONLY:
am axempt trom the provisions of the State of Calitornia Buainexi M
enC Professiona Cotle, ' ie(on hapter 9. VALUATION �%) PERMIT FEE E � , vV
SiB�ature of /�y/�/ V— PLAN CHECK 5 �O
ParmlttB /� �(� � ��,/" TAX 5 , LJ"O
A�chorizatlABent �te /� �Z J� `� TOTALPAID 5 OV
0 T �:
f. LICATION FOR A BUILDING PERM1.
BUILDING PERMIT NO. Eiectr��a� m
Tract Block Lot �.thru O Pormi[ No. a
Ruiltlin9 �^ �� � 0 . Plumbin9 . �
Aae«� 2171 thru2191 Pacific Ave. N �1��' PermitNo. �
� q�
Cross Mechaniral G
Area � Street � Pormlt No. �-
m
�
o'""ef 5UTf Vi2W IriC. �vaeorv,o�ea: ❑New ❑Alter ❑naa��io�
Adtlreu 161 1 Whittier BZVC�. ❑ Repalr ❑ Convert ❑Demo ❑ OccupancyPmt.
!� 11 $up. DISt./
CItY Whittier V`cl.. '2IP 906o�hona 9�7y70 A.P. InsD.Ared
Arc�itect/ Zone Sp�. Vmt. No.
Desi9�er License No.
Setba s P/L Fmn[ WL SL Street WIOth
Atltlress
Vartl Left g ear
Clty Zip Phone
aw o�. e g . .
Engineer Licenie No.
`� rk n9 Spa equ re ov e overe
p. AGtlress
A $truct o. o/ No. of
m Qty Zip Phone Hei9bt to�les Family
Y LICENSED CONTRACTOR'S DECLARATION vark Faes ves Fee
m 1 hareby affirm t�at 1 am licensetl untler provisions oi Chaptar 9 Requiretl No •T. Recelpt
L (commencing with Sectlon ]000 of Division 3 of the Businau antl Za���9 qOP/ovetl By: Date
`. ProfessiOns Cotlery' n0 my license is in full torce entl .�5yy�e%} t
� Licanse Claa 1J Licanse Number �`�+v 70
> Data�Cp�^ p•'moetor_T�—MAr TpG. Misc.
� AAdress �-Ul �1' VY ittier BZVC� P'opo5e0 Use
jl City nnd Zip
Whittier 90 09 Phone 9 7 702 �rse���c�,o
CONSTRUCTION LENDING AGENCV "
� I hereby atfirm that 2hare is a construetion lending egency tor the
0- performence of tha work for which ihie parmit is issuatl (Sec. 309], Occ. Type Cotle
' Civ. QL Class Const. Vear
,m Lnndei s Name none US CCUPANCV SIZE SQ. FT.
� Lender's Atltlress �
� OWNEH-BUILDER DECLARATION
r I horeby effirm thot I em axempt from the ConVactor's Licansa Law ��
t° for tha following roason:
� ❑ I, es owner of the property, nr my employees with wnges as their 2.
� mle compnnsation, will eo the work, and tha atruciure is not
w intandetl Or oftered forsele. 3
� ❑ I, as awner ot tha prOperty, am exclusively conttactlng with
licensed con[ractorsto consv�ct tha projoet.
.°�, ❑ I am eznmpt under Sec. , B&PC for this reason 4•
u
Q Dat� Owner
E WORKERS COMPENSATION DECLARATION Total Vaivation
� hereby afiirm thnt I Mava a certificate ot conaan[ io selt-insure, eqy�retl ❑ Ve5
or a cerUticata ot Workers' Compensation Insuranca, ot e cercifietl Encroacbman[ Permit R ❑ No
C copy t�arnof. GraCin9 PmQ Gratling
`� Policy No Wrn%n—i� Gb��ny �� � l`�T�2 RBqWreC ❑ Ves ❑ No PmL No.
� ❑ Certifiod copy is hereby turnishetl.
a Roug� Gratling V
G ❑ Certitietl wpy is filetl wiM Orange County, EMA. R
Q Approvetl by: Date
Data __ Appllcant 3
CEHTIFICATE OF EXEMPTION
FROM WOFKERS COMPENSATION INSURANCE Z
(This section naetl not be completetl if permit is for $700 or less). �
I certity thut in ihe parfOrmance ot the work fOr which Ihis permit is Q
issuetl, I ihall not omploy any persp n a y n o as to become rv
sub ec to the W r�k% rc' Comoensa w o i nio. PERMIT FEES
Dat'�`� AOP��cant 1� � �
NOTICE TO APPLICANTi� If, tar rtakinp this Certi(icata ot Structural E Plan Chetk $
Exemptian, you should become subject to [he Workeri Campensetion
rovisions of i�e Lebor Code, SOacial
P you must forthwith comply with such Electrl�al 5 ���s� y
provisions or this pwm(t shell ba deemed rewked.
1 CEFTIFV THAT I HAVE READ THIS APPLICATION AND STATE p��mbin9 S
THAT TME ABOVE INFORMATION IS CORRECT. I AGfiEE TO
COMP�V WITH ALL COUNTV ORDINANCES AND STATE LAWS
RELATING TO BUI�DING CONSTRUCTION, AND HEREBV AUTH- MCChaniWl E
ORIZE REPRESENTATIVES OF THIS COVNTV TO ENTER UPON
THE ABO M NT E PROPERTY POR INSPECTION PUR- pre-GraEe
POS /�_�2 _�� Inspectlon s
nat pplicant or Agent Date Pre-Gratle E Pormit s
Ret. No. Issua
Print ApplicanYe/Agan['s Name
All spacm within this box must be completod to process P�an , Issuanca
Cneck BY: Approvetl:
�,mr oaoa-wo �ev-ea� rav. o�av