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HomeMy Public PortalAbout6241 HART AVE_Building__ 76ge38A C?0803 3-69 i. APPLICATION FOR BUILDI G PER COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS `(' /�/ • tI� BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPT OF BUILDING NEAREST CROSS ST. O♦y! 1♦�, FOR APPLICANT TO FILL IN DISTRICT N0. GRO TYPF�LUlLS1. PR S Y (PRINT OR TYPE ONLY) (��� BUILDING STATISTICAL CLASSIFICATION SEWER MAP ADDRESS ��� CLASS NO. Jz4DWELL.UNITS BK PG LOT N0. ,20�9C520BLOCK USE ZONE MAP � / N0. C/ 0 TRACT '5-26? f SPECIAL I N0. OF BLDGS. I COND TIONS SIZE OF LOT NOW ON LOT USE OF EXISTING BLDG. BLDG. SETBACK FROM OWNER N f� TEL' _y4rfp� / FRONT PROP. LINE OF -(STREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD TOTAL ADDRESS J 9y CY (f! HIGHWAY WIDTH FROM C.L. + CITY ( ( ARCHITECT OR TEL. B .SETBA M (STREET) ENGINEER N0. SIDGDE PROP. LINE 0 TYPE OF EXISTING SETBACK HI + YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C.L. TEL. _ CONTRACTOR -� {..� NO. + a ADDRESS LIC. CORNER CUTOFF YES ❑ NO E] U LIC. a CITY CLASS SEE REVERSE SIDE FOR SOCEJIALIAPPROVALS CONSTRUCTION LENDER H NAME AND BRANCH e 1/ /`�' V ILL; CL ul ADDRESS SQ. FT. NO. OF NO. OF ❑ SIZE STORIES FAMILIES NEW ` USE OF ADD STRUCTURE ❑ ALTER REPAIR ❑ SIGNATURE OF - DEMOL ❑ APPLICANT .,�. VALUATION $ s APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMTFOUNDATION: LOCATION FEE $ FEE $ ♦ (/ G FORMS, ORMS MATERIALS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION FRAME: FIRE STOPS, BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUC- GAS VENT DUCTS TION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE LATH, INT. OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM- sq PENSATION INSURANC LATH, EXT. s SIGNATURE OFf4,0 HOUSE NUMBER CORRECT le PERMITTEE AND POSTED ADDRESS - FINAL JOHN F. LEWIS, PRI" IPAL STRUCTURAL EN PLAN CHECK VALIDATION CK. M.O. CASH - PERMIT VALIDATION CK. M.O. l' - 617 ,APPLI flCAS'Q®ISL F Fi BlJ gL D G PE.Rfail COUNTY OF LOS ANGELES BUILDING AND SAFETY .' BUILDING ZL FOR APPL CANT TO FILL IN ADDRESS BUILDING , � Al (j /�AT U LOCALITY ADDRESS "J 11A /� NEAREST Q _ CITY � ZIP T�� CROSS ST. NO.•OF BLDGS'. ASSESSOR SIZE OF LOT •J V• �� NOW ON LOT MAP BOOK PAGE PARCEL , DISTRICT P—_> UP TYPE FIRE` CESSED"BY 3 TRACT Q BLOCK L_OT NO.. s �' CONST. ZONE' ii TEL 'o K tOWNER _ NO. 12 _ STATISTICAL CLASSIFICATION- SEWER ADDRESS L N L' CLASS NO. DWELL.UNITS Bl6 PG, - CITY 7L� C I" 1 ZIP ' ci 1 9 0 ARCHITECT OR TEL. VALUATION $ ` ENGINEER NO. v- •' ' ADDRESS BLDG.SETBACK FROM "� ��jJ L, FRONT PROP.LINE OF (STREET) CONTRACTOR e NO.jj JSP NOTAL SETBACK FROM TYPE OF EXISTING {--* LIC _ HIGHWAY. .+ YARD = FRONT PROP.LINE HIGHWAY' WIDTH, ADDRES Q F"I _ NOM LIG. 4- CITY CITY_F4Eh\pLL C I I CLASS ' CONSTRUCTION LENDER BLDG.SETBACK FROM. NAME AND BRANCH N 0 I'll L. SIDE PROP.LINE OF (STREET) TOTAL SETBACK FROM TYPE OF EXISTING HIGHWAY + YARD = @, ADDRESS CITY SIDE PROP.LINE HIGHWAY WIDTH -- _• SO.FT./ NO.OF NO.OF CHECK + = V'. SIZE 6 STORIES FAMILIES ONE / ®' DESCRIPTION OF WF1C WORK yy�� NEW E] P.C Fee,$r23 Permli Fee Ab i � 'bb 'QATH ADD : ® . CA9 Issuance'Fee �•� LJ T ALTER C3, j REPAIR QA3 O ❑ Tota I,Fee USE OF EXISTING BLDG.' y� �LI{\j DEMOL ❑ O APPLICANT/°'� TEL PRINTIC1a • [3�L E NOa�S-���� J BY-(SIGNATURE) 3• ° x I HEREBY.ACKNOWLEDGE THAT•( HAVE THIS,APPLICATION AND STATE. , I' / L V 'THAT THE ABOVE'IS.CORRECT AND'AGREE. COMPLY,WITH ALL ORDINANCES "AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE.: WORK AUTHORIZED HEREBY I.WMEL NOT EMPLOY-ANY PERSON INiYIOLATION OF THEPENLABOR INSURANCE. -ALIFORNIA-IN',RELATING TO.WORKMEN'S COM ' - ' Z - o THEABOCODE OF THE STATE OFC - �5:53 L A # o 0,9 °'o l . SIGNATURE'OF ^, , PERMITTEE VVV ADDRESSV , 2'4 8,5 0,.. g TEL. ' ° ° 248,50 Q 7 (J CITY L L� ( r, NO.Q`J USE ZONE NO. Q ... a - ,,, � 0 -7, 1 '8-79 - _ SPECIAL a, r CONDITIONS ♦ g FINAL// DO 1BY r DATE G( O � f `76A638A C'c080.4 8-64.APPLICATION FOR [31J;ILD7'. PERMIT . COUNTY OF LOS ANGELES BUILDING DEPARTMENT .OF COUNTY ENGINEER ADDRESS l BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE'. COUNTY ENGINEER NEAREST COLEMAN W. JENKINS,SUP-T.OF BUILDING CROSS S DISTRICT NO G P TYPE. PR,O; 5D FOR APPLICANT TO FILL-IN S. O CONST. BUILDING ,�� STATISTICAL SSI FICATION SEVE P R✓✓µµqq ADDRESS / /(/� �� CLASS NO. DWELL UNITS.- .BK,v PG GGG��rre++++ LOT NO. _ BLOCK USE ZONE MAP NO. TRACT. SPECIAL �^ (/�� NO.'OF SLOGS,.. CONDITIONS SIZE OF LOT NOW ON LOT USE OF EXISTING B L.12 G. BLDG. SETBACK FROM. . C y TEL. �f_ FRONT PROP. LINE;OF'" (STREET) OWNE O NO. (J TYPE OF EXISTING SETBACK HIGHWAY + YARD - TOTAL ADDRESS ��( / - HIGHWAY WIDTH 'FROM C.L. ' �S + _ 4k CITY _ BLDG. SETBACK FROM . ARCHITECT OR TEL. SIDE PROP. LINE OF (STREET) ENGINEER NO., TYPE OF EXISTING SETBACK HIGHWAY + YARD TOTAL_ ADDRESS - HIGHWAY WIDTH FROM C.L. a 01- TEL. TEL. - + _ O CONTRACTOR NO U LIC. CORNER CUTOFF YES 11NO E:] O ADDRESS NO. CITY CILCASS ' SEE REVERSE SIDE•FOR SPECIAL.APPROVALS u DESCRIPTION OF WORK .CURB, GUTTER, DRIVEWAY APPROACH, Z— NEW ADD- ALTER REPAIR DEMOLISH SQ.FT. /NO.O. OF NO. OF S' 7` SIZE Fe STORES FAMILIES Note: Permits for curb, gutter; sidewalk, and drivonay approach t^• USE OF STRUCTURE sta a Ons should e taken outa -ihe < 13.ph, in^er's_Ofcce immed aiely in order.-to avO U 17141- a lengthy delay. Survey & m ."Design wk takes time and is not started IGNATURE F �es APPLICAN Un 1 City Hall. _ VALUATION$ APPROVALS DATE INSPECTOR'S SIGNATURE P.C. - PMT. FOUNDATION, LOCATION FEE$ FEE$ / ©' FORMS, MATERIALS - FRAME, FIRE STOPS,� 0- I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE.IS CORRECT AND AGREE TO COMPLY FURNACE: LOCA-TION` WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS'VENT. DUCTS '.s �• ��`% 9UILDING CONSTRUCTION. I CERTIFY THAT, IN DOING THE WORK r /) ✓ �_—J'`,•� AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH. INT. TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- ING TO WORKMAN'S OPEN CATION INSURANCE. LATH. EXT. G_ SIGNATURE / HOUSE NUMBER COR- PERMITTEE RECT AND POSTED �p ADDRESS - FI NAL ' �i , JOHN F. LEWIS."P INCIPAL STRUCTURAL E )H - o3 PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.0. CCASL IJ5 2 3 J!1L 12 1 D - d 76A638A CE.'8032-63•/7] H LfCATIOWG OR BUILDING. tl.• E9 \MI� _; COUNTY .OF LOS' ANGELES ADDR ISNs — DEPARTMENT OF COUNTY ENGINEER r BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST " WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. � DISTRICT NO. GROUP T E l ESSED BY FOR APPLICANT TO' FILL IN DI. NST. .BUILDING/ //''� STATISTICAL CLASSIFICATION- - S ER MAP ADDRESS..`•.� '/ !V4- K CLASS. NO. DWELL.UNITS LOT,NQ i - _BLOCK WATER NOT R SQUIRED RECEIVED i CERTIFICATE: TRACT _ MAP_ HIGHwnv STATE MAJOR SECOND., L CAL.. NO. OF BLOGS. - NO. ICIRCLE) SIZE OF LOT NOW ON LOT USE ZONE- SPECIAL CONDI - .USE OF - -:' TIONS. ' EXISTING.BLDG. • - .r /+ TEL'. ,•l b' I..., C OWNER , Ie r pc -NO.' � 0 BUILDING r EXIST. YARD HWY „STREET NAME ' (,. S_ET BACK � �-WIDTH , ADDRESS 7 wr f(Ir FRONT. ARCHITECT OR' FELl. P. L. < ENGINEER NO. - SIDE - a > - P.L. r ADDRESS 'TEL', i.✓ d i.d�i�i" t�r�,� .� '1 •. '.;� �`4+ ,zE V ,CONTRACTOR ,NO. .y PE .-..,,,`DESCRIPTION, OF WORK i` d ` ' °J f J T �.. D ALTER REPAIR DEMOLISH f - apt -� / O. OF NO. OFL1. � � DRIES FAMILIES •.V E E OFPPL I APPLICAN N'$ APPROVALS JDATEO INSPECTOR'S SIGNATUREP.0 -,.:' PMT. �- / FOUNDATION.: LOCATION FEE FEE FORMS, MATERIALS FRAME FIRE STOPS, , y I HEREBY,'ACKNOWLEDGE'THAT�I HAVE READ THIS APPLICATION BRACING. BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLYFURNACE: LOCATION, 'WITH ALL.COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS ' BUILDING'.'CON5TRUCTION.'I CERTIFY THAT.IN DOING THE WORK AUTHORIZED HEREBY-I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH. INT. TION OF,THE'LABOR CODE OF THE STATE OF CALIFORNIA RELAT- ING TO WORKMEN'S CO ENI13ATIO INSURANCE /'J�QJ' LATH. EXT. SIGNPERMITTR _%,_l ..^'v HRECT UMBER COR- PERMITTEE' RECT.AND.POSTED ADDRESS a' FINAL- - - JOHN F. LEWIS. PRINCIPAL STRUCTURAL ENG R - PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.D. cnsH V 2;8 6 .8 AUG`2 0 1 D F.0 0 . WORKERS COMPENSATION DECLARATION I hereby affirm .that .I'have q cerhfieate,of,consent to,self O O Q O D D D insure, or a:certifi.cate of Workers' Compensation Insurance, x a p p d C� QU 0 0 Gil FOR N .Q M. d G�]'C� p C G3Gv�i 0 or a certifipid copy th&&.of Sec:+3800'Lab: C )'' - r.,.. . �-�' Z COUNTY OF LOS ANGELES BUILbiNG Amb SAFETY PoltcyyNo J Compony. BUILDING .Certified copy•is$ereby furnishe�5 FOR APPLICANT'TO FILL ADDRESS �ert°fied copy is filed with;the county building'inspe BUILDING ` ^ tion deparimenY.• ADDRESS Date• D•z Applicant CTY59 ZIP LOCALITY CERTIFICATE OF EXEMPTION' OM''W RKERS' NO:OF BLDGS. - -- NEAREST _ COMPENSATION'IIJ URANCE SIZE OF LOT NOW ON LOT CROSS ST. (This'section'•;n'eed-not•be completed if the permit is•for one x' ASSESSOR hundred dollars.($100)or less ) ~ TRACT BLOCK LOT NO. 1 MAP BOOK PAGE PARCEL TEL. USE ZONE- MAP"" I certify that m the performance of the work forwhich,This OWNE -- NO. NO. 1 permit is issued'I shall potemploy any person mdny mariner .J-1 SPECIAL ADDRESS. I, O . so as to become'sublect to the Workers'Compensation Laws. CONDITIONS CITY, Date r is Applicant"' ARCHITECT'OR TEL. S NOTICE`•TO APPLICANT: If 'after making,this'Certificate'.of DIS T. GROUP, TYPE FIRE, R CES ED'BY ENGINEER NO. CONST ZONE U Exemption 'You'—should become subject to-the Workers' "`-"' in Compensaiion.provisions of-the Labor Code, you-must forth- ADDRESS -• with°comply'with such provisions or this'permit-shall be _ TEL. G STATISTICAL CLASSIFICATION' AP•T... CONDO. Z' deemed revoked , CONTRACTOR NO. kENSED CONTRACTORS DECLARATION CLASS NO. DWELL. S 'U NIT � •1 hereby affirm that l am licensed,underprovisionsof Chapter 9 ADDRESS �r (commenting with Sectibn 7000)of Division 3 of the Business and LIC. �j SEWER MAP Profes'sions'Code; and`my license is in-full for'ce.ond�effect. CITY CLASS 7CJ - VALIDATIOP! SQ. FT. NO. OF NO. OF CHECK /tet o'. SIZE - STORIES / FAMILIES - ONE " L°cenae.Num Li c:Class x e, _ VALUATION .. . . NEW ❑ i 8'9 �dq } ` O DESCRIPTION,OF WORK ' Contractor d1H ADD D- 1 I am empt u der Sec - - - o'0e' • e.. ALTER ❑ '0 0 40,51 B.&P.C. for this reason „ �a SU• - $ REPAIR _ _ Date:' USE OF ��".�0 .L Z' ` EXISTING BLDG. �O ( DEMOL•❑ __ Sig6citure -;_... . _ - FINAL APPLICANT '" L. OWNER-BUILDER DECLARATION PRINT).` -DATE ®'I� �I�BrQ .I hereby'affirm-that I,am.exempt from.the Contractor:s,License Law for the following.reason (Section 7031 5, Business and ADDRESS FIN Professions Code): .,., - PRESENT _ B _ BUILDING I, as owner of the property; or my employees with ADDRESS ' "� "wades as their sole compensatiori;\Till do tlii`wofk.and the structure is not intended or offered for sale(Section LOCALITY + 7044;Business and Professions'Code). ' "" MOVING,- 1, OVING: CONTRACTOR NO: • �- I, as owneF of the property, am exclusively contracting '� • ' -with*licensed contractors to construct the project.'(Sec- _.. ADDRESS ' ' tion 7044, Business and Professions Code): • � •.• - REQUIRED.. TOTAL SETBACK FROM _ XI T.., - CONSTRUCTION LENDING'AGENCY-- SET•BACK YARD HWY-•' PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT -the performance of-the•work for•which this permit is issued - - PAL - - - — - _ (Sec..3097,:Civ. C.). SIDE P.L..:. Lender's Name I �) LDMA'Ref # - - - P.Cr Fee$ Permit Fee - I V - Lender's Address I.certify that,I have read,this_6pplication and state.that the Issuance Fee -- - - ' LDMA P/C# a above information is correct. I agree to comply with all County Investigation Fee C _ordinances a. State laws,reldting„t building construction, Total-Fee• ;S LDMA Permr# - and hereby horize representativ f this County to enter upon the-mentioned proper f r inspection purposes. _ .. Q SEE REVERSE FOR EXPLANATORY LANGUAGE .Signature of Applicant or - - Date WORKERS'COMPENSATION DECLARATION M Ce ba certificate self certificate of irm that I Workes' Compensation Insurance' ' OM d D m , n n u , or a certifiedcop thereof (Sec. 3800 Lab.'C.)" i cc 2'0-424-1(6327 , Argonaut. I-ns,. . COUY�TYOF-LOS"AWCsELES BUILDIRI�sAIdDSAFETY. Policy No. Company BUILDING q Certified copy is hereby furnished. FOR APPLICANT-TO FILL.IN ADDRESS' vb © Certified copy.is filed with the county building inspec- BUILDING ` Tion department. ADDRESS -6 2 4'1 N Hart - LOCALITY NEAREST — Date 1 1 1 —Rd Applicant Randnl Rnnf"i ng CITY Itl ZIP 517.80 CROSS ST. _ CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. ASSESSOR COMPENSATION INSURANCE. SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL " (This section need not be completed if the permit is for one USE ZONE MAP hundred dollars ($100)or'less.) TRACT BLOCK LOT NO. NO. �L �✓ • TEL. r SPECIAL certify that in the performance of the work for which this OWNER NO. — CONDITIONS`_ C 'permit is issued, I shall not employ an person in an manner DIS RICT IGROUP TYPE FIRE PRO SSED BY O P y y P i ADDRESS 1 a / CONST. - ZONE L). ` so as to become subject to the Workers'Compensation Laws. �" - � s-.o CITY ' � ZIP 91780 - Date 5 I n—S 4' Applica6t R a n A n l R n n f; :;rt STATISTICAL CLASSIFIC TION, APT. ]CONDO. t­NOTICE TO APPLICANT: If, 'after:makin this Certificate'ofARCHITECT ORTEL. gU g ENGINEER NO." CLASS NO. DWELL. UNITS Exemption, you should become, subject to the Workers' 9. 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.�PGV VALIDATIOP! 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 ProfessionsCode, and my license is in full force and effect. CITY San G ab r"i 2'1 CLASS C-'3 9 $ 2 0 6 0 00. D SQ..FT. NO.OF NO. OF CHECK, License Number d 5 1 7 Lic.Class C-3 9 SIZE STORIES FAMILIES ONE ,. � .. . NEW ContractorR a n d'o 1 " R a n f.,n gDate n-$A DESCRIPTION OF WORKhouSe lomexemptundersec. & garage wi.th:. 2Q0# shi;ngl VD . ALTER . FINAL — /1 • B.&P.C. for this reason REPAIR' - DATE (p �4- USE OF Date EXISTING BLDG:, ' DEMOL E] FINAL Signature APPLICANT TEL r OWNER-BUILDER DECLARATION PRINT Randol Roofing No. 2$$-4040 I hereby affirm that I am exempt from the Contractor's Licensea Law-for, the following reason (Section 7031.5, Business and ADDRESS 529 'E . .V a 1 1'e.. .B 1. S an G ab r i . Professions Code):. PRE ENT 1 3,3-5.A El BUILDING ;" .. , o o 1o,o 0 I, as owner of the property, or;my employees with ADDRESS 1 wages as their sole compensation,will do the work and, .- 4 the structure is not intended or offered for sale(Section LOCALITY •. 2'a a 59,2.5 - 7044,Business and Professions Code). MOVING CONTRACTOR NOK TEL. . � I, as owner of the property, am exclusively contracting , 0 59 2.5 c� with licensed contractors to construct the project (Sec- 4j .a o t ADDRESS 'tion 7044, Business and Professions Code). "' ... 0 5 1 $—8 4 REQUIRED )jJOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY. SET BACK - YARD HWY PROP. LINE WIDTH D I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this.permit is issued P.L. (Sec. 3097, Civ. C.-). SIDE m P.L. ty o Lender's Name _ -P.C. Fee$ " ermit.Fee 48 . 75 Lender's Address I certify that I have read this application and state that the', Is`suanceFee 10 . 50 above information is correct. I agree to comply with,all County Investigation Fee g ordinances and State laws relating to building construction, Total Fee u and hereby outhorize'representotives of this County to enter m upon the above-mentioned property for inspection purposes.. " a lflbH/ �p�M/TN/(YY 5-1�,gc SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date S ..0s r: rF ' 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 1109260049 PHONE: (626) 285-0488 EXT: ILEGAL ID: NO. OF CONST I BUILDING ADDRESS: 1 ITR: 5904 LT: 208 BL: .001 I SQ. FT STORIES TYPE I 6241 HART AV 1 I (STRUCTURE: 27 V-B TEMP CA 917801631 1 (ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: 15384-007-020 I I THOMAS PAGE: 596 GRID: H2 LOCALITY: T I I (TENANT: IEXIST BLDG USE: RESID USE ZONE: R-1 (ISSUED ON: PROCESSED BY: 1 1 IEXIST OCC GRP: 109/26/11 SR 1 I I I I (OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: IF AL DATE FI Y: CODE: IKOUNG ROGER T;KAN S (626) 302-7203- 1 5,800 I -, `/ 16241 HART AV I - I I ITEMP 917801631 1 FEES PAID 1 ISCRIPTION OF WORK I IT/O OLD ROOF INSTALL CLASS A 30 YR COMPO SHINGLES - IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( (APPLICANT: TEL. NO: I - I ILAU, ALFRED (626) 285-9016- 1AA BLDG PERMIT ISSUANCE - - `27.80 1 14533 SHIRLEY AVE - IAB STATE GREEN BLDG FEE 5800.00 VAL 1.00 ISPECIAL CONDITIONS: I. IEL MONTE, CA 91731 IAC STRONG MOTION RESID 5800.00 VAL 10.60 1 1 ID2 PERMIT W/O EN-HC 5800.00 VAL 149.70 I I TOTAL FEES 1.79.10 I I, 1CONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE IGOLDEN KEY INC. (626) 285-9016- 1- 14533 SHIRLEY AVE LIC. NO ILOCATION AND SETBACKS IEL MONTE, CA 91731 775115C39 I ISOILS ENGINEER APPROVAL I I I (ARCHITECT OR ENGINEER: TEL. NO: 1 IFOUNDATION/TRENCH FORMS I I I 1 LIC. NO: (SLAB/UNDER FLOOR I. I IRAISED FLOOR FRAMING I IMAP NO: SEWER MAP BOOK: PAGE:, FIRE ZONE: CMP:1 (UNDERFLOOR INSULATION I I 1153H265 3 001 - I %A 1-1 I I - - -1 IFLOOR SHEATHING INC. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I I 1 0 NO 21 1 IROOF SHEATHING I 1 SCHOOL WITHIN HAZARDOUS ISHEAR PANELS (AIR QUALITY: 1000 FEET MATERIALS I I I I I NO NO NO IFRAME -INSPECTION 1 I (FIRE SPRINKLER HANGERS I I (INSULATION/WEATHER STRIPI I I I (INTERIOR LATH/DRYWALL 1 I I I I I I I - IEXTFRIOR LATH I _ IRATED FLOOR/CEIL ASSEM. 1 .RATED WALL ASSEMBLIES I I IRATED SHAFTS/OPENINGS I 1 1 IT-BAR CEILINGS I I I I ILOT DRAINAGE I I I I I I IREPORT ID: DPR261 ROUTE TO: BS0509 1 I 1 I 4