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Home My Public Portal About9328 DAINES DR_Building__ aG° PUCAMOM [FOR. 18MLIMHOPER07 it COUNTY OF LOS ANGELES_ BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS _ BUILDING ADDRESS �•� I hereby affirm that I have a certificate of consent to self insure, b �r or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) CITY ZIPILA, u'm LOCALITY Policy No. Company SIZE OF LOT I NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. 3 cvy` 1 SV NEAREST CROSS ST. TRAFT BLOCK LOT NO. 't I toy) ❑ Certified copy is.filed with the county building inspection �� 7 USEZONE MAP NO. department.' /93 -24 7 ASSESSOR MAP BOOK PAGE PARCEL Date Applicant `p SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER ' y "lrS TEL.NO. Z_ COMPENSATION INSURANCE t- OM1 . d(�,q Agt-Rat�fE ,2PS'gc2� WITHIN 1000 Fr.OF SCHOOL? YES NO ADDRESS (This section need not be completed if the permit is for one hundred DISTRICT GROUP TYPE CONST.' FIRE ZONE PROCESSED BY dollars($100)or less.) CITY zIP I certify that in the performance of the work for which this permit 7RL7 - pe- 3 �2c ,cmc Js issued, I shall not employ.any person in any manner so as to ARCHITECT OR ENGINEER TEL.NO. become subject to the Workers'Compensation Laws. Ly(A. - STATISTICAL CLASSIFICATION. APT CONDO Date Applicant ADDRESS - CLASS NO. DWELL UNITS NOTICE TO APPLICANT: If, after making this Certificate Of CONTRACTOR b-4/6 TELNO. REQUIRED TOTAL SETBACK FROM EXIST . Exemption, you should become subject,to the Workers' SET BACK YARD HWY PROP LINE, WIDTH Compensation provisions of the Labor Code, you must forthwith a V4._1a_yrz L,01 9- � FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL SIDE >_ LICENSED CONTRACTORS DECLARATION CITY LIC.CLASS PL CL hereby affirm that I am licensed under provisions of Chapter 9 EWER MAP CD (commencing with Section 7000).of Division 3 of the Business and SQ.FT SIZE NO.OF STORES NO.OF FAMILIES b�i.1 O+-i NEW ❑ [!K PG vProfessions Code,and my license is in full force and effect: av DESCRIPTION OF WORK ADD ❑ VALLI ON Lu License Number Lic.Class Q e $ N Contractor Date ALTER Z ❑ I am exempt under Sec. REPAIR .� BARC.for this reason IZA O_Se. e r DEMOL ❑ LDMA P/C# USE OF EXISTING BLDG. Date: PALS it�k C'4-4T1,C4 L.— URM. ❑ _ Signature APPLICANT(PRINT) TEL.NO. LDMA Perm# - 5 ❑ 1, as owner of the property, or my employees with wages as k A _ their sole compensation,will do the work and the structure is ADDRESS not intended or offered for sale (Section 7044, Business and FINAL DATE Professions Code.) (p WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN :3 pp ••�— r-g �I, as owner of.the property,am exclusively contracting With THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY I I_T yl 150 c 2'27 contractors to construct the project.(Section 7044, YES❑ NO D -- Business and Professions Code.). CASH , WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING COAST AOCCUPAIIR Q ALIREA PERMIT FOR ITY MANAGEMENT DISTRICT(ION OR SC OMD)SEECATION FROM K PERMITTING CHECKLIST UTH CONSTRUCTION LENDING AGENCY FOR GUIDELINES. I hereby affirm that there is a construction lending agency for YES❑ NO the performance of the work for which this permit is issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD 3097,CIV.C.). PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES I_IL� ��'''- '''• •"' m. COUNTY CODE,TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING - i..,,... Lender's Name HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. .2-'S5 ' Lender's Address OR AGENT r o'• I certify that I have read this application and state that the above P.C.FEE PERMIT FEE - information is correct. I agree to comply with all county ordinances and State laws relating to building construction,and a. hereby auth ' e representatives this County to enter upon ISSUANCE FEE 2 the ebov nti rop f ns Ion pu O✓• INVESTIGATION FEE TOTAL FEE y�e �.w a Applicant a Agp om SEE REVERSE FOR EXPLANATORY LANGUAGE DIVISION OF BUILDING AND SAFETY epartment of County Engineer UNLOING County of Los Angeles 1 wM. J. FOX, COUNTY ENG �INEER JAI 1 APPLICATION FOR APPLICANT TO4" �RT FOR OFFICE USE ONLY DISTRICT NOPLAN CK. ORepREcNOE7/R�M:oIIT(.NO. BUILDING Q3p p � ADDRESS tY la �,� RECEIVED BY DATE OF ADPL.. DATE ISSUED LOCALITY OVA N,f NEAREST BT. hY(? /_O�,/�lj CROSS X - .GL'7 BUILDING ADDRESS n3 .2 d2 ,rte f/?'7 • /7�' �'j a�R/ fS OWNER LOCALITY /-G/-.7 /l �2. MAIL ADDRESS NEAREST h ¢ CROSS ST. CITY � � t NO. ZFIREONE P"O °� I TYPE I I GROUP_T_or /d� ARCHITECT D TEL_ r- v ENGINEER NOr . O BLDG. 4RD. NO. SETBACK LINEy �7 ADORES= USE � - APPROVED TINCONTRACTOR �}h� h�J E NO. 7 ZON$ BY HOUSE NUMBERING DATE s ADDRESS ✓ MAP NUMBER Q NO. ASSIGNED BY LEGAL DESCRIPTION I. LOT NO.V -y 7 BLOCK � CORRECTIONS TRACT 15/�/J�Ly/7� I?•' / / C/' �/` ` NO. OF BLOGS. O SIZE OF LOT Sb X I50 I NOW ON LOT USE OF I NO.OF =` �U �� G /��• l r7 O 4 EXISTING BLDG. - — FAMILIESaL DESCRIPTION OF WORK o NEW ALTERATION ADDITION / Z r REPAIR DEMOLITION SQ.FT. N O.O F / SIZE ROOMS 4. STORIES EXT.WALL •'�'7 ROOF COVERING O I COVERING el USE OF STRUCTU F' r _407 274 INSPECTION FOR APPROVALS OCCUPANCYAS INSPEC .. R•SSIGNATURE DATE FOUNDATION: LOCATION FORMS, MATERIALS 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APS. S ✓ PLICATION AND STATE THAT THE INFORMATION GIVEN IS FRAME: FIRESTOPB, S„� CORRECT. BRACING, BOLTS J 1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION, AND STATE LFAjAW-,/�S REGULATING BUILDING CONSTRUCTION. GAS VENT, DUCTS ,y ®PERMTTTE Oi ob/zhole2,,.) �� JJ LATH, INT.-2111-1 3 ADORES ` D S f LATH. EXT. PLASTER, INT. AUTHORIZQD AOT. PLASTER. EXT. P.C.>S ra S �( FEE /� HOUSE NUMBER COR- (//A/ (� RECT AND POSTED VALUATION FINAL , ✓ FEE � .3 3 3° 76A63BA D853 1-52 COUNTY OF LO_S ANGELES ;- .y BUILDING AND SAFETY Q r fii>> WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN r Bul IN f JDRES_Sb / s7 I hereby affirm that I have a certificate of consent to self insure,' 6UILDING;ADDRESS or a certificate of'Workers' Compensation Insurance, or a certified copy thereof (Sec.3800,Lab.,C.) - CITY� .� ZIP�� 7CJ U t LOCALITY - Policy No.. •Company SIZE OF-LOT NO.OF BLDGS:NOW ON LOT ❑ Certified copy is hereby furnished. rJ , A ° NEAREST CROSS ST. ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. 1.'7 i -7 USE ZONE MAP NO. Date. Applicant ASSESSOR MAP BOOK PAGE Z7 I PARCEL O S / SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL NO. COMPENSATION INSURANCE _ WITHIN 1000 FT.OF SCHOOL? ves NO This section need not be completed if the permit is for one hundred ADDRESS ( P J 2 LN'�S DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY ' dollars ($100) or less.) • CITY - ZIP - I certify that in the performance of the work for which this permitJFL is issued, I shall not employ any.person in any manner so as to J1, become . become subject to the Workers'Compensation Laws. QArE4W iI;FF!81f_QA FY'SIP TEL NO. P pvo Z 1,431 STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT. If, -after making this Certificate of 9d ,L A-v REQUIRED 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 -O �V_x FRONT comply with such,provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL LICENSED CONTRACTORS DECLARATION PILE CITY iIG.CLASS PL ,I.hereby affirm that I am licensed underprovisions of. Chapter 9 SEWER MAP .(Commencing with Section 7000)'of Division 3 of the Business and SQ.FT.SIZE NO.OF STORIES NO.OF FAMILIES - ni Professidns Code,and my license is in full force and effect. L} perry11� NEW BK PG D O } ADD License Number Lic.Class DESCRIPTION OF WORK C] VALUATION 0 Contractor Date W ,ro 4"Abet, ALTER 11 $ 35 c7O0 ElI am exempt under Sea �$REPAIR 1:1 O� BAP.C.for this reason / DEMOL ❑ W LDMA P/C# Date: - USE OF EXISTING BLDG. URM ❑ a ��° `: _':It Co Sig ature. - - - APPLICANT(PRINT) - TEL'NO. LDMA Perm# ` �I Z as owner of the property, or my employees with wages as LIZVOW 14viAt4bMAIIIL 7-47.-L431 ~� O their sole compensation, will do the work and the,structure is ADDRESS • not intended or offered for sale '(Section 7044, Business and 2 ZdFINAL DATE Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL y y I( OR A'MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE J '� ❑ licensed en owner o Of the property, am exclusively contracting 44,ith AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY i. r licensed contractors to construct the project (Section 7044, ? I_, YES❑ NO❑ � � - Business and Professions Code.) WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING )µ I..'!'' i 7`_? ,t'.. _ OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH _ ^'"�°+ 'i - �'•'•=. CONSTRUCTION LENDING` AGENCY COASTAIRQUAUTY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR ' GUIDELINES. •L'rE I hereby affirm that there is a construction lending agency for YES❑ NO❑ N. the performance of the work for which this permit is issued(Sec. s;3 ,^lf I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING 3097,CIV.C.) _ CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. ❑ Lender's Address EL O OWNER OR AGENT ' I certify that I have read this application and state under penalty _ ? �' O of perjury that the above information is correct.I agree t0 comply P.C.FEE SV PERMIT FEE with,all county ordinances and State laws relating to building v D construction d hereby authorize re r §entatives of this Count ISSUANCE FEE / n to enter u e ab y entio ro p fy fo inspection purposes. �(O� INVESTIGATION FEE TOTAL FEE o (p / r o Aoa��cant or gent SEE REVERSE FOR EXPLANATORY LANGUAGE WORKERS' COMPENSATION-DECLARATION n M i10 nse bei-o certif carte of Worke s' Compensat oI have a certificate of n Insurancent to , A,P C�U IJV M- O M d D 0�l C� p C G3G�iv 0`� orcertified copy thereof (Sec. 3800,.'Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company ' ,. ❑ Certifiedcopyis hereby',furnished. :FOR APPLICANT TO FILL IN ao�Ress � � �� >° ❑ . Certified copy is filed with the county building'inspec- BUILDING nn?? �. tion department. ADDRESS `e� \�� ( �• �I� Date. Applicant' CITY \ f 1� L` ZIP `. �d LOCALITY NO. OF BLDGS. NEAREST r. CERTIFICATE OF.EXEMPTION FROM'WORKERS' SIZE OF LOT NOW ON LOT CROSS ST. j a7n COMPENSATION INSURANCEASSESSOR c (This section need.not be'completed if the permit is for one TRACT '�� BLOCK L T N 1 MAP BOOK J PAGE PARCELS/` hundred dollars ($100)or.less.,) �• `` e OWNER � ' 'L 5A USE ZONE'' OP /N O' I certify that`in the:performance of the.work for which this �]/�n Al '7 l� permit is issued, Ishall notemploy any:persorrin any manner -- ADDRESS �• � � - ��:� . . //� •��. - SPECIAL cv CONDITIONS :so as,to become subject to the Workers'Compensation Laws. O CITY e �i� . C\ ZIP `� �C;. U Date' Applicant ARCHITECT OR TEL. 0 NOTICE' TO.APPLICANT: If,'after, Takingthis Certificate of ENGINEER NO DISTRICT, GROUP TYPE FIRE PROCESSED BY CONST ZONE.' � Exemption, -,you should become' subject .to _the Workers' Compensation provisions of the Labor Code, you must forth- ADDRESS �� with comply with such provisionsor this permit.shal-I be TEL STATISTICAL LCLASSIFICATION APT deemedrevoked. CONTRACTOR CONDO. N Z LICENSED CONTRACTORS DECLARATION UC. CLASS NO:__,2 _DWELL. UNITS - I hereby affirm that I am licensed under provisions of Chapter 0 ADDRESS NO. (commencing with Section 7000)of Division 3 of the Business LIC. SEWER MAP and Professions Code,and my license is infull force and effect. CITY CLASSgK. �PG. �S�s VALIDATION SQ.:FT. NO. OF, NO. OF CHECK" ` License Number _'Li c." Class SIZE STORIES IFAMILIES ONE Contractor Date DESCRIPTION OF WORK NEW ❑ VALUATION e $ ./'y00 _- ADD D ❑I am exempt under Sec. ALTER 0 a B.&P..C. for this.reason REPAIR ❑ $ Date: USE OF » EXISTING BLDG. DEMOL ❑ APPLICANT TEL. Signature (PRINT). NO. FINAL... OWNER-BUILDER DECLARATION DATE 19_(p low affirm that I am exempt from the Contractor's License Law for the following reason:(Section 7031.5, Business and ADDRESS FINAL Profen ' ns Code): PRESENT By - %f .1. ILDING • I, as owner of thIr e property; or'my employees with ADDRESS _ ` e c n wages as their BU sole compensation,-will•do the work and the structure is not intended or offered for sale(Section LOCALITY q.l»i...qt�-, 7044, Business and-Professions Code:) MOVING TEL. D ❑ 1,'as owner of the property, CONTRACTOR NO. _ y , p p y, am exclusively contracting ;I 6 s ; with licensed contractors to,construct the project (Sec- ADDRESS tion'7044, Business and.Professions Code:) + [ �E S 7r j a 1 REQUIREDTOTAL SETBACK FROM EXIST. CONSTRUCTION'LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH r > + I hereby affirm that there is a construction lending agency for FRONT t_-HA'GE ` 0, .the performance of the work-for which this permit`is issued 'P.L. " (Sec. 3097, Civ. C.). SIDE' • ` P1. Lender's Name, i sl__1; I,E it ii . s : : 11 P.C. Fee$ Permit Fee LDMA-Ref. # ccs. - Lender's Address s -K, Art. a 0 1 certifythat 1 haJe'read this application and state that the Issuance Fee ' LDMA P/C.# D, above information is correct. I agree to comply with all County Investigation Fee. d' ordinances and State laws relating to building construction, Total Fee ' LDMA Perm. # y -a and hereby authorize representatives of this County to enter upon the ab ve- entioned per forr9spection purposes. - / SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of App icont or Agent Date - .� 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 1108090080 PHONE: (626) 285-0488 EXT: DUPLICATE ILEGAL ID: I NO. OF CONST BUILDING ADDRESS: ON FILE I SQ. FT STORIES TYPE 9328 DAINES DR 1 1 1STRUCTUREa V-B TEMP CA 917803110 (ASSESSOR INFORMATION NUMBER: 1 - I NEAREST CROSS STREET: CLOVERLY 1 18588-029-015 I THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY CAI (TENANT: IEXIST BLDG USE -RRSID - USE ZONE: R31� - -)TISSUED ON: PROCESSED BY: I IEXIST OCC GRP: 108/09/11 SR 1 I I I I (OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: AT$ FM: CODE: (ABI RACHED SAMIR;YOLLA - 1 2,800 19328 DAINES DR (TEMP 917803110 1 FEES PAID ID CRIPTION OF WORK 1 REPLACE ROOF SHINGLES 25 YEAR LIFE 1920 WT FOR 1600 SF RESIDI IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: IENCE (APPLICANT: TEL. NO': I I ISOTO, SAUL - IAA BLDG PERMIT ISSUANCE 27.80 I '1 11947 N GARFIELD AVE IAB STATE GREEN BLDG FEE 2800.00 VAL 1.00 (SPECIAL CONDITIONS: 1 (PASADENA CA 91104 1AC STRONG MOTION RESID 2800.00 VAL 0.50 I ID2 PERMIT W/O EN-HC 2800.00 VAL 99.10 1 1 I I TOTAL FEES 128.40 ICONTRACTOR: TEL. NO: I 1APPROVALS DATE INSPECTOR SIGNATURE IGOLDEN CONSTRUCTION SERVICES (626) 320-5004- 1 I. 11947 N GARFIELD AVE LIC. NO I.LOCATION AND SETBACKS IPASADENA CA 91104 895303 1 I ISOILS ENGINEER APPROVAL 1 1 1 1ARCHITECT OR ENGINEER: TEL. NO: 1. �IFOUNDATION/TRENCH FORMS I LIC. NO: - ISLAB/UNDER FLOOR IRAISED FLOOR FRAMING IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 1 IUNDERFLOOR INSULATION I 1147H265 3 OC'I _ I I __:I-FLOOR SHEATHING INC. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I - I I 0 NO 21 i ROOF SHEATHING 1 I 1 SCHOOL WITHIN HAZARDOUS 1 ISHEAR PANELS bI (AIR QUALITY: 1000 FEET MATERIALS 1 NO NO NO 1 (FRAME INSPECTION I I I I I I I I (FIRE SPRINKLER HANGERS I I __IINSULATION/WEATHER STRIPI I I I 1 IINTERIOR LATH/DRYWALL 1 1 I I I I I I I (EXTERIOR LATH 1. I i I I I I I IRATED FLOOR/CEIL ASSEM. I I I I IRATED WALL ASSEMBLIES 1 1 I I I I I I IRATED SHAFTS/OPENINGS I I IT-BAR CEILINGS I I T. ILOT DRAINAGE I I (REPORT ID: DPR261 ROUTE TO: BS0508 COUNTY-OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD/ALT/REP BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1105120070 PHONE: (626) 285-0488 EXT: ILEGAL ID: NO. OF CONST NEW BUILDING ADDRESS: I ON FILE SQ. FT STORIES TYPE OCCUP GROUPI, 9328 DAINES DR ISTRUCTURE: 0 1 V-B R-3 I TEMP CA 917803110 (ASSESSOR INFORMATION NUM13ER: GARAGE: I NEAREST CROSS STREET: 1 18588-029-015 OTHER: I THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY, Cl (TENANT: IEXIST BLDG USE: USE ZONE: (ISSUED ON: PROCESSED BY: 1 IEXIST OCC GRP: 105/16/11 SR I I (OWNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: 14A ATE FINAL BY: CODE: (ABI RACHED SAMIR;YOLLA (626) 794-5220- 1 7,500 I19328 DAINES DR' 1\ ITEMP 917803110 FEES PAID 1DESCRIPTION OF WORK 1 IREMODELING TWO BATHROOMS, KITCHEN CONVERT KITCHEN DOOR TO 1 IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: IWINDOW, CONVERT BEDROOM WINDOW TO SLIDING DOOR AND NEW 1 (APPLICANT: TEL. NO: I ICONCRETE LANDING FOR THIS DOOR I IGUIRGUIS, SAMIR (626) 449-6461- IBI PLANCHECK W/ENERGY 7500.00 VAL 171.50 I 1 1281 N. ALTADENA AVE IAA BLDG PERMIT ISSUANCE 27.80 ISPECIAL CONDITIONS: 1 IPASEDENA, CA - IAB STATE GREEN BLDG FEE 7500.00 VAL 1.00 1 I IAC STRONG MOTION RESID 7500.00 VAL 0.80 I IB2 PERMIT W/ENERGY 7500.00 VAL 201.80 ICONTRACTOR: TEL. NO: - 1FR INV WORK W/O PERMIT - 257.00 DOL 257.00 (APPROVALS DATE INSPECTOR SIGNATURE 1 IABI-RACHED, SAMIR & YOLLA (626) 794-5220- TOTAL FEES 659.90 1 _ I 19328 DAINES DRIVE LIC. NO 1 ILOCATiON AND SETBACKS I ' I 1 ITEMPLE CITY, CA 91780 NONE _ _ I I1 I ISOILS ENGINEER APPROVAL 1 1ARCHITECT OR ENGINEER: TEL. NO: 1 IFOUNDATION/TRENCH FORMS I I I LIC. NO: ISLAB,'UiDER FLOOR I I I IRAISED FLOOR FRAMING IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: ( IUN=ZFLOOR INSULATION I I I 3 001 . I- 11 1 I (1ST LEVEL FLOOR SHEATH 1 1 1 INO. OF FAMILIESc DWELLING UNITS: APT/COND: STAT CLASS: I I I 1 1 0 NO 21 1 12ND BEVEL FLOOR SHEATH i 1 SCHOOL WITHIN HAZARDOUS 1ROOF SHEATHING 1AIR QUALITY: 1000 FEET MATERIALS I I 1 NO NO NO 1 IFIRE DEPT. FRAME INSPECT( I I I" IBLDG DEPT. FRAME INSPECTI I I ISHEAR PANELS I IINSUTATION/WEATHER STRIPI 1 1 1 11NTERIOR LATH/DRYWALL I _ 1 I I I I I EXTERIOR LATH ILOT DRAINAGE 1 ISMOKE DETECTION DEVICES IFIRE DEPARTMENT APPROVAL( I I I I I I I IREPORT ID: DPR261 ROUTE TO: BS0508