HomeMy Public PortalAbout5419 CLOVERLY AVE_Building__ 76AG36A CE#80310.8 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES t BUILDING
DEPARTMENT OF COUNTY ENGINEER_`�.,` 4DDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE,COUNTY ENGINEER NEAREST
CASSATT D GRIFFIN SUPT OF BUILDING CROSS ST s l�C./l.�t.`►�c/
DISTR GR I TYPE I�ROCESSED BY
FOR APPLICANT TO FILL IN coNSTT
BUILDINGSEWER 1AA
ADDRESS STATISTICAL CLASSIFICATION K G
!I� S Z� 9 CLASS NO DWELL UNITS /~ I
LOT NO '" BLOCK MAP STATE yES_
t J NUMBER Q HWY
TRACT ,/ -yy �, {� L U E ZONE ,SPECIAL
%7'- �j'!a NO OF BLDGS y CONDITIONS '
SIZE OF LOT a ~MI NOW ON LOT -
USE OF
EXISTING BLDG BUILDING EXIST
SETBACK YARD HWY STREET NAME WIDTH
OWNER - (FRONT J t
ADDRESS SIDE
MAIL � P L
TEL
CITY I' NO � P L
ARCHITECTOR TEL INSPECTION RECORD
ENGINEER NO '
ADDRESS M
T
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TEL 1 -7 'i7 7 1"
_/ �I U� i�
CONTRACTOR OIfTEf�.]��7T '
STD r r G o kle
ADDRESS 1 -
DESCRIPTION OF WORK
NEW ADD ALTER REPAIR DEMOLISHSO /
SIZE T .2, 3" STORIES f FAMIILIES/ d oDA
USE OF STRUCTURE
SIGNATURE OF APPROVALS
APPLICANT
DATE INSPECTOR S SIGNATURE
ADDRESS / i`-' FOUNDATION LOCATION
FORMS MATERIALS
P CFRAME FIRE STOPS
FEE $C� BRACING BOLTS
UAQFA
VAL 'f� $ $ ,.
, � �FGASVENTLDUCTSN
FEE /
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH INT
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
_ STATE LAWS R�TBLDINCONST U N LATH EXT
SIGNATURE OF HOUSE NUMBER COR-
PERMI PF RECT AND POSTED f�
ADDRESS FINAL
CLYDE N DIRLAM PRINCIPAL STRUCTURAL ENG( EER
PLAN CHECK VALIDATION CK M o cns PESMIT VALIDATION CK M CAS
�'� 6083 PLAY 42 3 A 21 .00sM -
4�76A638A CE4803 5 65 APPLICATION FOR BUILDING PERM ruµ
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS t t-
BUILDING AND SAFETY DIVISION LOCALITY (>
JOHN A LAMBIE COUNTY ENGINEER NEAREST
COLEMAN W JENKINS SUP T OF BUILDING CROSS ST t -
DISTRICT N G TYPE _P
FOR APPLICANT TO FILL IN ` I CONST
BUILDING / �` p STATISTICAL C SIFICATION r, SEWER MAP
ADDRESS `� 1 l� ` CLASS NO DWELL UNITS --BK PG -
LOT NO BLOCK USE ZONE MAP
N O V (�
TRACT SPECIAL
_ NO OF BLDOS
CONDI TI ONS
SIZE OF LOT NOW ON LOT
USE OF
E IST,NG BLDG SETBACK FROM - 'I
_ TEL FRONT PROP LINE OF (STREET)
OWNER / f� NO _ TYPE OF EXISTING SETBACK HIGHWAY t+ YARD = TOTALS'
ADDRESS / {� CJ HIGHWAY IDTH
FROM
C L-
+
CITY -
BLDG' SETBACK FROM
ARCHITECT OR - - L SIDE PROP LINE OF (STREET)
ENGINEER O
TYPE OF EXISTING SETBACK HIGHWAY +__ YARDt_= TOTAL
_ ADDRESS HIGHWAY WIDTH FROM C L
TEL \ I + ' - = —_- d
CONTRACTOR NO (J _ ' O
ADDRESSp CORNER CUTOFF YES NO V
CITY, IC CL SEE REVERSE SIDE FOR SPECIAL APPROVALS 0
ESCRIPTION F WORKu
W
/J
v (/ CL
NEW ADD AL TEI'1 REPAIR DEMOLISH - N
. Z
SQ FT OF NO OF =`
SIZE STORIES FAMILIES
USE OF }}�� '� _
STRUCTURE r^j 6
SIGNATURE OF -
APPLICANT -
VALUATIONS
APPROVALS DATE INSPECTOR'SSIGNATURE
P C PMT FOUNDATION LOCATION
FEE$ FEE$ FORMS MATERIALS
IFRAME FIRE STOPS, _
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS _
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING I GAS VENT DUCTS r
9UILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK a
AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT -
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT
ING TO WORKMEN S CNS R NCE LATH EXT c "'
SIGNATURE OF ) HOUSE NUMBER COR-
ep
OM SATI I -
PERMITTEE RECT AND POSTED
ADDRESS F I NAL V
JOHN F LEWIS PRINCIPAL QST TU RAL ENGINEER
PLAN CHECK VALIDATION CK M 0 CASH _ PERMIT VALIDATION DK M C CASH-
6
',JAN 13 1 D - 6.0 0- 7
` C S
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
WORKER S COMPENSATION DECLARATION, FOR APPLICANT TO FILL IN BUILDING ADDRESS
14
I hereby affirm that I have a certificate of consent to self Insure BUILDING ADDRESS rcLQrgQ L I —/ N�� C�®l�Q
or a certificate of Workers Compensation Insurance or a certified 5 S
copy thereof(Sec 3800 Lab C) CITY ��M /L Cry ZI? 9179 0 LOCALITY
POIICy No Company SIZE OF LOT NO OF BLDGS/NOW ON LOT
❑ Certified copy IS hereby furnished SO x 7s 1 NEAREST CRO SST
(.7 !/ J�
❑ Certified copy is filed with the county building Inspection << TRACT BLOCK LOT NOCt" �Y
department �� O O USE ZONE MAP NO
Date Applicant ASSESSOR MAP BQ-4 Q PAGEPARCEL
S O � V V 6 /0,!(, SPECIAL CONDITIONS
CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER v � D TEL NO
COMPENSATION INSURANCE T �"R� �� A#1611&571-"46609!5' WITHIN 1000 FT OF SCHOOL? YES No
(This section need not be completed if the permit Is for one hundred ADDRESS 3// G!"rAV VIS 61-VD J 3/&410 g DISTRICT GROUP TYPE CONST F E ZONE PROCES D BY
dollars($100)or less) O
CITY - ZIP
I certify that In the performance of the work for which this permd 4M 4-06k l (� '9/ 7710
Is Issued I shall not employ any person in any manner so as to -
become subject to the Workers Co pensatlon Laws ARCHITECT OR ENGINEER TEL NO
WA STATISTICAL CLASSIFICATION APT C DO
Date Applicant �� ADDRESS CLASS NO DWELL UNITS
NOTICE TO APPLICANT If after making this Certificate Of RtOUIRED TOTAL SETBACK FROM EXIST
Exemption you should become subject t0 the Workers CONTRACTOR TEL NO SET BACK YARD HWY PROP LINE WIDTH
Compensation provisions of`the Labor Code you must forthwith' q FRONT
comply with such provisions or this permit shall be deemed revoked ADDRESS LIC NO P L
LICENSED CONTRACTORS DECLARATIONA,114r SIDE
CITYLIC CLASS P L
I A//4 hereby affirm that I am licensed underprovisions Of Chapter 9 SEWER MAP
(commencing with Section 7000)of Division 3 of the Business and SO SIZE NO OF STORIES NO OF FAMILIES d
Professions Code and my license is In full force and effect `�y�i, NEW ❑ BK PG ► O
License Number Llc Class DESC IPTION OF WORK ADD ❑ VALUATION V
Contractor Date �D o1v ALTER ❑ $ 3 ID t cc
ElI am exempt under Sec Flh-e4elss SHIN REPAIR $ F-
U
B&PC for this reason
DEMOL ❑❑ 1L
Date USE OF EXISTING BLDG i N
.S� CL
LDMA P/C#a6L� p'W , l�cs*,e. URM Z
Signature APPL T(PRINT) TEL NO LDMA Perm# r'ai g
,xi
as owner of the property or my employees with wages as 4� r�� wo ;/Lzs- Z �`'" °1r 47^ SLI
heir sole compensation will do the work and the structure Is ADDRESS ,.d O
not intended or offered for sale (Section 7044 Business and ?It E` ✓�!l 6t►W ole. .�� �e L 144 FINA DAl7�yj 9 Q 0, FJ
Professions Code) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL
OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE
❑ I as owner of the property am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDES FINAL BY <ijt�
licensed contractors to construct the project (Section 7044 _ ; c
Business and Professions Code) YES❑ Nvo �
�J
WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING _
OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH �� _ ! rr �{
COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKUST FOR
CONSTRUCTION LENDING AGENCY
GUIDEUNES
4 V-
I hereby affirm that there Is a construction lending agency for YES❑ No
a the performance of the work for which this permit is Issued(Sec /` r{{{• 1,_E f
3097 CIV C (HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING IL�iat{_{;� yE7I! >?fC.0
N ) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE 4=.f T�
TITLE 2 CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS
Lenders Name MATERIALS 2�E ING AND FOR OBTAINING PERMIT FROM T E SCAQMD kqq AIT
Lenders
o Lenders Address �..'�.n�� Tt1711�� 7
O OWNER OR AG T ,
o I certify that I have read this application and state under penalty
0 of perjury that the above Information is correct I agree to comply PC FEE PERMIT FEE
6m
all county ordinances and State laws relating to building
CID
construction and hereby authorize representatives of this County ISSUANCE FEE
m to enter9Pon th a e-mentioned property for Inspection purposes
/v'u� l U-.,S =! INVESTIGATION FEE TOTAL FEE
Fq,e— «AwntDere
X4 YAo j S C4. .v SEE REVERSE FOR EXPLANATORY LANGUAGE
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0906010022
PHONE (626) 285-0488 EXT
i
ILEGAL ID I NO OF CONST NEW I BUILDING ADDRESS 1
1 ON FILE I SQ FT STORIES TYPE OCCUP GROUPI 5419 CLOVERLY AV 1
(STRUCTURE 312 1 VN R3 I TEMP CA 917803108 1
(ASSESSOR INFORMATION NUMBER GARAGE NEAREST CROSS STREET OLIVE 1
18588-028-018 I OTHER , I THOMAS PAGE 596 GRID J4 LOCALITY TEMPLE CITY, Cl
I II I I
ITENANT IEXIST BLDG USE USE ZONE (ISSUED ON PROCESSED BY
1 1EXIST OCC GRP 106/01/09 SR
I I I I
(OWNER TEL NO IBLDGS NOW ON LOT VALUATION IFI AL DATE FINAL-BY CODE
ICHEUNG CHRISTINE (626) 428-4085- 1 46,2481
15419 CLOVERLY AVE I I I
ITEMPLE CITY CA 91780 1 FEES PAID lMq('RTPTIIDN OF WORK
I ICONVERT ENCLOSED PATIO TO BEDROOM AND FAMILY ADDITION IN THEI
I IFEE DESCRIPTION QUANTITY UOM AMOUNT IREAR OF THE HOUSE 312 S F I
(APPLICANT TEL NO I I I
ILAI (626) 288-2651- IAA BLDG PERMIT ISSUANCE 27 75 1
18748 VALLEY BLVD #K IAB STATE GREEN BLDG FEE `- 46248 00 VAL 2 00 ISPECIAL CONDITIONS I
IROSEMEAD, CA 91770 IAC STRONG MOTION RESID 46248 00 VAL 4 62 1 I
IAX BUILDING REVIEW FEE 54 70 I 1
1 DB2 PERMIT W/ENERGY 46248 00 VAL 834 41 1 I
ICONTRACTOR TEL NO I TOTAL FEES 923 48 (APPROVALS DATE INSPECTOR SIGNATURE I
(DAVID GENERAL BUILDING CONSTRUCTION (626) 926-2728- 1 I
1420 S ELECTRIC AVE LIC NO ILOCA7ION AND SETBACKS I I
IALHAMBRA, CA 91803 768772B I I I
ISOILS ENGINEER APPROVAL
ARCHITECT OR ENGINEER TEL NO JFOUN-�ATION/TRENCH FORMS I I V
I
LIC NO I ISLAB,UNDER FLOOR I I�
I i I I I I
IRAISED FLOOR FRAMING 1
IMAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP 1
I I
IUNDEPFLOOR INSULATION
I I I
3 Oli (1ST LEVEL FLOOR SHEATH
INO OF FAMILIES DWELLING UNITS APT/COND STAT CLASS I I I
NO 21 I 12ND LEVEL FLOOR SHEATH 1
I I I I I I
SCHOOL WITHIN HAZARDOUS IROOF SHEATHING I I I
(AIR QUALITY 1000 FEET MATERIALS I I I
1 NO NO NO I IFIRE DEPT FRAME INSPECTI I I
I I 1 1 I
IREQUIRED TOTAL SETBACK FROM EXIST I 1BLDG,DEPT FRAME INSPECTI I I
ISET BACK YARD HWY PROP LINE WIDTH I I I I I
IFRONT PL- I ISHEAP PANELSI
I 1
SIDE PL- i IINSU.ATION/WEATHER STRIPI I I
I I I I I
I (INTERIOR LATH/DRYWALL I 1 1
I I I I
(EXTERIOR LATH I I
I I I
I (LOT DRAINAGE
r
ISMOKE DETECTION DEVICES
I I I I I I
IFIRE,DEPARTMENT APPROVALI
REPORT ID DPR261 ROUTE TO BS0508 I I
I I I I I i
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 0907230014
PHONE (626) 285-0488 EXT
(LEGAL ID NO OF CONST BUILDING ADDRESS I
I ON FILE I SQ FT STORIES TYPE 5419 CLOVERLY AV I
ISTRUCTURE 127 V-B TEMP CA 917803108 I
(ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET OLIVE I
18588-028-018 I THOMAS PAGE 596 GRID J4 LOCALITY TEMPLE CITY Cl
(TENANT IEXIST BLDG USE RESID USE ZONE R-1 JISSUED ON PROCESSED BY
(EXIST OCC GRP 107/23/09 SR
(OWNER TEL NO IBLDGS NOW ON LOT VALUATION IF AL DAT FINAL BY CODE
IHUI SALLY - I 15,000
15419 CLOVERLY AVE I
(TEMPLE CITY CA 91780 FEES PAID IDES IPTIO OF WORK I
I INEW GABLE ROOF OVER REAR DROOM & FAMILY ROOM, NEW PATIO I
_IFEE DESCRIPTION QUANTITY UOM AMOUNT IBEHIVD FAMILY ROOM 127 S F KITCHEN, BATHROOM REMODEL & REPLI
(APPLICANT TEL NO I 1
ILAI (626) 288-2651- IAA BLDG PERMIT ISSUANCE 27 75
18748 VALLEY BLVD #K IAB STATE GREEN BLDG FEE 15000 00 VAL 1 00 ISPECIAL CONDITIONS 1
ROSEMEAD, CA 91770 IAC STRONG MOTION RESID 15000 00 VAL 1 50
1 IAX BUILDING REVIEW FEE 54 70 1 I
IB2 PERMIT W/ENERGY 15000 00 VAL 330 66 I
(CONTRACTOR TEL NO IFR INV WORK W/O PERMIT 257 00 DOL 257 00 IAPPPOVALS DATE INSPECTOR SIGNATURE 1
(DAVID GENERAL BUILDING CONSTRUCTION (626) 926-2728- 1 TOTAL FEES 672 61 1
1420 S ELECTRIC AVE LIC NO 1 ILOCATION AND SETBACKS I 1 1
IALHAMBRA, CA 91803 768772B
(SOILS ENGINEER APPROVAL I
(ARCHITECT OR ENGINEER TEL NO IFOUNDATION/TRENCH FORMS 1 1 I
I
LIC NO I SLAB/UNDER FLOOR I I I
RAISED FLOOR FRAMING I I I
SEWER NO MAP BOOK PAGE FIRE ZONE CMP I (UNDERFLOOR INSULATION I I I
1147H269 3 001 \ 1 1
I I I
c-7 !�6 U �v 2 I FLOOR SHEATHING
INO OF FAMILIES DWELLING UNITS APT/GOND STAT CLASS I ( I I I
I NO 21 1 (ROOF SHEATHING �� ✓ I 1
SCHOOL WITHIN HAZARDOUS I (SHEAR PANELS I
(AIR QUALITY 1000 FEET MATERIALS I I I
I NO NO NO I (FRAME INSPECTION
(REQUIRED TOTAL SETBACK FROM EXIST I IFIRE SPRINKLER HANGERS I
ISET BACK YARD HWY PROP LINE WIDTH I I I I 1
IFRONT PL- I 11NSULATION/WEATHER STRIPI, I I
I SIDE PL- I 1_ 11 1
11NTERIOR LATH/DRYWALL I I
1EXTERIOR LATH I I I
IRATFD FLOOR/CEIL ASSEM 1 I
1
IRATFD WALL ASSEMBLIES I I
(RATED SHAFTS/OPENINGS I I
IT-BAR CEILINGS I 1 I
I I* ADDITIONAL DATA ON FILE II I 1
LOT DRAINAGE
I I I
1 (REPORT ID DPR261 ROUTE TO BS0508
I I I I I I
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 0701080015
PHONE (626) 285-0488 EXT
LEGAL ID NO OF CONST BUILDING ADDRESS
ON FILE SQ FT STORIES TYPE 5419 CLOVERLY AV
STRUCTURE 20 VN TEMP CA 917803108
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET BROADWAY
8588-028-018 THOMAS PAGE 596 GRID J4 LOCALITY TEMPLE CITY, C
TENANT EXIST BLDG USE RESID USE ZONE R-1 ISSUED ON PROCESSED BY EXPIRES ON
EXIST OCC GRP 01/08/07 JK 01/03/08
OWNER TEL NO BLDGS NOW ON LOT VALUATION FINAL DATE FINAL BY CODE
CHEUNG CHRISTINE - 3 900 /��J
5419 CLOVERLY AVE
TEMPLE CITY CA 91780 FEES PAID DESCRIPTION OF WORK
REMOVE SHINGLES APPLY 30 YEARS COMPOSITION SHINGLES
FEE DESCRIPTION QUANTITY UOM AMOUNT
APPLICANT TEL NO
YANG (213) 400-7744- AA BLDG PERMIT ISSUANCE 27 75
3007 LAKEVIEW TER AC STRONG MOTION RESID 3900 00 VAL 0 50 SPECIAL CONDITIONS
FULLERTON, CA 92835 D2 PERMIT W/O EN-HC 3900 00 VAL 115 80
TOTAL FEES 144 05
CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE
BEST ROOFING AND CONSTRUCTION (714) 321-0335-
3007 LAKEVIEW TERRACE LIC NO LOCATION AND SETBACKS
FULLERTON CA 92835 552156 C39
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
147H269 3 01
FLOOR SHEATHING
NO OF FAMILIES DWELLING UNITS APT COND STAT CLASS _
NO 21 ROOF SHEATHING -7
SCHOOL WITHIN HAZARDOUS SHEA2 PANELS
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
I
EXTERIOR LATH
RATED FLOOR/CEIL ASSEM
RATED WALL ASSEMBLIES
RATED SHAFTS/OPENINGS
I
T-BAR CEILINGS
LOT DRAINAGE
i
REPORT ID DPR261 ROUTE TO BS0508
I
C
COUNTY OF LOS ANG[-.ES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT Or'PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0502140007
PHONE (626) 285-0488 EXT
L G ADDRESS.
ON FILE SQ FT STORIES TYPE OCCUP GROUP 5419 CLOVERLY AV
STRUCTURE- 312 1 VN R3 TEMP CA 917803108
ASSESSOR INFORMATIONGARAGE NEAREST CROSS STREET. OLIVE
8588-028-018 OTHER THOMAS PAGE 596 GRID. J4 LOCALITY TEMPLE CITY, C
TENANT EXIST BLDG USE USE ZONE ISSUED ON PROCESSED BY EXPIRES
EXIST OCC GRP 02/14/05 JK 02/09/06
OWNER TEL. NO: BLDGS VALUATION- FINAL DATEFYNO. CODE
GUNAWAN, SUN S (626) 864-2559- 6,240
5419 CLOVERLY AVE
TEMPLE CITY CA 91780 FEES PAID bT§(R
CONVERT ENCLOSED PATIO TO ROOM ADDITION 312 SQ FT
FEE DESCRIPTION QUANTITY. UOM: AMOUNT
WyErcm TEL
NO-
SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27 75 _
AC STRONG MOTION RESID 6240 00 VAL 0 62 SPECIAL CONDITIONS
B2 PERMIT W/ENERGY 6240 00 VAL 182 82
TOTAL FEES 211 19
CONTRACTOR 0: APPROVALS DATE INSPECTOR SIGNATURE—
SAME
IGN TURSAME AS OWNER -
LIC NO LOCATION AND SETBACKS
-`S–OFLS ENGINEER R VAL
ARCHITECT OR ENGINEER TEETVUFORMS
LIC NO SLAE/UNDER FLOOR
FLOORRAIISED
14AP N0: SEWER MAP BOO FIRE ZONE CMP UNDERFLOOR INSULATION
3 0'
'fgr LEVEL
NO OF FAMILIES: DWELLING UNITS. APT/COND: T CLASS:
NO 21 2ND LEVEL RSHEATff--
SCHOOL WITHIN HAZARDOUS
RM SHWHING
AIR QUALITY• 1000 FEET MATERIALS _
NO* NO NO FIRE DEPT. FRAME I S EC
REQUIRED
SET BACK YARD: HWY: PROP LINE WIDTH
FRONT PL- S EPR PANELS
SIDE PL-
0
ITT OR ATH/DRY
EM LATH
-O DRAINAG
'9UP DETECTIONE
FIRE DEPARTMENT APPROVA
REPORT ID DPR261 ROUTE TO BS0508