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95A638A+CEtt80312/6APPLICATION FOR BUILDING PERMIT `
COUNTY OF LOS ANGELES ASSESSOR
DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS i
COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST Of i
Print or tvDe onl CROSS ST.
DISTRICT NO. GROUP TYPE SSED BY
BUILDING
ADDRESS CONST.
• STATISTICAL CLASSIFICATION SEWER MAP
LOT NO BLOCK CLASS NO. OWELL.UNITS SBK Pq/23
TRACT ` � USE ZONE MAP
NO.OF SLOGS. NO. /
SIZIE OF LOT 2& X 2-1 NOW ON LOT �/ SPECIAL '
USE OF CONDITIONS '
EXISTING BLDG.
TEL.
OWNER NO. BLDG.SETBACK FROM
ADDRESSL G FRONF PROP.LINE OF (STREET)
TYPE 4F EXISTING SETBACK HIGHWAY + YARD = TOTAL-
Cl TY
OTAL•CITY HIGHW Y WIDTH I FROM C.L.
ARCHITECT OR TEL. + _
ENGINEER NO. BLDG. TBACK FROM
ADDRESS �' SIDE PR P.LINE OF (STREET)
TEL. - TYPE OF EX TING SETBACK HIGHWAY + YARD = TOTAL
CONTRACTOR NO. HIGHWAY WID FROM C.L.
ADDRESSLIC1,011f( RCC4 .
r NQp,771
LIC.
CIT` (� CLASS CORNER CUTOFF YES ❑ ❑ V
CONSTRUCTION LENDER
NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS
W
ADDRESS a
cn
SQ. FT. NO. OF NO. OF NEN, ❑ Z
SIZE STORIES FAMILIES
USE OF ADD ❑
STRUCTURE
ALTER
' L .4,-T, S
REPAIR
SIGNATURE OF ` A ❑
APPLICANT DEMOL ❑
VALUATIONS L APPROVALS DATE INSPECTOR'S SIGNATURE
P.C, PMT. / J FOUNDATION: LOCATION
FEES —' FEE S /< FORMS, MATERIALS
FRAME: FIRE STOPS,
I HEREBY. ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS
ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE- LOCATION,
WITH ALL ORDINANCES 'AND LAWS ,REGULATING BUILDING CON- GAS VENT, DUCTS
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT.
LABOR CODE OF THE STATE OF -CALIFORNIA IN RELATING TO
WORKMEN'S COMPENSATIQN INSURANCE. � � �J LATH, EXT.
SIGNATURE O� �'�li�"V HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS /Pi/t I/ ' /c[i�Li Sr SoG��/hYDar/ FINAL
JOHN F. LEWIS PRINCIPALSTR URAL ENGINEER
PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION cK M O. CASH
6 6 6,c:JUN. 21 1 D 5 1.0 0 asp
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76A638A CE#803 8.63APPLICATION FOR BUILDING PERMIT, �.
COUNTY OF LOS ANGELES BUILDING
ADDRESS'
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY I'J i
JOHN A. LAMSIE, COUNTY ENGINEER NEAREST /
WILLIAM A JENSEN, SUPT OF BUILDING CROSS ST. --
DISTRICT NO I GR P TYPE PR S D Y
4- 1' &1,6)R APPLICANT TO FILL IN
CO
BUILDING �+ STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS Q (Jj Q/r CBK PG
CLASS NO DWELL UNITS V
-LOT NO BLOCK WATER
ry CERTIFICATE. NOT REQUIRED . RECEI V,ED• •'
TRACT
MAP IGHWAY STATE MAJOR SECOND. OCAL
NO.OF BLDGS NO (CIRCLE)
SIZE OF LOT '70)( Z C NOW ON LOT USE ZONE SF9ltCIAL
USE OF CONDITIONS
EXISTING BLDG. ,
L
OWNER 60/4'Jl9J UJa[ Des Or O. BUILD NG YARD HWY EET E' EXIST
SETBACK WIDTH
ADDRESS FRONT /
ARCHITECT ORTEL. TZ7�o P. L
ENGINEER o.�Oe✓,�fd v►+ /a" SIDE
P L
ADDRESS Z f ((/� -,�- C APPROACH, a
TEL, AND PARKWA TREE REQUIRED0
CONTRACTOR - '' NO V
OL
ADDRESS ofer Permifs for curb, guiter, sidewalk, and driveway approach n-0
DESCRIPTION OF WORK 0all.Cor, houlari
Office, or T. C. Co. E,nr?necr's Ofiice immediately in order fo av' d d
NEW ADD LTER REPAIR DEMOLISH 0•164hy doloy. Surycy & Dasa gn work'tah,es time and is'not sfart dz"
Q. FT. /' NO OF NO OF .
SIZE (�'!J'OD STORIES FAMILIES 4�ify'i'Idll.' -
USE O
STRUCTURE
SIGNATURE OF a� G*' �Yr�'y`"�'• ,{/ � /W
/ �
APPLICANT �4,;V i 'Y �l
VALUATION �...+�.�, }
APPROVALS D,dTE I NSPECTORYS„SIGNATHRE ffff
P C PMT ( % �� FOUNDATION, LOCATION J 6 F
FEE $ FEE $ 7V't FORMS. MATERIALS A.—I
FRAME FIRE STOPS. _
�~
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS 3714/�r /
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS �Ey`
BUILDING CONSTRUCTION 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 COMPENSATION INSURANCE> LATH EXT.
SIGNATUREOF _.y./ HOUSE NUMBER COR- OrJ L.�.•-'
PERMITTEE �lA5
RECT AND POSTED /
ADDRESS �/ FINAL f [
EWIS
PAL
CEF
JOHN F. P NCI ST3 •�,URAL' NG
CHECK VALIDATION M O CASH PERM[IT'VALIDATION 0. Hr
LAL10 6 0 9 5- 1,10v 2 3 2 3 D 4 4. '5 A
"` 7394"' JAN 18 � 1 .D ' .. 88.50- INT
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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 0304280055
PHONE: (626) 285-0488 EXT:LEGAL-ID: NO. OF CONSTU L ADDRESS:
TR: 28317 LT: 1 SQ. FT STORIES TYPE 9166 LA ROSA DR
STRUCTURE: VN TEMP CA 917803016
ASSESSOR INFORMATION ER: NEAREST CROSS STREET: ENCINITA
5388-009-008 THOMAS PAGE: 596 GRID: J5 LOCALITY: TEMPLE CITY
TENANT: USE ZON : - ISSUED ON: PROCESSED B S .
SEXIST OCC GRP: 04/28/03 JK 04/22/04
i
OWNER: TEL. N0: BLOGS. NOW ON LOT: VALUATION: FINAL DE FINAL B :,,� CODE:
OTTING LARRY (626) 622-1141- 13,650
9166 LA ROSA �- �' J O
TEMPLE CITY 91780 FEES PAID DESCRIPTION
T/0 OLD BUILT UP ROOF; INSTALL NEW ONE
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:
APPLICANT:
ALAN P PRIVITT (562) 696-9587- AA BLDG PERMIT ISSUANCE 27.75
12511 PUTNAM AC STRONG MOTION RESID 13650.00 VAL 1.37 SPECIAL CONDITIONS:
WHITTIER 90602 D2 PERMIT W/0 EN-HC-_--: - 13650.00 VAL 283.80
TOTAL-FEES 312.92
CONTRA OR: TEL. N0: "i ,t.G• �� �� APPROVALS DATE INSPECTOR SIGNATURE
DICK MADSEN ROOFING (562) 696-9587-
12511 PUTNAM ST LIC. NO �:�/ � � �'%� �'�v ON AN SETBACKS
WHITTIER CA 90602 416797-C39
� �� SOILS ENGINEER APPROVAL
A 0 ENGINEER: N0: - r ( C— il;f l- ��\ �,A� FOUNDATION/TRENcFTORm
LIC. N0: I '" SLAB/UNDER FLOOR
RXISED FLOOV FRAMING
MAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE: CMF':, ,� - UNDERFLOOR INSULATION
144H265 304 - -
� �� FLOOR SHEATHING
OF FAMILIES: ELLI TS: /COND: STAT CLAS:
NO 21 , -� R SHEATH I NG
SCHOOLN -HAZARDOUSMew PANELS
AIR QUALITY: 1000 FEET MATERIALS
NO NO NO �'�`. ` �,�,' FRAME INSPECTION
REQUIRED AL SETBACK FROMST FIRE SPRIINLER HAN
SET BACK YARD: HWY: PROP LINE: WIDTH:
FRONT PL- ION/WEA H R STRIP
SIDE PL-
_ ORLATH/DRYWALL
EXTERIOR LATH
7-2 Q-O f 2c�G�p2Zs� /Ns�O — ��✓> R ED . 0 ASS5M.
/ ( RATED WALL ASSEMBLIES
i
RATEDH F N
T-BAR CEILINGS
* ADDITIONAL DATA ON FILE
LOT DRAINAGE
REPORT ID: DPR261 ROUTE TO: BS0508
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