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76Al89A C9#803 G 56 APPLICATION FOR, BUILDING PERMIT - 1'
COUNTY OF LOS ANGELES BUILDING
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DEPARTMENT OF COUNTY ENGINEER ' ' ADDRESS l
BUILDING AND SAFETY DIVISION I LOCALITY
JOHN A LAMBIE,COUNTY ENGINEER NEAREST ol
CASSATT D GRIFFIN,SUP T OF BUILDING CROSS ST
DISTRICT NO GROUP ITYPE CESSED BY
FOR APPLICANT TO FILL IN CONSr
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pQ CLASS NO DWELL UNITS '
LOT NO 299,/ BLOCK MAP STATE yES O
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NO OF SLOGS CONDITIONS ..
SIZE OF LOT 0 �- NOW ON LOT
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OWNER ( 1 FRONT
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CONTRACTOR IF IP//
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DESCRIPTION OF WORK
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SIGNATURE OF
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ADDRESS / Y � FOUNDATION LOCATION DATE INSPECTOR S SIGNATURE-
ADDRESS
FORMS MATERIALS 17
ey P C S �f FRAME FIRE STOPS
� .7 FEE � BRACING BOLTS
VALUATION O% FURNACE LOCATION d ._,/�..��IIr�l/
�^ FEE GAS VENT DUCTS 7 .LlJ�Ot�� >
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH INT
PLICATION AND STATE THAT THE ABOVE IS CORRECT ANDr y.
AGREE TO COMPLY WITH AL COUNTY ORDINANCES AND LATH,EXT / +
STATE LAWS RE TI UIL G NSTRUCTION _
SIGNATURE OF HOUSE NUMBER COR-
PERMITTE RECT AND POSTED
ADDRESS -Z--T-1
� FINAL
t CLYDE N DIRLAM PRINCIPAL ST RAL ENGINEER
' PLAN CHECK VALIDATION CK mo CASH PERM VALIDATION CK M O 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 0306120007
PHONE (626) 285-0488 EXT-
LEGAL
TR 6561 LT 299 SQ FT STORIES TYPE 5944 CLOVERLY AV
STRUCTURE: VN TEMP CA 917802018
ASSESSOR NEAREST CROSS STREET LAS TUNAS
8587-013-024 THOMAS PAGE 596 GRID: J3 LOCALITY TEMPLE CITY
TENANT EXIST GUSE S
EXIST OCCGRP 06/12/03 JK 06/06/04
OWNER TEL NO BLDGS NOW ON LOT VALUATIONNAL DATE FINA E.
DAY JAMES L,MARY E - 1,900 . (�-03
9729 LIVE OAK BLVD
TEMPLE CITY 91780 FEES PAID DESCRIPTION 0
T/O, SHEATH OVER SPACED SHEATHING & REROOF W/ASPHALT SHINGLE
FEE DESCRIPTION QUANTITY UOM AMOUNT
APPLICANT TEL NO
WILLIAM T NELSON ROOFING (626) 857-5558- AA BLDG PERMIT ISSUANCE 27 75
1325 E RUDDOCK ST AC STRONG MOTION RESID 1900 00 VAL 0 50 SPECIAL COND IONS
COVINA 91724 D2 PERMIT W/O EN-HC 1900 00 VAL 82 20
TOTAL-FEES 110 45
CONTRACTOR TEL NO- APPROVALS DATE INSPECTOR SIGNATURE
WILLIAM T NELSON ROOF CONTRACTOR (626) 303-0524-
1325 RUDDOCK ST LIC NO ' N AND SETBACKS
COVINA CA 91724 648085 C39
- SOILS ENGINEER APP OVAL
ARCHITECT OR ENGINEER T E i
[--Nb- - - 0 FORMS
LIC NO SLAB/UNDER FLOOR
RAISED FLOOR FRAMING
MAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP UNDERFLOOR INSULATION
150H265 3 01
SHEATHINGFLOOR
NO OF FAMILIES. DWELLING UNITS. APT/CONDC S
NO 21 ROOF SHEATHING
SCHOOL WITHIN HAZARDOUS S S
AIR QUALITY 1000 FEET MATERIALS
NO NO NO FRAME INSPECTION
REQUIRED TOTAL SETBACK FROM EX I ST- FIRE SPRINKLEff-ffXWffftT--
SET BACK YARD HWY PROP LINE WIDTH
FRONT PL- - INSULATIONNEATHER STRIP
SIDE PL-
EAT
EXTERIOR LATH
Ile RATED
FLOOR/CErU-A99ER-
RATED WALL ASSEMBLIES
RATED SHAFTS/OPENINGS
T-BAR CEILINGS
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REPORT ID DPR261 ROUTE TO BS0508