HomeMy Public PortalAbout10151 OLIVE ST_Building__ APPLICATION FOR BUILDING PERMIT
COUNTY 6F LOS ANGELES BUILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS
I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS
or a certificate of Workers'Compensation Insurance,or a certified
copy thereof(Sec.3800,Lab.C.)' CITY ZIP �J
Policy No. Company �/ / LOCALITY
SIZE LOT NO.OF BLDGS.NOW ON LOT
❑ Certified copy is hereby furnished. NEAREST CROSS ST.
❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO.
USE ZONE MAP NO.
department.
Date Applicant ASSESSOR MAP BOOK PAGE PARCEL
SPECIAL CONDITIONS
CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER P� F„n �O TEL NO.
COMPENSATION INSURANCE /V C/ ® WITHIN 1000 FT OF SCHOOL? YES No '
This section need not be completed if the permit is for one hundred ADDRESS
( P P T ' DISTRICT GROUP TY CONST. FIRE ZONE PROCESSED BY
dollars($100)or less.) 4� ���
kI certify.that in the performance of the work for which this permit CITY ZIP
is issued, I shall not employ any person in any manner so as to ARCHITECT ORE INEER TEL NO. ' D�
become'subject to the Workers'Compensation Laws. STATISTICAL C IFICATIONAPT CONDO
Date Applicant ADDRESS CLASS NO. DWELL UNITS
NOTICE TO APPLICANT. If, after making 'this Certificate of REQUIRED TOTAL SETBACK FROM EXIST
Exemption, you should become subject to the Workers`. CONTRACTOR TEL NO. SET BACK YARD HWY PROP LINE WIDTH
Compensation•provisions of the Labor Code, you must forthwith, L`�
F{iONT ,
comply with such provisions or this permit shall be deemed revoked.' ADDRESS LIC.NO. PIL
LICENSED CONTRACTORS DECLARATIONSIDE
CITY LIC.CLASS P,L
I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP
(commencing with Section 7000)of Division 3 of the Business and SO.FT.SIZE NO.OF STORIES NO.OF FAMILIES
Professions Code,and my license is in full force and effect. ' NEW ❑ 63 .PG �-
a
License Number Lic.Class DESCRIP�IQN.O
J. RK '4At ADD ❑ VALUATION n��_ U
Contractor Data y - ALTER ❑ �v
❑ I am exempt under Sec. � S REPAIR El
B,BP.C.for this.'reason ��,CLLf�Q DEMOL ❑ LDMA P/C a
LU
Date: USE OF EXISTING BLDG. .Z J URM ❑ 1L
Si ture I ,h / 1
APPLICANT(PRINT) / � TEL NO15� ., LDMA Perm+0 1 Z
as owner of'the property, or my employees with'wages as ad O — —` ��� I z ACCT e 4
their sole compensation, will do'the work and the.structure is ADDRESS
not intended or offered for sale (Section 7044, Business and �� QL�v� r l [ C s FINAL DATE Q o.3303 108.90
�
Professions Code.) I WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL Z C 1, 1 ITEMS
El 1, f owner of the OR.A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE �y
property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY 11 NO �.�y
� n �
licensed contractors to construct the project (Section 7044, YES NO
Business and Professions Code.)
WILL THE INTENDED USE MI THE BUIDLING BY THEAPPLICANT.MODIFICATION
OR FUTURE BUILDING CHECK .108.90
• I OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION.FROM THE SOUTH ,+ CHANGE
r♦ �'y
CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR ' }III 4HA(�{GE eOO
I GUIDELINES
I hereby affirm that there is a construction lending agency for YES❑ NO❑
N the performance of the work for which this permit is issued(Sec.I
IHAVEREADTHE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING
a 3097,CIV,C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE.LOS ANGELES COUNTY CODE, �ry(y
C4 TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS QGOO-0001 1/ .8/96
Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD.
0 Lender's Address 4'123 1 AM Q-"25
p OWNER OR AGENT
0 1 certify that I have read this application and state under penalty: _
oP.C.'FEE PERMIT FEE fj p/I p
0 of perjury that the above information is correct.I agree to comply
N with all county ordinances and State laws relating to building
construction,and hereby authorize rep sentatives of this County) ISSUANCE FEE
to enter upon ove- ntio d p for inspe tion urposes J
CO
, INVESTIGATION FEE TOTAL FEE
n X sm.Iw,d m ome
SEE REVERSE FOR EXPLANATORY LANGUAGE
I
At WORKERS'COMPENSATION DECLARATION
hereby affirm that I have certificate of consent to s.f APPLICATION FOR BUILDING PERMIT
insure, 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 copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS
❑ Certified copy is filed with the county building inspec- I BUILDING t�
tion department. ADDRESS
Date Applicant , CITY7F') o\ p LE ZIP "1 11 LOCALITY
CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT Q' NOW ON LOTS CROSS ST.
T.
COMPENSATION INSURANCE ASSESSOR
(This section need not be completed if the permit is for one TRACE BLOCK LOT NO. MAP BOOK PAGE PARCEL
hundred dollars ($100)or less.) TEL. '`
OWNER�O� cX�C�U�. �.(�� f(V, O. y 4�' USE ZONE MAP
I certify that in the performance-of the work for which this 1
permit.is issued, I shall not employ any person in any manner ADDRESS E ST. 1 SPECCONDITIONS lIL
so as to become subject to the kers'Compensation Laws. O
���Q� CITY\E M PLIC ,%T ZIP `11 VQ
Date\�1 Applicant ARCHITECT OR TEL,
NOTICE TO APPLICANT, If, after making is Ce ificate of ENGINEER NO DISTRICT GROUP TYPE FIRE PROCESSED Y -
CONST. E
Exemption, you should become subject to the 'Workers' -• l�
Compensation provisions of the Labor Code, you must forth- ADDRESS -00 IG
with comply with such provisions or this permit shall be TEL. Z
deemed revoked.. CONTRACTOR N��- NO. STATISTICAL CLASSIFICATION APT: CONDO.
LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. 7— ELL. 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 PG. VALIDATION
SQ. FT. NO. OF NO.OF CHECK
License Number Lic. Class SIZE STORIES FAMILIES ONE
VALUATION
Contractor Date DESCRIPTION OF WORK NEW ❑ s bo '00
❑I am exempt under Sec. 1� \l D �jp ADD .
ALTER ❑ ►
B.&P.C. for this reason REPAIR ❑ $
Date: USE OF
EXISTING BLDG. RSV s E DEMOL ❑
Signature APPLICANT
NO –
OWNER-BUILDER DECLARATION (PRINT)"QAVL(, jV\C MRMW .4y $ FINAL
I hereby affirm that I am exempt from the Contractor's LicenseDATE
ADDRESS �0�5 �'L t V E ST. '1 E MPL� C t T
Law for the following reason (Section 7031.5, Business and FINAL
Professions Code): PRESENT By u
❑ I, as owner of"the property, or•m employees• with BUILDING `C�` L / A%CT A
gcompensation,
P P Y� YADDRESS 3-07 40,51
wages as their sole com ensation,will do the work and r ' i.J
the structure is not intended or offered for sale(Section LOCALITY
7044, Business and Professions Code.) MOVING R� n\ TEL. j ITE
❑ I,as owner of the property,am exclusively contracting CONTRACTOR IVB iv NO.
with licensed contractors to construct the project (Sec- TL.7TAL 40 a TO
tion 7044, Business and'Professions Code.) - ADDRESS NECK
rI
REQUIRED TOTAL SETBACK FROM EXIT. 4HECK 40.5
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH oll
I hereby affirm that there is a construction lending agency for FRONT CHANGE
the performance of the work for which this permit is issued P.L.
(Sec. 3097, Civ. C.). SIDE
P.L. 0000—OCID 1 11/i4/84
Lender's Name � � � '
LDMA Ref. #
Lender's Address
P:C. Fee$ Permit Fee >CJ,C7'� , 6755 1 AM 8:46
' I certify that I have read this application and state that the Issuance Fee LDMA P/C#
above information is correct.I agree to comply with all County Investigation Fee
I ordinances and State laws relating to building construction, Total Fee 41h LDMA Perm. #
nd hereby authorize representatives of this County to enter
E u n the ab ve-me tinned property for inspection purposes.
SEE REVERSE'FOR EXPLANATORY LANGUAGE
Signature of App ant or gent Date
WORKERS'COMPENSATION DECLARATION
� hereby affirm that 1 havecertificate of consent to self
i Car APPLICATION FOR BUILDING PERMIT
insure, a certi�lcate of Workers'Compensation Insurance,
or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. Company
Certified copy is hereby furnished. BUILDING
FOR APPLICANT TO FILL IN ADDRESS
❑ Certified copy is filed with the county building inspec- BUILDING ,
tion department. ADDRESS 1 AJ
Date Applicant CITY r ZIP ` LOCALITY
CERTIFICATE OF EXEMPTION FROM WORKERS' Ir NO.OF BLDGS. NEAREST
COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST.
(This section need not be completed if the permit is for one - ASSESSOR
hundred dollars($100)or less.) TRACT' BLOCK LOT NO. MAP BOOK PAGE PARCEL
TEL. p p USE ZONE MAP
I certify that in the performance of the work for which this OWNER C N0.yy o�-Z p��
rl(/ NO. >-
permit is issued, I shall not employ any person in any manner �s SPECIAL IL
so as to become subject to the Workers'Compensation Laws. ADDRESS CONDITIONS O
�A—!Q C� CITY l ZIP
Date pplicant
NOTICE TO APPLICANT: If, after making t ' Cer to of ARCHITECT OR TE DISTRICT �GUP TYPE FIRE ESSED BYO
ENGINEER Exemption, you should become subject to the Workers' ' /tom /]Li 7 CONST. / ZONE U
Compensation provisions of the Labor Code, you must forth- ADDRESS C J1 11 J/
with comply with such provisions or this permit shall be us
deemed revoked. TEL• STATISTICAL CLASSIFICATION I APT. JLO. Z
CONTRACTOR NO.
LICENSED CONTRACTORS DECLARATION LIC, CLASS NO.. DWELL. UNITS
-
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO.
(commencing with Section 7000)of Division 3 of the Business and LIC. SEWER MAP
Professions Code, and my license is in full force and effect. CITY CLASS BK PG VALIDATION
SQ.FT. NO.OF ` NO.OF CHECK
License Number Lic.Class SIZE STORIES FAMILIES , ONE
❑ VALUATION
Contractor Date
DESCRIPTION OF WORK NEW GI
�y
❑ , _
❑I am exempt under Sec. ADD
❑
ALTER
B.B.P.C. for this reason REPAIR ❑ $
Date: USE OF
EXISTING BLDG. X DEMOL ❑
Signature APPLICAfW-,--% G TEL. FINAL
OWNER-BUILDER DECLARATION PRINT �C V O DAT "
I hereby affirm that I am exempt from the Contractor's License ADDRESS ���3 S D
Law for the following reason (Section 7031.5, Business and
Professions Code): PRESENT
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 ;2 6 5 6 3 A
7044, Business and Professions Code). MOVING TEL.
❑ I,as owner of the property,am exclusively contracting CONTRACTOR NO. # 0 0 0 0 0 1
with licensed contractors to construct the project (Sec- ADDRESS0 03300
tion 7044, Business and Professions Code).
REQUIRED TOTAL SETBACK FROM I T.
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH =
I hereby affirm that there is a construction lending agency for FRONT o 0 0 3 3 •0
the performance of the work for which this permit is issued P.L. 0224-87
(Sec. 3097, Civ. C.). SIDE
a P.L.
o Lender's Name LDMA Ref. #
P.C. Fee$ Permif PE9
- Lender's Address �'7
r I certify that I have read this application and state that the Issuance Fee .6• C/ LDMA P/C# '
s above information is correct. I agree to comply with all County Investigation Fee
ordinances and State laws relating to building construction, Total LDMA Perm. #
and hereby authorize representatives of this County to enter `
on the above-mentioned property for inspection purposes.
C+ SEE REVERSE FOR EXPLANATORY LANGUAGE
,Signature of A licanf r Age Date
WORKERS'COMPENSATION DECLARATION
insu`reboraafcertif carte of Wo ke s'tCompensation Insurance, APPLICATION FOR BUILDING P E RM I T
or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. Company r
❑ copy y FOR APPLICANT TO FILL IN ADDRESS !�
Certified co is hereby furnished.
Certified copy is filed with the county building inspec- BUILDING c p
tion department. ADDRESS \��rr``\ t \ p 7� LOCALITy— �NEAREST <-d
vD�/�
Date Applicant CITY �" ZIP :\\,``� CROSS ST. /� !I�
CERTIFICATE OF EXEMPTION FROM WORKERS' \ NO.OF BLDGS. ASSESSOR
COMPENSATION INSURANCE SIZE OF LOT X It NOW ON LOT MAP BOOK PAGE PARCEL
(This section need not be completed if the permit is for one USE ZONE MAP
hundred dollars ($100)or less.) TRACT BLOCK LOT NO. NO.
SPECIAL
I certify that in the performance of the work for which this OWNER NO. �/` CONDITIONS 9L
DISTRICT GROUP TYPE FIRE PR ESSED BY O
permit is issued, I shall not employ any person in any manner ADDRESS CONST. ZONE V
so as to become subject to the Workers'Compensation Laws. p �.
Date Applicant CITY ' ZIP TEL. STATISTICAL CLASSIFICATION APT. JCON567�
NOTICE TO APPLICANT: If, after making this Certificate of ARCHITE OR a U
Exemption, you should become subject to the Workers' ENGINEER NO. CLASS NO. DWELL. UNITS 0.
Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP
with comply with such provisions or this permit shall be TEL.
deemed revoked. BK, PG, VALIDATION
CONTRACTOR NO.
LICENSED CONTRACTORS DECLARATION LIC.
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. VALUATION
(commencing with Section 7000)of Division 3 of the Business and V LIC.
Professions Code, and my license is in full force and effect. CITY CLA $ U
SQ.FT ® NO.OF NO.OF ' CHECK
License Number Lic.Class SIZE STORIES I I FAMILIES ONE
$
Contractor Date DESCRIPTION OF WORK NEW ILI ❑
r-1I am exempt under Sec. �— ADD Ano ❑
ALTER ❑ FINAL � 6
B.$P.C. for this reason REPAIR ❑'�
DATE
USE OF
Date: EXISTING BL DEMO ❑' FI
Signature APPLICANT E
OWNER-BUILDER DECLARATION PRINT
I hereby affirm that I am exempt from the Contractor's License `f
Law for the following reason (Section 7031.5, Business and ADDRESS 1
Profjessions Code): PRESENT
BUILDING
j/ 'lLh3�1 I, as owner of the property, ormy employees with ADDRESS
wages as their sole compensation,will do the work andLOCALITY a V
the structure is not intended or offered for sale(Section
7044, Business and Professions Code). MOVING TEL.
❑ I,as owner of the property,am exclusively contracting CONTRACTOR NO. 5 7 3 A
with licensed contractors to construct the project (Sec- ADDRESS
tion 7044, Business and Professions Code).
REQUIRED TOTAL SETBACK ROM EXIST.
CONSTRUCTION LENDING AGENCY SET BACK YARp HWY PROP. IN WIDTH -0 -0400,506
1 hereby affirm that there is a construction lending agency for FRONT �h x
the performance of the work for which this permit is issued P.L. W o a a 4 0. 5 0 5
tSec. 3097, Civ. C.). SIDE ( G22-86
0
P.L.
Q Lender's Name `
3 P.C.Fee$ Permit Fee C�
Lender's Address
r I certify that I have read this application and state that the Issuance Fee
above information is correct. I agree to comply with all CountyInvestigation Fee
ordinances and State laws relating to building construction, Total Fee
and hereby authorize representatives of this County to enter
4pqn the above-mentioned property for inspection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE ®s
/ Signature of Ap)itlicantNtr Agent Date
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
.DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD
BUILDING ARD SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0012120021
r PHONE: (626) 285-0488 EXT:
GAL ID: 0. OF CONST NEW BUILDING ADD ESS:
BK: 33 PG: 86 PC: 4 SQ. FT STORIES TYPE OCCUP GROUP 10151 OLIVE ST
STRUCTURE: 0 1 VN R3 TEMP CA 917803345
ASSESSOR INFORMATION NUMBER: GARAGE: NEAREST CROSS STREET: BALDWIN
8586-026-030 OTHER: 600 1 VN R3 THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY
TENANT: E ISTBLDG USE: USE ZONE: ISSUED ON: PROCESSED BY: EXPIRES 0
EXIST OCC GRP: 02/05/01 UT 08/04/01
OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DAE F Y: CODE:
10151AOLIVEGS7 (262) 452-9323- 2 47,520 �q�d
TEMP 917803345 FEES PAID DESCRIPTION OF WORV
GUEST HOUSE-600 SQ. FT (NO WCHEN - NOT A RENTAL)
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:
APPLICANT: TEL. NO:
SAME AS OWNER - B1 PLANCHECK W/ENERGY 47520.00 VAL 721.44
AA BLDG PERMIT ISSUANCE 27.75 SPECIAL CONDITIONS:
AC STRONG MOTION-RES I'D -47520.00 VAL 4.75
DB2 PERMIT,,W%ENERGY:,.; 0520.00 VAL 848.76
tr: 1,�;.�::: •'__: TOTAL.FEES , 1,602.70
CONTRACTOR: TEL. N0: °%;"r'. .t"l�j:��•-o APPROVALS DATE INSPECT SIGNATURE
SAME AS OWNER - o
LIC. NO �? `� r ' % �� LOCATION AND SETBACKS Up
SOILS ENGINEER APPROVAL
ARCHITECT OR ENGINEER: TEL. • �' `j�y �� ' 'r FOUNDA IO /TRENCH FORMS 1
2123
LIC. NOf�/'' SLAB/UNbCR FLOOR
i
RAISED FLOOR FRAMING 4 20
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CM07' =-; n .- -� ; •> > `- UNDERFLOOR INSULATION 1 -,
1
S'rT LEVEL FLOOR SHEATH
0. OF FAMILIES: DWELLING ITS: APT/COND: STAT CL SS•-- - -- ------ -- ---- -- - -- - -- — ---- d
NO 2ND LEVEL FLOOR SHEATH
SCHOOL-91TRIN HAZARDOUS "�; ` ,/ „ ROOF SHEATHING
/
AIR QUALITY: 1000 FEET MATERIALS
NO NO NO FIRE DEPT. FRAME INSPECT
REQUIR D TOT SETBACK FROM XIST ", + BC)�DEFT. FRAME I SPEC q4 /
SET BACK YARD: HWY: PROP LINE: WIDTH:
FRONT PL- SHEAR PA-VE-L-9-
SIDE
A ELSIDE PL- _ -_ --- - O
+ '~' _ _ --•
INSULATION/WEATHER STRIP "
INTERIOR LATH/DRYWALL
EXTERIOR LATH
LOT DRAINAGE
SMOKE D TECTIO DE CES
FIRE DEPARTMENT APPROVAL
REPORT ID: DPR261 ROUTE TO: BS0508
COIRITY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD/ALT/REP
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1102160041
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I NO. OF CONST NEW BUILDING ADDRESS:
JBK: 33 PG: 86 PC: 4 I SQ. FT STORIES TYPE OCCUP GROUP 10151 OLIVE ST
I ISTRUCTURE: 0 1 V-B R-3 TEMP CA 917803345
(ASSESSOR INFORMATION NUMBER: I GARAGE: NEAREST CROSS STREET: BALDWIN
18586-026-030 I OTHER: I THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY, Cl
I I I
TENANT: EXIST BLDG USE: USE ZONE: ISSUED ON: PROCESSED BY:
(EXIST OCC GRP: 104/06/11 SR
I
[OWNER: TEL. NO: JBLDGS. NOW ON LOT: VALUATION: �F T FIN H CODE: J
JLUI, PAUL (626) 389-8684- 1 25,000 1
110151 OLIVE ST
TEMP 917803345 I FEES PAID IDESCRIPTIO OF WORK [
I I IFIRE DAMAGE REPAIR @ EXISTIN GUEST HOUSE ONLY [
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:( I
(APPLICANT: TEL. NO: I I I
1WEBER ENGINEERING INC. (714) 898-3862- JB1 PLANCHECK W/ENERGY 25000.00 VAL 439.60 [ 1
P.O. BOX 1585 JAA BLDG PERMIT ISSUANCE 27.80 ISPECIAL CONDITIONS: [
ICYPRESS CA 90630 JAB STATE GREEN BLDG FEE 25000.00 VAL 1.00 1 [
I JAC STRONG MOTION RESID 25000.00 VAL 2.50 [ [
1 JB2 PERMIT W/ENERGY 25000.00 VAL 517.10
ICONTRACTOR: TEL. NO: [ TOTAL FEES 988.00 JAPPROVALS DATE INSPECTOR SIGNATURE [
IC K CONSTRUCTION (626) 807-2378- [ 1 [
12205 ECKHART AVENUE LIC. NO [ ILOCATION AND SETBACKS [ [ [
IROSEMEAD, CA 91770 497984 B [ I I I [
I I (SOILS ENGINEER APPROVAL I I I
JARCHITECT OR ENGINEER: TEL. NO: I IFOUNDATION/TRENCH FORMS I I I
IWEBER ENGINEERING (714) 898-3867.- 1 1 [ 1 1
JP.O. BOX 1585 LIC. NO: 1 JSLAB/UNDER FLOOR I I I
(
CYPRESS, CA 90630 NONE _
I 1 (RAISED FLOOR FRAMING 1
IMAP NO: SEWER MAP BOOK; PAGE: FIRE ZONE: C6iP:J 1UNDERFLOOR INSULATION I [ I
3 OOI J1ST LEVEL FLOOR SHEATH J J I
INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I I J I
[ NO 21 1 12ND LEVEL FLOOR SHEATH
I 1 I I I I
SCHOOL WITHIN HAZARDOUS ROOF SHEATHING I 1
AIR QUALITY: 1000 FEET MATERIALS &ZA
[ NO NO NO FIRE DEPT. FRAME INSPECTI ' [ I
I 1BLDG DEPT. FRAME INSPECT1
I ix
I [ ISHEAR PANELS 1 J I
I14I
1 I JINSULATION/WEATHER STRIP,I 1 1
I
I I (INTERIOR LATH/DRYWALL I1
I
J 1 1EXTERIOR LATH I J I
I I I
ILOT DRAINAGE I I I
I I I
1 SMOKE DETECTION DEVICES 1 I I
I I IFIRE DEPARTMENT APPROVAL( I I
I I 1 J I I
IREPORT ID: DPR261 ROUTE TO: BS0508 I [ 1 1
I I I I I I