HomeMy Public PortalAbout6103 MUSCATEL AVE_Building__ I ,
WORKERS' COMPENSATION DECLARATION
MI hereby affirrrf that'I hava3 fi certificate of consent to Self P I'LL I CAT I®N FORBUILDING PERMIT
ins.'�re, or a certificate of Workers' Compensation Insurance,
or a"Fertified copy thereof(Sec. 380, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. Company
ElCertified copy is hereby furnished. N' FOR APPLICANT TO FILL IN ADDRESS 6103 /
❑ Certified copy is filed with the county building inspec- BUILDING �il
tion department. ADDRESS . 0 �.{q�1—C
CITY ZIP S
Date Applicant LOCALITY P �
NO.OF BLD NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' "SIZE OF LOT '® NOW ON LOT CROSS ST. r,
COMPENSATION INSURANCE ASSESSOR
(This section need not be completed if the permit is for one •TRACT 4nas BLOCK LOT NO. MAP BOOK PAGE PARCEL
hundred dollars ($100)or less.) TEL,
OWNER NO. ONE MAP �� I
I certify that in the performance of the.work for which this NO.
permit is issued, I shall not employ any pe n' any manner ADDRESS CONDITIONSCL
so as to b ome bject to the Workers' WS. O
Zf an
CIN ZIP a
Date Applicant ARCHITECT OR TEL. STRICT GROUP TYPE FIRE PROCESSED BY O
NOTICE TO APPLICANT: If, after ma ing this Certificate of ENGINEER NO. CONST. U ZONE
Exemption, you should become subject to the Workers' ,
Compensation provisions of the Labor Code, you must forth- ADDRESS 9� W
o_
with comply with such provisions or this permit shall be CONTRACTOR,--____'"
ONTRALTO NO. STATISTICAL CLASSIFICATION APT. CONDO, v7
deemed revoked. z
LICENSED CONTRACTORS DECLARATION LIC. CLASS N . DWELL. UNITS
-
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 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.a.,(l PG. O� VALIDATION
SQ. FT. NO. OF NO.OF CHECK
License Number Lic. Class SIZE STORIES FAMILIES ONE
vawaTIor�
Contractor Date � DESCRIPTION OF WORK I NEW ❑ $
ADD
El am exempt under Sec. AJ%649 Oman,— 7-roti"t
ALTER ❑
pool
B.BP.C. for this reason REPAIR ❑ $
Date: USE OF
EXISTING BLDG. DEMOL ❑
Signature APP(P AN TEL.
NT) NO. FINAL
OWNER-BUILDER DECLARATION DATE l�V�
I hereby affirm that I am exempt from the Contractor's License
Law for th following reason (Section 7031.5, Business and ADDRESS FINA C
Profe s Code): PRESENT sy, tT°4
UROP BUILDING
I, as owner of the property, or my employees with ADDRESS
wages as their sole compensation,will do the work and
the structure is not intended or offered for sale(Section LOCALITY , 3307 37°,xr
7044, Business and Professions Code.) MOVING TEL.
❑ I,as owner of the property,am exclusively contracting CONTRACTOR NO. 1 ITEt'w
with licensed contractors to construct the project (Sec- ADDRESS TOTAL 87.38
tion 7044, Business and Professions Code.)
CONSTRUCTION LENDING AGENCY 1 SETT BACK YARD HWY TOTAPROPAINEFROM WIDTH CHANGE
$7°38
I hereby affirm that there is a construction lending agency for FRONT 4iT?fJYGE 0[1
the performance of the work for which this permit is issued I P.L. °
(Sec. 3097, Civ. C.). I SIDE
Lenders Name P.L. 0000-1001 7/28/89
i P.C. Fee$ Permit Fee `p , LDMA Ref.q °
Lender's Address , 1
1 certify that I have read this application and state that the " I Issuance Fee LDMA P/C#
above information is correct.I agree to comply with all County Investigation Fee
ordinances and State I to building construction, Total Fee 3 LDMA Perm. #
and hereby authoriz resentativ sof this County to enter
upon the abov 1 propert for inspection rpos
ie SEE REVERSE FOR EXPLANATORY LANGUAGE
JW
Signature dVApplicant or Agent
Dal
WORKERS'COMPENSATION DECLARATION l \�
Y Nereby affirm that I have a certificate of consent to sllf
OR , GMIT'
insure, or a certificate of Workers'Compensation Insurance, APPLICATION FN
or a certified copy thereof(Sec. 3800, Lab. C.) i
COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. Company . . --- P 6
I BUILDING
Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS r
Certified copy'is filed with the county building ihspec- BUILDING / �l / �) C/� .�
tion department. ADDRESS E� nO^ !/�V-%! V-V`!�� � CL f 1
Date Applicant CITY / 1 /E ZIP / LOCALITY NIJ.
CERTIFICATE OF EXEMPTION FROM WORKERS' V NOW ON LOT NEARESST.
COMPENSATION INSURANCE • - SIZE OF LOT DCROSS-
(This section need•not be completed if the permit is for one ASSESSOR "
hundred dollars($100)or less.) TRACT )� cBLLOCK LOT NO. MAP
MAP BOOK PAGE PARCEL
OWNER J/1 ko' rA-i7 C� / NO. /9 USE ZONE MAP
I certify that in the performance of the work for which this ' NO. (/ y
permit is issued', I shall not employ any person in any.manner O ^ , vV � v ya SPECIAL d
so as to become subject to the Workers'Compensation Laws. ADDRESS v v 2• CONDITIONS 0
Date Applicant CITY jxv&EZIP \ 09
NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. DISTRICT G OUP. TYPE FIRE PROC SSED BY 0
ENGINEER NO. /�3 CONST. ZONE t7
Exemption, ou should become subject to the Workers' � - r/6(` .
P Y I 514 3 W
Compensation provisions of the Labor Code, you must forth- ADDRESS
with comply with, such provisions or this permit shall be in
STATISTICAL CLASSIFICATION APT. CON Z
deemed revoked. CONTRACTOR NO. OBJ`
LICENSED CONTRACTORS DECLARATION LIC• CLASS I. DWELL. UNITS
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS . NO. SEWER MAP
(commencing with Section 7000)of Division 3 of the Business and LIC.
Professions Code,and my license is in full force,and effect.) CITY CLASSBK "VALIDATION -
SQ.FT. r-7 NO.OF NO.OF CHECK
License Number Lic.Class SIZE v STORIES FAMILIES ONE
YY ) VALUATION
Contractor Date j DESCRIPTION OF WORK' V! V S NEW ❑ $ 'n O O
I am exempt under Sec. ADD (/ ,
ALTER 1 2 2 9 A
B.&P.C. for this reason IJ'r�u�'f��s S ��� ./�vS� REPAIR ❑ $
USE OF ❑ 0 0 0 0. 0 1
Date: EXISTING BLDG. r DEMOL
Signature APPLICANT TEL. f�� FINA � ) 0 1 2 1,8 8
8.
OWNER-BUILDER DECLARATION PRINT NO. v DAT 0 0 1 2 4 8 8
1 hereby affirm that I am exempt from the Contractor's License ADDRESS FI U
Law for the following reason (Section 7031.5, Business and
Professions Code): PRESENT B 1 21 484
❑ BUILDING
I, as owner of the property, or my employees with ADDRESS ,
wa es as their sole compensation,will do the work and i
structure is not intended or offered for sale(Section LOCALITY , P
7044, Business and Professions Code). MOVING TEL. ( t
{'
I, as owner of the property,am exclusively contracting CONTRACTOR NO. � G{`� 1 •,-� . ' ff '
with licensed contractors to construct the project (Sec- . / )�6 3 ( ; %7
tion 7044, Business and Professions Code). ADDRESS
REQUIRED TOTAL SETBACK FROM T. ' r,•'
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH' ! '
hereby affirm that there is a construction lending agency for FRONT r � ,�i;,Qi;X•G i "�!''I �:rl 1 `
the performance of the work for which this permit is issu�d P.L. 1
(Sec. 3097, Civ. C.). SIDE
I` P.L.
p_ Lender's Name
� I � LDMA Ref.•N
Lender's Address P.C.Fee$ Permit Fee f'
r I certify that I have read this application-and state that the Issuance Fee 6 0SO 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 2-4 .a LDMA Perm.#
and hereby ze r presentatives of this County to enter
i upon he menti ned property for inspectionpose .
o SEE REVERSE FOR EXPLANATORY LANGUAGE
Si nature of Applicant or Agent Date I
WbRKERS'COMPENSATION DECLARATIONAPPLICATIC ` �, �
• ' •,, lea&Affirm that I have a certificate of consent to self R E ��� RMI �
'r 1�yyure, ork a certificate of Workers'Compensation Insurance,
-- erWied copy thereof (Sec. 3800, Lab. C. COUNTY Ohio Casualty CO �TY OF LOS ANGELES BLDI0®INC': AND SAFETY
Policy N anY , BUILDING
Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS
Certified copy is filed with the count building inspec- BUILDING
�r----�` tion department. Don E. Hatfield ADDRESS 63.03 Muscatel LOCALITY
NEAREDatel2/7/84 Applicant dbaAmericanBuilde '' ITY San Gabriel ZIP CROSS ST. r
CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT 90�Cl.00 NO.OF BLDGS. 2 ASSESSOR
COMPENSATION INSURANCE NOW ON LOT MAP BOOK PGE PARCEL
(This section need not be completed if the permit is for one USE ONE MAP n
hundred dollars($100)or less.) TRACT' BLOCK LOT NO.. n�� Il NO. oQ
Michael. Dion TELNO.287-8043 �� SPECIAL �-
I certify that in the performance of the work for which this OWNER NO. CONDITIONS 0
permit is issued, I shall not employ any person in any manner DISTRICT GROUP TYPE FIRE PROC SSED BY
so as to become subject to the Workers'Compensation Laws. ADDRESS 6103 ML1Scate3. �r t�_ CONST. ZONE U
San Gabriel ZIP �d J� �j 3 0
Date Applicant
CITY STATISTICAL CLASSIFICATION APT. COND I
NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. u
g ENGINEER none NO. CLASS NO. DWELL.UNITS �
Exemption, you should become subject to the Workers' C16-
Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP
with comply with such provisions or this permit shall be
deemed revoked. CONTRACTORmeri-=anBui.ldersNo 287-9744 BK, PG, VALIDATION!
LICENSED CONTRACTORS DECLARATION X58193' Tem eCit BlLIC' 104325
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRE 2 P y NO. VALUATION
(commencing with Section 7000)of Division 3 of the Business and Temple le City LIC. B-1 dj0®
Professions Code, and my license is in full force and effect. '', CITY CLASS $
104325 B-J SIZE STOHECK
RIIES 1 FAMINO. LIES
1 CONE
Licen Number -5 Lic.Class /
On Z° ^anBL�i J_d�areS J_2/7/84 ^
DESCRIPTION NEW ❑ $
Cord,-c�r Ameri.. d 121.2 A
2 Bedroom 1 Bath Shell ADD
I am exempt under Sec. s
ALTER ❑ FIINALy � # 0 0 0 0 0 1
B.BP.C. for this re a F Addition REPAIR ❑ DAT ,-- fr
USE OF Dwelli_ncr & Garage DEMOL El1212-84 U
EXISTING BLDG. o
Signature XX "'�- SAPPU IRIRNN merican Bui_lder_sN 87-9744 Y
OWNER- LDER D O
I hereby affirm that I am exempt from the Contractor's License AD 9 z Temp leC i tyBl°Temp J eC i ty
Law for the following reason (Section 7031.5, Business and
Professions Code): ` PRESENT
❑ BUILDING
I, as owner of the property, or myemployees with ADDRESS
wages as their sole compensation,will do the work and
the structure is not intended or offered for sale(Section LOCALITY
7044, Business and Professions Code). MOVING TEL.
❑ I,as owner of the property,am exclusively contracting CONTRACTOR NO.
with licensed contractors to construct the project (Sec- ADDRESS
tion 7044, Business and Professions Code).
REQUIRED TOTAL SETBACK FROM EXIST.
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH D
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.
tSec. 3097, Civ. C.). SIDE
P.L.
o Lender's Name ` `
8 P.C:Fee$ Permit Fee U
Lender's Address
xI certify that I have read this application and state that the Issuance Fee S�
above information is correct. I agree to comply with all County Investigation Fee
ordinances and State laws relating to building construction, Total Fee
9 and hereby authorize representatives of this County to enter
upon thmaebove-meennnttiovguprgp rty for' action purposes.
F! 15 11 E SEE REVERSE FOR EXPLANATORY LANGUAGE ®s
o y
Sig ure of lica o n Date
n WORKERS'COMPENSATION DECLARATION
rI sure, iSTfo4 ficjt I haver certificate of consent to self APPLICATION FOR - BV I L D I N G P E RM I T
insure,,or"d cdr`tificate of Workers' Compensation Insurance, '
or a certifded copy thereof(Sec. 3800, Lab. C.) COUNTY OF'LOS ANGELES BUILDING AND SAFETY
Policy No. Company _7 BUILDING
❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN Annu-sS
Certified copy is filed with the county building inspec- BUILDING -e p� , �(�Se/Q-�L
tion department. O1' ��
Date Applicant ' CITY T_�`- ZC � ZIP LOCALITY
O.OF BLDGS. NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT
OC) NOW ON LOT t CROSS ST.-
COMPENSATION INSURANCE ASSESSOR ,��
(This section need not be completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK a PAGE A, PARCEL�J d
hundred dollars ($100)or less.) . =_====
nn // USE ZONE MAP
OWNER egA-d-L • b lod NO. 2 S'/9'65 NO
I certify that in•the performance of the work.for which this ^► SPECIAL �
permit is issued, I shall not employ an son ny.manner ADDRESS {V- s CONDITIONS
.so as to bec me'subject to the Work s' mpens tion Laws. ^n O
CITY • ZIP /"/ S �..:; U
XA
Date Applicant ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE,... P OCESSED BY,.• :,0
NOTICE T PLICANT: If, after making this Certificate of ENGINEER NO. CONST.
Exemption, you should become subject to the Workers' �U
Compensation provisions of the Labor Code, you must forth- ADDRESS. ��6 �� a_
with comply with.such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION N
deemed revoked. CONTRACTOR C/GvIV 0. iy h�'-
LICENSED CONTRACTORS*DECLARATION O CLASS N0.�DWELL. UNITS
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. _• _
SEWER MAP
. (commencing with Section 7000)•of Division 3'of the Business � LIC. f_I,1�;,_,^-
and Professions Code,and my license is in full force and effect. CITY CLASS _
BK VALIDATION
° _
SQ. FT NO.OF NO.OF CHECK
License Number Lic. Class SIZE Q 5 STORIES 2 FAMILIES ( ONE
VALUATION
DESCRIPTION OF WORK NEW
❑ - _
Contractor Daten-- -- -"!-i-` "
❑I am exempt under Sec: ( � 2QQ/yf ADD $6oDo� _ _ i,'.,I:_ _
ALTER ❑ _
B.BP.C..for this reason AT2!d Ab REPAIR ❑ $ `-- ' "' '
Date: '
EXISTING BLDG. Saida rAM &44C44— DEMOL ❑ � ='^E
Signature APPLICANT TEL• FINAL Y=''• r =' i� _ `-�L
OWNER-BUILDER DECLARATION (PRINT) p,,I NO. - -
DATE
I hereby affirm that I am exempt from the Contractor's License / - `=�_=•:� _ . .,
Law for the following.reason (SectTon'7031.5, Business and ADDRESS &t o3/J m ose..4F-eL FINAL -
Profes ' s Code): PRESENT By ,
Ft,%13_
BUILDING
I, as owner of the property,•or my employees with ADDRESS //11011
wages as their sole compensation,will do•the work and
the structure is not intended or offered for sale(Section LOCALITY If(_U
7044, Business and'Professions Code.) MOVING TEL.
❑ I,as owner of the property,am exclusively contracting
CONTRACTOR NO. mow:
with licensed contractors to construct the project (Sec- ADDRESS
tion 7044, Business and Professions Code.)
CONSTRUCTION LENDING AGENCY REQUIRED TOTAL SETBACK FROM EXIST.-
CONSTRUCTION BACK YARD HWY PROP. LINE WIDTH,
( 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.
P.L.
Lender's Name
Lender's Address P;C. Fee$ c� Permit Fee LDMA Ref: #
I certify that I have read this application and state that the Issuance Fee �7 �� LDMA P/C# ,
above information is correct. I agree to comply with all County Investigation Fee
ordinances an ate law relating to building construction, Total Fee /�� LOMA Perm. #
and hereby uthor' a repre entatives of this Count to nter
upon the ove entioned roperty for inspectio //pur oses.
SEE REVERSE FOR EXPLANATORY LANGUAGE "
Sign tuFe a nt or Agent' Date
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 1209120058
PHONE: (626) 285-0488 EXT:
LEGAL ID: NO. OF CONST BUILDING ADDRESS:
ITR: 5903 LT: 51 SQ. FT STORIES TYPE 6103 MUSCATEL AV
_ ISTRUCTURE: V-B TEMP CA 91780
[ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET:
15386-009-046 I THOMAS PAGE: 596 GRID: G2 LOCALITY. TEMPLE CITY, Cl
(TENANT: JEXIST BLDG USE: REBID USE ZONE: R-1 JISSUED ON: PROCESSED BY:
EXIST OCC GRP: 109/12/12 SR
OWNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: [FINAL DATE FINAL BY: CODE:
1WONG, DAVID (972) 623-7820- 1 16,000
16103 MUSCATEL AVE I --Y3!1-3
1
TEMPLE CITY CA 91780 FEES PAID CP. PTIO OF WORK
IKITCHEN, THREE BATHROOMS LMODET. AND TEAR OFF AND REROOF
IFEE
DESCRIPTION: QUANTITY: UOM: AMOUNT:IWITH 30 YEAR COMPOSITION SHINGLES
APPLICANT: TEL. NO: I I
SAME AS OWNER - 1AA BLDG PERMIT ISSUANCE 27.80 1
JAB STATE GREEN BLDG FEE 16000.00 VAL 1.00 ISPECIAL CONDITIONS:
1AC STRONG MOTION RESID 16000.00 VAL 1.60
JB1 PLANCHECK W/ENERGY 16000.00 VAL 296.80
JB2 PERMIT W/ENERGY 16000.00 VAL 349.10 I-_
CONTRACTOR: TEL. NO: IFR INV WORK W/O PERMIT 342.20 DOL 342.20 JAPPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER - I TOTAL FEES 1,018.50 I-__
I LIC. NO ILOCATION AND SETBACKS
SOILS ENGINEER APPROVAL
ARCHITECT OR ENGINEER: TEL. NO: i JFOGNDATION/TRENCH FORMS I I I
LIC. NO: 1 (SLAB/UNDER FLOOR I I I
IRAISED FLOOR FRAMING
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( (UNDERFLOOR INSULATION I I I
115OH261 3 001 I 1-1 I
I I IFLOOR SHEATHING I I I
INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I
0 NO 21 1 (ROOF SHEATHING
-1 1
SCHOOL WITHIN HAZARDOUS I ISHEAR PANELS I 1
(AIR QUALITY: 1000 FEET MATERIALS I I I I
NO NO NO 1 [FRAME INSPECTION
I I (FIRE SPRINKLER HANGERS I I I
(INSULATION/WEATHER STRIP( I I
I IINTSRIOR LATH/DRYWALL I I I
I I I
1 (EXTERIOR LATH I I 1
I I I
liAT-hD FLOOR/CEIL ASSEM. I I I
IRATED WALL ASSEMBLIES
I
I (RATED SHAFTS/OPENINGS
i I
I 1 IT-BAR CEILINGS I I
ILOT DRAINAGE
I
IREPORT ID: DPR261 ROUTE TO: BS0508 I I I I
I I I I I I
r
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 1304220068
' PHONE: (626) 285-0488 EXT:
ILEGAL ID: I NO. OF CONST I BUILDING ADDRESS: I
ITR: 5903 LT: 51 SQ. FT STORIES TYPE 1 6103 MUSCATEL AV 1
1 (STRUCTURE: V-B I TEMP CA 91780 1
1ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: I
5386-009-046 I I THOMAS PAGE: 596 GRID: G2 LOCALITY: TEMPLE CITY, Cl
I I I
(TENANT: kXIST BLDG USE:
RESID USE ZONE: R-1 IISSUED13N: PROCESSED BY:
(EXIST GRP:
[
I I I I
(OWNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: IFIFAL DATE FINAL CODE: [
IWONG, DAVID/WEI (972) 623-7820- 1 700 IOf
I
16103 MUSCATEL AVE I I I
ITEMPLE CITY CA 91780 1 FEES PAID IMCICIPTION OF WORK 1
I IREPLACE 4 WINDOWS AND EGRES WINDOW ON 2ND FLOOR 1
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:( I
(APPLICANT: TEL. NO:
ISAME AS OWNER - IAA BLDG PERMIT ISSUANCE 27.80 1 I
1 JAB STATE GREEN BLDG FEE 700.00 VAL 1.00 ISPECIAL CONDITIONS: I
I JAC STRONG MOTION RESID 700.00 VAL 0.50 ]
I ID2 PERMIT W/O EN-HC 700.00 VAL 43.70 ]
1 1 TOTAL FEES 73.00 1 I
[CONTRACTOR: TEL. NO: 1 [APPROVALS DATE INSPECTOR SIGNATURE I
ISAME AS OWNER - I I I
I LIC. NO 1 [LOCATION AND SETBACKS I I I
I I I I I I
I I ISOILS ENGINEER APPROVAL I [ 1
ARCHITECT OR ENGINEER: TEL. NO: 1 FOUNDATION/TRENCH FORMS I I I
LIC. NO: I ]SLAB/UNDER FLOOR 1 I I
I ]RAISED FLOOR FRAMING [ [ [
I I I I I I
[MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:I (UNDERFLOOR INSULATION I I I
1 3 001 1 1-1 1
I I FLOOR SHEATHING I 1 1
INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I I I I
1 NO 21 1 [ROOF SHEATHING I I 1
I I I I I I
1 SCHOOL WITHIN HAZARDOUS I (SHEAR PANELS I I I
[AIR QUALITY- 1000 FEET MATERIALS 1 1 I
1 NO NO NO 1 1FRAME INSPECTION 1 I I
I I IFIRE SPRINKLER HANGERS 1 I [
I I INSULATION/WEATHER STRIP( I [
I I (INTERIOR LATH/DRYWALL ] I I
I I I I I I
I 1 [EXTERIOR LATH I I I
[ [RATED FLOOR/CEIL ASSEM. [ 1 [
IRATED WALL ASSEMBLIES I I
I IRATED SHAFTS/OPENINGS I
I IT-BAR CEILINGS [ [
] I ILOT DRAINAGE I I I
1 IREPORT ID: DPR261 ROUTE TO: BS0508 1 I I [