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76A688A CE#803 tO S8 APPLICAT FOR BUILDING PERMITI'i
COUNTY OF LO GELES BUILDING C
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DEPARTMENT OF UNTY ENGINEER ADDRESS
BUILDING SAFETY DIVISION LOCALITY
JOHN A MBIE COUNTY ENGINEER NEAREST I 4
CASSA D GRIFFIN SUP T OF BUILDING CROSS ST i
F APPLICANT TO FILL IN DISTRICT NO GROU I TYPE
CONS
+ADOREN / i/ STATISTICAL CLASSIFICATION I SEWER MAP
ADDRES 4 a K G �
CLASS NO DWELL UNITS
LOT N BLOCK
MAP _ _ TATE'
NUMBER HWY YES NO
TRACT USE ZONE SPECIAL
NO OF BLDGS CONDITIONS
SIZE OF LOT NOW ON LOT Z
USE OF
EXISTIN BLDG BUILDING EXIST
SETBACK YARDP HWY STREET NAME WIDTH
OWNER f. `e r FRONT ,
MAIL P L
ADDRESS SIDE i
If TEL P L
CITY NO INSPECTION RECORD
ARCHITECT OR TEL
ENGINEER NO
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ADDRESS f
TEL r ��I B
CONTRACTOR NO 0-7/j/02
ADDRESS /
DESCRIPTION OF WORE -�y f/Pel P 6TF_GTr .t/Fo
NE ADD ALTER REPAIR DEMOLISH
SQ FTNO F J NO F 7
SIZE y 5 STOROIES / FAMIOLIES /
USE OF19TRUCTURE
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SIGNATUREOF APPROVALS y c
APPLICANT
DATE INSPECTOR SSI GNATURE
ADDRESS FOUNDATION LOCATION r
$ FORMS MATERIALS 7-3-5-9
P C S FRAME FIRE STOPS
FEE BRACING BOLTS
VALUATI N S FURNACE LOCATION
r FEE GAS VENT DUCTS c�7'
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP LATH INT R T 1
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND slz
STATE LAWS RE ATING BUI DLNG CONSTRUCTION LATH EXT i
SIGNATUROF HOUSE NUMBER COR
PERMIT-.'EE RECTANDPOSTED /D -�'SGj �f r
ADDRESS FINAL
CLYDE N DIRLAM PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION c o CASH PERMIT VALIDATION CK mo CASH
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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 0211180052
PHONE (626) 285 0488 EXT
LEGAL ID NO OF CONST BUILDING ADDRESS
TR 5903 LT 20 BL 001 SQ FT STORIES TYPE 6129 AVON AV
STRUCTURE VN SGAB CA 917752605
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET LONGDEN
5386 007 028 THOMAS PAGE 596 GRID G2 LOCALITY TEMPLE CITY
EXISTTENANT BLDG USE RESID USE ZONE R 1 ISSUED ON PROCESSEDS 0
EXIST OCC GRP 11/18/02 JK 05/17/03
OWNER TEL NO 9LDGS NOW ON LOT VALUATION FINAL DA FINAL BY COD
MCLEAN SHIRLEY (949) 361 5554 2,500
82 AVENIDA CRISTAL b L
SAN CLEMENTE FEES PAID D C ION OF WORK
INSTALL 30YR CLASS A GAF TIMBERLINE FIBERGLASS COMP SHINGLES
FEE DESCRIPTION QUANTITY UOM AMOUNT OVER EXISTING
APPLICANT TEL 0
A & S ROOFING OF PASADENA (626) 357 7715 AA BLDG PERMIT ISSUANCE 27 75
848C MERIDIAN ST AC STRONG MOTION RESID 2500 00 VAL 0 50 SPECIAL CONDITIONS
DUARTE D2 PERMIT W/0 EN-HC 2500 00 VAL 99 00
TOTAL FEES 127 25
CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE
A AND S ROOFING OF PASADENA (626) 357 7715
848 C MERIDIAN ST LIC NO LOCAT ON AND SETBACKS
DUARTE, CA 91010 324573 C39
OILS ENGINEER APPROVAL
ARCHITECT OR ENGINEER TEL NO FOUNDATION/TRENCH FORMS
LIC NO SLAB/UNDER FLOOR
FRAMINGRAISED FLOOR
MAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP UNDERFLOOR INSULATION
150H261 3 01
, FLOOR SHEATHING
NO OF FAMILIES D CLASS
NO 21 ROOF SHEATHING
SCHOOL WITHIN A O S SHEAR PANELS
AIR QUALITY 1000 FEET MATERIALS
NO NO NO FRAME INSPECTION
REQUIRED 0 AL SETBACK FROM EXISTSPRINKLER HANGERS
SET BACK YARD HWY PROP LINE WIDTH
FRONT PL INSULATIONNEATHER STRIP
SIDE PL
INTERIOR LATH/DRYWALL
EXTERIOR LATH
RATED 00 L ASSEM
RATED WALL ASSEMBLIES
RATEDSHAFTS/OPENINGS
BAR CEILINGS
LOT DRAINAGE
REPORT ID DPR261 ROUTE TO BS0508