HomeMy Public PortalAbout5635 PAL MAL AVE_Building__ 7 5A036 CE 4P Rw 6-62 APPLICATION FOR BUILD NG PLA0
COUNTY OF LOS ANGELES BUILDING
r DEPARTMENT OF COUNTY ENGINEER noDREss
BUILDING AND SAFETY DIVLSION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST L-12 s--
WILLIAM
-WILLIAM A JENSEN BNP T OF BUILDING CROSS ST
DISTRICT GROUP TYPE P- SSED BY
FOR APPLICANT TO FILL IN CONST
BUILDING STATISTICAL CLA SSIFICATION , S WER MAP
A ESS BK P
CLASS NO _DWELL UNITS t
OT BLOCK WATER y ..1
CERTIFICATE OT REQUIRED RECEIVED
,TRACT MAPHICNwAY - -
p NO OF BLDGS _ NO (CIRCLE) 'STATE MAJOR SECOND L CAL
SIZE OF LOT NOW ON LOT USE ZONE` SPECIAL.
USE OF . /I� � CONDITIONS `
EXISTING BLDG r //T• I
16 TEL
OWNER ` � ^ NO 11 klql BUILDINGEXIST ( I
/�L SETBACK YARD HWY ST TNAM k WIDTH `
ADDRESS ^ FRONT
ARCHITECT OR TEL P L ~
ENGINEER NO 1�P
ADDRESS TEL -✓ A,9-10A Mme'1 / //'t/+D u
ONTRACTOR NO
DDREOC55
DESCRIPTION OF WORE
EW ADD ALTER REPAIR DEMOLISH
IZE SNO OF
TORIES / NO OF EB J~,.,/}]� • ��* L �, ��P�1/ r �ifl ' Z
SE OF
gTRUCTURE �.-,
1l-c,f 16BFT IQoT(CE -1 CPu lurT
SIGNATURE OF c OILS I Id PC T W41LIAjT
APPLICANT 4 /J
VALUATION $
/ ' ti APPROVALS I DATE INSPECTOR 65ICNAT RE
PC PIATJ A� I FOUNDATION LOCATION
* J
FEE $ FEE $ FORMS MATERIALS //S / �/✓I"
FRAME FIRE STOPS
I HERESY ACKNOWLEDGE THAT V HAVE READ THIS APPLICATION BRACING DOLTS C 8/j tt[[
AND STATE THAT THE ABOVE 16-CORRECT AND AGREE TO COMPLY FURNACE LOCATION t
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING , GAS VENT DUCTS
SUI LDING CONSTRUCTION I C TIFY THAT, IN DOING THE WORK y
AUTHORIZED HERESY I WILL T EMPLOY ANY PERSON IN VIOLA LATH INT t '
TION OF THE LABOR OC THE RTATE OP CALIFORNIA RELLT
INC TO WORKMEN PE ION IN URA CE T ' • /� LSI
' (LATH^EXT (�s
SIGNATURE OF HOUSE NUMBER COR' /
PERMITTEE _ RECf AND POSTED
ADDRESS 'FINAL , Ai �6,f A
JOHN F LEWIS PR NCI L STR RAL ENGINEER
PLAN CHECK VALIDATION CK ' M D CASH _ PERNIIT VALIDATION GK M D CASH
L iCO 0 5 1 7 FEB 1 1 D 1 1 .50—
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f iJ
APPLICATION_FQ -BUILDING PERMIT
COUNTY OF LOS ANGELES d } BUILDING AND SAFETY
FOR APPLICANT TO FILL IN 81L� ADDRESS
pa
WORKER S COMPENSATION DECLARATION rj
' 1 BUILDING ADDRESS -
n I hereby affirm that I have a certfaate of consent to self Insure _ PAI ,
or a cerliflcate of V,bInsurance o
rkers Compensation Icr a certified - -
0 I
copy,thereof(Sec 3800 Lab C I CITY ZIP
T e c o t LOcnLrry ,
Policy No Comi Tem I e C I't
SIZE OF OT NO OF BLDGS NOW ON LOT +
❑ Certified copy Is hereby furnished NEAREST CROSS T ,
❑ Certified Copy is filed with'the county building nspectan ^ TRACT BLOCK LOT NO L rhI C Oak - 1
department j USE ZONE MAP NO
Date "I Applicant ASSE R K RAGE PARCEL
Qty D ,7 SPECIAL CONDfTIONS
CERTIFICATE OF EXEMPTION FROM WORKERS
OWNER TEL No + - f YES No ,
COMPENSATION INSURANCE R' — G{j.� n Gni R/0'- o -O WITHIN 1000 FT of SCHDOP
ADDRESS
(Thus section need not be completed if the'permit m for one hundred p/ _ I l pSTii1GT GROUP TYPE CONST FIRE ZONE PROCESSED BY
dollars ($100)or less) - J mR '
I cer CTY ZIP
trfe that h the t erfprloy an of the work for mann this as to E /e G2i
is issued I shall not empty any person m arty manner so as to !/D
become subject to the Workers Comper5atan Laws 'I ARCMfTECT OR ENGINEER - TEL mraT1CAL CATION APT CONDO
r,
Date Applicant ADDRESS - - CLASS NO DWELL UNfTS
NOTICE TO APPLICANT- If after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST'
ExEmphorl you should become subject to' the Nbrkers CONTRACTOR — TEL NO SET BACK YARD My _ PROP LINE WIDTH
Compensation provisions of the Labor Code you must forthvathFRONT '
complyLwith such provisions or this permit shall be deemed revoked ADDRESS IK NO PL
SIDE
LICENSED CONTRACTORS DECLARATION CITY _ LIC CLAS P L _
j 1
I hereby affirm that I am licensed underprovisions sof Chapter 9, SEWER MAP
(commencirq with Section 7000)of Ow6ion 3 of the Business and SD FT SIZE NO OF STOPoES NO OF FAMMJES '
Professions Code'and� license is in full force and'effect' � NEW ❑ 'BK PG ; r d
IUcenae Number -Lc Class MSG WORK ADD O $UA�N �� _ Q
cc
Contractor Date GG -�- ALTER El
❑ I am exempt under Sec REPAIR ❑ 23 0
BSPC for this reason ,y>L DEMOL ❑ LDlM Pica ACCT.i V
W
' Date USE OF EXISTING BLDG URM ❑- '- 1 3303 ' 50.50
Sgnetum APPLICANT(PRINT) TEL NO LDMM Perm♦ 1 _ z
I•as owner of the property or my employees with wages as = 1,1,
tf1Hr Sole Compensation will do the Work and the structure is ADDRESS , F ACCT`.T
not intended or offered for Sale (Section 7044 Business and FINAL DATE G 3303 125.75
Professions Code) wr,L THE MPLIGVIr OR H-MURE WLONG OCCUPANT H D E A HAZ/3i4:A18 MATERAL '
❑ I as owner of the property am Exclusively contract) with OR A MIx E CCNTNNINO A HAZADOUS MATERIAL EOUAL TO CR GREATER,THAN THE T ['��
WOLHIe SPEGFED ON THE HA]A3>ro115 MATERMLS INFORMATION GUIDE' FINAL BY > ' 1`2 1TG IBJ
laerlsed contractors to construct the project (Section 7044 rss❑ ro❑ I F I -
Business and Professions Code) - � 1 TOTAL 1-76 - 25
WILL THE INTENDED USE OF THE IIIRILNG BY IXE IPFIJGM OR r1TTLRE eULpNG ,
6.2I_ OCCUFPNT REQUIRE A PERMI FOR CONSTPUCTON OR MOOFlCATION FROM THE S 11
CONSTRUCTION LENDING AGENCY Ca MR QUAurY M GEMENT EISTLCT NSC Vm SEE PERMIITNG CHECKLIST FOR • '1 CHECK 176.29
1
hereby affirm that there is a construction lending agency for11SNp❑ - I, _ - t� _r 'CRAKE •00
the performance of the work for which this permit Is issued(Sec
W HAVE READ THE HNAfLCIF MAIEPdLL9NFORMATaNGuoE ANO THE SCILMOPERMIiID ✓' J` A' r '
n 3097 Civ C) i� CHECKLIST I UNDERSTAND MY RECUREMEITS UNDER THE 1-08 ANGELES COUNTY CODE - ,:'�• N)} J ,DO
TITLE 2 CHAPTER 220 SECTIONS 2 20100 THiOUGH 2 2D 100 CONCERNING HAZARSCCS �
Lenders Name MATERtML3 REPORTING AND FOR OEI A G A PERMIT FROM THE SCAOAD 00�-0001 9/ 6/45
Lenders Address - -
m �m 2154 R 1 AM,,E:15
1 certify that I have read this application and state under penaltyf
g PC FEE PERMIT FEE
N
with
perjury that the above s and
is correct agree to campy LSD, d
with all county omlrnances end State laws relating to building
construction and hereby authorize representatives of this County ISSUANCE FEE I ij �yO
to a upon the�mentaoparty for ins
m x INVESTIGATION FEE TOTAL FEE L r
1 \ SEE REVERSE FOR EXPLANATORY LANGUAGE
WORKERS COMPENSATION DECLARATION ,
APPLICATION FOR' �ll,ILDING PERMIT
hereby affirm that haveta cerhfi cote Sconsent to self _ t
insure ora irmfthate of ve,a seComp tic r- '
ryfyaae������opy-1 a eof ec-38 Lab r
COUNTY OF LOS ANGELES `` @ BUILDING AND SAFETY
Its?ry •�' .
y `
Certified copy is hereby'f nrshed -- - BUILDING , `' ve
❑ / /���� -FOR APPLICANT TO'FILL IN ADDRESS `
`2'Certified cop.is filed with the county'budding msp c- BUILDING ��//''� �/ �y�/
LJ tion department �- `y• ' 1 - ADDRESS D[y�� /Y •/I/7G LOCALITY
�]/
a'DateyApphca rf `• n��l�V�/ CITV- 6.Y7 5 �� ZIP - CROSSSST
CERTIFICATE OF EXEMPTION FROM WORKERS I- NE "
`„' s O Of BLDGS �* ASSESSOR
COMPENSATION INSURANCE SNOW ON LOT - MAP BOOK PAGE PARCEL
(This section need not'be completed if the permit is for oneJ < - USE ZONE
hundred dollars (b1DD)or less ) • , , BLOCK LOT NO NO .L Y.
!�, r < /' TEL SPECIAL ! i O
� NO r. CONDITIONS
( 916
•certify that in the`performanca of the work for which this V
t ` DISTRICT GROUP TYPE \ FIRE P D BVpermit is issued shall not employ any person in any manner d so as to became subject to the Workers CompensatronvLaws G �� CONST Z,Date ' "Y ° Appbcarit ' �/ /� -/ ZIPSTATISTICAL APT CONDO
"NOTICE TO APPLICANT If- after nri this Certificate of ENGTEL
•• �! t,. NO .�- - °Exemption you should become subject to The' Workers _ CLA55 NO Cl'DWELL UNITS_ - d
N
e '.Compensation provisions of the Labor Code ryou must forth .r' ADDRESS ' l t SEWER MAPF t n'
with comply with such provisions or this permit-shall be ,/C yam~
deemed revoked - y CONTRALTO '- ryG ^NL' -/Yy t BK PG r - VALIDATION S` `
-,LICENSED CONTRACTORS DECLARATION y.,s . IC _
hereby affirm that I am licensed under provisions of Chapter 9 ' ADDRESS /D"_ !/l�il/ O��T�`/'' VALUATION .F
(commenting with Section 7000)of Division 3 of the Business and / / LIC r '
Professions Code' end license is in full force and effect CITY_5a'e p�•� CLASS / 5 �,SG�/01
�'. - -
�qQ�/
SO FT - NO OF NO OF CHECK,'
` F2�� // �'` \ ' SIZE 7TC� STORIES t /• '
' License Numbe r Lic Class f FAMILIES I ONE
ej- ���G '�� DESCRIPTION OF WORK ' NEW t
Coniracto Date - /L ON W
_ +❑ /V4EW f/ GA1.-' - ADD y
am exempt from the licensing requirements as am a t -
L1 11
censad architect or a regtstered'professionol engineer �� n� ATTER Q ,- FINAL
rI' f/ ❑ 'DATE J/ G
acting in d professional capacity (Section 7051, REPAIR - y
Business and Professioris Coda) ' _ USE OF
,-: Exl5T1NG BLDG ` i tie e . ` DEMOL FINAL
Cc'0_r Reg No Date y � _ APPLICANT / t TEL By gr • t
OWNER-BUILDER DECLARATION - (PRINT `p - Nf17-16
�I hereby affirm m tractor that I aexempt from the Cons License
..Law for,the following reason(Section 7031 5 Business and ADDRE �06- DEAN ��✓,J �� y" `"� ' '6 `
v
Professiohs Code) I
ai ow
er .. _
` nof-the property or my employees with BUILDING
_
wages as their sole compensation wd1 do the work and LOCALITY - - _ ..r _ �'N ' e ' �•2 0 9 4 A -
the structure is novintended or offered for sale(Section '- - - 1
7044 Business and Professwns'Code) MOVING TEL '
. - _ _ '•
I as owner of the property'am exclusively contracting' CONTRACTOR 4 NO- � t
❑' with licensed contractors to construct therproject (Sec ADDRESS '
bon 7044 Business and Professions Code) '' s --r - 2 5.1 00 '
constructionREQUIRED TOTAL SETBACK FROM EXIST s _ • • ,,
' CONSTRUCTION LENDING AGENCY SET BACK YARD NWY PROP LINE All r .�
•+ hereby affirm that there is a construction lending agency Tarr - FRONT '.5 0,Y50
thp
e erformance w
of the ork for which this permit is issued P L• 7 v `` _ ( 1 3 0 8 1
_(Sec 3197 Civ C ) _ _ _ 'SIDEGl - ..... -.. - r - - = �' - - >•- '
PL t vu e
Lander Is r fame J _ - - K 1 - r -1 '
Lender s Address PC Fee,E Perma Fee
w certify that have read this application and state that the P Issuance Fee / a s `
above information is correct agree to comply with all County ._ Investigation Fee- .-._ .. } -•- - `•
ordinances and State jaws relating to building construction total Fee V .•
x =and hereby authorize represenfah ves of tFi is,County to enter T -
ti up ,/th�ls abo a nti o'ned prope7ty for mspe`cbon p, poses F- _
�'! �X.�7� _ �/ �S / 6 - • SEE REVERSE FOR EXPLANATORY LANGUAGE • • '
Signature of Applicant or Agent Date
APPLICATION FOR BUILDING PERMIT}}
COUNTY OF LOS ANGELES BUILDING AND SAFETY 3
FOR APPLICANT TO FILL IN BUILDING TRE
WORKER'S COMPENSATION DECLARATION bb
BUILDING ADDRESS
I hereby affirm that I have a mpen ati of concent to calf Ireure
rh
c a certificate of 38DO L Compensation Insurance or a certiffe0 '
copy thereof(Sec 3800 Lab C) Cf_ ZIP (? 0
Policy No Company ( N LOCAL" ^� MI
SIZE F LOT NO OF SLOGS NOW ON LOq�_ V a 1
❑ Certdled copy s hereby furnished J� NEAREST CRGss sT
❑ Carolled copy s filed wM the county, budding Inspection �'� -1 LLOCK L TNO` .Q
department y /- •�. USEZONE MAP NO
I ASSESSOR Date - Applicant MAP Boo PAGE I 1 PARCELy 'I SPECIAL CONDITIONS
CERTIFICATE OF EXEMPTION FROM WORKERS' - (,� T gNo - WITHIN toxo Fr of SCHOOL?SPECIAL
YES NO
COMPENSATION INSURANCE
(Thio section need not be completed If the permit n for one hundred 3 M I DISTRICT GROUP TYPE CONST FIRE 20HE
J V
dolim($100)or lees) 4 CITY v ZIP � Y✓� Lj�/ 2
I certify that In the performance of the work fa which this pennd Y/1
m bl2,•.,3 J
Issued I shall not employ any person In any manner s0 F1 as t0 ARpt CT ENGINEFA - TNO
become subject t0 the Workers'Compensation Laws STATISTICAL CVSSIFICATION I APT JrlCO
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 SETBACK YARD rWY PROP LINE WIDTH
Compensation provslors of the Labor Code you runt forthwith
comply with such provisions or this permit Shall be deemed revoked ADDRESS LIC NO FRONTPLIL
LICENSED CONTRACTORS DECLARATION CITY SIDE 1
LIc cuss P L
I hereby affirm that I am licensed under provisions of Chapter BSEWER MAP
(Commencing with Section 7DOO)of Division 3 Of the Business and SQ FT SIZE NO OF ORES NO OF FAMILIES
Professions Code and my Iroense s In full force and effect NEW ❑ BK PG ALT+
License Number LIC Class D ION OF W(M `� ADD ❑ VALUATION , a
Contractor I Date �f) `11� ALTER z
,❑ I am exempt under Sec {_ \.Y'� REPAIR ❑ $
B SPC for this reason DEMOL ❑ LOMA P/C 0
Date OF EXISTING BLDG URM ❑ ,
SignatureA
APPLICAW(PRtT I ` TEL NO1 I LOMA Pym 6 1
C1I es owner of the property or my employees with wages as OlitIA4 % - O Aff T.i
their sole compansebon will do the work and the abucturs is ADDRESS( \ F -rc
not Intended or offered for sale (Settlor, 7044 Business and _ RNALD T�] Imo,
PFOfeSelOfn Code) -waLTHEAPPLIGNfI011 FUTtAIE901tLOI3 IW1UU`A IIATBWL rA • ,� 1 ITEI i�
❑ I as owner of the property em exclusively contract) with �'�Wxn1BE CCNTAININO A HAIAADOUS 4ATFAIAL EQUAL TO OA OREAT91 THM
ng MAYNUIU906rtAIDp1 ANE HAZMDOUILMTDiLl UAIpiWTxIN eOIOEI FINAL BY ♦��
licensed contractors to construct the project (SeCWO 71314 M NO❑ ' TOTAL '58 - 75
1 Business and Professions Code) �J[' {/
K
WILL TIE eliBaJFD V3E OF THE BIALDINO 4Y n1E MPLIC.Wi OR NM1E eUUxNO C FICC 58.f C
COAST
AIR
QUAJLrEA PDwIn FCB LONruuCT r(8C OBD)IME TgNFRfMITHESOUTH
` CONSTRUCTION LENDING AGENCY F�uu oELu�NANAOEMENr asTmcT tec�owot SEE Fv+wT*eIo CHECq.IST Off
herebyth1
CHANGE �-
I hereby affirm at there s e construction lending agency for t.Ey 1:1 No Cl - '
the performance of the wok for which this permit IS sued(Sec I NAVE Pecan THE NAZMDOUS IIATEAI B INFORMATION GUHM MD THE BCAOYD
3097 C.IV C) PEA WTTWG tl1ECKIJST I UIOEASTMD W riEOU1REMErrt6 UNDEA THE LOCI ANGELES
Lender's NameIwAeoous�MATEri a nr�iosiwo�oR ae�rAl'ruw it uTtEr 1303—ow1 ]/ .'/90
Landers Address; 1647 1 AN1f1:17
o I certdy that 1 have reed this application and state that the above
Information Is correct 1 agree to comply with all county, PC FEE PERMIT FEE
ordinances and State laws rolating to building construction and
hereby authorize mpresentahm of this County to enter upon ISSUANCE FEE I3• ry O
the above-mentionparty for Ins tKm purposes
ro _, �J 7 Q D INVESTIGATION FEE TOTAL FEE r
p/r{Yi.
BEE 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 0403250002
PHONE (626) 285-0488 EXT DUPLICATE
LEGAL ID NO OF CONST- BUILDING ADDRESS
TR 8822 LT 1 BL 001 SQ FT . STORIES TYPE 5635 PAL MAL AV - - • -
STRUCTURE 2100 VN TEMP CA 917802855
ASSESSOR INFORMAiIUM NUMBER 8586-012-027 NEAREST CROSS STREET LIVE OAK
THOMAS PAGE 597 GRID C3- LOCALITY TEMPLE CITY
TENANT EXIST BLDG USE RESID 09-20NE-W-T— ISSUED ON PROCESSED BY EXPIRES ON
EXIST OCC GRP 03/25/04 VG 03/20/05
OWNER 5NOW ON LOT VALUATION F!4 N OD
KOU TAI HSIEH 8 YUAN HSIA CHUANG (626) 447-6624- 5,800 „ / G�
5635 PAL MAL AV l� �i�7i(1
TEMPLE CITY 91780 T/OEXI� UP OOF, R�
T/0 EXIST ROOF, REPA ROTTED WOOD AND INSTALL 30-YR COMP
APPLICANT TEL NO FEE DESCRIPTION QUANTITY LION AMOUNT SHINGLES ON PITC4ED OOF 8 MODIFIED TORCH DOWN ON FLAT AREAS
NEVADA GOLDEN KEY (626) 285-9016- AA BLDG PERMIT ISSUANCE 27 75
AC STRONG MOTION RESID 5800 00 VAL ` 0 58 SPECIAL
D2 PERMIT W/O EN-HC 5800 00 VAL 149 40 '
TOTAL FEES 177 73
CONTRACTOR. 0 APPROVALS DATE INSPECTORSIGNATURE
NEVADA GOLDEN KEY (626) 285-9016-
4533 SHIRLEY AVE LIC NO LOCATION AND SETBACKS
EL MONTE CA 91731 775115 C39
SOILS ENGIN55R
ARCHITECT OR ENGTgn'V— TEL NO FOUNDATiON/TRENCH FORP-9-
3 LIC NO SLAB/UNDER
RAISED FLOOR FRAMING
MAP NO SEWER00 C P UNDERFLOOR INSULATIOR
XX 3 01
NO OF FAMILIES -DRnTTWr0NIT'9 APT/COWD STAT CLASS T15M-'§MTHING
NO 21 ROOF
--trWE WITHIN HAZARDOUS SHEAR PANELS
AIR QUALITY 1000 FEET MATERIALS
NO NO NO FRAME INSPECTION
REQUIRED M A79FTEIACK FROM EXIST FIRE SPRINKLER HANGERS
SET BACK YARD HWY PROP LINE WIDTH
FRONT PL- INSULATIDN/WE.ATHER SIRIP
SIDE PL- _
INTERIOR LATH/DRYWALL
EXTERIOR LATH
LI
RATED SRAFTSJOPENIM—
T-W CEILINGS
* ADDITIONAL DATA ON FILE
LOT DRAINAGE
REPORT ID DPR261 ROUTE TO BS0508
i
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 7 BUILDING PERMIT `
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTFRATION/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 8L 0508 0403250002
PHONE (626) 285-0488 EXT
LEGAL ID NO OF CONST BUILDI G_ADDR
TR 8822 LT 1 BL 001 SQ FT STORIES TYPE 5635 PAL MAL AVASSESOR INFORMATION NUMBER:— • '
STRUCTURE 2100 VN TEMP CA 917802855 '
NEAREST CROSS STREET LIVE OAK
8586-012-027 THOMAS PAGE 597 GRID C3 LOCALITY TEMPLE CITY
TENANT EXIST BLDG USE RESID USE 'ZONE–V-7— ISSUED ON PROCESSED BY EXPIRES ON
EXIST OCC GRP 03/25/04 VG 03/20/05
OWNER BLD69 NOW ON LOT TIO FI D
KOU TAI HSIEH 8 YUAN HSIA CHUANG (626) 447-6624- 5,800
5635 PAL MAL AV /b
TEMPLE CITY 91780 - - -
T (EXIST ROOF, REPAIR ROTTED WOOD AND INSTALL 30-YR COMP
APPLICANT FEE DESCRIPTION QUANTITY UOM AMOUNT S INGLES ON PITCHED ROOF 8 MODIFIED _TORCH DOWN ON FLAT AREAS
NEVADA GOLDEN KEY (626) 285-9016- AA BLDG PERMIT ISSUANCE 27.75
AC STRONG MOTION REBID 5800 00 VAL 0 58 SPECIAL
D2 PERMIT W/0 EN HC- 5800 00 VAL 149 40
TOTAL FEES 177 73
CONTRACTORAPPROVASIGNATURE
NEVADA GOLDEN KEY L H L OR
(626) 285-9016-
4533 SHIRLEY AVE LIC NOLOCATION AND SETBACKS
EL MONTE CA 91731 775115 C39 * '
SOI LS i
N RO
ARCHITECT OR ENGTNEER TEL NO
r FL�p6AfIbAJf�EAZTF6kA�'
LIC NOA�C�/UNp "FL (t
I --
MAP NO
SEWER PMTT5ffZ'_ PAGE FIRE ZONE CMP UNDERFLOOR INSULATION
XX 3 01 1
NO OF FAMILIES -NELLING LIMITS APT/COND STAT CLASS. Tr5ffff7MTHING
NO 21 RabF3AEA1HiNc
HAZARDOUS
AIR QUALITY 1000 FEET MATERIALS
NO NO NO FRAME INSPECTION
SET BACK YARD HWY PROP LINE WIDTH
FRONT PL- 1
INSULATION/WEATHERST
SIDE PL-
A
EXTERIOR
LAT
RATEDL ASSEMBLIES
T-BAk CEILINGS
! I
* ADDITIONAL DATA ON FILE
LOT DRAINAGE
REPORT ID DPR261 ROUTE TO BS0508