HomeMy Public PortalAbout5430 MCCULLOCH AVE_Building__ 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 1210040059
PHONE: (626) 285-0488 EXT:
LEGAL ID: I NO. OF CONST I BUILDING ADDRESS: 1
ITR: 31886 UN: 13 I SQ. FT STORIES TYPE [ 5430 MCCULLOCH AV I
I ISTRUCTURB: 7 V-B I TEMP CA 917803562 I
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET:
18573-014-038 [ [ THOMAS PAGE: 597 GRID: D3 LOCALITY: TEMPLE CITY, Cl
I 1
ITT: (EXIST BLDG USE: RESID USE ZONE: R-2 ISSUED ON: PROCESSED BY: I
1 (EXIST OCC GRP: 110/04/12 SR
TOWNER: TEL. NO: - 1BLDGS. NOW ON LOT: VALUATION: [FINAL DATE FI BY: CODE: 1
GARDEN VIEW HOA [ 2,900 ICD
FEES PAID [D SCRIPTION OF WORK II
(INSTALL 30 # FELT OVER EXISTING SHINGLES INSTALL GAF 30 YR [
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:ISHINGLES
(APPLICANT: TEL. NO:
IJIM RODGERS (626) 355-4585- IAA BLDG PERMIT ISSUANCE 27.80 I
15750 SAPPHIRE ST: JAB STATE GREEN BLDG FEE 2900.00 VAL 1.00 ISPECIAL CONDITIONS:
(ALTA LOMA CA 91701 JAC STRONG MOTION RESID 2900.00 VAL 0.50 [
1 ID2 PERMIT W/0 EN-HC 2900.00 VAL 99.00 1 1
TOTAL FEES 128.30 [ [
(CONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE
IRODGERS ROOFING (909) 732-3293- 1 1 I
15750 SAPPHIRE STREET LIC. NO I ILOCATION AND SETBACKS
I I
(ALTA LOMA, CA 91701 620156 C39
II ISOILS ENGINEER APPROVAL I I 1
1ARCHITECT OR ENGINEER: TEL. NO: IFOUNDATION/TRENCH FORMS I I
I _ 1
I I-
1 LIC. NO: 1 [SLAJR/UNDER FLOOR I I
I I [RAISED FLOOR FRAMING
I I I I
[1MAPHNO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:l 1UNDERFLOOR INSULATION I I I
277 3 001 1
I I IFLOOR SHEATHING [ 1
INO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: I I 1
1 0 NO 21 [ [ROOF SHEATHING I I
I SCHOOL WITHIN HAZARDOUS [ ISHEAR PANELS
(AIR QUALITY: 1000 FEET MATERIALS
I NO NO NO [ IFRAME INSPECTION I I I
1 I
IFIRE SPRINKLER HANGERS I
I
I 1 [INSULATION/WEATHER STRIP( I I
[ 1 [INTERIOR LATH/DRYWALL [ [ 1
[ 1 [EXTERIOR LATH [
I
[ 1 1RATED FLOOR/CELL A338M. 1 I
[ 1 IRATED WALL ASSEMBLIES
1 1 1RATED SHAFTS/OPENINGS 1
I I
[ 1 [T-BAR CEILINGS [ [ 1
1 1 ILOT DRAINAGE I I 1
I
1 IREPORT ID: DPR261 ROUTE TD: BS0508 I
I I I 1 I
s3oAPPLICATION FOR BUILDING PERMIT
FOR AFfPLICANT TO FILL IN (Print or type only)
BUILDING -� •r. N OUNTY OF LOS ANGELES
ADDRESCyj, �ARTMENT OF COUNTY ENGINEER
CITY % ZIP BUILDING AND SAFETY DIVISIO
NO.OF BLOGS, BUILDING BULL
SIZE OF LOT ` NOW ON LOT ADDRESS
Zj
TRACT BLOCK LOT NO. LOCALITY L� 'd L L
TE NEAREST
OWNER / j59PVjre—(10NOL 7 CROSS ST. L
ASSESSOR
ADDRESS , a MAP BOOK PAGE PARCEL
DISTRICT GROUP TYPE FIRE7SSE
D BY
7.
CITY ZIP ``'' pCONST, Zp
ARCHITEC TELu / s,/OS
ENGINEER G NO,�
STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS a CLASS NO.-O-0—DWELL.UNITS BK G
GONTRACTOQ JO T L USE ZONE MAP o 6—d
k/ /Jl� r, NOSPE. !!
ADDRESS w , p(y' NO CON DIT ONS
CITY dCIAL
� � J,/6 .7 LIC.
C / V CLAS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑
CONSTRUCTION LEND
NAME AND BRANCH J lei? BLDG.SETBACK FROM
FRONT PROP.LINE OF (STREET)
ADDRESS CITY HIGHWAYF YARD TOTAL SETBACK FROM TYPE OF EXISTING C
SQ. FT NO. OF NO. OF CHECK FRONT PROP. LINE HIGHWAY WIDTH
SIZE %" STORIES FAMILIES ONE /� / D
t NEW + [C? O
DESCRIPTION OF WORK
3 TI� ADD ❑ BLDG. M
0 SI LINEOF p
T SIDE PROP.LINE OF (STREET) co
tv ALTER ❑ HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING
�rr REPAIR❑
SIDE PROP:. LINE HIGHWAY WIDTH
USE OF
EXISTING BLDG..S/n I� x,11 I DEMOL ❑ +
�� l n CORNER CUTOFF YES ❑ NO
P ❑
AP(PRI NT) L NOL Ort
BY (SIGNATOR ' IN OPEN SPACE YES ❑ NO ❑
QfL6/ IN COASTAL ZONE YES ❑ NO ❑
VALUATION$ v CATEGORICAL EXEMPTION YES❑ NO ❑
I HEREBY ACKNO EDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE)
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE)
HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
LABOR CODE OF THE STATE C IN ING TO
WORKMEN'S COMPENSATI
SIGNATURE O
PERMITTEE
ADDRESS
TE FINAL BY
CITY NOL.
DATE ��/ /��
MAKEC.HEC KS PAYABLE 7'O: P.C. � r PMT.$
HARVEY T. BRANDT, COUNTY ENGINEER FEE FEE
PLAN CHECK VALIDATION CK. M.O. CASH PERMI ALIDATION CK. M.O. CASH
8 7 8=!T;tg 27 2 3 D' 8 1.9 0 B.
7GA638A CE#803 12/72 �-! .�� 8 9 8 1i't-MAY 9 1 0 1 3 6.5 0 ,&5-6