HomeMy Public PortalAbout9510 LAS TUNAS DR_Building__ 78A898A DBS-9 APPLICATION FOR BUILDING PERMIT
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DIVISION OF BUILDING AND SAFETY
BUILDING
Department of County Engineer ADDRESS ESSS v (J
County of LOS Angeles LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
CASSATT D. GRIFFIN, SUPT OF BUILDING CROSS ST.
DISTRICT NO. GROUP TYPEEWER MAP
FOR APPLICANT TO FILL IN I CONSBK PG
T.
BUILDING �J /� t II YES NO
ADDRESS + ��r L ,/ (,/y, MAP STATE
/ NUMBER HWY
LOT NO. BLOCK USE ZONE SPECIAL
CONDITIONS
TRACT f✓9 J� C/ � ,
NO.OF BLDGS.
SIZE OF LOT BUILDING,� Xr�O NOW ON LOT YARD HWY STREET NAME EXIST.
USE OF
SETBACK WIDTH
EXISTING BLDG. FRONT
OWNER SIDE
MAIL
ADDRESS / ( � Mo N O TRACT DWELL. I UNIT
TEL. 5 INDUSTRIAL
CITY NO.
1 DWELL. 1 UNIT 6 PUBLIC BLDG.
/ ^/(/I�}+}�Lt.�..�icr - -
ARCHITECT OR TEL. 2. DUPLEX 2 UNITS 7 ADDN.,ALT., ETC.
ENGINEER NO. 3 APT. UNITS -
8 MISCEL.
ADDRESS 4 COMMERCIAL -
TEL.
CONTRACTOR NO. INSPECTION RECORD
ADDRESS
J DESCRIPTION OF WORK
EW ADD ALTER REPAIR. DEMOLISH
SQ. FT. NO. OF NO. OF
SIZE STORIES FAMILIES
USE OF STRUCTURE— s1
-S z
2 /
SIGNATURE OF -
APPLICANT APPROVALS
ADDRESS DATE INSPECTORS SIGNATURE
FOUNDATION: LOCATION
FORMS, MATERIALS
FEE FRAME: FIRE STOPS,
VALUATION BRACING, BOLTS
527-Mzi�111112001= FEE FURNACE: LOCATION,
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS GAS VENT. DUCTS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH,INT.
AND STATE LAWS REGULATING BUILDING CONSTRUC-
TION.
LATH. EXT,
SIGNATURE O HOUSE NUMBER COR-
PERMITTEERECT AND POSTED
ADDRESS FINAL 015
JOHN A.LAMBIE, COUNTY ENGINEER VALIDA;M, CLYDE N. D RLAM, CHIEF BLDG. INSPECTOR
CK MO &-Sip
5M SETS 9-44 = , APPLICATION FOR PERMIT
PARTMENT OF BUILDING AND SAFETY
-cour-rrY OF LOS ANGELES
BUILDING
�l�TG
WM. J. FOX, CHIEF ENGINEER �.J
DISTRICT NO. PLAN CK. NO. PERMIT NO. 1
LIN
PLANS
.'
NO. OF 2 SED ACK E �G. ORD.NO. � 0
r
FIRE APPROVED _
ZONE (�Q BY DATE RECEIVED BY DATE OF APPL. DATEISSUED
USE
ZONE v AYPROVED DATE 41-6
APP Ig IN HEAVILY OUTLINED PORTION ONLY
O K NAMEIS Construction r,-,ay he in violation Oi . BUILDING
ADDRESS ,� �.�.,,y
U w War Production oar orders. ou er � `
W Z ADgg�S,� ,.] a �.,u„1+ •r•+� n .Cx xlar LOCALITY/,�`
n O:f' NEAREST /
U m CIT�frO�ucticn�ccsdv�.lce before comment CROSS ST. C/ V 9le Y ,
Ir STAW the miork authorized i T /J�L
LICENSE NO. O. E NAME � (,rd?4 _CLAI ' 1105:4 CORP!
--// _ ..J/ W MAIL_r h ICY '�' %'V%C. Al l�`w%h
0 NAME 6 lYS ,/V 3 ADDRESS IQAT4 AS78LF1 A$
1- t6cQ ADDRESS 6S3I, O CITY NO.
f/✓E
F
Z CITY �LO,IR1�(rGL6 S I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
0 APPLICATION AND STATE THAT THE ABOVE IS CORRECT
U STATE TEL. 7 / 4Sr AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
LICENSE NO. D NO. �IE�R.I�I 6� AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
0 LOT NO. SIZE OF LOT y�1t/'� SIGNATURE
OWNER O 7 N"����_ ��;{ _ a
NO. OF BLDGS. A/, AUTHORIZED
6. BLOCK NOW ON LOT II�/p,n/
J N TRACT s�al ,26RRCTIONS
W
D USE OF BLDGS.
NOW ON LOT ;t/t21.,�../�k�a .:a✓ '��r2,�14-L;�' a9 ti•n..,
DESCRIPTION OF WORK
USE OF
BUILDING
i
O
z
a
r
NEW TYPE GROUP
NO. OF NO. OF ®®,
ALTERATION ROOMS X 2 FAMILIES
ADDITION SIZE
REPAIR STORIES
MOVING WALL COVERING
DEMOLISH I ROOF COVER IN GICCOMP OS• l l 11.
$ Lir FEE $ V r O D FINAL APPROVAL,
`v $// A10 INSPECTOR'S
NAME
VALUATION FEE / ® TE�/ I
DA
DEPARTMENT OF BUILDING AND SAFETY . APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES
WM. J. FOX, CHIEF ENGINEER BUILDING
N'. OF BLDG. ORD.NO. DISTRICT NO. PLAN CK. NO. PERMIT NO.
PLANS SETBACK LINE ?/�
FIR _ APPROVED
ZONE BYDATE RECEIVED BY DATE OF APPL. DATE ISSUED
USEAPPROVED ')A
ZONE �-3 BY DATE A1,03..
`
APPLICANT FILL IN HEAVILY OUTLINEDA POQ�RTION ONLY
BUILDING
0 NAME ADDRESS
W Z ADDRESS LOCALITY
I-
= Z NEAREST
U W CITY CROSS ST. r
n
Q STATE TEL.
LICENSE NO. NO. E NAME rRBe�G7� •t�•PjL
3 z MAIL e�V
0 NAME �V�/�J�✓lX / ADDRESS /7��
y� y�/ �-
< S ADDRES 'J �'(/! r a0n�// ��...• O CITY + NO.
~ 1 HEREBY ACKNOWLEDGE THAT 1-HAVE-READTHIS
O CITY // Q6 APPLICATION AND STATE THAT THE-'ABOVE IS CORRECT
U STATE TEL. AND AGREE TO COMPLY WITH AL•L COUNTY ORDINANCES
LICENSE /NO.Q�h No. AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
0 SIZE OF LOT
LOT NO. lQ O iG.. I �/l SIGNATURE OF
OWNER
XJ �i
J F- NO. OF SLOGS.
Q IL BLOCK NOW ON LOT / AUTHORIZED.AGT.
0 � n
J
In TRACT / CORRECTIONS V
D USE OF SLOGS.
NOW ON LOT
DESCRIPTION OF WORK
USE OF �.
BUILDING
O
I
z
z
a
NEW E! TYPE I GROUP \
i/ NO. OF \ NO. OF \ -
ALTERATION ROOMS FAMILIES \
ADDITION SIZE \ \
REPAIR STORIES
MOVING WALL COVERING \�
DEMOLISH ROOF COVERING
�— C.-FEE $ FINAL APPROVAL
so? INSPECTOR'S!,
NAME
VALUATION FEE ; DATE Gtr _.
'�
WORKERS' COMPENSATION dECLARATION
'Hereby affirm.that I have a certificate of consent to self APPLICATION FOR BUILDING- PERMIT..,
it ure, or a,certificate of Workers' Compensation Insurance,
or.'b,certi f ied copy thereof (Sec. 3800, lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy Ito. Company "
❑' Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING
ADDRESS ,rte�Q LL�
❑ Certified copy is filed with the county building inspec-. BUILDING ]�y
Tion department. ADDRESS D Y/ 1
CITY' r 1 C� f ZIP / o LOCALITY
Dare Applicant" NO. OF BLDGS.
NEAREST
CERTIFICATE OF-EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST.
COMPENSATION INSURANCE ASSESSOR
(This section need not be completed if the permit is fof one TRACT BLOCK I LOT NO. MAP BOOK I PAGE PARCEL
hundred dollars ($100)or less.) �,7� �
OWNER S I. .� 1 USE ZONE MAP
NO.
I certify that in-the performance of the work for which this SPECIAL >_
permit is issued, I shall not employ any person in any manner ADDRESS �n CONDITIONS
so as to'become subject to'the Workers' Compensation Laws. Q O
CITY. e IF / �J U
Date Applicant- ARCHITECT OR TEL. 'DISTRICT GROUP TYPE FIRE PROCESSED BY W
NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER . NO. CONST. ZON E O
Exemption, you should become subject to the.Workers' )) w
Compensation provisions of the Labor Code, you must forth- ADDRESS
with comply with such provisions or this permit shall be TEL STATISTICAL CLASSIFIC TION APT.' CONDO. to
deemed revoked. CONTRACTOR NO. Z
LICENSED CONTRACTORS DECLARATION ADDRESS �/�' LIC. CLASS NO. DWELL. UNITS
I hereby affirm that l am licensed under provisions of Chapter 9 NO. SEWER MAP
(commencing-with Section 7000)of Division 3 of the Business LIC.
and Professions Code,and my license is in full force and effect. CITY CLASS BK PG VALIDATION-
SQ. FT. NO. OF NO. OF CHECK
License Number Lic.'Class SIZE STORIES IFAMILIES ONE
VALUATION
Contractor Date DESCRIPTION OF WORK NEW ❑ $ �t-Q
❑
ADD
am exempt under Sec.
��
I ❑ l/ ,
ALTER -
B.&P.C. for this reason REPAIR ❑ $
Date: USE OF.
EXISTING BLDG. DEMOL ❑
Signature APP(R .APPLICANT
INT) NOFINAL
OWNER-BUILDER DECLARATION DATE /
I hereby affirm that I am exempt from the Contractor's License
Law or the following reason (Section 7031.5, Business and ADDRESS FINAL - i
Pro ssions Code): PRESENT By
1, as owner of the property, or my"employees with ADILDI NG
DRESS
wages as their sole compensation,wiH do the work and ;
the structure is not intended or offered for sale(Section LOCALITY __
7044, Business and Professions Code:) MOVING TEL. , -•
I N{�-
CONTRACTOR NO. L I�.i�
❑ I, as owner of the property, am exclusively contracting
with licensed contractors to construct the project (Sec- ADDRESS `rt-U HL ��.-�'•
tion 7044, Business and Professions;Code.)
REQUIRED TOTAL SETBACK FROM EXIST.
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH
I herebyaffirm that there is a construction lendinga enc for FRONT t the perormance of the work for which this perit is issued P.L. '"• £;ff1i� '`e''`
(Sec. 3097, Civ. C.). SIDE.
P.L.
Lender's Name
LDMA Ref. #
'
P.C. Fee$ Permit Fee
Lender's Address
` J Z�
o I certify that I have read this application and state that the Issuance Fee LDMA P/C# -
above information incorrect. I agree to comply with all County Investigation Fee
8 ordinances and,State laws relating.to.building construction, Total Fee O 'i+ LDMA Perm. #
< and hereby authorize representatives of this County to-enter
u,pIn the above-mentioned property for inspection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of.Applicant or Agent Date
APPLICATION FOR. BUILDING PERMIT �1
4 f COUNTY OF LOS ANGELES BUILDING AND SAFETY
YVORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS , r
BUILDING ADDRESS �7(O I LJAJ/45 P 1Z
I hereby affirm that I have a certificate of consent to self insure, �s i o �. LAS �/(As V k.
or a certificate of Workers'Compensation Insurance,or a certified CIS, G6�Y ZIP C ,
copy thereof(Sec.3800,Lab.C.) - V LOCALITY
Policy No. Company SIZE bF LOT I NO.OF BLDGS.NOW ON LOT
ElCertified copy is hereby furnished. 2S 1 O I NEAREST CROSS ST �,l M�O /L O ��
C3Certified Copy is filed with the county building inspection TRACT BLOCK LOT NO.
department. 95 6 ' 692 � USE ZONE MAP NO. -1 2.
ASSESSOR MAP BOOK PAGE PARCEL r s°'
Date Applicant 2 SPECIAL CONDITIONS
CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER ' � � TEL.NOBS D7 YES NO
COMPENSATION INSURANCE WITHIN 1000 FT.OF SCHOOL?,
ADDR SS ^ �� IZ,
(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
I certify that in the performance of the work for which this permit (�
is issued, I Shall not employ any person in any manner SO as to ARCHITECT OR ENGINEER I TEL.NO.
become subject to the Workers'Compensation Laws. 01—WEIZ LAY 262^ 1STATISTICAL CLASSIFICATION APT CONDO
Date Applicant ADDRESS CLASS NO. -22/ DWELL UNITS
NOTICE TO,APPLICANT: If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXISI Exemption, 1 CONTRACTOR TEL.NO:
p you'ShOUId become subject t0 the Workers' 'SET BACK YARD HWY PROR'LINE WIDT
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
CITY LIC.CLASS SIDE 37;_i7
, ;I o u II
LICENSED CONTRACTORS DECLARATION PL o
I hereby affirm that I am licensed under provisions of Chapter 9 SEWER MAP T,; v
(commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORES _NO.OF FAMILIES - r
Professions Code,and my license is in full force and effect. �b t NEW ❑ BK PG O
.)-.E Vit» 12 .
ESCRI IN OF WORK ADD ❑
_ VALUATION
License Number Lic.Class �t�OPEL
arj/Q OOQ, D� 1_14t q_. 1 7:: �`N
Contractor Date t ALTER yam,,,i;_� =_
NAME 11t e_itl
ElI am exempt under Sec. � REPAIR
B.BP.C.for this reason
" DEMOL ❑ LDMA P/C# $Cl jI i j 1,ii_E It 11,
'f`?l
USE OF EXIST[ BLDG.
Date: 1J URM ❑ = _ _
Ignature APPLICANT PRINT) - TE .NO. LDMA Penn# Y1 1 �
Ll U,t.�J I;w p�.orj z ,t'E
as owner of the property, or my employees with wages as O _
their sole compensation,will do the work and the structure is ADDRESS �/��-�� �� t1 �D,c F #; x
not intended or offered for sale (Section 7044, Business and
IP Al• �/� �.�,��--ry7 f1� ., FINAL DATE -ny Q
Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL y'� / f'/ O s i I1
❑ I, as owner Of theproperty, am exclusively contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN
Y g THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BX p / " Q 4•.i? j
licensed contractors to construct the project.(Section 7044, \_/J �/j �- '°
VES❑ NO❑
Business and Professions Code.) 1"j;
WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING ''-•+1S-•=.l -" -
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❑
the performance of the Work for Which this permit Is issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD
3097,CIV.C.). PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES I I ?Si Q ''� I'•'- 2 '
�. COUNTY CODE,TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING
o Lender's Name HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. t s '
l(
Lender's Address OM On AGINT y tii'. _•_'
w
o 1 certify that I have read this application and state that the above PC.FEE / �� PERMIT FEE
information is correct. I agree to comply with all county /
ordinances and State laws relating to building construction,and
a. her y authorize representatives of this County to enter upon ISSUANCE FEE /3
above mentioned property for inspection purposes.
a -- 0 INVESTIGATION FEE TOTAL FEE / �J., �p
'p ure of APMI=t o.Age D.W
SEE REVERSE FOR EXPLANATORY LANGUAGE
r COUNTY OF LOS ANGELES' TEMPLE CITY # 0508 BUILDING PERMIT
- DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS COMMERCIAL ADD/ALT/REP
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1308280035
PHONE: (626) 285-0488 EXT:
LEGAL ID: 1 NO. OF CONST NEW BUILDING ADDRESS:
ITR: 6561 LT: 682 1 SQ. FT STORIES TYPE OCCUP GROUP 9510 LAS TUNAS DR
STRUCTURE: 200 1 V-B B 1 TEMP CA 917802104 I
(ASSESSOR INFORMATION NUMBER: 1 NEAREST CROSS STREET: CLOVERLY i
18587-012-017 1 I THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY CAI
(TENANT: (EXIST BLDG USE: COMME USE ZONE: C-1 JISSUED ON: PROCESSED BY: I
1 (EXIST OCC GRP: B 101/08/14 SR
(OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: 1FINA DA7E F NAL Y: CODE: 1
ITSOU SU CHIN HUANG (626) 451-0789- 1 25,000
19508 LAS TUNAS DRIVE
(TEMPLE CITY CA 91780 1 FEES PAID _SCRIPTIO OF WORK
FRONT FACADE IMPROVEMENT & MIN INTERIOR REMODELING I
1 IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 1
(APPLICANT: TEL. NO: I I
IFAN, DAPHNE (626) 928-7746- 1A1 PLANCHECK W/EN-HC 25000.00 VAL 458.00 1 -
12550 W MAIN ST #211 IAA BLDG PERMIT ISSUANCE 27.80 (SPECIAL CONDITIONS: I
JALHAMBRA CA 91801 IAB STATE GREEN BLDG FEE 25000.00 VAL 1.00 I
IAE STRONG MOTION OTHER 25000.00 VAL 5.30 1 I
1 1A2 PERMIT W/ENERGY-HC 25000.00 VAL 538.90 I I
(CONTRACTOR: TEL. NO: I TOTAL FEES 1,031.00 1APPROVALS DATE INSPECTOR SIGNATURE
IPETRA CONSTRUCTION,MANAGEMENT INC. (626) 233-8148- 1 1
12550 W. MAIN STREET STE 211 LIC. NO (LOCATION AND SETBACKS 1 I 1
1ALHAMBRA CA 91801 761300 1 I I
(SOILS ENGINEER APPROVAL I I
(ARCHITECT OR ENGINEER: TEL. NO: I (FOUNDATION/TRENCH FORMS 1 1
ILAM, GARY (213) 928-7746- 1 1_ 1 1
12550 W MAIN STREET #211 LIC. NO: (SLAB/UNDER FLOOR I
JALHAMBRA CA 91801 71544 1 1 I I
(RAISED FLOOR FRAMING 1 1 1
_ I
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:1 (UNDERFLOOR INSULATION 1
3 001 1 I
1FLOOR SHEATHING 1 1
INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I I
0 NO 22 1 (ROOF SHEATHING I
1 SCHOOL WITHIN HAZARDOUS 1 ISHEAR PANELS I
1AIR QUALITY: 1000 FEET MATERIALS I I - I
1 NO NO NO I (FRAME INSPECTION Vy
IFIRE SPRINKLER HANGERS 1 1 I
I I
11NSULATION/WEATHER STRIPI I 1
(INTERIOR LATH/DRYWALL I 1
1EXTERIOR LATH
1 1 IRATF.D FLOOR/CEIL ASSEM. I I
IRATED WALL ASSEMBLIES 1
I
(RATED SHAFTS/OPENINGS I
IT-BAR CEILINGS
1 1* ADDITIONAL DATA ON FILE 1- 1 1 1
ILOT DRAINAGE 1 1
I I I 1
I (REPORT ID: DPR261 ROUTE TO: BS0508
I I 1
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SIGN
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1406180027
PHONE: (626) 285-0488 EXT:
ILEGAL ID: INUMBER OF SIGNS: 1 I BUILDING ADDRESS: I
ITR: 6561 LT: 682 ISIGN DESCRIPTION: WALL SIGN ILLUMINATED CHANNEL LETTERSI 9510 LAS TUNAS DR !
TEMP CA 917802104 - 1
(ASSESSOR INFORMATION NUMBER: I 1 NEAREST CROSS STREET: CLOVERLY !
18587-012-017 ! THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY CAI
I I I— I
(TENANT: (EXIST BLDG USE: (ISSUED ON: PROCESSED BY: 1
(SHERATON (EXIST OCC GRP: 106/18/14 SR l
I I I I
(OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: (FINAL DATE FI BY: CODE:
(SHERATON (626) 451-0789- 1 1,800 !
19510 LAS TUNAS DRIVE I qlils"
I
ITEMPLE CITY CA 91780 FEES PAID OF WORK
I (WALL SIGN ILLUMINATED CHAN L LETTERS
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: (
(APPLICANT: TEL. NO: I I
ILUANG, THOMAS (626) 758-7252- IAA BLDG PERMIT ISSUANCE 27.80 1
15454 PENDOSA AVENUE IAB STATE GREEN BLDG FEE 1800.00 VAL 1-.00 ISPECIAL CONDITIONS:
ISAN GABRIEL CA 91776 IDI PLANCHECK W/O EN-HC 1800.00 VAL 82.10 !
I ID2 PERMIT W/O EN-HC 1800.00 VAL 82.20 I
1 1 TOTAL FEES 193.10 I
(CONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE 1
188 SIGN CORP. (626) 442-8033- 1 1--
11906
_11906 DOREEN AVE LIC. NO I ILOCATION AND SETBACKS I I
ISO EL MONTE, CA 91733 702474 * I 1-
I
I ! (SOILS ENGINEER APPROVAL
(ARCHITECT OR ENGINEER: TEL. NO: IFOUNDATION/TRENCH FORMS I I I
I LIC. NO:
ISUPPORT STRUCTURE I I I
! I I I I I
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( I I I
I ocl I I I
INO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: I !
1 NO 20 I I I
1 SCHOOL WITHIN HAZARDOUS I I I
(AIR QUALITY: 1000 FEET MATERIALS I I I
NO NO NO
I ! I I I I
I I I I I I
I I I I I I
I I I I I I
! 1* ADDITIONAL DATA ON FILE ,
I I I
I IREPORT ID: DPR261 ROUTE TO: BSO508 I I I