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FOA636A CE#SGS s-69 APPLICATION F'OR'BUILDING PERMIT LJ
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS O5 ( /L
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A.JENSEN, SUPT OF BUILDING CROSS ST.
D�ST�iIC N G TYPE P
FOR APPLICANT TO FILL IN `j TYPE �
BUILDINGSTATISTICAL CLA IF TION S WER MAP
ADDRESS. J"7O �Iy14eoSE v BK
CLASS. NO. DWELL.UNITS
LOT NO. IV 1 ]� �jr7 BLOCK WATER
CERTIFICATE: NOT REQUIRED ❑ RECEIVED
TRACT
/N ( !y, sv MAP DHIGHWAY STATE MAJOR SECON ,LOCAL
NO.OF LDGS. NO. (CIRCLE)
SIZE OF LOT $'O NOW ON LOT / �S Z E SPECIAL
USE OF `.v )¢ CONDITIONS
EXISTING BLDG. Esi ovcg-
o TEL. 9C
OWNER PE /C)tvl NO. B ILDING EXIST.
SETBACK YARD HWY STREET NAME WIDTH
ADDRESS '577Q ,01RO aVF FRONT e-
ARCHITECT OR TEL. P. L. ozo
ENGINEER NO. SIDE
P. L
ADDRESS ,l_ I ( C
1111,411, f
CONTRACTORkowwrovaewir-
ADDRESS ,7, O O ryD� GCi SS
DESCRIPTION OF WOR$ l/`}�
�.�•- Gam-`"--' �.��� r W
NEW ADD• ALTER REPAIR DEMOLISH r (7 W
SQ.FT. i NO.OF NO.OF
SIZE 7 STORIES FAMILIES
USE OF f 4 lC%7' .��YG/•A✓�f1+r� s� .,.%
STRUCTURE F.19^111- Y ROO'"� / 7 " / l• a +j
GA RA CA5 XX SI AI as
SIGNATURE OF
APPLICANT
VALUATION$, ,13 C! `Vt �D
APPROVALS DPyTE INSPECTOR'S SIGNA u i"
PMT. .� FOUNDATION: LOCATION
FEE $ FEE $ JV` ( v V FORMS, MATERIALS /..
FRAME: FIRES TOPS, a T f �'" 1" 01
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS 9'P`' .FYI J.'�'✓'I•� wf•"'-3�f"�
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE:. LOCATION, /p(y �•/ ��-"�/�y�f�r, ,,�
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS /•/ '� ��i��.(l ,�y
BUILDING CONSTRUCTION.'1 CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA � •�•+�•^�/T�l�•f{
LATH. INT.
TION OF THE LABOR CODE OF E STATE OF CALIFORNIA RE
INC TO WORKMEN'S CO NSA N IN RANGE. LATH, EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS ®/ A FINAL
JOHN F. LEWIS.'PRINC'IPAL ST RAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERIM VALIDATION j M.O.. CASH
L�Af' 5 5 1 1 NOV 4 1 •D : 1 5.0 0~ d
/eA888A 1308-8
APPLICATION FOR BUILDING PERMIT
1•SS
DIVISION OF BUILDING AND SAFETY BUILDING d 6,gF
Departalent of County Engineer ADDRESS
County of Los Angeles LOCALITY
JOHN A.LAMBIE, COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST. 4'
FOR APPLICANT TO FILL IN DIST ICT NO. GROUP ICONS
TYPE
:t: ISEWER MAP
_ T.•
BUILDING MAP /�
ADSTATE
DRESS O NUM ER �v HWY YES ,
LOT NO. t (} BLOCK USE ZONE SPECIAL
CONDITIONS
TRACT•
NO.OF BLDGS. '
SIZE OF LOT I NOW ON-LOT BUIeDING YARD HWY STREET NAME EXIST.
USE OF SETBACK WIDTH
EXISTING BL G. FRONT
` P.L.
OWNER SIDE
MAILL.
ADDRESS O OJWv*✓�trJ P/ / O TRACT DWELL. 1 UNIT 5 INDUSTRIAL
CITY -
TEL 1 DWELL. 1 UNIT
�-L�t NO 6 PUBLIC BLDG.
ARCHITECT OR TEL. 2 DUPLEX 2 UNITS ADDN.,ALT.. ETC.
ENGINEER NO. 3 APT. UNITS
8 MISCEL.
ADDRESS 4' COMMERCIAL
TEL.
CONTRACTOR NO. INSPECTION RECORD.
ADDRESS
DESCRIPTION OF WORK
NEW ADD ALTER REPAIR DEMOLISH
SO.FT. NO. OF NO.OF
SIZE STORIES FAMILIES
USE OFF SSTRUCTURE
SIGNATURE OF
APPLICANT APPROVALS
ADDRESS DATE INSPECTOR'S SIGNATURE
r�0 FOUNDATION:LOCATION
P.C. $ FORMS.MATERIALS
FEE FRAME: FIRE STOPS.
VALUATION $ t-b BRACING. BOLTS
FEE FURNACE: LOCATION,
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GAS VENT,DUCTS
APPLICATION AND STATE THAT T ABOVE IS CORRECT
AND AGREE TO COMPLY WITH AL OUNTY ORDINANCES LATH. INT.
AND STATE LA� RE ULATING UILDING CON TRUC-
TION. 111 LATH. EXT.
SIGNATURE OF �4A� } s:� HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESC�'_�` FINAL
IOHN A.LAME.COUNTY ENGINEER ALIDATION CLYDE N.DIRLAM, CHIEF BLDG. INSPECTOR '
C MO QWH
&1 6 5 7 Z 'ocT24 1 -2.0 0
%
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 SL 0508 0308180028
PHONE: (626) 285-0488 EXT:
LEGAI-I]Y-- NO. OF CONST BUILDING
TR: 6561• LT: 657 SQ. FT STORIES TYPE 5709 PRIMROSE AV:
STRUCTURE: VN TEMP CA 917802508
ASSESS 0 NEAREST CROSS STREET: WORKMAN
8587-011-030 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY
TENANT. EXIST BLDG •
RESID UgroNE: R-1 ISSUED ON: PROCESSED BY: EXPIRES ON:
EXIST OCC GRP: 08/18/03 JK 08/12/04
OWNER: TEL. NO: B DGS. NOW 0 0 VALUATION: A DA N CODE:
GI! ALICIA S - 4,000
5709 PRIMROSE AV arm' �>-
TEMP 917802508 FEES PAID UESCUMOONOF WORK
APPLICANT: p• FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:
T/0 HOUSE & GARAGE; INSTALL PLYWOOD SHEATING & 30Y COMP
TONY R CSUROR (310) 313-1987- AA BLDG PERMIT ISSUANCE 27.75
4073 BLEDSOE AVE AC STRONG MOTION RESID 4000.00 VAL 0.50 SPECIAL CONDITIONS:
LOS ANGELES 90066 D2 PERMIT W/O EN-HC 4000.00 VAL 115.80
TOTAL FEES 144.05
CONTRACTOR: TEL. 0: APPROVALS DATE INSPECTOR SIGNATURE
MARINA CONSTRUCTION SERVICES (310) 313-1987-
4073 BLEDSOE AVENUE LIC. NO LOCATION AND SETBACKS
LOS ANGELES, CA 90066 718537 B,
SOILS ENGINEER APPR A
ARCHITECT OR ENGINEER- L. 0: FOUNDATION/TRENCH FORMS
LIC. N0: SLAB/UNDER FLOOR
RAISED G
MAP NO: SEWER MAP BOOK: PAG FIRE ZONE: CMP: UNDERFLOOR I SULATION
15OH269 3 01
N0. OF FAMILIES: D EL I G ITS: CO D: STA C SS: FLOUR-ISM 9Tff G
NO 21. ROOF SHEATHING
b
SCHOOL WITHINHAZARDOUS SH R PANEL
AIR QUALITY: 1000 FEET MATERIALS
NO NO NO FRAME INSPECTION
REQUIRED O A SETBACK RO EXIST FIRE SPRI G RS
SET BACK YARD: HWY: PROP LINE: WIDTH:
FRONT PL- S LATION/WEA ER STRIP
SIDE PL-
INTERIOR A
EXTERIOR LATH
RATED FLOORMIL ASSEM.
RATED WALL ASSEMBLIES
RATED S/0 GS
T-BAR CEILINGS
OT DRAINAGE
REPORT ID: DPR261 ROUTE TO: BS0508