HomeMy Public PortalAbout5541 PAL MAL AVE_Building__ '
fbIVI30p MG ANSAFETY
'Department of CountyEngineer BUILDING ILD ' NG
.r ' Oomty of L,08 AngelSS
WM. J. FOX, L'OUNTY ENGINEER APPLICATION
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
DIBTRICT MO. PLAN CK.RR RLQ NO PERMIT NO.
BU
ILD sSy/ No Pave /
LOCALITY DATE
/� G [IV[D BY DAT[Or APPI- DAT[IBCBULD
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OWNLR r �
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ADDRESS SS M N4/ NEAREST
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CITY Q Cr/� , a ON_ Flp[ 0► TYPE OROU
7 ;192QNE PLANE
ARCHITECT OR TEL
ENGINEER NO. SLOG, ORD NO
SETBACK LINK
ADO [HS UBEAPPROVED
TEL ZONE BY DAT[ 3�
CONTRACTOR HOUSE�( NUM13ERINO
ADDRESS MAP NUMBER^L_NO ASSIGNED BY
-
GL
LOT MG, BLOOK CORRECTIONS
TRACT i�
SIZE O► LDr D NaW aON BLDGaLOT
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USE OF w6 O►
EXISTING BLDG R42SIANILIEI
DESCRIPTION OF WORK aD
a
NEW ALTERATION ADDITION Z
r
REPAIR DEMOLITION
B0.rT NO.OF
BIZ[ ROOMS STORI[B
EXT WALL ROOF
COVERING COVERING
USE OF STRUCTURE
INSPECTION FOR APPROVALS
OCCUPANCYAS INSPECT R'BBIGNATURE DATE
FOUNDATION LOCATION
►ORMB, MATERIALS
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FRAME- rIREBTOPS,
PLICATION AND STATE THAT THE INFORMATION GIVEN IB
CORRECT BRACING, BOLTB
1 ABR[ TO QOMP Y WITH ALL LbUNTY 13ROINANCIS rURNAC[• LOCATION,
AND 9TAT[ WB RE LATINO ILDINO CON ION OAB VENT,DUCTI
SIGNATURE or LATH. INT
PERMITTE
LATH. EXT.
ADDR Br+
PLASTER. INT. I•
AUTHOR12m AOT. )) j
PLASTER. EXT. NO
P C /
F[[ HOUSE NUMBER CDR"
J gEDT AND POSTED /
VALUATIONrag S�f FINAL
7IALTd1 000 3 1•R4,
TEMPLE CITY
76AS30A CE#*03 263APPLICATION FOR BUILDING PELRgIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY /
JOHN A LAMBIE COUNTY ENGINEfiR NEAREST
WILLIAM A JENSEN SUP T OF BUILDING CROSS ST
DISTR T N TYPE SSED BY
FOR APPLICANT TO FILL IN CONST
BUILDING `��/ �/` GL STATI CAL CLASSIFI CA TION WER MAP
ADDRESS J (� BK
CLASS NO Zd—DWELL UNITS .
LOT NO BLOCK WATER NOT REQUIRED RECEIVED
CERTIFICATE
TRACT MAP HIONWAY STATE MAJOR SECOND A
NO OF BIDGs NO ICIRCLq
SIZE OF LO NOW ON LOT USE ZONE SPECIAL
USE / CONDITIONS
EXISTING BLDG Z
OWN, A BUILDING YARD HWY STRE NAM5,/7 SETBACK WIDTH
ADDRES O FRONT
ARCHITECT OR TEL P L
ENGINEER NO SIDE r
ADDRESS P L d
O
CONTRACTO NO IJ
GC
ADDRES O
DESCRIPTION F WORK LLVrI
d
N
NEW ADD ALTER REPAIR EMOLIS ♦ Z
SO FT NO OF
SIZE STORIES FA ILIES
USE OF
STRUCTURE 42
SIGNATURE OF
APPLICANT
VALUATION S eV
APPROVALS DATE INSPECTOR S SIGNATURE
PC PMT FOUNDATION LOCATION
FEE S" FEE $ FORMS MATERIALS
FRAME FIRE STOPS
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE To Co MPLY FURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HERCBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT
TIOM OF THE LABOR CODC OF THE STATE OF CA FORNIA RELAT
[NO TO WORKMEN E COM ISATION 11 NCE LATH EXT
SIG U HOUSE NUMBER COR
PER RECT AND POSTED
ADDRES FINAL -(4-
PLAN CHECK VALIDATION CK w o CASH JOHN F LEWIS PRINCIPAL STR AL ENGINEER
PERMIT VALIDATION UK No CASH
L,jW 5 9 8 5:O FEB 2 7 1 D 4.00-
764638A E2aI S3 86 t
PPLICATION FOR 8UDi IG PERMIT
COUNTY OF LOS ANGELES "U'L02
DEPARTMENT OF COUNTY ENGINEER ADDRESS 551111 P21 MAI
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
}�
COLEMAN W JENKINS SVP'T or BVILOINc CROSS ST. Daa ur
❑IS ICT N{iy 0 TYPE P O Sfl�BY
FOR APPLICANT
� TO FILL IN OV coNsr. �
BUILDING Pal Mal STATISTICAL C(}/�3IFICATION SEWER MAP '
ADDRESS CLASS NO. DW
ELL UNITS BHG PG/,Z;rA
LOT NO. BLOCK U ZONE MAP
NO.
TRACT 2$607 SPECIAL
N0. OF SLOGS,
SIZE OF LOT NOW ON LOT
USE OF Cv, L40 4A �hds
N tingleFam. Res. BLOC. SMACK FROM
TEL FRONT PROP. LINE OF (STREET)
OWNER NO. TYPE OF EXISTING I SETBACK I HIGHWAY t YARD = TOTAL
ADDRESS HIIHWAY FRQM C.L.
CITY
Tem le Cit D + U = a
ARC HITEC OR TEL. BLDG. ROP.SETLIN FROM
ENGINEER h0, $ID[ PROP. LINE 01 !TREAT(
TYPE 01 [%ItTINS ![TSACK HIGHWAY } YARD = TOTAL
ADDRESS HIGHWAY WIDTH IROM C.L. y
TE'_ } p
CONTRACTO NO
ADDRESS 18 Camellia LIC NO f2'Ni-Bl CORNER CUTOFF YES NO O
clrr Temple City `L F
SEE REVERSE SIDE FOR SPECIAL APPROVALS w
DESCRIPTION OF WORK Z
NEW ADD L ALTER A REPAIR DEMOLISH -
SO.FT. NO. OF NO. OF
SIZE STORIES FAMILIES j ) �"y' - . :1 A
USE OF _ (�• I `
STRUCTURE
go IF ry I
SIGNATURE-OF
APPLICANT 7 A
VALUATI s , _ / APPROVALS DATE INSPECTO 'SSIGNATyAE
-�S] FOUNDATION, LOCATION
FEE $ � FEE$"--� ! FORMS, MATERIALS
FRAME, FIRE STOPS,
I HERESY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS tA-
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DU CTS
•UILOING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK
AUTHORIZED HERESY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT.
TION OF THE LABOR CODE OF THE STATE OF CALIFON IA RE
INOTO WORKMEN' PENMTIONI SURAN LATH. EXT.
SIGNATURE HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS Tvce FINAL il>
JOHN F. LEWIS. PRINCIPAL ST AL ENGINEER
PLAN CHECK VALIDATION H a _ PERMIT VALIDATIO CK. M.O cABH
�7 4 9 4 Nov22 10 32SO- 9
70AGiY "880L_!-!T APPLICATION FOR BUILDING PE Z
COUNTY OF LOS ANGELES BUILDING -17
DEPARTBUM OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE,COUNTY ENGINEER NEAREST
GSGATT D GRIFFIN au.^T OI BUILDING CROSS ST
DISTRICTNO 11 GRO SEWER MAP
FOR APPLICANT TO FILL IN --.5— CONST a
BUILDING
ADORE88 urySTATISTICAL C S6IFICATION
CLA89 NO E UNIT
LOT NO BLOCK MAP STATE
NUMBER HWY YE NO
TRACT USEZONE 9PEC111
NO OFBLDGS ,^ CONDITIONS
SIZE OF LOT NOW ON LOT +�1(-'
USE OF
EX"n,GBLDQ BUILDING Y RD HWY STREET NAME EXIST
SETBACK WIDTH
OWNER Wlnthw,p 14 rmAn FRONT
MAIL P L
ADDRESS SIDE
T P L
CITY TA A r.1 fa
ARCHITECT OR TEL INSPECTION RECORD
ENGINEER NO
ADDRESS
TE
CONTRACTOR O L
799-517
DO
DESCRIPTION OF WORK
NEW ADD ALTER REPAIR 3r DEMOLISH
SO FT NO OF NO OF
SIZE STORIES FAMILIES
USE OF STRUCTURE
SIGNATURE OF APPROVALS
APPLICANT
DATE INSPECTOR S SIGNATURE
ADDRESS FOUNDATION LOCATION
FORMS MATERIALS
S P C f FRAME FIRESTOPS
�T� FEE BRACING BOLTS
VALUATION�KV•� ♦ 170 FURNACE LOCATION
FEEjjjMGAS VENT DUCTS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP LATH INT
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLYJMITH ALL COUNTY ORDINANCES AND
STATE LAWS U}ATING B I G CONST CTION LATH EXT
SIGNATURE 0 HOUSE NUMBER COR-
SECT AND POSTED
ADORES FINAL IO
JOHN LAMBIE COUNTY ENGINEER CLYDE DIRLAM IRINCIPALS AL ENGINEER
PLAN CHECK V•T IDAMOH CK No CAJIH PEBl9T VALIDATI CK. r o wH
a 1p ' 64449 "24 1 0 12.00" 7
, I
APPLICATIOUKOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
WORKER S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILD&NE / L AL
I hereby ahem that I have a oerhf"t9 of consent to self insure B"L➢aKi= /
a a certificate of Markers Compensation Insurance or a certified Cr G..
copy It—
( Q Lab C IPoi Nosm ��)tr� crry �M `TS L.17 ffi a LOCALITYNo V �0 SIZE OF LOT O OF BLDG NOW ON LOT
11Certded copy a hereby furnished NEAREST CROSS ST
❑ Certded copy a filed with the coy budding mspWion TRACTBLOCK IM
LOT NO
depart it USE ZONE P NO
DateApplpant ASSESSOR MAP BOOK PAGE PARCEL
SPECIAL CONDITIONS
CERTIFICATE OF EXEMPTION FROM WORKERS OWNER L TEL NO YES NO
COMPENSATION INSURANCE 7 WrrHN 1000 FT OF SCI100L7
(This seem need not be Completed d the permit a for one hundred ADDRESS dol ars($1GO)« PAC,
, OsTREir GROVP CONST FIRE ZONE PROCESSED BY
I cerbty that In the perlamarnce of the work for which the permit CITY -r q
e issued I shall net employ any person In any manner so as to ��' -„J
become subleCt to the Workers Compensation Laws ARCHITECT OR WEER TEL NO
STATISTICAL FICATgN IV APT CONDO
Date Applicant ADDRESS CLASS NO DWELL UNRS
NOTICE TO APPLIGNT It after making the Certificate of REOWRED TOTAL SETBACK FROM EXIST
Exempten you shoulo become subed to the Mbrkers CONTRACTOR TEL SET BACK YARD HWY PROP LINE WIDTH
Compensation pranspns of the Labor Code you crust forthwith o
—FRONT
comply With such pfoveens or the Perr1u1 mall be deemed newokaC ADDRESS , O r LLC NO r P L
LICENSED CONTRACTORS DECLARATION a SIDE
CT' LIC CLASS P L
hereby engin that I am licensed o urderprevecns d Chapter 9 s SEWER)AAP
(Cofos&orlllg with andiron 4cens of in fsen 3 of the Ifect se and SO FT SIZE NO OF RES NO FNAILIES
Profeesloru Code and may Icerae e m IWI I«ca Ilect NEW ❑ BK PG loo.
}
License,Numbs/ Lin C� DESCRIPTION OF WORK ADD ❑ yALDAn : a
Contracts _1{/[�y�- ate ALTER ❑ $ Ofl � O
M
❑ I am exempt under Sec �5 ap REPAIR � $ O
f-
BBPC f« the reason =,OJO DEMOL ❑ ADM PAC• W
Date USE OF EXISTING BLDG URM ❑ d
Signature APPLICANT(PRINT) TEL NO LDMA Perm r 1 Z
10,I W Owner of the property « my employees with wages as = ACCT.:
Marr sole compensation will do the work and the structure is ADDRESS 0
net intended or offered for sale (Sedum 7044 Business and FIS DATE Q 3'403 242.10
Profesaarm Code) C
Nil TIE APM1CNrt m FUTIAE alAflwl6 CGCIRIwrT HV T A IAGREATER MATERNL 1 I TEM I
«I A Wnlll>E Ca1TAYWp A IUZA300113 MATEIWL E«wL TO OR GREATER TIYN TIE M r � 7 11
❑ I as Avner of the property am the
cSeCt mg wind AudMrs SPEC on TIE IULFDO rs MA,ERws 14F M TpM aunEt FINAL BY > TOTAL 242. 10
Icenses contractors to Code)
the protect (SecixOn 7044 YEs❑ Io❑
Business end Professions Code 1
wLL TIE MENDED USE « TIE BUOUA IN TIE N'PLpIwlT m FUTURE BllapNa CHECK 242.10
CCCUPAKT RECURS A PERAVT FOR CD!Sen CTpN 011 M064pL.T101I FRCIA TIE a011TI
CONSTRUCTION LENDING AGENCY COAaT AR a1AurY vARAOEWW DSTWT(u D)ME PERMITRNO CHECKLIST Foil I'HALL-C .00WDEU s
I hereby affirm that there a a construction lending agency for YEs❑ Ip❑
n
the performance,of the work for which the permd a issued(Sec
oIIIWE PEM TIE INZNro019 AUTER413KmYAlpNDUDERND TIE 9LAOI.OPERLIITWp
3097 Cm C) CIECItIIeT I ulnEgsLerD w MooAwExErns J"DiR E MANC
Ds EMES CouWY coaE
Lenders Naez OM noz ��iW AT S a�, ""�""°°'� ��►'OOU1 7/16/93
Nam min
137556 1 AM 7-52
o Lenders Address
I ceraty that I have read the application and state under penalty
8 of perNry that the above Information a Correct I agree to comply PC FEE PEFDWT FEE
$ with all dainty ordmarces and State laws relate g to bulldog
canntr5 9p here home repree r tatnres of the County ISSUANCE FEE
g ear Lq0 1� b en d property f« r s
n "JESTIGATION FEE TOTAL FEE O
SEE REVERSE FOR EXPLANATORY LANGUAGE
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 1501140061
PHONE (626) 285-0488 EXT
LEGAL ID I NO OF CONST I BUILDING ADDRESS
ITR 28607 LT 14 SQ FT STORIES TYPE S541 PAL MAI. AV
(STRUCTURE 24 V-B TEMP CA 917802851 I
(ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET
18586-011-059 I I THOMAS PACE 597 GRID C3 LOCALITY TEMPLE CITY CAI
TENANT EXIST BLDG USE RESID USE ZONE R-1 ISSUED ON PROCESSED BY
(EXIST OCC GRP 101/14/15 SR 1
(OWNER TEL NO IBLDGS NOW ON LAT VALUATION IF AAL DATE FI BY CODE
KWOK FRANK YUK LINDA PO YIN LO (626) 579-4170- 1 7 000 1 �2
5541 PAL MAI. 1
EMP
T9178028511 I FEES PAID I CRI PT ION OF WORK I
I1 EAR OFF ALL iAYBRS OF ROOFING ON HOUSE AND GARAGE NAIL DOWN1
I IFEE DESCRIPTION QUANTITY VOM AMOUNT 30# ASTH FELT INSTALL 30 YEAR GRADE A SHINGLE I
1APPLICANT TEL NO I I I
MARTIN KEVIN (626) 333-5615- IAA BLDG PERMIT ISSUANCE 27 BO I
1507 N AZUSA IAB STATE GREEN BLDG FEE 7000 00 VAL 1 00 ISPECIAL CONDITIONS 1
11A PUENTE CA 91744 IAC STRONG MOTION REBID 7000 00 VAL 0 70
ID2 PERMIT W/O EN-HC 7000 00 VAL 166 20
I 1 TOTAL FEES 195 70 I_ I
ICONTRACTOR TEL NO I (APPROVALS DATE INSPECTOR SIGNATURE I
IREXWAY ROOFING INC (626) 333-5615 1 1 1
1507 N AZUSA AVENUE #C LIC NO I VACATION AND SETBACKS I
IIA PUENTE CA 91744 655986 I 1 1
I ISOILS ENGINEER APPROVAL 1 I 1
(ARCHITECT OR ENGINEER TEL NO FOUVDATION/TRENCH FORMS
LIC NO SLAB/UNDER FLOOR 1 I
I (RAISED FLOOR FRAMING I
IMAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP I IUNDCRFLOOR INSULATION I
I 3 001I I 1
IND OF FAMILIES DWELLING UNITS APT/COND STAT CLASS I I PIAOR SHEATHING
I I I
NO 21 I R00' SHEATHING
I I I
SCHOOL WITHIN HAZARDOUS I SHEAR PANELS
(AIR QUALITY 1000 FEET MATERIALS
NO NO NO i (FRAME INSPECTION 1
1 IFIRE SPRINKLER HANGERS
I I I I I(I
1 I IINBDLATIDN/WFATHER 91RIPI ( 1
(INTERIOR LATH/DRYWALL
I I I I I
1 I I Cil(TERIOA LATH 1
RATED PIAOR/CEIL ASSEM I I
I I (RATED WALLASSETIDLIES
I
(RATED SHAFTS OPENINGS
IT-BAR CEILINGS
I I I
(IAT DRAINA08 1 I
IREPORT ID DPR261 ROUTE TO BS0508 1
1 I I I I