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7GA638A CE#803 2 63 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING O r q' rA
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DMSION LOCALITY / O
JOHN A LAMBIE COUNTY ENGINEER NEAREST
WILLIAM A JENSEN SUP T OF BUILDING CROSS ST
DISTR T NO s GROUP TYPE CESSED BY
FOR A P N FILL CONST r
BUILDING STATISTICAL CLASSIFICATION S WER MAP
ADDRESSCLASS NO DWELL UNITS BK G
LOT NO BLOCK WATER
CERTIFICATE NOT REQUIRED RECEIVED
TRACT �Q I MAP HIGHWAY
NO OF BLDGS NO (CIRCLE) STATE MAJOR SECOND LOCAL
SIZE OF LOT NOW ON LOT USE ZONE SPECIAL _
USE OF CONDITIONS
EXISTING B DG /
TE ` pp
OWNER < N /rJ5 BUILDING YARD HWY STR ET NAME EXIST
SETBACK WIDTH
ADDRESS Lo K FRONT �IC
ARCHITECT OR TEL P L
ENGINEER NO SIDE
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ADDRESS / — O
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CONTRACTOR -SO?GDS ` NO � � �,� pf�4✓I t
ADDRESS 4 � O (j 4 �` I 0
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DESCRIPTION OF WORK
W ADD ALTER REPAIR DEMOLISH / ' I Z
SQ FT NO OF NO OF
O STORIES FAMILIES
USE
USE OF " �1
STRUCTURE P
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SIGNATURE OF �� Nd
APPLICANT -
VALUATION $ pd �,/ /�/ CI LAI
APPR VALS DATE INSPECTORS SIG-.AUpV
PC �n PMT / FOUNDATION LOCATION
FEE $j ` FEE $(d FORMS MATERIALS -IVA# i
FRAME FIRE STOPS
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS ✓R
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS V Y
BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
AUTHO ZED HEREBY I WILL NOT EMPLOY ANY PERSON IN IOLA LATH INT
TION O THE LABOR CODE OF T E STA CALIFORNI ELAT't
ING TO W MPENSAT IN RANC
LATH EXT
SIGNATURE OF HOUSE NUMBER COR
PERMITTEE RECT AND POSTED
ADDRESS FINAL
PLAN CHECK ALIDATION CK Mo CASH � JOHN F LEWIS PRINCIPAL STR RAL ENGINEER f
PERMIT VALIDATION CK MCI CASH
LA,O 47,7 4 6 hill 2 2 2 3 D 2 8 5 Q d
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COUNTY OF LOS ANGELES f TEMPLE CITY # 0508 BUILDING PERMIT R
DEPARTMENT OF PUBLIC WORKS i 9701 LAS TUNAS ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0506130015
4 PHONE (626) 285 0488 EXT
LEGAL ID NO OF CONST BUILDING ADDRESS
TR 9848 LT 80 BL 001 UN 004 SQ FT STORIES TYPE 5013 BALDWIN AV
STRUCTURE 20 VN TEMP CA 917804011
v ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET LA ROSA
8589-026 039 THOMAS PAGE 597 GRID B4 LOCALITY TEMPLE CITY C
TENANT EXIST BLDG USE RESID USE ZONE R1 ISSU--D ON PROCESSED BY EXPIRES ON
EXIST OCC GRP 06/13/05 JK 06/08/06
OWNER TEL NO BLDGS NOW ON LOT VALUATION FINAL DATE FINAL Y CODE
AQUINO SERAFIN M CARMEN TRS (626) 444 3987- 2 500
5013 BALDWIN AV ((a r
TEMP 917804011 FEES PAID DESCRIPTION OF WORK
TEAR OFF AND REROOF EXISTING SHINGLES AND REPLACE WITH
FEE DESCRIPTION QUANTITY UOM AMOUNT SHINGLES HOUSE AND GARAGE
APPLICANT TEL NO
SAME AS OWNER AA BLDG PERMIT ISSUANCE 27 75
AC STRONG MOTION RESID 2500 00 VAL 0 50 SPECIAL CONDITIONS
D2 PERMIT W/O EN-HC 2500 00 VAL 99 00
TOTAL FEES 127 25
CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER
LIC NO LOCATION AND SETBACKS
SOILS ENGINEER APPROVAL
ARCHITECT OR ENGINEER TEL NO FOUNDATION/TRENCH FORMS
LIC NO SLAB/UNDER FLOOR
RAISED FLOOR FRAMING
MAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP UNDERFLOOR INSULATION
144H269 3 01
FLOOP SHEATHING
NO OF FAMILIES DWELLING UNITS APT COND STAT CLASS I
NO 21 ROOF SHEATHING
SCHOOL WITHIN HAZARDOUS SHEAF PANELS / J
AIR QUALITY 1000 FEET MATERIALS
NO NO NO FRAME INSPECTION
REQUIRED TOTAL SETBACK FROM EXIST FIRE SPRINKLER HANGERS
SET BACK YARD HWY PROP LINE WIDTH
FRONT PL- INSULATION/WEATHER STRIP
SIDE PL
INTERIOR LATH/DRYWALL
EXTERIOR LATH
RATED FLOOR/CEIL ASSEM
RATED WALL ASSEMBLIES
RATED SHAFTS/OPENINGS
T BAP CEILINGS
LOT DRAINAGE
REPORT ID DPR261 ROUTE TO BS0508
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