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I VISIONDEPARTMENTOFUI COUNTY ENGINEER BUILDING
DIVISION OF BUILDING AND SAFETY`
COUNTY OF LOS ANGELES
♦ Wl"—W 'J. FOX, COUNTY ENGINEER APPLICATION
CASSATT D. GRIFFIN, SUPT OF BUILDING
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
DISTRICT
�NO. PLAN CK.OR REG. No. PERMIT NO.
BUILDING
ADDRESS (/ AV& J 3 .1,
LOCALITY / V RECEIVEq BY DATE OF APPL. DATE ISSUED
1--, q1 Q
NEAREST ��p 1
CROSS ST G+
�� BUILDING
OWNER '/j�1 ADDRESS U
AMAILDDNEAREST
RESS S//2 Sa, S G4 LOCALITY Com.
CITY SLf �+ - NO,TEL. +/ .76` CROSS ST.
ARCHITECT OR TEL. FIRE I NO. OF TYPE I GROUP
ENGINEER
-
ENGINEER NO. ZONE PLANS j!
BLDG. /IO ' _NO.
ADDRESS SETBACK LINE e(J
TEL. /� USE APPROVED
CONTRACTOR • NO. � .r ZONE - BY DATE LC.
ADDRESS '� HOUSE NUMBERING
/` / /
LEGAL MAP NUMBER NO. ASSIGNED BY
DESCRIPTION I LAc/OT NO., I BLOCK
CORRECTIONS
TRACT 'i
NO. OF BLDGS.
J SIZE OF LOT 4'./ I NO ON LOT '�" •c..� �!3
USE OF I NO. OF %
EXISTING BLDG. FAMILIES
- DESCRIPTION OF WORK a —
NEW ALTERATION ADDITIONI
2
REPAIR DEMOLITION D
r
SQ. FT. /� f NO. OF
SIZE V ROOMS STORIES O g
EXT. WALL t57'u�.-e COYERING �j
CROOF
OVERING E" t2 m.6
USE OF STRUCTURE
fri
APPROVALS
� INSPECTOR'S SIGNATURE DATE
FOUNDATION: LOCATION
FORMS, MATERIALS "-
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FRAME: FIRE STOPS,
PLICATION AND STATE THAT THE INFORMATION GIVEN IS BRACING, BOLTS
COR AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION,
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. GAS VENT, DUCTS
SIGNATURE OF LATH, INT. i v
PERMITTE 67 R
LATH. EXT. r
J
ADDRESS ���
PLASTER, INT.
AUTHORIZED AGT.
PLASTER, EXT.
$ '14 a r P. C. $
n<7 a FEE HOUSE NUMBER COR-
. - _ RECT AND POSTED
VALUATION FEE $ FINAL 1�
76A688A DBS 3 9-52
I J
COUNTY OF LOB ANGKLZS TEMPLE CITY # 0508 BUILDING PERMIT
DKPARTMYNT OF PUBLIC WORKS 9701 LAB TSS ALTZRATION/REPAl'R
BUILDING AND SAFETY / L1LID DEVELOPMENT TYMPLIC CITY CA 91780 BL 0506 0511080013
PHONE, (626) 285-0488 YTP:
LEGAL TO. 170. OF CONST BUILDING ADDRESS:
TR. 17867 LT: 56 BQ. FT STORIES TYPE 10709 GRAND AV
STRUC UREi 1395 VN TEMP CA 91780340E
ASSESSOR INFORMATION NDMBKR. *MARIIST CROSS STREET: HI, MONTE
8574-002-032 THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY, C
TKiA]ET: IIIST BLDG USE: REBID USX ZONE: R-1 ISSUICD ON: PROCIBBED BYi ]EXPIRES ON:
]EXIST OCC GRP: 11/08/05 JK 11/03/06
OWNERS TEL. NO: BLDGS. NOW ON LOT, VALUATION 1 FINAL DATE FINAL BY: CODE:
CHAUNIS C (626) 673-3185— 2,800
1070 `/�
10 7 0 9 GRAND 1V � /"7
TDO7 91780340E VIES PAID D]EBCRIPTION OF WORK
TEAR Olt AND REYDOF WITH SHINGLES TILES ROOF
F= DESCRIPTI00i: QUA]ETITYt DOM: AMOUNT
APPLICA]ETs TEL. NO
SAMN AS OWNER — AA BLDG PERIQT ISSUANCE 27.75
AC BTRONG MOTION RLBID 2800.00 VAL 0.50 SPZCIAL CORDITIONSi
D2 PZR= W/O KN—HC 2800.00 VAL 99.00
J?R INV WORE W/O P 257.00 DOL 257.00
TOTAL, VICES 384.75
CONTRACTOR. TEL. NOt APPROVALS DATN INSPECTOR SI®TIIYE
SAME AS OWNICR —
LIC. NO LOCATION AND SETBACKS
BOILS ENGINEER APPROVAL
ARCHITECT OR ZQGITffii TM. 190. FOUMDATION TRYtCH POEMS
LIC. NO: SLAB UNDZR FLOOR
. RAISID FLOOR FHAMSBG
MAP NOz SNWZR MAP BOOKi PAGEi FIRZ ZONIC CMP, U3[DZRYIO0R INSULATION
147H277 3 01
FLOOR SHRATHING
NO. OF FAMILTVA i D XI i ING BUTS s APT CO®i STAT CLASS:
NO 21 ROOF SEMTHING
SCHOOL WITHIN HILZAR'OUB ®1R PANLLB
AT-2 QUALITY 1 1000 FELT MATER rALS
NO NO MIO FRAME INBPECPION
REQUIRED TOTAL SETBACK VROM EXIST FIRE SPR13rKLXR HANGERS
BET BACK TZ HWYl PROP LINE: WIDTH.
FRONT PL— INSULATION W]EATHER STRIP
SIDE PL—
INTYRIOR LATH DRYMALL
EITERIOR LATH
RATED FLOOR CEIL ABBMDI.
RATED XLLL ASSEMBLIES
RATED SHA➢TB OPXUINGS
T—BAR C]EILIIM
LOT DRLIYIGE
REPORT ID: DPR261 ROUTE TOS B80508