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76A638A CE#803 2 63 APPLICATION FOR BUILDING P,,14RI '
COUNTY OF LOS ANGELES B U I LD I N
DEPARTMENT OF COUNTY ENGINEER ADORES ,
BUILDING AND SAFETY DMSION LOCALIT
JOHN A LAMBIE COUNTY ENGINEER NEAREST
WILLIAM A JENSEN SUP T OF BUILDING CROSS ST
DISTRICT N GROUP TYPE R E BY
FOR APPLICANT TO FILL IN CONS
BUILDING STATdSTICAL CLASSIFICATION SEWER MAP
ADDRESS Av ' CLASS NO DWELL UNITS BK P
LOT NO p LOCK WATER
CERTIFICATE NOT REQUIRED RECEIVED
TRACT , MAP HIGHWAY fLC���LLL
NO OF BLDGS NO D (CIRCLE) STATE MAJOR SECOND OCA
SIZE OF LOT / NOW ON LOT USE ZONE SPECIAL /'
USE OF CONDITIONS y i/ ew//G L '
EXISTING BLDG m, G 716 / 3
TEL V
OWNER Q P,� NO B ILDING YARD HWY STREET NAME EXIST
SETBACK WIDTH
ADDRESS O FRONT
ARCHITECT OR TEL P L
ENGINEER NO SIDE
P L }
ADDRESS �y.. 0
TEL
CONTRACTOR NO or
ADDRESS
DESCRIPTION OF WORK aaJ
011 CL
NEW ADD LTEFJ REPAIR DEMOLISH N
17
Z
T NO OF NO OF
SIZE STORIES FAMILIES
USE OF
STRUCTURE
SIGNAT E OF �/�
APPLI ANT V
VALUATION $ /
�} APPROVALS DATE INSPECT-OR
SSSIGNATURE
P C PMT (� FOUNDATION
MATERIALS /
FEE FEE $ /
FRAME FIRE STOPS
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATIO 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 r
BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT �C /✓g�,l. .•G�yl
TION OF THE LABOR CODC OF THE STATE OF CALIFORNIA RELkr
ING TO WORKMEN PENSATION INSURAN LATH EXT y ,r
SIGNATURE O HOUSE NUMBER COR
PERMITTEE 0 , � RECT AND POSTED i /�—� Zf/�
ADDRESS ZZ FINAL
JOHN
PLAN CHECK VALIDATION M G CASH _ PERMIT VALIDATION TRCK RM o ENGINEER
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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 1002160073
PHONE (626) 285 0488 EXT
LEGAL ID NO OF CONST BUILDING ADDRESS
ITR 6561 LT 738 ON 002 SQ FT STORIES TYPE 5837 OAK AV
I 1STRUCTURE 21 V B TEMP CA 917802132 1
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET LAS TUNAS
18587 006 009 i 1 THOMAS PAGE 596 GRID J3 LOCALITY TEMPLE CITY Cl
TENANT JEXIST BLDG USE RESID USE ZONE R 3 JISSUED ON PROCESSED BY
1BACK HOUSE 1EXIST OCC GRP 102/16/10 SR 1
OWNER TEL NO IBLDGS NOW ON LOT VALUATION IFINAL DATE FINAL BY CODE
IPICCIONE JOE (626) 286 0848 5 760
19532 PENTLAND ST I �� 1
TEMP 917803844 FEES PAID (DESCRIPTION OF WORK 1
REPLACE (E) CAP SHEET ROOFING TO BE ROOFED OVER INSTALL CARL
IFEE DESCRIPTION QUANTITY UOM AMOUNT JISLE TPO SARE FLEX ROOFING MEMBRANE TITLE 24 COOL ROOF WITH
APPLICANT TEL NO I I
ISMITH (626) 815 1279 IAA BLDG PERMIT ISSUANCE 27 75 I 1
I IAB STATE GREEN BLDG FEE 5760 00 VAL 1 00 ISPECIAL CONDITIONS I
IAC STRONG MOTION RESID 5760 00 VAL 0 58 1
ID2 PERMIT W/O EN HC 5760 00 VAL 149 40 1
TOTAL FEES 178 73 1
ICONTRACTOR TEL NO 1 1APPROVALS DATE INSPECTOR SIGNATURE 1
1J N DAVIS ROOFING (626) 815 1279 1 1 I
11308 E COLORADO BLVD #B LIC NO I ILOCATION AND SETBACKS I I I
1PASADENA CA 91106 572125C39 * 1 I- 1 1 I
1 I ISOILS ENGINEER APPROVAL-I I I
(ARCHITECT OR ENGINEER TEL NO I IFOUNDATION/TRENCH FORMS I I I
LIC NO 1 1SLAB/UNDER FLOOR I I I
1 I 1RAISED FLOOR FRAMING I 1 1
IMAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP I 1UNDERFLOOR INSULATION I I I
1150H265 3 001 1 1 1 I
I 1FLOOR SHEATHING
INO OF FAMILIES DWELLING UNITS APT/GOND STAT CLASS I I � OVwY QK�S
1 NO 21 1 IROOF SHEATHING
I I
1 SCHOOL WITHIN HAZARDOUS 1 ISHEAR PANELS I I I
1AIR QUALITY 1000 FEET MATERIALS 1 1 -1-1 I
1 NO NO NO 1 IFRAME INSPECTION
I I I
IREQUIRED TOTAL SETBACK FROM EXIST 1 IFIRE SPRINKLER HANGERS I I I
1SET BACK YARD HWY PROP LINE WIDTH 1 I I I I
1FRONT PL 1 11NSULATION/WEATHER STRIP( I I
SIDE PL 1
I I 11NTERIOR LATH/DRYWALL I I 1
1 1 1EXTERIOR LATH 1 1 I
I I IRATED FLOOR/CEIL ASSEM I I I
I I I
I 1 IRATED WALL ASSEMBLIES I I I
I I I
1 I
IRATED SHAFTS/OPENINGS I I I
I I 1T BAR CEILINGS
I I ADDITIONAL DATA ON FILE 1 I 1 1
I I
ILOT DRAINAGE I
I I I
1 IREPORT ID DPR261 ROUTE TO BS0508 1 1 1 I
I I I I I I