HomeMy Public PortalAbout5203 MCCLINTOCK AVE_Building__ APPLICATION FOR COUNTY OF LOS ANGELES
OF COUNTY
B U I L D I N G PERMIT DEPARTMENT BUILDING AND SAFETY DIVISION ENGINEER
BUILDING -
FOR APPLICANT TO FILL IN ADDRESS -
BUILDING _
ADDRESS LOCALITY r
�� NEAREST
CITY ZIP CROSS ST.
NO.OF BLDGS. ASSESSOR
SIZE OF LOT Lh12_<%1pL,,1N0W ON LOT MAP BOOK PAGE PARCEL
� DISTRICT GROUP TYPE FIRE SSED BY
TRACT1:3 SVIBLOCK LOT NO. CONST. ZONE
ELpp ��
OWNER J NO. `i STATISTICAL CLASSIFICATION
�// WER AP
ADDRESS O v �(' CLASS NO.P�DWELL.UNITS
US ZONE
CITY - I - l ZIP 90930 � NO.MAP
ARCHITECT OR TEL. v SPECIALB /1
ENGINEER NO. CONDITIO
ADDRESS ROAD'DEPARTMENT APPROVAL REQUIRED 'YES[] *NO❑
CONTRACTOR TEL. BLDG.SETBACK FROM
NO FRONT PROP.LINE OF (STREET)
LIC.
ADDRESS NO. HIGHWAY + YARD TOTAL SETBACK FROM HIGHWAY EXISTING
LIC. FRONT PROP. LINE
CITY CLASS _
CONSTRUCTION LENDER(n
a
NAME AND BRANCH BLDG.SETBACK FROM
ADDRESS CITY
SIDE PROP.LINE OF (STREET) CC7
SQ. FT NO. OF NO. OF CHECK HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING C
SIZE t)� STORIES FAMILIES ONE SIDE PROP. LINE HIGHWAY WIDTH
_ V
DESCRIPTION OF WORK rNEW ❑ + �'
• ��� F � 1511-11 ADD ❑ CORNER CUTOFF YES ❑ NO ❑ Z
i"tALTER
TDEMOLEPAIREIIN OPEN SPACE YES ❑ NOEXISTING BLDG.USE OF IN COASTAL PERMIT ZONE YES ❑ NOi �b CLL
AP PRICANL .' !i7 /VC:f i C ✓f!' �!� ��L.� LuYraJ�- s�
s Ysuo 4
BY (SIGNATURE)
I HEREBY ACKNOWLEDGE THAT 1 HAVE RE T IS PPLICAT ION
AND STATE THAT THE ABOVE IS CORRECT A D AG TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY IWILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
LABOR CODE OF THE ST TE OF CALIFORNIA IN REL TING TO
WORKMEN'S COMPENSATI INSURANCE.
SIGNATURE OF FINAL //� // BY
PERMITTEE M f/ DATE ot>__
ADDRESS ���� ✓� ✓ 1
^ TEL• P.C.Fee$ Permit Fee 4_57CITY` NO.
Q Issuance Fee
VALUATION$ l
r � �v Total Fee 115-
PLAN CHECK VALIDATION cK. M.o. CASH PERMIT VALIDATI CK. • M.O. CASH
7 ti MAY- 31 1 -15.0 0 sy8
76A638A CIROB03B 12/75 ^ /JTZ c? M
APPLICATION FOR, COUNTY OF LOS ANGELES
OF COUNTY
' BUILDING PERMIT DEPARTMENT BUILDING AND SAFETY DIVISIONENGINEER.
BUILDING
FOR APPLICANT TO FILL IN ADDRESS �j�� Me
BUILDING /�
ADDRESS,5 CJ. U LOCALITY
.-� NEAREST
CITY Ie✓h /� �(. ZIP CROSS ST.
' AO.OF BLDGS. ASSESSOR
SIZE OF LOTS , s NOW ON LOT MAP BOOK PAGE PARCEL
•
DISTRICT I GROUP TYPE FIRE LfiNROOFESSED BY
Gv CONST. ZONE
1
TRACT BLOCK LOT NO.
OWNER JkS _ NOTEL��nnff. `7"1 STATISTICAL CLASSIFICATION
OEWER MA
ADDRESS C� _ CLASS NO. '&
CITY e_ Ie, 0-1-Mf ZIP j Q /J�) NE NOP5 ,1
ARCHITECT OR NOL' �ro
ENGINEER CONDITIONS
ADDRESS ROAD DEPARTMENT APPROVAL REQUIREC` YES[-] NO❑
CONTRACTOR TEL. BLDG.SETBACK FROM
NO FRONT PROP.LINE OF (STREET)
LIC.
ADDRESS NO. HIGHWAY + YARD _ TOTAL SETBACK FROM TYPE OF EXISTING
LIC. FRONT.PROP. LINE HIG WAY WIDTH
CITY CLASS _
CONSTRUCTION LENDER +
C L ' �l
NAME AND BRANCH BLDG.SETBACK FROM c
ADDRESS � ' CITY
SIDE PROP.LINE OF (STREET) G.
SQ• FT NO. OF NO: OF CHECK HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING C
SIZ STORIES ! FAMILIES ! ONE SIDE PROP. LINE HIGHWAY WIDTH
DESCR PTION OF WOR NEW ❑ +
ADD ❑ CORNER CUTOFF YES ❑ NO ❑
ALTER ❑
IN OPEN SPACE YES ❑ NO ❑
EPAIR❑
USE OF IN COASTAL PERMIT ZONE YES ❑ NO ❑
EXISTING BLDG. DEMOL ❑
APPLICAN,T�� ` YTI
�,` ,y
(PRINT) .f LUPI �{
BY (SIGNATURE)
I HEREBY ACKNOWLEDGE THAT 1 HAVE EAD I APP CATION
AND STATE THAT THE ABOVE IS,CORRECT AND G EE T COMPLY
WITH ALL ORDINANCES AND LAWS REGULA NG BUILDING CON-
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT EM
PLOY•ANY TERSOHI IN'VIOI:A' ION"OR;TXE -r
LABOR CODE OF THE STAT OF CALIFORNIA- IN EL'ATI
WORKMEN'S COMPENSAT N URANCE. • • •• I • r^Jf,r
SIGNATURE OF
' 'FINAL � � BYi '(� -
PERMITTEE DATE
ADDRESS
r•E-L,: P.C.Fee$ -.2 3. Permit Fee
CITY NO..
i Issuance Fee
VALUATION$
gi D•O Total Fee
PLAN CHECK VALID •CK
ATION. .•. . ._M.o... CASHp PERMIT VALIDATIO1yN <!!:K:2� M.O. CASH
7 0 8-"SAY• 31 2 3 A. ._ - 3.8.0 L7�0 @i.. pi r
.. '� .+ • • v JJ
76ASSBA CE#8098 12/75 6 9 61JUL 20 1 B 1 23.C) 0 A56
WORKERS' COMPEf;:SATION DECLARATION
'*%I I hereby affirm that I have'' h;artificate of consent to self
insure .or a certificate of Wor "rs' Compensation Insurance, APPLICATION FOR B U I L D I N G PERMIT
or a••1'drti'fied copy thereof (Sec. 3800, Lab. C.)
� COUNTY OF LOS ANGELES BUILDING AND SAFETY
Ido. Company `
y Certi?ied copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING �.
ADDRESS Z S me C1►N CC
❑ Certified copy is filed with the county building inspec- BUILDING �,I `
tion department. ADDRESS Zd� '` cC111, {) f'" le Ck CA- � ( W
Date Applicant QTY a VVI f C . C,t ZIP, J 17 ig LOCALITY
NO. OF BLDGS. NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST. C e✓' .
COMPENSATION INSURANCE �+ 7 G
(This section need not be completed if the permit is for one TRACT V y BLOCK LOT NO. /, ASSESSOR
BOO %574 7 PAGE 004 tPARCEL007
hundred dollars ($100)or less.) TEL.
OWNER RIJ et Z,V1Ah a No. I?-S5 "J6Sq USE ZONE OP
I certify that in the performance of the work for which this /r ` SPECIAL >:-
permit is issued, I shall not employ any person in any manner ADDRESS 512-03 Mcc1lq 0CA CONDITIONS a
so as to become subject to the Workers'Comeensation Laws. ii / (► 7p/7 OO
� QTY ?vn IY C. ZIP 7( /6 V
DateJ_.24_�) Applicant - C vjwoy ARCHITECT OR TEL.
NOTICE TO APPLICANT: If, after making this Certifi ate of ENGINEER NO DISTRICT GROUP TYPE FIRE PROCESSED BY O�•-
Exemption, you should become subject to the Workers' [Y
CONST. Z E V
Compensation provisions of the Labor Code, you must forth- ADDRESS �99 d /_"� 13-
with comply with such provisions or this permit shall beTELin
deemed revoked. ' CONTRACTOR EVh e Cvv►g�, NO F-;57-4 97 STATISTICAL CLASSIFICATION APT. CONDO. Z
LICENSED CONTRACTORS DECLARATION P LIC. CLASS NO,—/-'V— DWELL. UNITS f�
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 2-90 I6+ 1--LV"Q NO. 75 3 6 3
( LIC. �} SEWER MAP
(commencing with Section y license.
of Division 3 of the Business CITY V�U 1 rov*lit C&I , CLASS 1?� VALIDATION
and.Professions Code,and my license.is in full force and effect. 7
BK. PG
License Number '595;6r 3 Lic. 'Class �' SIE�Sg/ STORIOES ( FAMILLIIES ONE
K
► . (� 7 NEW VALUATION �O
C W1�Y' . 1" W ►j DESCRIPTION OF WORK tM( S/ / a
Contractor � CG'1S. -'Date $ �d O �� ►
96.0VA 16�D-9r�
ADD ❑
Tam exempt under Sec. � � c c,-J'
��J'A �" ALTER ❑
BAP.C. for this reason 0 �!ti ee3 `` REPAIR 1:1 $
Date: USE OI F. BLDG. �l
DEMOL 1:1
Signature APPLICANT . �L• FINAL. +
O NER-BUILDE CLARATION
(PRINT) Vit
�12t/' NO. -3� 6 DATE
I hereby affirm that I am exempt from the Contractor's License '
Law for'the following reason'(Section 7031.5, Business and ADDRESS O �,- I-Vne. WO'.')VVIAL C., FIVI(, FINAL -
Professions Code): PRESENT By
BUILDING 'j`
❑ 1, as owner of the property, or my employees withADDRESS - ?;Ez
wages as their sole compensation,will do the work and C•jl�i ' 'the structure is not intended or offered for sale(Section LOCALITY
7044, Business and Professions Code.) MOVING TEL. , 3 1 it:'E
❑ 1,as owner of the property,am exclusively contracting CONTRACTOR NO. TOTAL
I_I 1 N� ,=s = -
with licensed contractors to construct'the project (Sec- .� _
tion 7044, Business and Professions Code.) ADDRESS =. ti i n
REQUIRED TOTAL SETBACK FROM EXIST. i t
CONSTRUCTION LENDING AGENCY SETBACK YARD HWY PROP. LINE WIDTH ( I;t� t I_(
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 t
P.L. r-.�:
Lender's Name (.l(_h ICI-'I�LIti-1
- /� �1,Li LDMA Ref.# v k rr 1 s
P.C. Fee$ Permit Fee or T� vti . 1
Lender's Address
Pr
i I certify that I have read this application and state that the Issuance Fee A LDMA P/C# ,
' above information is correct. I agree to comply with all County Investigation Fee
ordinances and State laws relating to building construction, Total Fee / LDMA Perm. #
and hereby authorize representatives of this County to enter
upon thp ab ve- entioned property for inspection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
I . f Signature of rnt or Agent .Date
WORKERS' COMPENSATION DECLARATION
I affirm that I have certificate of consent to self APPLICATION FOR BUILDING P E RM I T
insure,
o or a certificate of Workers! Compensation Insurance,
or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. Company
❑ Certified co is hereby furnished. FOR APPLICANT TO FILL IN BUILDING ( LL
PY Y //'� ADDRESS ii 7 [d
❑ Certified copy is filed with the county building inspec- ADDRESS (j17 C Cr �h dG F.-
tion
l C
tion department. D r CcT� a• / LAD
Date ' Applicant CITY � VA Cts ZIP f, D LOCALITY
NO.OF BLDGS. NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST. Pit im r_V-
COMPENSATION INSURANCE ASSESSOR
(This section need not be completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL
hundred dollars ($100)or less.) jj TEL,
OWNER Id Gc t_V'm4A $.2_ NO. '350''65 USE ZONE MAP
1 certify that in the performance of the work for which this i NO.
permit is issued, I shall not employ any person in any manner I ADDRESS 5w,•, VIC Ic h TW \ CON SPECIAL
>6-
so
so as to become subject to the Workers'Compensation Laws. �•- j �y t� 0
Ll-Z1 j .{� �G�LI I CITY 1 zip 8�7Q
Date ! Applicant 6Gi' 11 ARCHITECT OR TEL. 0
—� DISTRICT GROUP TYPE FIRE PROCESSED BY O
NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. CONST. Z E V
Exemption, you should become subject to the Workers' i w
Compensation provisions of the Labor Code, you must forth- ADDRESS 'D� ✓ a
with comply with such provisions or this permit shall be TEL• STATISTICAL CLASSIFIC TION APT. CONDO. N
deemed revoked. CONTRACTOR 1:"^--VV ,A . NO. 1I -7i%066
Z
LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. `.;z DWELL. UNITS-0
I hereby affirm that I am licensed under provisions of Chapter 9 I ADDRESS VtO Q It/'Linn G NO. 5
(commencing with Section 7000)of Division 3 of the BusinessLIC. SEWER MAP
and Professions Code,and my license is in full force and effect. CITY V4[r%,V f►d► C a. CLASS BK PG VALIDATION
Lir. Classy
SQ.
FT STORIES FAMILLIIES ONE
License Number � CHECK
i VALUATION
Contractor � Date Lt-3 D•��j DESCRIPTION OF WORK e`�/�ITJ 0.V'ctNEW ❑ s
ADD ❑ ►
I am exempt under Sec. I
[:-,4) � I ALTER EJB.BP.C. for this reason O -A a 0 c Z §
REPAIR ❑
Date: USE OF
�l EXISTING BLDG. rC DEMOL
Signature I APPLICANT +� TEL. FINAL
(PRINT) o!! 'N'!2 N0.7SLY-3� -alb DATE
NER-BUILDER D LARATION � i
I hereby affirm that I g r exempt-from the Contractor's License e
Law for the following reason (Section 7031.5, Business and ADDRESS FINAL
Professions Code): PRESENT B
❑ I, as owner of the property, or m employees with BUILDING y fr;:1 .7
P P Y� YADDRESS
wages as their sole compensation,will do the work and ADDRET
the structure is not intended or offered for sale(Section
7044, Business and Professions Code.) MOVING TEL. i ;-ti 115 -
.r
❑ I,as owner of the property,am exclusively contracting '
CONTRACTOR NO. I .L(�•t i
with licensed contractors to construct the project (Sec- TOTAL 1 A a� a 00
tion 7044, Business and Professions Code.) ADDRESS -_
i REQUIRED TOTAL SETBACK FROM EXIST. CHECKi�,j,11_I
CONSTRUCTION LENDING AGENCY i SET BACK YARD HWY PROP. LINE WIDTH
I hereby affirm that there is a construction lending agency for I FRONT . �;;
the performance of the work for which this permit is issued I P.L.
(Sec. 3097, Civ. C.). SIDE
P.L.
Lender's Name GGCl0-i-1€I' {,j a `i 1_
$ �B� LDMA Ref. # -- .i_J�. z. +1.��
Lender's Address P.C. Fee$ Permit Fee ' • AIM V-11 L.
0 1 certify that I have read this application and state that the Issuance Fee �' B-U LDMA P/C#
above information is correct. I agree to comply with all County Investigation Fee p �/
ordinances and State laws relating to building construction, Total Fee O o r� LDMA Perm. #
and heleby authorize representatives of this County to enter
upon tfie a ve- entioned property for inspection purposes. j
1 V -.9) SEE REVERSE FOR EXPLANATORY LANGUAGE
47 Sign tura of Appl' I or Agent Date I
WORKERS'COMPENSATION DECLARATION
hereby affirm that I have d'gcertificate of consent to self APPLICATION FOR BUILDING PERMIT.
insure, or ertificate of Workers' Compensation Insurance,
or'o certified copK thereof(Sec. 3800, Lab. G.) COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. Company
❑ Certified co is hereby furnished. FOR APPLICANT TO FILL IN BUILDING 523 ��
PY Y ADDRESS t' ac k
❑ Certified copy is filed with the'county building inspec- BUILDING
tion department. ADDRESS g- W e- I Vl d C \ 7e--n ,- t} Calif., 1/
CITY e. - C1 ZIP 1770 LOCALITYDate Applicant
NO. OF BLDGS.
CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT S6 3tt'X 165 I NEAREST
NOW ON LOT
CROSS ST.
COMPENSATION INSURANCE d`Qti'11'
SSESSOR — -
(This section need not be completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK PAGE ��� PAR62L/0 1
hundred dollars ($100)or less.) TEL.
OWNER1ftqt gvic 6mas NO. USE ZONE MAP
I certify that in the performance of-the work for which this NO. 14171-1 '277 j
permit is issued,"l.shall not employ any person in any manner ADDRESS C Jlv OC A/ I SPECIAL
CONDITIONS d -
so as to become subject to the Workers'Compensation Laws. n,1�Q O
/�- 4 -91 n /� CITY w Q ' 1 ZIP r UU
Date t7 Applicant rm e 1-0�5 ARCHITECT OR TEL. 0
NOTICE TO APPLICANT:- If, after making-this Certificate of ENGINEER NO. >a� DISTRICT GROUP TYPE FIRE PROCESSED BY O
CONST. ZONE
Exemption, you should become subject, to the Workers' 15
Compensation provisions of the Labor Code, you must forth- ADDRESS ��� 0// V EL
with comply with such:provisions or this permit shall be - TEL. STATISTICAL CLASSIFICATION APT. CONDO. N
deemed revoked. CONTRACTOR MCW Cdv►5 NOS -359-%67 Z
LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS
I hereby.affirm that I am licensed under provisions of Chapter 9 ADDRESS 240 LlI ne# 13 NO. 5 5 363
/+ LIC. SEWER MAP
(commencing with Section 7000)of Division 3 of the Business CITY�OV�1rbUl�1 I..GL. CLASS $
and Professions Code,and my license is in full force and effect.' �7 BK. PG VALIDATION
License Number' 595363 Lic..Class s ZEA 93 STORIES FAMILIES ONE
K
�e VALUATION
Emery cVli . Date 6'-4-71 DESCRIPTION F WORK NEW ❑ $ �yQ+C per.
Contractor er pp p y rpt 7 J
I-am exempt under Sec. I)f.Y7�+1 f ton- BFl 41 �O�w1 9 ADD WI ►
ALTER ❑
B.BP.C.-for this reason NO Enr� S t C h4 Cv\lwq. REPAIR ❑ $
//.•
Date`-G-4-71_ USE OF EXISTING BLDG. DEM
OL ❑
SignatureSAMI11yLL APPLICANT TEL.(PRINT). FINAL
"ER-BUILDER DECLARATION DATE NO DATE
I hereby affirm that I am exempt from the Contractor's License
Law for the following reason (Section 7031.5, Business and ADDRESS FINAL
1
Professions Code): PRESENT
❑ BY.
BUILDINGI, as owner of the property, or my employees with `t•t.,sI,
�a
ADDRESS
wages as their sole compensation,will do the work and LOCALITY u•!t
,Gj. al�r � ;3 l-
the structure is not intended or offered for sale(Section i'(i
7044, Business and Professions Code.) MOVING TEL., ; =�1-
❑ I, as owner of the property,am exclusively contracting CONTRACTOR NO. s-I E
with licensed contractors to construct the project Sec-
-1.-1 t �'
P I ( ADDRESS
1.-1 s AIL 4FE-13 m 90'
tion 7044;Business and Professions Code.)
REQUIRED YARD HWY TOTAL SETBACK FROM EXIST. ,,.HECK
CONSTRUCTION LENDING AGENCY SET BACK PROP. LINE WIDTH
I hereby affirm that there is a construction lending agency for FRONT CiE
the performance of the work for which this permit is issued P.L.
(Sec. 3097, Civ. C.). : SIDE
P.L.
Lender's Name tl I E'-I'I';' `�
�70 �� LDMA Ref. #
P.C. Fee$ Permit Fee `3 f;�: ._
Lender's Address , r,t ,? I=ii?s'u= _i
I certify that I have read-this application and state that the Issuance Fee ' 4-P LDMA P/C#
above information is-correct. I agree to comply with all County Investigation Fee . g` ��
ordinances and State laws relating to building construction, Total Fee ✓ LDMA Perm. #
and hereby authorize representatives of this County to enter
upon the above-mentioned property for inspection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
iSignature of Applicant or Agent Date 7 �.
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 1102280032
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I NO. OF CONST I BUILDING ADDRESS:
ITR: 13384 IT: 22 SQ. FT STORIES TYPE I 5203 MCCLINTOCK AV 1
ISTRUCTURE: 33 V-B I TEMP CA 917803559 I
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: I
18574-004-007 1 1 THOMAS PAGE: 597 GRID: D4 LOCALITY: TEMPLE CITY, Cl
1TENANT: (EXIST BLDG USE: RESID USE ZONE: R-1 (ISSUED ON: PROCESSED BY: 1
IEX ST OCC GRP: 102/28/11 SR
(OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: IFINAL DATE FIN BY: CODE: 1
ITEHAMAN, BLANCA - J 8,410 �
15203 MCCLINTOCK AV 1 I
ITEMP 917803559 I FEES PAID I SCRIPT=ON OF WORK 1
1 I IREMOVE OLD ROOF INSTALL CLASS "A" G.A.F/ELK COMPOSITION
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:ISHINGLES
(APPLICANT: TEL. NO: I I I
ISKYLINE ROOFING - JAA BLDG PERMIT ISSUANCE 27.80 1 J
1129 HIGHLAND PL JAB STATE GREEN BLDG FEE 8410.00 VAL 1.00 ISPECIAL CONDITIONS: J
IMONROVIA, CA 91016 JAC STRONG MOTION RESID 8410.00 VAL 0.80
I ID2 PERMIT W/O EN-HC 8410.00 VAL 200.30 J
I I TOTAL FEES 229.90 I- J
ICONTRACTOR: TEL. NO: I IAPPROVA;S • DATE INSPECTOR SIGNATURE J
ISKYLINE ROOFING (626) 303-2301- I 1 I
1129 N HIGHLAND PL LIC. NO I ILOCATION AND SETBACKS I I
IMONROVIA CA 91016 B * I 1
ISOILS ENGINEER APPROVAL I I I
I I I I I I
JARCHITECT OR ENGINEER: TEL. NO: IFOUNDATION/TRENCH FORMS I I I
LIC. NO: I JSLAB/UNDER FLOOR I I I
1 IRAISED FLOOR FRAMING I I
I I I I I
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:J JUNDERFLOOR INSULATION I I I
147H277 3 001 1 I I I
I FLOOR SHEATHING I I I
INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I I I I
NO 21 J JROOF SHEATHING I I
J SCHOOL WITHIN HAZARDOUS J ISHEAR PANELS I I
JAIR QUALITY: 1000 FEET MATERIALS I I I I
J NO NO NO I JFRAME INSPECTION I I I
I IFIRE SPRINKLER HANGERS I I I
I JINSULATION/WEATHER STRIPI I I
I I I I I I
I JINTERIOR LATH/DRYWALL
I I I
I I JEXTERIOR LATH I I I
I I I
I IRATED FLOOR/CEIL ASSEM. 1
I IRATED WALL ASSEMBLIES I I I
I IRATED SHAFTS/OPENINGS 1 I I
I 1T-BAR CEILINGS 1 1 I
I J* ADDITIONAL DATA ON FILE 1
(LOT DRAINAGE I 1
I IREPORT ID: DPR261 ROUTE TO: BS0508 J I I
I I I I I I