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HomeMy Public PortalAbout5020 FIESTA AVE_Building__ 78A888A CE#808.9.60 APPLICATION FOR BUIL ING PERMIT COUNTY OF LOS ANGELES ADD Els"s 5020 N. FIESTA AVE. DEPARTMENT OF COUNTY ENGINEER TEMPLE CITT BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST. LA ROSA DR. DISTRICT O. GRTYPE PROMESSED BY FOR APPLICANT TO FILL IN '� � CONST BUILDING STATISTICAL CL SDWELL. UNITSSIFICATION I SEWER MAP ADDRESS 02 CLASS. C BK PG NO. LOT NO. MAP ,.p /' STATE BLOCK NUMBER (,.J l:� HWY. YES NO TRACT j _ USE ZONE SPECIAL NO.OF BLDGS. 1 CONDITIONS SIZE OF LOT I NOW ON LOT L!- 1 USE OF HOME BUILDING EXIST. EXISTING BLDG. YARD HWY STREET NAME TEL. SETBACK _WIPTH OWNER DOUGLAS LONGACRE NO. FRONT P. L. ADDRESS ABOI.W SIDE ARCHITECT OR TEL. P.L. - ENGINEER NO. INSPECTION RECORD ADDRESS C Ngk7Xj4OME BUILDERS INC. NO 0 ADDRESS 9109 w. PICO BLVD. L.A. 0 DESCRIPTION OF WORK W a NEW ADD ALTER XREPAIR DEMOLISH h Z SIZET 1500 STORIES FAMILIES USE OF STRUCTURE' ALUMINUM SIDING SIGNATURE OF APPLICANT - VALUATION$ 2 O.00 I APPROVALS DATE INSPECTOR'S SIGNATURE p,C, I PMT. 6Z� FOUNDATION: LOCATION FEE $ FEE $ FORMS. MATERIALS FRAME: 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 GAS VENT DUCTS BUILDING CONSTRUCTION. I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED I SHALL NOT LATH, INT. EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUSUECT TO THE WORKMEN'S COMPENSATION LAWS OF CALIFORNIA. LATH,EXT. SIGNATURE O - -•-�j HOUSE NUMBER COR- RECT AND POSTED [� J SIGNPER TU ADDRESS 91 W.RICO BLVD. L.A. FINAL ��'/ '.�, ,a CLYDE N. DIRLAM, PRINCIPAL STR URAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMT VALIDATION �C M.O. CAsa WORKERS' COMPENSATION DECLARATION hereby affirm that I have a certificate of consent to Self A P P L I CAT I O N ' F O R BUILDING PERMIT insure, or a certificate of Workers'Compenstion Insurance, or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company E Certified copy is hereby furnished. BUILDING FOR APPLICANT TO FILL IN ADDRESS �0d11 Certified copy is filed with the county building inspec- BUILDING ��++ � tion department. ADDRESS LOCALITY e— t/G g Date Applicant CITY NEAREST ZIP 'jCa CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT air x I �� NO0 OF W ON LOTS. 2 ASSESSOR COMPENSATION INSURANCE ' MAP BOOK PAGE PARCEL ��h(This section'need not be completed if the permit is for one 92 pis USE ZONE �,SPE;CDIAIL undred dollars ($100)or less.) TRACT 133`Zd"I BLOCK LOT NO.� t�� TEL. 2� i �I certify that in the performance of the work for which this OWNER �:E 0. : .4 NO. F�'� ITIONS O DI RICT GROUP TYPE FIRE PR ESSED BY permit is issued, I shall 'not employ any person in any manner / U . ADDRESS �O rL•F� tG�7 CONST. ZONE so as to become subject to the Workers'Compensation Laws. ✓� � � I �o CITY - ZIP �p Date /! 142— 0Applicant STATISTICAL CLASSIFICATION APT. CONDO. f� ARCHITECT OR TEL. NOTICE TO APPLICANT: If; after making thi Certificate of � Exemption, you should become subject to the Workers' ENGINEER NO. CLASS NO. DWELL. UNITS . Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP with comply with such provisions or this permit shall be TEL. deemed revoked. CONTRACTOR NO. BK. PG, VALIDATION LICENSED CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC. Professions Cade, and my license is.in full force and effect. CITY CLASS $ SQ. FT. NO. OF NO. OF CHECK License Number Lic.Class SIZE 2 STORIES 1 FAMILIES. I ONE y� Contractor Date DESCRIPTION OF WORK PArL`a 1Z(27.C:t_S NEW ❑ I am exempt from the licensing requirements as I am a fj-Ap y�� t•j y� r 0�� ADD U licensed architect or a registered professional engineer ALTER FINAL acting in my professional capacity (Section 7051, W h"X C REPAIR DATE 7-P Business and Professions Code). USE OF FINAL EXISTING BLDG. DEMOL E By Lic.or Reg. No. Date APPLICANT TEL. ( 6 OWNER-BUILDER DECLARATION (PRINT) NO. EZ I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS 5-0-Lc- `�r5TA 4K$, 7"i�c Professions Code):: PRESENT BUILDING I, as owner.of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. a.3 1 O'3 A I, as owner of thero ert am exclusive) contracting CONTRACTOR NO. P P Y- Y 9 # 0 0 0 0 ,0 1 withlicensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). 2.­ 2200 REQUIREDTOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT o o 0 2 2 0 0 czi the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE 1 .1,2 4—80 P.L. Lender's Name Lender's Address P.C. Fee$ Permit Fee S' I certify that I have read this application and state that the Issuance Fee a above information is correct. I agree to comply with all County Investigation Fee _27 r 0 ordinances and State laws relating to building construction, Total Fee and hereby authorize representatives of this County to ente a upon the above-mentioned property for inspection purposes. d i i.— io:�, SEE REVERSE FOR EXPLANATORY LANGUAGE Signaturgaf Applicant or Agent Date _ ©s-� ` APPLICATION FOR BUILDINGPERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS _ D o /x,/ I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESSOZp �'l"� 74V r= . or a certificate of Workers'Compensation Insurance,or a certified l copy thereof(Sec.3800,Lab.C.) CIT��. E j Ty zIP Policy No. Company LOCALITY � SIZEFOOF I F LOT I NO.OF BLDGS.NOW ON LOT / ❑ Certified copy is hereby furnished. S X Zb =1 o3' NEAREST CROSS ST. ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. USE ZONE MAP NO. department. ,/ Date-Applicant ASSESSOR MAP BOOK PAGE PARCEL n ��IAL PP ///! ONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER EL. O. VES No COMPENSATION INSURANCE '1 s� —0 .2-97-0,t, WITHIN 100D FT.OF SCHOOL? ADDRESS (This section need not be completed if the permit is for one hundred p-2-0F( 'T Pt Jam• DISTRICT GROUP TYPE CONST.' FIRE ZONE PROCESSED BY dollars($100)or less.) clry fJ T ZIP 2 I certify that in the performance of the work for which this permit T� � '.d" is 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. UA V(Arf- Z!/�y� D 30,D STATISTICAL CLASSIFICATION APT CONDO Date—Applicant' ADDRESS ,r 1 CLASS NO.1 DWELL UNITS NOTICE TO APPLICANT: If, after making this Certificate of 2-2-7-7 Uv' V�(' LV REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become Subject to the Workers' CONTR CTOR TEL.NO. SETBACK YARD HWY PROt;tINE WIDTH Compensation provisions of the Labor Code, you must forthwith FRONT _ comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL _77 ' LICENSED CONTRACTORS DECLARATION CITY LIC.CLASS FIDE i i . 'y o hereby affirm that I am licensed under provisions of Chapter 9SEWER MAP - V (commencing with Section 7000)of Division 3 of the Business and SO.FT.SIZE NO.OF STORES NO.OF FAMILIES U1 =iL Professions Code,and my license is in full force and effect. NEW E] BK PG 9 9 ► .� - :0 License Number Lic.Class DESCf11PTION OF WOADDC)AJ 70rL oT- AW ❑C3 " +' RK VALUATION -w CEC tA NGE Contractor Date y, ALTER $—�� A ' z 131 am exempt under Sec. F REPAIR El $ + i B.BP.C.for this reason f— L DEMOL ❑ " Date: . URM ❑ LDMA P/C# U E IING BLG s l;u G �- �fi U►1 U/ Kos s �� -•. Signature APPLICANT(PRINT , TEL.NO. , LDMA Perm# El 1, as owner of the property, or my employees with wages as V /V1 �I I S 7G — ($ Zp their sole compensation,will do the work and the structure is ADDRESS I/cA� r'1/ �f ,Q({� ��� p not intended or offered for sale (Section 7044,Business and �2�— �' "� "�L/ F:,WT,), I�t�° 1 1 FINAL DATE Q Professions Code.) 144) L WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLEA HAZARDOUS MATERIAL j I, as owner of theproperty, am exclusive) contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN Q Y g THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY licensed contractors to construct the project.(Section 7044, YES❑ NO❑ Business and Professions Code.) 11 WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST //''�"' FOR GUIDELINES. C 1 hereby affirm that there is a construction lending agency,�forvas❑ 1-1No ,•,_ *". r,,.. , the performance of the work for which this permit is issued(Sec: I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD "' _-; "i;; '3-• -• 3097,CIV.C.). PERMITTING CHECKLIST.1 UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES I i., j t ;]'p 1-r7 '•"l '.:.,'� -., 2, COUNTY CODE,TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING 1'I I_s y_. 3' I-.,• u 3 Lender's Name HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. j Ga'= ~•i !t IL Lenders Address o 1 certify that I have read this application and state that the above rnW+eRORADENr e•-`� j;4 �7=� - Information is correct. I agree to comply with all county RC.FEE / PERMITFEE ordinances and State laws relating to building construction,and hereby authorize representatives of this County to enter upon ISSUANCE FEE r., C+ the ab o mentioned propertJAAy for ins tion purposes. �' sl 41 Q i.,1 4N:' ipf.I 6 INVESTIGATION FEE TOTAL FEE /I/f' T! 7 !J a / 4 u kM k ftn of Appfi e w Apenf ,.:,SEE REVERSE FOR EXPLANATORY LANGUAGE• " I""'' APPLICATION FOR .BUILDING PERMIT F' COUNTY OF LOS ANGELES BUILDING AND SAFETY • WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS 2f7 v s-r v"^ A or a certificate Workers'Compensation Insurance,or a certified CITY IT�mg�� /'r z copy thereof(Sea cy.380-0,Lab.C.) Gf�l LOCALITY y gP,00llicy No. �Z� t'�Company IZE F L T N .OF BLDGS.NOW ON LOT �'i9 PG Idl Certified copy is hereby furnished. $3 NEAR ST CR.QSS.ST. }� TR CT El Certified copy IS filed with the county building inspection BLOCK department. USE ZONE MAP NOS � � 3 2 �(�'r'l �T � 5� ASSESSOR M ,B OK PAGE PARCEL Date j �� pplicant — �r�- C A i5/ elf r SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' f/ OWNS S 7 �s L "!:0/ / NO_ D `� YES NO COMPENSATION INSURANCE F- �[ WITHIN 1000 FT OF SCHOOL? il ADDRESS (This section need not be completed if the permit is for one hundred O ZO F-(-FST L DISTRICT GROUP TYPE CONST.' FIRE ZONE PROCESSED BY dollars($hat or less.) CITY L y ZIP///�� S. 3 I certify that in the performance of the work for which this permit `-� G(T �-/T �` is issued, I shall not employ any person in any manner So as to ARCHITEC OR ENGINEER TEL.N become subject to the Workers'Compensation Laws. (� y� Cf $(5 tO STATISTICAL CLA FICATION APT CONDO Date Applicant ADDRESS Z ZS ��� f r , ��h��3� CLASS NO.�'DW.E L NITS NOTICE TO APPLICANT: If, after making this Certificate of L.V �+ REQUIRED TOTAL SETBACK FROM EXIST Exemption, you ShOUId become Subject t0 the Workers' CONTRACTOR r TEL.NO. SETBACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith 0/99 FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS L C.NO. r PL LICENSED CONTRACTORS DECLARATION CITY ft-Cuss SIDE CL PL O I hereby affirm that I am licensed under provisions of Chapter 9 I� SEWER MAP c3 (commencing with Section 7000)of Division 3 of the Business and SG.FT 1 V NO.' STORES NO. F FAMILIES r C Professions Code,and y licens is in full force and effect. (/�O NEW BK PG , iCD v PTIONVALLI TION License Number '� Lic.Class.- DESCRIOF WORK ADD ❑ Contractor 7.S�.y6 S D� //-S-r/'0 l i I R = G L U 1 y ALTER ❑ • �d� TIG�.� (/� �� 3�°4€( 40j,�=t='�� ❑ I am exempt under Sec. ,^ REPAIR ❑ � F ,_ B.&P.C.for this reason FAMit,Y k� 2 — 0�0POM DEMOL ❑ (� USE PF EXISTING BLDG. LDMA P/C# TOTAL 07 m 2 Date: Ho Z URM ❑ Signature APPLICANT T) - O. LDMA Perm# ❑ CHECK I, as owner of the property, or my employees with wages as 1'1�/" eH 0 -CHANGE h[ x010 their sole compensation,will do the work and the structure is ADRSS , not intended or offered for sale (Section 7044, Business and X X W. VALWLVD CAFINAL DATE Q Professions Code.) WILL THEAPPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL 2,, J 0000-0001 OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN El 1, as owner of the property, am exclusively Contracting With THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY _ o ii 1 licensed contractors to construct the project.(Section 7044, %;%' �'�•01 2 4 � Ail 10* r Business and Professions Code.) ves❑ No❑ WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR GUIDELINES. I hereby affirm that there is a construction lending agency for YES❑ NO Elthe performance of the work for which this permit is issued(Sec. 3097,CIV.C.. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQK46' I:'i ' - ",L: PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES" i ,i :.1`• i"r3 "'"f m. COUNTY CODE,TITLE2,CHAPTER 2.20SECTIONS 2.20.100THROUGH 2.20.14000NCERNIIIIG, i, 'i •.u•• •'•" •^.1 ^•^4 a Lender's Name HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. 4:'! - f- f-•a o Lender's Address L:+ L OWNER OR AGENT i. ! „�,•i o 1 certify that I have read this application and state that the above information is correct. I agree to comply with all count P.C.FEE ,y �J / /7 PERMIT FEE Q G'J 'C $ 9 P Y YL1 /� t7s�� 0 s`:.s N ordinances and State laws relating to building construction,and ¢ hereby authorize representatives of this County to enter upon ISSUANCE FEE T* the above-mentioned property for inspection purposes. t ••. t g -P. INVESTIGATION FEE TOTAL FEE C rl ¢ I/ �yW , T,;r, r•. r Sgnawn of Appllonl or Ag-1 Dale SEE REVERSE FOR EXPLANATORY LANGUAGE COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1301220065 PHONE: (626) 285-0488 * EXT: ILEGAL ID: I NO. OF CONST NEW I BUILDING ADDRESS: ITR: 13329 LT: 56 1 SQ. FT STORIES TYPE OCCUP GROUPI 5020 FIESTA AV (STRUCTURE: 0 1 V-B R-3 I TEMP CA 917803818 (ASSESSOR INFORMATION NUMBER: GARAGE: NEAREST CROSS STREET: 18590-018-018 .OTHER: THOMAS PAGE: 597 GRID: A5 LOCALITY: TEMPLE CITY (TENANT: IEXIST BLDG USE: RESID 11SSUED ON: PROCESSED BY: IEXIST OCC GRP: R-3 101/22/13 SR I I I I (OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: IFINr1' DA F Y: CODE: I IHELEN HUANG 626 297 -7568 1 26,000 1 15020 FIESTA AV I 1 ITEMP 917803818 I FEES PAID ID SCRIPTION OF WORK I I IROOF MOUNTED SOLAR 14 PV 4.6 KW CHANGE CONTRACTOR SEE ALSO 1 I _IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: IBL 1212260010 1APPLICANT: TEL. NO: I IIVEZZY, MICHAEL (951) 681-5811- IAA BLDG PERMIT ISSUANCE 27.80 1 1 13080 12 TH STREET I TOTAL FEES 27.80 ISPECIAL CONDITIONS: I IRIVERSIDE CA92507 I I I I I I I I ICONTRACTOR: TEL. NO: I' (APPROVALS DATE INSPECTOR SIGNATURE I CHAMPION ELECTRIC (951) 276-9619- 1 I 13950 GARNER RD LIC. NO ILOCAIION AND SETBACKS IRIVERSIDE CA 92501 744374 1 I I ISOILS ENGINEER APPROVAL I 1ARCHITECT OR ENGINEER: TEL. NO: IFOUNDATION/TRENCH FORMS I 1 LIC. NO: 1 ISLAB/UNDER FLOOR I I I I _ I I I IRAISED FLOOR FRAMING 1 I I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: I (UNDERFLOOR INSULATION I I i 1144H269 L 99 3 COI 1_ 11 I I I I FLO',R SHEATHING I I I INO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: I- I I I I 0 0 NO 99 I IROOF SHEATHING I I SCHOOL WITHIN HAZARDOUS I ISHEill2 PANELS I I (AIR QUALITY: 1000 FEET MATERIALS I NO NO NO I I FPUU,;E INSPECTION IFIRE SPRINKLER HANGERS I I IINSULATION/WEATHER STRIPI I IINTSRIOR LATH/DRYWALL I IEXTERIOR LATH I I IRATED FLOOR/CEIL ASSEM. I I 1 I IRATED WALL ASSEMBLIES I I IRATED SHAFTS/OPENINGS I - I I I- IT-BAR CEILINGS I I* ADDITIONAL DATA ON FILE I I I ILOT DRAINAGE IREPORT ID: DPR261 ROUTE TO: BS0508 I I I I I I I 'COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1212260010 PHONE: (626) 285-0488 EXT: ILEGAL ID: 1 NO. OF CONST NEW 1 BUILDING ADDRESS: 1 ITR: 13329 LT: 56 I SQ. FT STORIES TYPE OCCUP GROUPI 5020 FIESTA AV 1 I (STRUCTURE: 0 1 V-B R-3 I TEMP CA 917803818 1 (ASSESSOR INFORMATION NUMBER: I GARAGE: 1 NEAREST CROSS STREET: 1 18590-018-016 1 OTHER: i THOMAS PAGE: 597 GRID: A5 LOCALITY: TEMPLE CITY 1 (TENANT: IEXIST BLDG USE: RESID (ISSUED ON: PROCESSED BY: 1 IEXIST OCC GRP: R-3 112/26/12 SR 1 (OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: IFINAL ATI F AL Y: CODE: 1 (HELEN HUANG 626 297 -7568 1 26,000 / 1 15020 FIESTA AV 1 1 x ITEMP 917803818 FEES PAID 1D SCKIPTION OF WORK 1 I (ROOF MOUNTED SOLAR 14 PV 4.6 KW 1 _(FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( (APPLICANT: TEL. NO: I I I (SCOTT, CAMPBELL (951) 681-5811- 1AA BLDG PERMIT ISSUANCE 27.80 1 1 13080 12 TH STREET IP1 RES PV PC<IOKW 153.90 ISPECIAL CONDITIONS: 1 (RIVERSIDE CA92507 IP2 INSPCTRES PV <10KW 138.00 1 1 TOTAL FEES 319.70 1 1 ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE 1 (ELITE ELECTRIC (951) 681-5811- 1 19415 BELLEGRAVE AVE LIC. NO 1 (LOCATION AND SETBACKS (RIVERSIDE, CA 92509 418242 I 1 I 1 ISOILS ENGINEER APPROVAL 1 1ARCHITECT OR ENGINEER: TEL. NO: 1 IFOUNDATION/TRENCH FORMS I I I 1 LIC. NO: 1 (SLAB/UNDER FLOOR 1 I I I I IRAISED FLOOR FRAMING 1 I I I I I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: ( 1UNDERFLOOR INSULATION I I I I I 1 XX XX XX 3 001 1 1-1 1 I I IFLOOR SHEATHING I I INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS.: 1 1 1 1 1 0 0 NO 20 1 IROOF SHEATHING 1 SCHOOL WITHIN HAZARDOUS 1 (SHEAR PANELS I I I 1AIR QUALITY: 1000 FEET MATERIALS 1 1 NO NO NO ( (FRAME INSPECTION I 1 I I (FIRE SPRINKLER HANGERS 1 I I I 1 1 IINSULATION/WEATHER STRIPI I I 1 1 (INTERIOR LATH/DRYWALL 1 1 1 I I I I IEXTERIOR LATH 1 1 1 1 1 1 IRATED FLOOR/CEIL ASSEM. 1 I IRATED WALL ASSEMBLIES I I I I 1RATED SHAFTS/OPENINGS 1 1 IT-BAR CEILINGS 1 I* ADDITIONAL DATA ON FILE 1 1-1 1 I I 1 ILOT DRAINAGE I I I I IREPORT ID: DPR261 ROUTE TO: BS0508 1 1 1 I I I I I