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76A638A CE4803 5-65 APPLICATION FOR BU ILDI P MIT -� -
COUNTY OF LOS ANGELES BUILDING / v
DEPARTMENT OF COUNTY ENGINEER ADDRESS (p
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
COLEMAN W JENKINS,SUP,T OF BUILDING CROSS ST
DIST J.0G UP YPE, P CE D'9 Y
FOR APPLICANT TO FILL IN e T ONST
BUILDING STATISTICAL ^VjSSI . ATION SEWER-.MAF?
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ADDRESS a, J CLASS NO ELL UNITS B '•P G-.' ^
LOT NO = OCK USE ZONE MAP
NO C/ _
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NO OF SLOGS CONDITIONS
SIZE OF LOT NOW ON LOT -
USE OF
EXISTING B RC1 BLDG SETBACK FROM -
^L� FRONT PROP LINE '•(STREET)
OWNER LL�� TYPE OF EXISTING SETBACK HIGHWAY _+ YARD. TOTAL
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,� A. w' HIGHWAY WIDTH 'FROM C L
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ARCHITECT OR - TEL- BLD SETBACK FROM
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ADDRESS A// HIGHWAY WIDTH FROM C L
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CONTRACTOR /,NO i - O
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DESCRIPTION OF WORK ,�;
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NEW ADD ALTER REPAIR DEMOLISH Z
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SIGNATURE OF f '
APPLICANT r t _
VALUATION$ DD
APPROVALS DATE INSPECTOR'SSIGNATURE
P C PMT !Y FOUNDATION, LOCATION _
FEE$ FEE • FORMS, MATERIALS -
FRAME, FIRE STOPS,
1 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
9UILDING 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 5 Cn MPE NSATIONINSURANCE LATH EXT -
SIGNATURE OF / HOUSE NUMBER COR- -
PERMITTEE RECT AND POSTED -
ADDRESS •,k �% � FI NAL �'�/�
JOHN F LEWIS PRINCIPAL ST RAL ENGINEER
PLAN-CHECK VALIDATION CK M 0 CASH _ PERMIT VALIDATION CK - M G CASH
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APPLICATION FOR BUIL&IVG'P T
` COUNTY OF LOS ANGELES BUILDIN
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DMSION LOCALI itrr
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN SUPT OF BUILDING CROSS —.•�.�.-
DISTRICT7. GROUPED mss BY
FOR APPLICANT TO FILL IN co r.
BUILDING STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS K PG
CLASS.NO DWELL UNITS
LOT NO Ell)fT 1 �H/ 0 L O r BLOCK WATER ' NOT REQUIRED RECEIVED
�1CERTIFICATE Er
TRACT 1 f'l 607 'w" MAP HIGHWAY
NO OF BL GS NO Q (CIRCLE) STATE MAJOR SECOND, LOCAL
SIZE OF LOT O O NOW ON LOT USE ZONE SPECIAL r
USE OF CONDITION JQ "
EXISTING BLDGN eI¢ -+Q Q ^�`^ f CLj (W '
OWNER ^49 /le'
/G /le' K V w141l o BUILDING EXIST
SETBACK YARD HWY STREET NAME WIDTH
ADDRESS 0 IrRONT
ARCHITECT OR '. TEL 'P L
ENGINEER NO SIDE
P L . >_
ADDRESS '/,J /
TEL �(' G�I ,f INSPECTION RECORD �, rr 0/
CONTRACTOR Jl. J 7 e NO H bv" ,1 ���/ (>
ADDRESS L'(Ac �� ,I 'T/glQf
DESCRIPTION OF WORK
NEW V ADD r"'ALTER, REPAIR DEMOLISH iq
y_ y
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IZE • d '� STORIES FAMILIES
USE OF•
STRUCTURE n t c -��y� �z'`Y.,t{''. .rrttli.v,
•'�i[�� eII 1 H/ W I T L -
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SIGNATUR _OF}�;a, / y-' •` " . -�^-
APPL'ICA '
VALUATION-4
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APPROVALS DA E INSPEC•T,OR'S,SIGNATURE
FPIC PMTEE $ FEE $ FOUNDATION LOCATION . : /A I/ -4
FORMS,MATERIALS1 (D .M I/ /'�
FRAME FIRE STOPS, .4 '
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS r
AND STATE THAT THE ABOVE IS CORRECT,AND AGREE TO'COMPL.YFURNACE LOCATION,
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS 'I( 'Af,q '
BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK • ,
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA, LATH,INT. _7�-..�1./
TION OF THE LABOR CODE OF THE ST E OF CALIFORNIA RELAT-
•ING'TO WORKMWSPENSAT11OURANCELATH,EXTSIGNATURE `� l HOUSE NUMBER COR- /'
PERMITTEE- RECT AND POSTED / 11
ADDREs �' /i - tfIrIr O FINAL •�
CLYDE N. DIRLAM, PRINCIPAL STRU URAL ENGINEER
PLAN CHECK VALIDATION aK M.D. CASH PERMIT VALIDATION aK M.O. CASH
( ( �3 .5 OCT 3 I. D 9 .0 0
r
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 0706200019
PHONE (626) 285-0488 EXT
LEGAL ID. NO OF CONST
� BUILDING ADDRESS:
ON FILE
SQ. FT STORIES TYPE , 9462 LEMON AV
ISTRUCTURE 24 VN TEMP CA 917801302
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET
15382-014-021 I THOMAS PAGE 596 GRID J1 LOCALITY TEMPLE CITY, Cl
TENANT- JEXIST BLDG USE RESID USE ZONE R-1 (ISSUED ON. PROCESSED BY. EXPIRES ON
(EXIST OCC GRP. 106/20/07 SR 06/14/08
OWNER TEL. NO IBLDGS. NOW ON LOT VALUATION FFgNAL DATEi;;� FIN Y: CODE- 1
IGRUNWALD FELIX (626) 447-5994- 1 4,000
19462 LEMON AV 1
ITEMP 917801302 I FEES PAID InEbtCRIPTION F WORK
I I IREPAIR STUCCO, INSTALL 24 -F 30 YR. SHINGLES ROOF INSTALL 1
I IFEE DESCRIPTION: QUANTITY UOM: AMOUNT IGUTTERS I
(APPLICANT TEL NO I I - I
CHRIS QUIROGA (626) 939-0133- IAA BLDG PERMIT ISSUANCE 27.75 I 1
11760 W CAMERON AVE IAC STRONG MOTION RESID 4000 00 VAL 0 50 ISPECIAL CONDITIONS: 1
IWEST COVINA 91790 ID2 PERMIT W/O EN-HC 4000 00 VAL 115 80 I I'
TOTAL FEES 144 05 1 I
(CONTRACTOR TEL NO- I (APPROVALS DATE INSPECTOR SIGNATURE
1
IKELLY CONSTRUCTION (626) 939-0133- I I 1
11760 W. CAMERON AVE #101 LIC NO I ILOCATION AND SETBACKS
IWEST COVINA, CA 91790 835093E II I 1
I I ISOILS ENGINEER APPROVAL 1 I I
(ARCHITECT OR ENGINEER- TEL. NO: I IFOUNDATION/TRENCH FORMS I I I
1 LIC NO 1 1SLAB/UNDER FLOOR 1
IRAISED FLOOR FRAMING 1 I I
IMAP NO SEWER MAP BOOK PAGE FIRE ZONE: CMP I (UNDERFLOOR INSULATION I I I
1153H265 3 011 1 11 I
I I IFLOOR SHEATHING 1 1 I
INV OF FAMILIES DWELLING UNITS APT/GOND STAT CLASS: I I I I
1 NO 21 I IROOF SHEATHING I 1
1 SCHOOL WITHIN HAZARDOUS I ISHEAR PANELS I I I
I I I
(AIR QUALITY 1000 FEET MATERIALS I I I I I
NO NO NO 1 IFRAME INSPECTION
I I I
IREQUIRED TOTAL SETBACK FROM EXIST I IFIRE SPRINKLER HANGERS I I I
ISET BACK YARD HWY PROP LINE WIDTH. 1 I I I I
IFRONT PL- I (INSULATION/WEATHER STRIPI I I
I SIDE PL- 1 1 1
I 11NTERIOR LATH/DRYWALL I I I
I I I I I
u I IEXTERIOR LATH I 1 I
1 I IRATED FLOOR/CEIL ASSEM I I 1
I I I
1 I IRATED WALL ASSEMBLIES 1 I 1
I I I
IRATED SHAFTS/OPENINGS I I I
I I I
1 I IT-BAR CEILINGS I 1 I
I I I
1 1 ILOT DRAINAGE I I 1
I I I
IREPORT ID DPR261 ROUTE TO: BS0508 I I I
I I I I I I