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HomeMy Public PortalAbout9519 BLACKLEY ST_Building__ i!ISON OF BUILDING AND SAFETB IDepartlment of County'Engineer y BUILDING County of Los Angeles 3 193 LICATION YWM. J. FOX, COUNTY ENGINEER APP FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY _ ` / DISTRwTllm-- PLAN CK, OR RFC.NO. PERMIT NO. BUILDISS / �W' C ADDRESS / l �EIVED BY, DATE OF APPL. DATE ISSUED LOCALITY 1 / e- N;EAREBT ROBS HT. BUILDING � ADDREH9 7 OWNER t MAIL LOCALITY t ADDRESS NIEAREBT � 'TEL �J r (� QROBB BT. CITY I. v✓ �b FIRE NO.OF �� TYPE GROUP AROHITE T OR { T ZONE ( PLANS ENGINEER _ BLDG. L—_T ORD. NO. SETBACK LINE / ADDREBB USE APPROVED TEL ZONE177. BY DATE CONTRACTOR OUSE NUMBERING ADDRESS LEGAL /��U4 MANUMBE / 60 NO. ASSIGNED BY DESCRIPTION LOT NO. BLOCK I y3•-7 CORRECTIONS /, NO OF BLOCRILL- SIZE-OF LOT �C"C NOW ON LOT O d w r" USE OF NO. OF �� - _ _ " EXISTING BLDG. FAMILIES _ -DESCRIPTION OF WORK A. _ J 3 AS o ' NEW ALTERATION ADDITION .T =7� D - r REPAIR DEMOLITION �. .9 ZE ROOMS BT IES EXT.WAL y ROOF COVERT COVERING �� ,� G_�✓ 7��� .iC/.�� USE O HTR TORE — �� ✓ �� �i�� l�V� INSPECTION FO OCCUPANCYABR L� '� ,�Fp APPROoALfGNATURE DATE ( FOUNDATION: LOCATION FBRMB, MATERIALS dU 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- PLICATION AND STATE THAT THE IN GIVEN IS FRAME: FIRE STOPS, CORRECT. BRACING, BOLTS hp__ z 1 A®REE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION, AND STATE LAWS REGULATING BUILDING CONSTRUCTION. GAS VENT, DUCTS SIGNATURE O ( LATH, INT. PERMITTED LIL�'� LATH. EXT. ADDRESS /1 PLASTER, INT. � AUTHORIZED AGT. ZZ-0 '�' PLASTER, EXT. ~ FEE HOUSE NUMBER CDR- Q RECT AND PORTED v- VALUATION 'I .-�- FINAL FEE 76A63BA DBS 3 1J2 ` ©s 76A638A :, �r 4f- CE#803(REV 1, /78) J ��:•✓ APPLICATIO -FOR. BU IN PERM I"1" ,COUNTY OF,LOS,ANGELES_.. �:- BUILDING AND;SrAFETY•.-,,_-. ; FOR APPLICANT TO_FILL• IN ADDRESS $�� �• j`a Lf�t - ~' BUILDING yy� ( ) -�- •K ADDRESS q5ti.,_•/p Ej 46a k,L LOCALITYNEAREST 7 CITY `� T ZIP CROSSST v NO OF,BLDGS ASSESSOR•, SIZE OF LOT NOW ON LOT _ MAP BOOK' y { '"' d PAGE. PARCEL 1.T•• DISTRICT GROUP TYPE FIRE', ED BY TRACT BLOCK LOT NO EONST'_r Z NE_ - TEL + NO _ OWNER STATISTICAL CLASS ICATION 4ERAPADDRESS S DWELL UNITS,CLASSNOCITY ZIP-,. " ARCHITECT OR a TEL VALUATION ENGINEER- - ' - - NO - •� �/CS�'C/V r ar_ ;cy`y ADDRESS, " BLDG;SETBACK FROM ~ TEL y FRONT PROP LINE OF' (STREET) f,'• ' CONTRACTORTOP �11CZF`tJ O - ' 'TOTAL SETBACK FROM TYPE OF EXISTING f� LIC sy HIGHWAY '+ YARD = FRONT PROP LINE' HIGHWAY WIDjH_ ADDRESS.'�i��L ' DU V' f_E NO Y LIC +. q_r CITY L MoK -y , CLASS C BLDG SETBACK FROM CONSTRUCTION LENDER - SIDE PROP LINE OF' r, (STREET) NAME AND BRANCH ;�' HIGHWAY + YARD '"TOTAL SETBACK FROM TYPE OF EXISTING IL ADDRESS CITY' SIDE,PROP LINE HIGHWAY 'WIDS,W; ,0 50 FT NO OF NO OF CHECK "+ Y t - V, r' ag SIZE STORIES - FAMILIES ONE e f1 USZO Ew MAP DESCRIPTION-OF WORK - r NEW ❑ �/%� O �\ SPECIAL IL : ADD CONDITIONS w ALTER El FINAL' BY ? REPAIR ❑ DATE ��• ���` ®�� USE OF- DEMOL '' r EXISTING BLDG., {� _ ,-ZO APPLICANT' e� TEL y} ' (P.RINTI f5 BY(SIGNATURE(, I _ v, v I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS A LIC ION AND STATE - sue :THAT`THE.ABOVE 15 CORRECT-AND,AGREE TO_COMPLY WITH ALL.ORDINANCES 'AND LAWS REGULATING BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE - = pir7 r� WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF V A V',/ 2't 4 A`K ` THE LABOR CODE OF,THE,STATE OF CALIFORNIA IN RELATING TO WORKMEN 5 COM _ - Z PENSATION INSURANCE, ,#,O O O 0.. SIGNATURE OF Y Z ° °•5 2,O ' PERMITTEE ' ADDRESS `Z °`6,0,5 2 0 0.5 L. •r+--- _.TEL •�j ,. w....._ _ O _ .O '�,2��I• S�. .C. . CITY li. 6It fG- NO 7 P C Fee$ Permit Fee -7 Issuance Fee alio ,T,otal_Fee,� /a! KERS' COMPENSATION DECLARATION T. �i VI insure, or a`certi�cote of WorkersrtCompensat on ificate of ensuran ent to lf A L I�A-;l I®� ! ®� ®��'C� P�E ROUT!T ' or a certified copy thereo,• (Sec 3800,'1 Lbb C ) i j COUNTY-OF LOS ANGELES.- BUILDING.AND SAF TY Policy No Compahy ' Certified copy is hereby furnished FOR APPLICANT TO FILL IN,- BUILDING ADDRESS ❑ Certified copy is filed-with the county building inspec- BUILDING `` tion,department ADDRESS q�) a L►acK,L Date Applicant CITY %IE5(Y� 1"r ZIP l v LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' / NO OF,BLDGS NEAREST COMPENSATION INSURANCE . SIZE OF LOT (00 X �-L(,9NOW ON LOT ©IOV E CROSS ST _ (This section need not be completed if the permit ,s for one n r ASSESSOR , hundred dollars ($)00)or less ) TRACT `"�O BLOCK' LOT NO V MAP BOOK PAGE PARCEL o. TEL USE NE NOP f I certify that in thef performance of the work for which this OWNER ILK 1(/ NO —375 permit is issued, I shall not employ any person in any manner : -� ' �I SPECIAL ADDRESS S Al KE: AS' I I , CONDITIONS so as to'become�s�uyblect to the Workeis'`Compensation laws - � � U Zy OC/ • W 1 LIC}0.�S00.J CITY ' ZIP Date Applicant ARCHITECT OR TEL NOTICE ,T A PLICANT "If, after'making this Certificate of ENGINEER 'rJC L-� NO } ti DISTRICT GRO P TYPE' FIRE, PROCESSED BY O Exemption, you should become subject t the Workers' s CONST/ ZOtjJE Compensation provisions of the LaborCo u must forth- ADDRESS with comply with'such provisions ar� ermit shall be deemed revoked TEL STATISTICAL CLASSIFI TION• APT NDO CONTRACTOR NO Z LICENSED CONT 1 E DECLARATION . LIC CLASS NO _ I�DWELL 11NI7S - I hereby affirm that I lic under provisions of Chapter 9 ADDRESS NO '(commencing with 7 )of Division 3 of the Business and LIC SEWER MAP Professions'Co my license is'in full force and effect CITY CLASS ' • BK - VALIDATION l SQ FT, NO OF NO,OF ,'CHECK License/lyurt� er Lic Class SIZE STORIES FAMILIES ONE VALU TI-Qty'QD, DESCRIPTION OF WORK A •• NEW- ❑ UU C ntr ctor Date ADD ® $ I am exempt under'Sec 100 0 5� ALTER , B&P C for this reason 11,110 : REPAIR $ USE Date EXISTINGBLDG 5 L�,�V0 S l -�-A,w� DEMOL ❑ 2tO 01.3.A Signature APPLICANT TEL ( FINAL # o o to;• o t -OWNER-BUILDER DECLARATION - PRINT K ILK NO DATE 3y �' 2 8 5 0 I hereby affirm,that I am exempt from the Contractor's License q - o'o Law for the following reason (Section,7031:5, Business and ADDRESS,9,510%1� 1.AG�L� S'� FINA r , 0, o;o • _ Professions Code) By 2 8 5 O v BUILDING r 1, as owner of the property, or my employees.with ADDRESS- 1'' w ,: .r *,• (�`Z$',-�88 wages ds'their sole compensation,will do the work and r LOCALITY the structure,is not intended or offered for sole,(Sechon 7044, Business and Professions Code) MOVING TEL I, as owner of the property, am exclusively contracting CONTRACTOR NO- T with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK3 �'•i CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP LINE ` WIDTH ^ +, I hereby affirm that there is a construction lending agency for. FRONT ` the performance of the work for which this permit is issued'' - P L (Sec 3097, Civ C ) SIDE PL Lender's Name O _ `, LDMA Ref-,ii' m P C Fee'$ Permit.Fee t(% Lender's Address '. I certify that I have read this application and state that the Issuance Fee �� LDMA P/C# above information is correct 1 agree to comply with all County Invest'go,on Fee �( 0 ordinances and State laws relating to building construction, Total Fee .-'U E LDMA Perm q and hereby authorize representatives of this County fo enter ; u on the above-mentio ed operty for inspection purposes f a � � SEE REVERSE FOR EXPLANATORY LANGUAGE t �, } , Signature of Applicant or Agent Da WORKERS'COMPENSATION'DECLARATION r 1 _ ;`�" r. vC .,•r.• t 'APPLICATION _.. es`e. affirm that-I have a ,certificate of consenfnto self • w ysu*ej Giga certificate'of Wotkers'•Compensation Insurance, 'A P P L I•CAT I O IV^' FOR IJ I:L D I dV C =. PERMIT— oriacertfled copy.tFPereof (Sect3800; Lab C )` ` '_ _ y,, ii' ;;a, r, r „ -.-t t'', r; t• COUNTY OF LOS-ANGELES BUILDING}AND3AFETY Policy No-.., ...., ...Company,. .C•, - - __J, u_ _ _ a -Geitified:copy,is)lhereby furnished•. • A' FOR APPLICANT TO FILL IN BUILDING' / S I i _v t ADDRESS , a6;�tifie8`.copy is filed with the".county buildrng'irslbec, BUILDING; ' tion`d'epariment � ADDRESS Date••' of :� Applicant. CITY'�y ZIP LOCALITY i i CERTIFICATE OF EXEMPTION FROM•WORKERS' NO OF BLDG5 �" NEAREST_,. 4 SIZE'OF LOT NOW ON LOT - COMPENSATION,INSURANCE- : i CROSS' : y'(Thr's secTion_need not be:,com'pleted if ihe'permit'rs,for one. - 2;--- ASSESSOR " ,r TRACT BLOCK LOT NOT MAP'BOOk �' PAG PARCEL ~ hundred dollars ($1,00)or'less ), _ e "-• .„ - - T r 9; OWNER O C 1 TEL USE ZONE- MAP r. I"certify that in'the performance of the work for wKich this NO f permit is,5sued`'1-'shall noYemploy any person in any manner ' ' ADDRESS• _ r =�- r=SPECIAL-` t:r,. - - so'as to become subject to the Workers'rCoympensal4or'Laws \ „ CONDITIONS'`" r ^r,. « O ,.:^:: �- •-'.:,, _�' s: '� i.;!�y�'� >,-.` ,� CITY } .L. �"� , ZIP,,-�-� � ��a.. ..� '--*- - ', -k _•- Y �r .-% Date` �' ': "O , NOTICE' O''AP LICANT If;?offer' rnakih this Certificate of ARCHITECT OR TEL k DISTRICT. GROUP__TYPE_• 4 _ FIRE PROC SE BY 9° ENGINEER NO -ZONE ^`" i G' *` _ Exe`rrijption',-''+'you 'should become' subject 'to they Workers' n rJ' , . !� M ' r Ly ComperisaTion provrsron`tof the Labor Code, y,ousmust,forih= ADDRESS: - M S DU;w -, �J - T- 44 mj with comply,wrthr�such-proprsions orE;thrs}permit sha_ll„ be _ - _ - - - -- deemed,revoked r TEL` STATISTICAL CLASSIFICATION APT CO DO i Z 'V. r -_`�4•,E"*"� ... t CONTRACTOR `cif NO T �•'' LICENSED CONTRACTORS DECLARATION_ ,�•.,� _ , v _--_. _ _ �,„ _ n LIC t CLASS NO owEii•UNITS -+ v i I hereby affirm that I am licensed underlprovvsions of Chapter,9 ADDRESS NO ` (commencing with»Section 7000)of D v,ston 3 of,the.Business and __ _ _ - • _ SEWER-MAP" - ;,'r ,-I sr, .+•_° + LIC- -Professrons;Code, and my license is'in full force and`effect `"" CITY, 4 CLASS, M -'ti"" VALIDATION" t. SQ FTS -, _ NO OF•�- - - NO OF - .. t _HECK ..,.I a' �?� License Number`a Y L c Class K" '' SIZE- STORIES FAMILIES ONE nxs sa;a '-9°t'`�++ •-.te 1' , i• �,> , ,1 A _ ..._� ` _ VALUATION •t ,., t._ �.✓� �» s , ,. :4, DESCRIPTION OF,WORK NEW- ,, Contractor'•`= Date $ �:. ADD QI am exempt,under Sec = _ ALTER B 6P C- foi'thrs''reason REPAIR - } '- Dare a USE OF, ���-�-�• DEMOL., EXISTING BLDG iSig atu e ",. - - =APP PR NTT T I I } NO -�7 FINAL T•. OWNER BUILDER DECLARATION-,' I DATE,= - 1 ` I-Hereby.affrrm.that.l:am,exempt,,from the,Contractor:siicense ADDRESS Rr`�� I50 FIN a a Law,for•the`followrng reason.�(Sechon'7031'S, Business an ^ ¢ .Professions;Code) - , e - .7«, _ ... . RESENT BUILDING- 6ri of the',property, or my employees,with ADDRESS_ �Y _ °{4 ` a,: , wages as'tFieii sole cam ensafion, wrll.do•the work and The•structure•is not intended or offered for sale(Section4 s LOCALITY'- 7044, Business°andrProfessions Code) - MOVING' , s� '-TEL `µ,« _ ' ^`• -� + e e,?,&-J�Q•, I; as owner,of The property, am exclusively contracting CONTRACTOR NO r ,_; �wrth'licenaed*contractors to construct the project (Sec �= r', __ _'t_ ._. _ zc.-i,Te` �•� j� ro_o 0 Z a:5 0i Tion 7044; Busm_ess'and Professions Code-) ADDRESS: ' ' A 1 1•• �{s« ; . REQUIRED Y.TOTAL SETBACK F y,_ a� `` t ' `La5. )� } l`-;} I,' n g 5, r r' CONSTRUCTION=LENDINGAGENCY." SETBACK y 'YARD HWY ;PROP LINE WIDTH 'C,t Y t • 4 ! u-3 %•t I hereby affirm that there is"a construction lending agency for FRONT the erformance of the-work for,,whrch this permit is-issued —; - P Lx P (Sec ,3097,'Civ'_C ) SIDE Lender's:Name - ' . .4 ;^..,., .--- �;} - -. -'..r--„-_ `.r ,'--_ P C Fee$' - `- PermitrFee• � C/.. -i-� --- - -.• �.ww._._ .a - e Lender's Address' i ;^� , 10 I certify,thdt,l havesread_thrs,a licatson.and state-that the _ _ _ _ ¥ -•' PP b c Issuance Fee [1- LDMA•P/G#- a above information is correct•1 agree to comply withall CounTy Investigation Fee \• ` .; F.`'.1*. ,. " ' } m -,ordinances and"State'laws relating;to buildingycgnkte2cTion, __ -_ _ _ Total Feer C/. LDMA'P r 'R - ' �;' �'" f� `� ,1 t• « r-' `�"t ' u and hereby authorize representahves-of this County to enter_ a upon theyabove-mentioned property for mspectron purposes SEE^REVERSE'FOWEXPLANATORYjLANGUAGE" 1-'r •, �,•-= x VI ' I�• ignature of:Appl.cantammo�reee-ACCCgent c ;...a, Dat =,c M1 P �` •a•,;_ _y »>n.,::. ..ti'.s,,.w.-'t" _ _ .-O i t ' 48RKERS'COMPENSATION DECLARATION ?=; . =,�; - r'• - r _ _ _ I�,liergp}�affirm that-I have a certificate of conserit to self , ' ��'� msuie, or a'certificote of Workers' Compensation'Insur'ance, I AT 1 ' N 'FOR RM U I L D I RI G P E RM I T t ' :o-rIO.rtified copy'Thereof (Sec'3800,-Lab C )'' ', " ' i COUNTY OF LOS ANGELES BUILDING AND SAFETY - _.t s-.,: r + ' Policy No�ee am any Certified,copy_is hereby furnished-. 't Y; FOR-APPLICANT TO FILL IN x BUILDING ADDRESS Certified copy'is filed`with'the'cou'nty building inspect BUILDING' i r ' tion'department ADDRESS f •; Dote/0.. �; +A Iplccant` CITY ZIP LOCALITY i 1 CERTIFICATE OF EXEMPTION, OM WORKERS'+,` ''' - NV-OF BLDGS z:' - NEAREST_ COMPENSATION INSURANCE-, •' SIZE OF LOT NOW ON LOT CROSS"ST { ; Th'ts section'need,not be.com IeTed if-the ermri cs fonone `� t ASSESSOR.,, +n ( P P 7 " TRACT (/ BLOCK' LOT NO r t MAP BOOK'"t'�'•`f' �' {}, _i PAGE} PARCEL x hundred dollars ($,1,00)or,,less ) _ , , w/- • USE ZONE MAP I'certrfy that`int the perfor'mance of the workr fowhich this OWNER u NO t• permit is issued,I,shall not employ any person in any mariner 1 +I SPECIAL -T-- •- r •-;• - ' d x ADDRESS "' I CONDITIONS Y IO so as'to become subject to-the Workers''Com`pensatcon Laws _ t V Lr yti _ CITY. ZIP. - D`dte Apphcont ARCHITECT OR` TEL 0 =NOTICE,TO APPLICANT If, after making1thcs Certificate'of r• ENGINEER L NO DISTRICT _ GROUP TYPE- FIRE PROC SED BY _ f Exemption; ,you'`should become•subject to' the.Workers' �C/ CONST ' ZONE V Compensationlproviscons,of the Labor Code,.you must forth- ADDRESS 1 d .._ _ _. fd ,wjth,camply, with`,such,provisions or.this permit,shall, be -.- .,._,r -_ __. _ _� r 4 ? deemed revoked_,,--..,'-. T 1 STATISTICAL CLASSIFICATION "APT CO + :+ CONTRACT0 t LICENSED"CONTRACTORS DECLARATION , - - - Lg . I CLASS NOi DWELL'UNITS — I hereby affirm-that-1 am licensed under,provisions of Chapter 9 ADD RE NO e� 2� (comme6i , g with Section 7000)of Division 3 of'The Business and _ _ _ LIC .- SEWER'MAP Professions Code, and my license ism full force and effect CITY CLASS ­BK PG VALIDATION" �,'. �b', < c,:r. SQ FT , '�» NO OF NO OF -- CHECK License Number Lic'Class SIZE STORIES FAMILIE ONE I, •3.• a VALUATION } _ ,J � � ' DESCRIPTION OF WORK' Contract _tr�'�LIi� Dat $ aaaI•r, s - - -, ADD" I am exempt under Sec , _ l t �• _ ALTER B&P C for this reason ❑ $ �•`- t' _ _ _ _ REPAIR_ Dote--- t USE'OF e3 EXISTING BLDG — DEMOL ❑ _ Si nature APPLICANT _TE r. 9 OWNER-BUILDER DECLARATION PRINT` = !/,,?wig > FINAL rt� tl Y.._ �,3;3,7 J IA, �• I hereby affirm that I am exempt from the.Cantractor's License - - -DATE: �� w.#!o.o_e.oTs��- Law for the following;reason(Section 7031 5, Business and ADDRESS u� FIN ." " e - 49.8,8 } Professions Code) y PRESENT vti -• - BY - Y -_ &C-)- 1, }. BUILDING y e e e..4"9 8 8 c) ❑ I, as~owner of the property, or my employees'with ADDRESS Y _ :_ _;- _ _ y ��.,�,Cr- --8:5''":;'�, wages as tliei�sole compensation,will do the work,and, The structure is not intended or offered for sole(Section LOCALITY 7044,-Business-and Prof essioris-Code)"' �" 'MOVING-' TEL` CONTRACTOR NO ❑^ 1, as owner of the property, am exclusively contracting - -with licensed contractors to construct*the-prolect'(Sec- - _- _ t z•_ .. - y _ _. _`., _,_-,._,__ .�__. __,. _ . . c. tion 7044,Business and Professions Code) . ADDRESS x REQUIRED _ YARD "'HWY TOTAL SETBACK _ °,' ' __ t4tti'. •,tom } "';''_ 'r___ _ CONSTRUCTION LENDING-AGENCY "'"� SET BACK PROP-LINE _ WIDTH t < - I hereby affirm that there is a construction lending agency for, FRONT 'y' ':'?,z the performance-of the work for-which This permit•is•issued P LTT (Sec 3097, Civ C ) SIDE �t• t t ml1 Lender's ,P L, I LDMA Ref # { - Lender's Address P C- Fee$ _` Perm t Fee- - -: -- " fy that-I-have.read_this application-and state that,the .._. Issuance Fee �' LDMA•P/C# , - _ '_. , __,�+?• - c ' a µa ove i formation is car ect I agree"to comply with all County _ Invest Investigation Fee y - , or ina es and State ws relati'n to bu n construction, g $ _ 9 9 _ _ - -- _ Total Fee - - �" - ;•LDMA"Pere #'-t_a•t �a� ,1 -_ _.. _ _ a ereby outthonz repr sentatives of s County,to enter. { on the above-m tion p perty f inspection purposes � _ _ _ _` - _ _ _ - "•` _`- .^• .- SEE REVERSE FOR EXPLANATORY LANGUAGE •--- r_� _ ,') _._, _ +, _ti - _ __ _ :. ._..._.�. ; Sign atu e f A ant or-A Date ^_ _ _ ._ �. _ _ _ __ .___ .__. 1Q►+ 'COUNTY OF LOS ANGELES TEMPLE CITY I # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS r RESIDENTIAL ADD/ALT/REP BUILDING AND SAFETY / LAND DEVELOPMENZ TEMPLE CITY CA 91780 - BL 0508 9912150054 PHONE: (626) 285-0488 EXT: LEGAL ID: N0. OF CONST NEW BUILDING-ADDRESS: TR: 17190 LT: 8 SQ. FT STORIES TYPE OCCUP GROUP 9519 BLACKLEY ST STRUCTURE: 389 1 VN R3 TEMP CA 917803143 ASSESSO INFORMATION NUMBER: GARAGE: NEAREST CROSS STREET: CLOVERLY 8590-005-010 OTHER: THOMAS PAGE: 596 GRID: A LOCALITY: TEMPLE CITY TENANT: EXIST BL6-G USE: USE ONE: SSU D ON: PROCESSED EXPIRES ON: EXIST OCC GRP: 12/15/99 UT 06/12/00 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: DE: WILKINSON ROBERT K;LAURA A (818) 286-3756- 1 28,800 9519 BLACKLEY ST 2,h TEMP 917803143 FEES PAID DESCRIPTION OF WORK ADDITION OF MASTER BEDROOM AND BAT , 1/2 BATHROOM, LAUNDRY FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ROOM AND EXTEND FAMILY ROOM APPLICANT: EL. N0: TOM O'LEARY - AA BLDG PERMIT ISSUANCE 27.75 5823 AGNES AVE. AC STRONG MOTION RESID 28800.00 VAL 2.88 SPECIAL CONDITIONS: TEMPLE CITY, CA AX BUILDING REV,PEW IF54.70 B2 PERMIT W/,ENERGY({yE�E28800.00 VAL 576.02 �OTA FEES 661.35 CONTRACTOR: TEL. NO: �S SEES APPROVALS DATE INSPECTOR SIGNATURE TOM O'LEARY CONSTRUCTION (818) 287-0927- 5823 AGNES AVENUE LIC. NO LOCATION AND SETBACKS TEMPLE CITY, CA 91780 489354 B-1 SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: ` FOUNDATION/TRENCH FORMS LIC. N0:7 ~` lllllll SLAB/UNDER FLOOR AISED FLOOR FRAMING z-22 9 MAP N0: SEWER MAP BOOK: PAGE: FIRE ZON : CM01 UNDERFLOOR INSULATION3UISBIWC OF�U J 3 1ST-LEVEL FLOOR SHEAT N0. OF FAMILIES- DWELLING UNITS: APT/CONDI STAT CLS _ NO 21 0 ND LEVEL FLOOR SHEATH OL WITHIN HAZARDOUS �) SHEATHING AIR QUALITY: 1000 FEET MATERIALS `/�00 NO NO NO El ® °� ®� FIRE DEPT. FRAME INSPECT REQUIRED OTAL SETBACk FROM TQ� BLDG . FRAME IN ECT SETFROBACK YARD: HWY: PROP LINE: WIDTH: �C �+PL- �'�yD� T��� 10 SHEAR PANELS � / SIDE PL- V I� INSULATION/WEATHER STRIP -/``t INTERIOR LATH/DRYWALL 5klo 41�1 17 EXTERIOR LATH LOT DRAINAGE G SMOKE DETECTION DEVICES FIRE DEPARTMENT APPROVAL REPORT ID: DPR261 ROUTE TO: BS0508