HomeMy Public PortalAbout5729 ENCINITA AVE_Building__ 78A 638A CEH803 3-68 rP�
APPLICATION FOR BUILD NG PERM
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY f
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPT of eu,LDING NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN DISTRICT NO. CONST.ROU P C ss�PD B
(Print or type only) O J�� C. J
BUILDING STATISTICAL C , IFICATION SEWER MAP
ADDRESS ZO EriCimt$ Tem 1 it CLASS NO. CWELL.UN ITS BK L PC .
LOT NO. ' BLOCK 'USE ZONE MAP
NO.
TRACT J "� SPECIAL'
NO.OF BLDGS. CONDITIONS
SIZE OF LOT NOW ON LOT
USE OF
EXISTING BLDG, Dwelline BLDG.SETBACK FROM
TT,,x,T
TEL, FRONT PROP.LINE OF (STREET).
OWNERMrs. E'T Sherrill NO' TYPE OF EXISTING SETBACK HIGHWAY + YARD' = TOTAL'
ADDRESS 20 EnCinita tWAY WIDTH FROM G.L.
-
CITY Temple Cit +
BLDG.SETBAC K'F - (STREET)
ARCHITECT OR TEL. SIDEPROP.LINE OF
ENGINEER NO.
TYPE OF EXISTING -SETBACK IHIGH + YARD = TOTAL
ADDRESS p HIGHWAY WIDTH FROM L.L.
CONTRACTOR
nVirgin RoofA NO. 28 _D O _ + a
ADDRESS 6D0 S V Lo."' CORNER CUTOFF YES 0 - NO
LIC. ¢
CITY CLASS SEE REVERSE SIDE FOR SPECIAL APPROVALS
U
DESCRIPTION OF WORK d
NEW ADD ALTER 4VWX DEMOLISH z
SQ. FT. NO. OF NO. OF
SIZE - STORIES - FAMILIES
USE OF
STRUCTURE Reroof'House-& Attached Gara
with 235# ComP. Shingles
SIGNATURE OF
APPLICANT
VALUATION $ ZZ OO APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. MT. 'FOUNDATION: LOCATION
P
FEE $ FEE S FORMS, MATERIALS
FRAME: FIRE STOPS,
I HEREBY ACKNOWLE O GE THAT 1 HAVE READ THIS APPLICATION BRACING, BOLTS
AND STATE THAT TME ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION,
WITH ALL COUNTY, ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS
BUILDING CONSTRUCTION, I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA
TION OF THE LABOR ODE OF THE STATE 01
CALIFORNIA RELAT LATH, INT.
INC TjOOTT`W�p.1RRKMEON'�S C MP NSATION IHSURAN
IGvITA'l�F ORR.00 O. TH, EXT.
P ERM(TTEE HOUSE NUMBER COR-
S ,
RECT AND POSTED ,/ /
ADDRES FINAL C41 U
JOHN F. LEWIS. PRI CIPAL STTURAL ENGINEER
PLAN CHECK VALIDATION CK. M.G. CASH _ PERMIT VALIDATION EK. M.D, DASH
;Lko5 y 9 2�2 AUO 16 1 D 9.00-
t
COUNTY OF LOS ANGELES r BUILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION FOR APPLICANT To:FILL IN '',. + BUILDING ADOREss
BUILDING ADDRESS �'«'
I hereby affirm that I have a certificate of consent to'self insure,
of a certificate Of Workers'Compensation Insurance,or a confined
copy thereof(Sec.3800,Lab. C) CITY .� ¢IP / 1'—
�,h C /(rjJ LOGALIT
Policy No. _. _ Company- 512E OF LOT // / N0.OF BLDGS.NOW N LOT L
❑ Certified copy is hereby furnished. ['7 6 NEAREST CROSV ST.
❑ Certified copy is filed with the county bbiltling inspection 'TRS'!' BLOCK LOT NO- '
department. I , I I USE ZONE MAP NO.
i
Date Applicant ASSE86OR MAP BOOK AQ/ PAG EQO—a PAROEGLOC�2p SPECIAL CONDITIONS
CERTIFICATE
OFXEMPTIINSURANCE FROM WORKERS' OWNER .OL. YES
NO
COMPENSATION y WITHIN tiaD FT of scro
(This section need not be completed if theermit is for one_hundred ADDRE s 2�
P DISTRICT GROUP TYPE CONST. FIRE 20NE PROCESSED BV
dollars($100) or less.)
I certify that in the performance of the viork for which this permit CITY ` i^ i ZIP / n^
is issued, I shall not employ any person in any manner so as t0 ARC CT R ENGINEER T L NO �ZJ` Vlie
'
become subject to the Workers'Compensation Laws. tt!. oO a STATISTICAL CLA�SSIFIGATION APT CONDO
7c X Date Applicant - ADD B /y. - GLASS NO. -a /L DWELL UNITS
NOTICE TO APPLICANT' If, after making this' Certificate of .ICH•'A REQUIRED TOTAL SETBACK FROM EXIST
Exemption, you should become Subject t0 the Workers' C N ACTOR G ENO. I,i SET BACK - YARD HWY PROP LINE WIDTH
Compensation Provisions of.the Labor Code;:you must forthwith. G 1^JIf-3le
f FRONT
comply with Such provisions or.this permit shall be deemed revoked. V"AdbRESS IC NO. P L
LICENSED CONTRACTORS DECLARATION SIDE -
CITV LIG.OL S P L
I herebyaffirm that I am licensed underprovisions of Cha ter 9
P P SEWER MAP
(commencing with Section 7000)of Division 3 of the Business and SQ.F7 S E NO.OF 5 RIES OF FAMILIE - }
Professions Code.and my license is In full force and effect. Jr _ NEW El BK PG D a
DESC TONyO OHK VALUATION
, License Number Lia Class ` .Li16 ) b 11O ' ADD O
Contractor Date /J� ALTER $ ��/ '/'
!_
❑ 1 am exempt under Sec. r REPAIR ❑ $
B&P.C.for this reason //JIB - DEMOL ❑ LDMA PIC A y W
Date:
—USE-OF EXISTING BLDG URM ❑ •/ 1
(10
ignature APPLICANT(PRI TEL p�Q Q „/ LDMA Perm x j)(.(_.T
as owner of the property;or my employees with wages as AD B iu� Q"'( l0 �D ; 1 , O Y, ri- _r= L;-I
their.sole compensation, will do the work and the structure is /not intended or Offered for sale (Section 7044, Business and E"b't r �. i -' FINAL DATE 7�' - G i
PfOfeSBIOnS Code.) WILL THE PPLICANT OR FU E BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL I_ /�✓ f/ f g
WI A F URE CONTAINING A AZAROOUS MATERIAL EQUAL TO OR GREATER THAN THE' J Hf ) u F
❑ I, as owner of the property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE' FINAL B _ > t
licensed contractors to construct the project (Section 7044, / r (':
Business and Professions Code.) YES E3 NO .30No 43 1`6f3
,9Y'
WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTUPE BUILDING qITEMS
f�:<'
OCCUPANTREQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH J_/`. ,1 �L, u { \' ( -'\,I IT , S
CONSTRUCTION LENDING AGENCY COAST AIR OUAUTY MANAGEMENT DISTRICT JSCAQMm SEE PERMITTING CHECKUST FOR s' _ _
GUIDELINES. �'i t"?
I hereby affirm that there is a construction lending agency for ,,A/ yff��y��/44F(/////��fff�yy11'1'��1�}}}�-- LI TI- aU.'=1,4,
VES❑ NO LJ J
the performance Of the work for which this permit is issued(Sec. - I . '�a1F(.Y; :!is .46
(HAVE READ THE HAZARppU MATEPIALB INFOR NGUIDE THE LES PERMITTING
3Q97,C.IV.(..) CHECKLIST.I ONDERSTAN Y REOUIREMEN pER THE ANGELES COUNTY CODE hFI_F 7
N TITLE 2.CHAPTER 2 20 ONS 220.10 OUCH 22 4 CONCERNING HAZARDOUS LFIyIy`i a '
Lender's Name MATERIALS REPORTING D F R ORTAINI P RMIT�" E ,
o Lender's AddressnV/
o �ZAAIS Orr AoIs
d I certify that I have read this.application and state under penalty L U00-1000i �G„/17l4'r
O of perjury at the above infer ation is correct, I agree to Comply P.C.FEE rJ� p PERMIT FEE -
with all ordinane nd St la relating to building !� 6'A "/• / ;v_'7j Et O-e,
1 RI! v=.,1 ,
m COnehuc ❑d here out pre 'olives Of this County ISSUANCE FEE // o
to ente - '� ope ti0 Looses.
a INVESTIGATION FEE TOTAL FEE '
SEE REVERSE FOR EXPLANATORY LANGUAGE
COUNTY OF LOS ANGELES BUILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADD ss
I hereby affirm that I have a certificate of consent t0 Self insure, BUILDING ADOR�QE5,,5 ii7a� • �� • v
or a certificate of Wodcers'Compensation Insurance,or a certified � UVC ���
copy thereo Sec.3800,Lab.C.) J o�.1 L C y ZIP_I
Policy No. -S S Company'^�N t L LOCAUTY�^
q rmo
SIZE OF LOT NO.OF BLDGS.NOW ON LOT lS+
❑ Certified copy is hereby furnished. /-�_ Y NEAREST CROSS ST. -
Certified c0 is filed with the count building inspection TRACT BLOCK LOT NO.
PY Y 9 Pe USEZONE MAP NO.
department.
Date lr�Applicant C ASSESSOR O PAGE PARCEL
3 SPECIAL CONDITIONS
o
po 0/
CERTIFICATE OF EXE TION FROM WORKERS' OWNER ' , +L - O _./
V YES NO
COMPENSATION INSURANCE ��-)�I WITHIN 1000 FC OF SCHOOL7
ADDRE ���
(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 p � �7
I Certify that in the performance of the work for which this permit 'r-'a /,P, 3 ✓�(
is Issued, I shall not employ any person in any manner so as to ARCHITECTOR ENGINEER TEL.NO.
become subject t0 the Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT CONDO
Date Applicant ADDRESS - CLASS NO. -212/ DWELL UNITS
NOTICE TO APPLICANT: If, after making this Certificate Of REQUIRED TOTAL SETBACK FROM EXIST
CONTRACTOR NEL.NO.
Exemption, you should be Com¢ subject t0 the Workers' SETBACK YARD HWY PROP LINE WIDTH
Compensation provisions of the Labor Code, you must forthwith NQ _Lo �-V V S FRONT
comply with such provisions or this permit shall be deemed revoked. ADDRESS
S O PL
\ wV ' QQI I I SIDE d
LICENSED CONTRACTORS DECLARATION CITY UN PtCVSS PL U
I hereby affirm that I am licensed under provisions of Chapter 9 SEWER MAP 2
(commencing with Section 7000)of Division 3 Of the Business and SO. BI E NO. F STORES NO.O FAMILIES ,
NEW SK PG
Professions Code,and my license is in full force effect o
I` DESCRIPTION OF WORK ADD E] VALQA O W
License Number Lic.Clas/s i0'1� Z
contractor Date tg-ga a ALTER ❑
REPAIR ❑
❑ 1 am exempt under Sec. (�! 2
B.BP.C.for this mason I .� W 4o� DEMOL ❑ LOMA P/Ck
Date: USE OF EXISTItBLDG,^ 'URM El
A7
Signature APPLIC T M6 C
9 TEL.NO. LOMA Perm#
{ Z
❑ I, as owner of the property, or myemployees with wages as ` O
their sole compensation,will do the work and the structure is ADDRESS FINAL DATE Q i f
not intended or offered for sale (Section 7044, Business and -- i" I-
1 Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL
OR A MIXNRE CONTAINING A HAZARDOUS MATERIAL EOUAL TO OR GREATER THAN Q
❑ I, as owner of the property, am exclusively contracting With 'THE AMOUNTS SP IFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINALA(-{-.T A-
licensed contractors to construct the project 'Section 7044, YES ElNOi 1 =3
Business and Professions Code.) WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING ',did! E y F a�_•i
OCCUPANT REOUIREA PERMIT FOR CONSTRUCTION OR MODIFICATION FROMTHESOUTH
COAST AIR .00MO)SEE PERMITTING CHECKLIST
CONSTRUCTION LENDING AGENCY FOR GUIDELINES.ITV MANAGEMENT DISTRICT(SC �j M
1 hereby affirm that there is a construction lending agency for YES❑ NO
the performance of the work for which this permit is issued(Sec.
1 HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAGMD
3OST,DIV.C.). PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES 'H 1:-`.)( ^,'�I E--7 C
COUNTYCODE,TITLE2,OHAPTER2ASEOTIONS2M.IWTHROUGH2W.IJDCONCERNING
3 Lender's Name HAZARDOUSTFAI E RTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. 5�
Lender's Address o FFMAGMT
Qo- I certify that 1 have read this application and state that the above P.C.FEE PERMIT FEE
information is correct. I agree to comply with all county
p$y ordinances and State laws relating to building construction,and �'
�� C1fiDI—i:(S 337,i 1 61 1'.7
hereby authorize representatives of this County t0 enter upon ISSUANCE FEE
the above-mentions property f r inspection pur oses. moi:.- _ HIM if,
� ��18�92 INVESTIGATION FEE TOTAL FEE ` d .
SEE REVERSE FOR EXPLANATORY LANGUAGE
♦ DEPARTMENT OF COUNTY ENGINEER
DIVISION OF BUILDING AND SAFETY MIDD U R L D H H O
COUNTY OF LOS ANGELES u
•I WILLIAM J: FOX, COUNTY ENGINEER APPLICATION
CASSATT D. GRIFFIN, 6UP•T OF BUILDING
FOR APPLICANT'TO FILL IN FOR OFFICE USE ONLY
DISTRICT NO. PUN CK,OR REC.No. PERMIT NO.
BUILDING -7Q9 d
A-Al / , I I J &
ADDRESS L /�/
/I I R VED BY DATE OF APPL. DATE ISSU�FD
LOCALITY 1. - /n
NEAREST _`' '
CROSS ST.L14LJ BUILDING ( r�^� '� •�}�L
ADDRESS
OWNER - � _
MAIL LOCALITY
^ I
ADDRESS / A NEAREST
CITY U
^P To i/ CROSSST.
ARCHITECTOR L.
FIRE NO. OF
ENGINEER NO. ZONE I PLANS I TYP GROUP
-
BLDG. ORO. NO.
ADDRESS SETBACK INE
r TEUSE APPROVED
_CONTRACTOR �� F.� NOL. �_. ZONE / BY DATE
,/J HOUSE NUM ERINO
ADDRESS _/�//(_(-
LEGAL MAP NUMBER—' NO. ASSIGNED BY
DESCRIPTI .I LOT NO. V G'K I� CORRECTIONS
TRACT V i
NO. OF B-DGS.
SIZE OF LOT I NOW ON LOT 7 b ,(,�
USE OFI NO. OF
EXISTING BLDG. FANiu E9
DESCRIPTION OF WORN -
v A
NEW ALTERATION ADDITION
Z
REPAIR DEMOLITION r
SO. FT. / NO. OF
SIZE ROOMS STORIES
EXT. WALLROOF
COVERING I COVERING
USE OF STRUCTURE
l A /✓ �
Q
APPROVALS "
INSPECTOR'S SIGNATURE DATE
FOUNDATION: LOCATION
FORMS, MATERIALS
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FRAME: FIRESTOPS.
PLICATION AND STATE THAT. THE INFORMATION GIVEN IS BRACING. BOLTS
CORRECT.
IAGREE TO COMPLY WITH ALL COUNTY,ORDINANCES FURNACE: LOCATION,
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. GAB VENT, DUCTS
SIGNATURE OF /I. j`/ �/ LATH. INT.
PERMIT-TEP I .T
LATH. EXT.
ADDRESS
PLASTER, INT.
AUTHORIZED AGT.
PLASTER, EXT.
$ P. C. S HOUSE NUMBER COR-
4.,62 FEE
VALUATION CL//// FEE lY' FINAL {�(`)11w..L�._. 5f'
I.A696A 9003 9-5E I - V
DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT '
COUNTY OF LOS ANGELES oDAJ{ ('(?
WMU m. J. FOX, CHIEF ENGINEER 1�3i IIJJ
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
,c
BUILDING
5 �J / �/ G//.J �l,V, DISTRICT NO. i_ - -P----K: NO. -- — -PERMIT KO;
SDDRE S � i 'r;6
r; 6 .C/
'. LOCALITY / RECEIVED BY DATE OF/APPL. /DATE IISS�U,&
NEAREST
^ �] D BW LDINO
OWNER / [ / ��,� bl ADDRESS
MAIL ` / w LOCALITY —�
ADDRESS ._7 / /�I- �.L•/I./
NEAREST,.
!� .T ✓ �.G✓
_ TEL CROSS ST l/���
TYPE GROU
CITY NO. FIRE NO. OF P
ARCHITECTOR TEL ZONE 1 PLANS '
ENGINEER NO. /
BLDG.
ADDRESS
SETBACK LINE
APPROVED
BY
CONTRACTOR "�"�• • NO. I I 1 DATE I
USE APPROVED
ADDRESS ZONE BY ( DATE
a LEGAL , CORRECTIONS
DESCRIPTION LOT NO. BLOCK
TRACT ,J //-.l -
�j NO. OF SLOGS.
SIZE OF LOT J - /l O I NOW ON LOTUSE
EXISTING DBIDS. Q$. FAMLIESII ROOM9J
DESCRIPTION OF WORK
NEW � ALTERATION ADDITION
.. ... ... ......._.. A
REPAIR MOVING DEMOLISH
G
BO.FT. 4w.� NO.OF . . . .........'I,� IIDIL<.f:^f. .^L�. _
SIZE .l 'V RODMB STORIES D
WALL I ROOFt-
-COVERING COVERING
USE OF NEW ` p •"f G✓�"CI
BUILDING O/ d C•�K�J f
/rte 0 G '�—/.(Jrr✓ S' a
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION: LOCATION INSPECTOR DATE
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FORMS, MATERIALS
/\ ' FRAME: FIRE STOPS,
SIGNATURE OF y( BRACING, BOLTS
PERMITTE ///"`�"
LATH, INT.
AUTHORIZED AS _
LATH. EXT.
76A—A-3 to-SU $ ��(� P.C.$ PLASTER. INT.
r/ FEE PLASTER, EXT.
$ CA
VALUATION.. __..... _ FEE �.J VV_' FINAL
DEPARTMENT OF BUILDING AND SAFETY 4 APPLICATION FOR PERMIT
'ZOUNTY OF LOS ANGELES 3 ® �
WM. J. FOX, CHIEF ENGINEER. I . LP3 4�
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
�f/9 ` DISTRICT NO. /IPJLAiN CK.NO. ^y,/PERMIT/NO.O.
ADD REBS •tj�// 7 /vn ,'..,Q// /•E U Y ® / "�' v
LOCALITY /l l ��'-1 RECEIVED BY DATE OF APPP,L. DATEISSUED
NEAREST
CROSS ST.
BUILD
INB G / y c �.
OWNER (�
/h��fd/ �/ y�J%�,E_ ADOREB
MAILr
i ADDRESS I 73 && ASI LOCALITY r
�/ [ / NEARESTCROSS ST.
AT
CITY FIRE NO.OF�j .TYPE ,// GROUP 1/.
ARCHITECT OR TEL ZONE ��=PLANB.•p� Y /4
ENGINEER NO. "
BLDG. � ( fw`-�� ORD.N
ADDRESS BETBACKLINE �d. LyC. eCy�A '
i APPROVED��/Jq�//y
_CONTRACTOR Fs,G, ,yim..tAAVd"`NO.fTT, T BY /"c`�/N/9//.L:fG DATE
USE
ADDRESS D / 3 T -� �, ZONE I TBYP OVED DATE
LEGALleNa,/� CORRECTIONS
_DESCRIPTION LOTO.
TRACT NO.OF BLOBS.
W�
512E OF LOT :.lvC�L'.H+✓, - .rf0 7���y ��(T �„p ^/d
•�/�'� )KU 1 ,® a I NOW ON LOT y
' �`��I E� jyy,�j�/
! EXISTING BLDG.USEOF F��Es ROOMS
£.fib �S �►+ 3ajJ`. ➢N
D/E�SCRIPTION'OF WORK
NEW /�� ALTERATION ADDITION N ( p.��Q,.q ei(f "G•�'
A .
REPAIR MOVING DEMOLISH
Sq.FT. [y NO.OF (/ p_ /� /�//�• Z
SIZE (}' ROOMS V STORIES , : 1I—//( -(/y rll-f, N Rlnr/'R/?n Rill r
COVERINGe I ROVOERINO 0.4-W+-110I ✓O� yEY
USE OF NEW
BUILDING
Al
A -
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS
APPLICATION AND STATE THAT THE ABOVE 18 CORRECT FOUNDATION: LOCATION INSPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
FRAME: FIRE STOPS, i
SIGNATURE OF BRACING,BOLTS
PERMITTEE L LATH, INT.:
AUTHORIZED AST LATH,EXT.:
oes-a Som SETS 1-46 IS / �) P C B PLABTER,INT.
FEE a PLASTER,EXT. /
VALUATION FEE ��i' I FINAL %•F7iy�il»...--.7J/.f�l
DSION ISNN7 OF DING ENGINEERF �� n � n �� � �7 /�
y DMSION OF BUILDING AND SAFETY kd�f-� E �WWW^VVVVd({��-J�+'
COUNTY OF LOS ANGELES ll
' WILLIAM J. FOX. COUNTY ENGINEER APPLICATION
CASSATT D. GRIFFIN, 8UP•T GP BUILDING
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
DISTR T NO. I PUN CI[.OR REC.No. � tEMIT NO.
BUILDING 0
ADDRESS `J O
LOCALITY RECEIVED Y DATEOF APPL. DATE ISSUED
NEAREST A, F 3 3
CROSS ST
BUILDING An
ADDRESS J~
OWNER
MAIL ` 7Z ' LOCALITY
ADD HSL NEAREST 1 SSI
TEL CR039 ST.
CITY44 i�4 O
` ARCHIT OR TEL. FIRE NO. OF TYPE - GROUP /
ENGINEER NO. ZONE ��I PLANS I �(
ADDRESS BLDG. r O D. NO.
/f--1 SETBACK LINEUSE
CONTRALTO - TE�/ F 7l/ - ZONE 1 _ BYPROVED DAT
ADDRESS -d&cA ` > HOUSE NUMBERING
LEGAL U MAP NUMBER �u 12$14 NO. ASSIGNED BY
DESCRIPTION LOT NO. � BLOCK CORRECTIONS
TRACT I I A-- 7r � Z, � .L.✓1 _
SIZE OF LOT o I NO. OR SLOGS.
NOW ON LOT // L � "SAO _USE
EX 9TOING BLDG. I F MILe6 /7
- DESCRIPTION OF WORN y _a4 J-54 R t Ltn I="t I.I.L— o
NEW TERATON�I DEMOITI ON ADDITION
REPAIR
D
r
HO. FT. Q� NO. OF
SIZE / ROOMS STORIES
EXT. WALL I ROOF
COVERING COVERING
USEOFSTRUCTU RE
�i
V -
APPROVlLS
INSPECT k HSIGNATURE DATE
FOUNDATION: LOCATION
FORMS. MATERIALS is--/ J�/./Y
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FRAME: FIRESTOPS,
PLICATION AND STATE THAT THE INFORMATION GIVEN IS BRACING, BOLTS ems"
CORRECT. FURNACE: LOCATION.
1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES GAS VENT. DUCTS
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
SIGNATURE RMITTE OF �y��� LATH. INT.
LATH. EXT. C
ADDRESS 9-1
l�� fief
V �✓ PLASTER. INT.
AUTHORIZED AGT.
PLASTER, EXT.
S �I Q'� P. C. S/ H
—
� Q OUSE NUMBER COR-
-�� $VALUATION ,� RECT AND POSTED
FEE FINAL
79AW" One a-ea
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 EUILUING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 SL 0508 0405260031
PHONE: (626) 285-0488 EXT:
LEGAL ID: 0. OF CONST BUILDING DRESS:
ON FILE SQ. FT STORIES TYPE 5729 ENCINITA AV
STRUCTURE: 38 VN TEMP CA 917802418
ASSESSOR INFORMATION UMBER: NEAREST CROSS STREET:
5387-018-013 �� - THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, C
TENANT: EXIST BLDG USE: RESID _ US : R- ISSUED ON: PROCESSED BY: R S ON:
EXIST OCC GRP: 05/26/04 VG 05/21/05
OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DA CODE:
TAM, SIMON - 2,600 -3 �
5729 ENCINITA AV J -
TEMP 917802418 FEES
PAID DESCRIPTION OF WORK
CONVERT STORAGE TO BATHROOM
APPLICANT:
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:
L. N0:
PETRA CONSTRUCTION MANAGEMENT INC. (626) 233-8148- AA BLDG PERMIT ISSUANCE 27.75
AC STRONG MOTION RESID 2600.00 VAL 0.50 SPECIAL CONDITIONS:
AX BUILDING REVIEW FEE 54.70
D2 PERMIT W/O EN-HC 2600.00 VAL 99.00
_ FS INV WORK W/O PERMIT 257.00 DOL 257.00
CONTRACTOR: TEL. NO: TOTAL FEES 435.95 APPROVALS DATE INSPECTOR SIGNATURE
PETRA CONSTRUCTION MANAGEMENT (626) 233-8148-
2550 W. MAIN ST., #211 LIC. NO LOCATION AND SETBACKS
ALHAMBRA, CA 91801 761300 B
SOILS ENGINEER APPROVAL
ARCHITECT OR ENGINE R: -Y N-EL Oo FOUNCATION/TREN H FORMS
LIC. NO: SLAB//UNDER FLOOR
RAISED FLOOR FRAMING
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION
XX 3 01
FLOOR -1EATHING
NO. OF FAMILIES: DWELL14G UNITS: APT/CO : STAT CLASS: _
NO 21 ROOF SHEATHING
SCHOOL WITHIN HAZARDOUS SHEAR PANELS
AIR QUALITY: 1000 FEET MATERIALS
NO NO NO (FRAME INSPECTION
REQUIRED TOTAL SETBAC OM EXIS F[�SP INKLER HANGER
SET BACK YARD: HWY: PROP LINE: WIDTH:
FRONT PL- INSULATION/WEATHER STRIP
SIDE PL-
INT ERIOk LA H/UIFYWAL-L
EXTERIOR LATH
RATED FLOOR/CEIL ASSEM.
RATED WALL ASSEMBLIES
RATE SHAFTS/OSI HGS
T-BAR CEILINGS
LOT DRAINAGE
NAGE
REPORT ID: DPR261 ROUTE TO: BS0508
.,
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 0406290025
PHONE: (626) 285-0488 EXT: -
LEGAL ID: NO. OF CONST BUILDING ADDRESS:
ON FILE $0. FT STORIES TYPE 5729 ENCiNITA AV
STRUCTURE: 38 VN TEMP CA 917802418
ASSESSOR INFORMATION NUMBER: NEAREST CROSS-STREET:
5387-018-013 THOMAS PAGE.: 596 GRID: J3 LOCALITY: TEMPLE CITY, C
TENANT: E ST BLDG USE: REBID USE 76NE: R-1 ISSUED ON: PROCESS BY: EXPIRES ON:
EXIST GCC GRP: 06/29/04 JK 06/24/05
OWNER: TEL- NO.. BLDGS. NOW UH LUT: VALUATION: FI AL TE / FIN ,BY i" CGDE:
TAM, SIMON - .. '•� 5000;;/// �, �
5729 ENCINIAV _ U
TEMP 9178024141 8 FEES PA 11 - SCRiPT[ON OF UORX
EXISTING PORCH
FEE DESCRIPTION: QUANTITY: DTO LEGALIZE THE OM: AMOUNT: Eu "�7 25L?(h�
APPLICANT: TEL. N0: J
PETRA CONSTRUCTION MANAGEMENT INC. (626) 233-8148- AA BLDG PERMIT ISSUANCE 27.75
AC STRONG MOTION RESID 500.00 VAL 0-50 SPECIAL CONDITIONS:
D2 PERMIT WIC EN-HC 500.00 VA,- 43-65
TOTAL FEES 71.90
CONTRACTOR: TL. NO: APPROVALS DATE INSPECTOR SIGNATURE
PETRA CONSTRUCTION MANAGEMENT (626) 233-8148-
2550 W. MAIN ST., #211 LIC. NO LOCATION AND SETBACKS
ALHAMBRA, CA 91801 761300 8
SOILS ENGINEER APPROVAL
-_
ARCHITECT OR ENGINEER: TEL. NO: FOUNDATiONi TRENCH FORMS
LiC. NO: SLABi UN'OER FLGGR
RAISID IR FRA,^ NG
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOORIir'SULATION --
XX 3 01
FLOOR SHEATHING
NO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS:NO 2'. ROOF SAFATHiNG
SCHOOL WITHIN HAZARDOUS SHEAT? PANELS
AIR QUALITY: 1000 FEET MATERIALS _
NO NO NO FRAME IMSPCTION
REQUIRED TOTAL SETBACK FROM EXIST FIRE SPRINKL-R-FANGERS _
SET BACK YARD: HWY: PROP LINE: WIDTH: _
FRONT PL- INSULATION/WEATHER STRIP
SIDE PL-
INTERIOR LAT,.'/DRYWALL
EXTERIOR L.^,Tfi �i
RATED FLOC-R CE?I. ASSEM.
RATED WALL ASSEMBLIES
RATED SHAFTS/OPENINGS
T-BAR CEILINGS
LOT DRAINAGE
REPORT ID: DPR261 ROUTE TO: BS0508