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Home My Public Portal About6109 PRIMROSE AVE_Building__ DEPARTMENT OF BUILDING AND SAFETY "PIALUALLWI COUNTY OF LOS ANGELES 0 IQ WM. J. FOX. CHIEF ENGINEER U FOR APPLICANT TO FILL IN FOR-OFFICE USE ONLY DISTRICT NO. PLAN UK.NO. PERMIT NO. BUILDING ADDRESS 9 Primrose Avenue 2 z- -tOOALITY 7; cz RECEIVED By DATE OF APPL- DATE ISSUED NEAREST Is C tv BROSS BT. 'Q rlbglal v2Ue, T BUILDING OWNER Meeker and Company ADDRESS MAIL ADDREsa11236 Live -Oak Avenue LOCALITY NEAREST Arcadia TEL. DO-72151 dRosesT. CITY NO. NO.0 Type spoup-r- ZONE PLAN ARM"" FIRE = �J ENGMUR'dReg, A.Bissell Ttl- 20 BLDG. CIRO NO. ETS r :LINE 9 ADDRESS APPROVED TEL. By DjATE CONTRACTOR NO. use APPROVED ONE 171 By DATE ADORESa CORRECTIONS LEGAL DESCRIPTION I LOT No. 27sLocK TR^OT 17179 N .OF SLOGS. -n SIZE DFL13T 6ox98.18 MI N.W.NLOT none - USE orND.OF NO.or 6 one X". 7 -rXISTIN.1313LDig. none Lf"ml IES ROD-I DESCRIPTION OF WORK A NEW x ALTERATION ADDITION j. of REPAIR MOVING .. DEMQLISH SIZE SIZE 6 1113 Rooms STORIES 1 r WALLoor COVERING Plaster a COVERING wo Shgles USE or NEW Residence BUILDING Plan 2-A v- 67; . d)V Garage 18 x 20 I HEREBY ACKNOWLEDGE THAT I HAVE :CAD THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE CORRECTUNDATiON,%LOCATION IN I I-,TOR DATE AND AGREE TO COMPLY WITH ALL DOUNTY.DRDINANCCS FORMS,MATERIALS I v , 4.,-,, AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FIRE STOPS.F=Fall Ila,BOLTS SIGNATURE orCOMPANY PERmlTTmw MMER LA3TP. LATH, INT. AUTHORIZE 59 D%w0J0fA4! LATH, EXT- 7SA63BA-3 7-49 q; -15-0 p.0- PLASTER,INT. - py '7 00 FEE PLASTER,F-x-r. J I VALUATION 0 sc) 3o FINAL 76A838A CE#603 3 CITY\ FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING / / Ci '71 - DEPARTMENT OF COUNTY ENGINEER ADDRESS 01/v / // ' BUILDING AND SAFETY DIVISION %; 6"z!n / JOHN A. LAMBIE, COUNTY ENGINEER LOCALITY �'�'�� J COLEMAN W. JENKINS, SUP'T OF BUILDING NEAREST CROSS ST. /dif/.'•7(��T.• i .FOR APPLICANT TO FILL IN DISTRICT NO. GRO P TYPE eRQCE�$SED BY (Print or type only) Sj CONST. ✓ 7�t / ,1; BUILDING` STATISTICAL CLASSIFICATION JS1EWE-CRIMAP((i i ADDRESS 6109 No. Primrose, Temple City CLASS NO..=:2 ZDWELL.UNITS BK rPG-' LOT NO. BLOCK USffE ZONE NOP✓ TRACT ✓1nI SPECI AL COEDIT ONS NO.OF BLDGS. SIZE OF LOT NOW ON LOT USE OF EXISTING BLDG. BLDG.SETBACK FROM Gerald F. Carroll TEL-285-5416 FRONT PROP.LINE OF (STREET) OWNER NO. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS 61.09 No. Primrose KIr;HWAY WIDTH FROM C.L. CITYTemple City, Ca. �� + 7 BLDG.SETBACK FR-O ARCHITECT OR TEL. SIDE PROP.LINE OF (STREET) ENGINEER NO. TYPE OF 1EXISTING SETBACK I HIGHWA _ YARD = TOTAL ADDRESS I,. o HIGHWAY WIDTH FROM C.L. �\ CONTRACTOR Frank Foulk NO.82-1 8 + a ADDRESS 112 So. Marengo N0 7 '253163 CORNER CUTOFF YES ❑ NO ❑ CITY Alhambra, Ca, cLAss Roofing SEE REVERSE SIDE FOR SPECIAL APPROVALS DESCRIPTION OF WORK "a u. z NEW ADD ALTER REPAIR DEMOLISH SQ. FT. NO. OF NO. OF SIZE STORIES FAMILIES USE OF STRUCTURE Reroof house & Garage SIGNATURE OF APPLICANT VALUATION$550.00 APPROVALS DATE INSPECTORS SIGNATURE P.C. PMT. -FOUNDATION: LOCATION FEE$ FEE$9.00 FORMS, MATERIALS FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION. 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 BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT. LATH, INT. ING TO WORKMEN'S COMPENSATION INSURANCELATH, EXT, SIGNATURE OF HOUSE NUMBER COR- PERMITTEE• /, RECT AND POSTED ADDRESS T2 Cr. Ma»ran eambw%--G^9._ FINAL 5 �3 7 _•— JOHN F. LEWIS. PR�INCIPAL STR RAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION GK. M.O. CASH � �6 .8. 00c_ . SEP17 1 D 9t00- 04-C t tj /•� wbkKERS'COMPENSATION DECLARATION hereby a:-tr?n Jhq!9 I have a certificate of consent to self APPLICATION FOR BUILDING PERMIT � insure,`or o certificate of Workers'Compensation Insurance, or,Certified copy thereof (sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company t n ' ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDR 55. ❑ Certified copy is filed with the county building inspec- BUILDING !.a tion department. ADDRESS .01 � nDatee2&' Applicant /' CITY ! r' ZIP ' LOCALITY or CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. NEAREST / COMPENSATION INSURANCE SIZE OF LOT i NOW ON LOT CROSS ST. (This section need not be completed if the permit is for one ASSESTRACT BLOCK LOT NO. MAPF SOF PAGE PARCEL hundred dollars($100)or less.) OWNER NO.c .rte US EL ZONE [!rPI certify that in the performance of the work for which this 7 . SPE SPECIAL permit is issued, I shall not employ any person in any manner ADDRESS �.nns.Ste_ 1 CONDITIONS O so as to become subject to the Workers'Compensation Laws. 0 C-orqw-, CITY ZIP @S Date Applicant ARCHITECT OR TEL. O DISTRICT GROUP TYPE FIRE P SSED BY NOTICE TO APPLICANT: If, after making this Certific of • ENGINEER NO. CONST. Z NE � Exemption, you should become subject to the Workers' ? AU Compensation provisions of the Labor Code, you must forth- ADDRESS �i k.3 U) with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. ONDO. deemed revoked. CONTRACTOR �� NO. rG �•C LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS l j NO. L SEWER MAP (commencing with Section 7000)of Division 3 of the Business and LIC. Professions Code, and my license is in full force and effect. CITY -2�'�= CLASS -7 BK PG VALIDATION r' SQ. FT. NO.OF NO.OF CHECK License Number ��2 2 Lic.Class_ SIZE -2-.5 STORIES FAMILIES ONE ✓ZT DESCRIPTION OF WORK ✓' VALUATION Contractor - '� Date �� l� `�' NEW ❑ $ ��,�l7 ❑ ADD , am exempt under Sec. /j/� -�� ALTER LJ B.BP.C. for this reason REPAIR ❑ $ Date: USE OF DEMOL ❑ EXISTING BLDG. APPLICANT E. �. 3 2 2 6 A Signature,.( � / ! - ,/ ��$ ��G FINA� )_ OWNER-BUILDER DECLARATION PRINT NO. ' DATE # 0 0 0 0 0 1 1 hereby affirm that I am exempt from the Contractor's License y� Law for the following reason (Section 7031.5, Business and ADDRESS lazoe. AL Professions Code): PRESENT B J �7•� 1:1 1, I a 1 6 2 3 8 I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and /J (! 162383 the structure is not intended or offered for sale(Section LOCALITY o o 7044, Business and Professions Code). MOVING TEL. ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. ( (121 -85 with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). REQUIRED YARD HWY TOTAL SETBACK FROM I CONSTRUCTION LENDING AGENCY SET BACK PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE g P.L. t Lender's Name c7� LDMA Ref. # 3 P.C. Fee$ Permit Fee . !J Lender's Address �] I certify that I have read this application and state that the Issuance Fee V Q •` LDMA P/C# t above information is correct. I agree to comply with all County Investigation Fee aa ordinances and State laws relating to building construction, Total Fee ...J LDMA Perm.# and hereby authorize representatives of this County to enter upon thea ove-menttiioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Ageqf Date APPLICATION FOR BUILDING PERMIT � COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPEP+SSATION DECLARATION FOR APPLICANT TO FILL IN BUILDIN ADDRESS I hereby affirm that I have a certificate of consent to self Insure, BUILDIN OD ISS • /D% / /h Q S L' or a certificate of Workers'Compensation Insurance,or a certified CITY ZIP eTfgSac.380.Lab.C.) o IC I�To. ��(—��Company� 1e L LO LITY SIZE OF LOT NO.OF BLD S.NOW ON LOT L 4!:Z/ Certified copy is hereby furnished. NEAREST CROSS ST. Certified copy Is filed with the county building inspection TRACT BLOCK LOT NO. dee ant USE ZONE MAP NO. DateAppllcant Cl "�ih' ASS OR MA BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNERTEL NO. /_ WITHIN 1000 FT OF SCHOOL? YES NO COMPENSATION INSURANCE ADD ESS GO (This section need not be completed if the permit Is for one hundred 5 c DISTRICT GROUP TYPE CONST' FIRE ZONE PROCESSED BY dollars($ or less.) ZIP ( Q I certify that in the performance of the work for which this permit W is Issued, I shall not employ any person in any manner so as to ARCHITECT OR ENGINEER TEL NO. become subject to the Workers'Compensation Laws. STATISTICAL CLAAS��SIFICATION APT CONDO Date Applicant ADDRESS CLASS NO.�vIF� DWELL UNITS NOTICE TO APPLICANT. If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you Should become subject to the Workers' CO R TEL NO. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code,you must forthwith Z FRONT comply with such provisions or this permit shall be deemed revoked. LIC. / ' PL 3 LICENSED CONTRACTORS DECLARATION C A LICeLAss, PIDE I hereby affirm that I am licensed under provisions of Chapter 9 a . SEWER MAP (commencing with Section 7000)of Division 3 of the Business and .S zE No.OF ORES NOZ FAMILIES ce Professions Code,a my license is in full force and effe NEW ❑ BK PG v License Number .. Lie.Class D CR to WORK ADD ❑ VALUATI o Cont o f'9ate �d _ / ALTER S62®� c t �� REPAIR ❑ I am exempt under Sec. BARC.for this reasonXA o C3 ® DEMOL ❑ LDMA P/C N Date: c S URM ❑ Signature lim IQ T NO. LDMA Perm# _ ❑ I, as owner of the property, or my employees with wages as Z their sole compensation,will do the work and the structure is ADDRESS p ~ :.::t i? I�•C° not intended or offered for sale (Section 7044, Business and FINAL DATE G Professions Code.) Y WILLTHEAPPLICANTORFUTURE BUILDING OCCUPANT HANDLEAHAZARDOUS MATERIALj1 ❑ I, as owner of the property, am exclusively contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY licensed contractors to construct the project (Section 7044, ' --tTH_ 105-25 Business and Professions Code.) YES NO WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING C 1'I,I OCCUPANT REQUIREA PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CHECK °i''' CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST y FOR GUIDELINES. :• f'li iIJ� a++-' I hereby affirm that there Is a construction lending agency for YES❑ NO❑ the performance of the work for which this permit IS issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD 3097,CIV.C.). PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES - - 1: COUNTY CODE.TITLEZ CHAPTER 220 SECTIONS 220AWTHROUGH 22D.140 CONCERNING iiS,I_I+I--i«li �l;. .� i•..ij •' z Lenders Name HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. a Lenders Address owNEnoRAoe+r o I certify that I have read this application and state that the above information Is correct. I agree to comply with all county PC'FEE PERMIT FEE o ' ances and State Is iiding construction,and d%P% hereby uthori ntat)ves of t County to enter upon ISSUANCE FEE / the abo o ed p arty for' pection purpo9. INVESTIGATION FEE TOTAL FEE ` sgnmea ar � J SEE REVERSE FOR EXPLANATORY LANGUAGE WORKERS' COMPENSATION DECLARATION APPLICATION FOR BUILDING PERMIT 1 hereby affirm that I have a certificate of consent to self insure, or a certificate of Workers'Compenstion Insurance, or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES` BUILDING AND SAFETY Policy No. Company BUILDING Certified copy is hereby furnished. FOR APP ICANT TO FILL IN ADDRESS lam' �S ❑ Certified copy is filed with the county building inspec- BUILDING / / /� tion department. ADDRESS l(/ (r o LOCALITY /�G. i • / NEAREST _ '! Dote Applicant CITY — ♦! ZIP / CROSS ST. �� CERTIFICATE OF EXEMPTION FROM WORKERS' /n NO. OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT C %4 /(� 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 J NO. TEL. d s— -�/ SPECIAL d. I certify that in the performance of the work for which this OWNER , NO, 0� �� CONDITIONS O permit is issued, I shall not employ any person in any manner r DISTRICT GROUP TYPE FIRE PROLES BY LJ ADDRESS LO GSC CONS ZO so as to become subject to the Workers'Compensation Laws. ' O(r 7 CW CITY G !� ZIP / d Date Applicant STATISTICAL CLASSIFICATION APT. CONDO. U NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. ��J, W Exemption, you should become subject to the Workers' ENGINEER NO. CLASS NO. DWELL. UNITS H Compensation provisions of the Labor Code, you must forth- ADDRESS SEW Z with comply with such provisions or this permit shall be 2 TEL. 3 VALIDATION deemed revoked. CONTRACTOR � NO. IAC PG, fJ LICENSED CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. VAL��O` (commencing with Section 7000)of Division 3 of the Business and LIC. Professions Code, and my license is in full force and effect. CITY CLASS $ / SQ. FT. NO. OF NO. OF / CHECK License Number Lic.Class SIZE G STORIES FAMILIES 1 ONE Contractor Date DESCRIPTION OF WORK NEW ❑ $ F-1ADD 8 I am exempt from the licensing requirements as I am a _ licensed architect or a registered professional engineer ALTER EJFINAL acting in my professional capacity (Section 7051 . ' dote- REPAIR DATE U 7 Business and Professions Code). USE OF ,y ❑ FINAL EXISTING BLDG. (! DEMOL ❑ BY �< c t•._ Lic.or Reg. No. Date APPLICANT(PRINT) TEL. r OWNER-BUILDER DECLARATION (PRINT) LL I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS 10 `fie C 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 7044, Business and Professions Code). MOVING TEL. I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P L (Sec. 3097, Civ. C.), SIDE PI Lender's Name P S Permit Fee Lender's Address Fee I certify that I have read this application and state that the Issuance Fee 17 ` above information is correct. I agree to comply with all County Investigation Fee �— r 3 ordinances and State laws relating to building construction, Total Fee �J and ereby outhorize repr ntatives of this County to ente � up the above- tion d�operty for i ection purposes. , SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Dote ' ®t i COUNTY OF LOS ANGELES TEMPLE CITY # 0508 I BIIILDING PERMIT DEPARTMENT OF PUBLIC WORKS I 9701 LAS TUNAS ALTERATION/REPAIR BIIILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1207310046 PHONE: (626) 285-0488 EXT: ILEGAL ID: NO. OF CONST I BUILDING ADDRESS: 1 ITR: 17179 IT: 2 I SQ. FT STORIES TYPE ] 6109 PRIMROSE AV 1 I I1 STRUCTURE: 26 V-B I TEMP CA 917801658 1 ]ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: 1 15385-008-002 I 1_ THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY, Cl ITENANT: EXIST BLDG USE: RESID USE ZONE: R-1 (ISSUED ON: PROCESSED BY: 1 EXIST OCC GRP: 107/31/12 SR [ [OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: 1PIAL DATE FI Y: CODE: [CARROLL GERALD F;CARLA A (818) 285-5416- [ 12,000 16109 PRIMROSE AV ITEMP 917801658 [ FEES PAID 1DE9CRIPTION OF WORK I [ [TEZ�R. OFF INSTALL GERARD CA.A. SHAKE ON HOUSE + GARAGE 26 SFJ I 11FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:ICL4SS "A" ESR 1491 (APPLICANT: TEL. N0: 1 I ILABBE, GUY (626) 815-1279- AA BLDG PERMIT ISSUANCE 27.80 1 [ IAB STATE GREEN BLDG FEE 12000.00 VAL 1.00 [SPF_IAL CONDITIONS: IAC STRONG MOTION REBID 12000.00 VAL 1.20 ] 1 .1 D2 PERMIT W/0 EN-HC 12000.00 VAL 250.20 1 TOTAL FEES 280.20 (CONTRACTOR: TEL. N0: [ 1 E'ROVALS HATE INSPECTOR. SIGNATURE 1 1JN DAVIS ROOFING CO. (626) 815-1279- [ I [ 1139 S. ORANGE LIC. NO [ ILOCATION AND SETBACKS I I 1AZUSA CA 91702 572125 1 1 I I I ISRLS ENGINEER APPROVAL ] I _ I _ 1ARCHITECT OR ENGINEER: TEL. N0: � IFOLNDATION/TRENCH FORMS I ] [ LIC. NO: I 1SLAB/UNDER FLOOR I I I 1 1 1RAISED FLOOR FRAMING 1 1 IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP;] 1UNOERFLOOR INSULATION [ I [ 1150H265 3 001 1__ [ I [ I I IFLQUR SHEATHING I I [NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I I [ 0 NO 21 [ RO F SHEATHING 1 I � SCHOOL WITHIN HAZARDOUS S PANELS 1 AIR QUALITY: 1000 FEET MATERIALS [ I_. I I 1 NO NO NO I ]FRAME INSPECTION I [ ] ] I 1FIL2E SPRINKLER HANGERS 1 1 1 I ] ]INSULATION/WEATHER STRIP] I [ I 1 I I IIN�ERIOR LATH/DRYWALL 1 I I I EXTERIOR LATH 1 [ I I I I I 1 I IRATED FLOOR/CEIL ASSEM. I I I I I IRA�fED WALL ASSEMBLIES I I I 1 i II 1RPTED SHAFTS/OPENINGS I ] I I IT-BAR CEILINGS I ] I I I X DRAINAGE I I I IREPORT ID: DPR261 ROUTE TO: BS0508 I 1 I I I I 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 1405220073 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: ITR: 17179 IT: 2 SQ. FT STORIES TYPE 6109 PRIMROSE AV ]STRUCTURE: V-B I TEMP CA 917801658 [ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: GARIBALDI 15385-008-002 1 I THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY CAI I I I (TENANT: ]EXIST BLDG USE: RESID USE ZONE: R-1 JISSUED ON: PROCESSED BY: [EXIST OCC GRP: 05/22/14 SR OWNER: TEL. NO: [BLDGS. NOW ON LOT: VALUATION: IFI TE F BY: CODE: ICARROLL GERALD F;CARLA A (626) 285-5416- I 4,500 16109 PRIMROSE AV /� TEMP 917801658 I FEES PAID ID SCR PTIO OF WORK I IWINDOW REPLACEMENT 14 TO IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: [APPLICANT: TEL. NO: I I [SAME AS OWNER - IAA BLDG PERMIT ISSUANCE 27.80 I IAB STATE GREEN BLDG FEE 4500.00 VAL 1.00 ISPECIAL CONDITIONS: IAC STRONG MOTION RESID 4500.00 VAL 0.50 ID2 PERMIT W/O EN-HC 4500.00 VAL 132.60 IFR INV WORK W/O PERMIT 171.90 DOL 171.90 CONTRACTOR: TEL. NO: I TOTAL FEES 333.80 JAPPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - I LIC. NO I ILOCATION AND SETBACKS I I I I I ISOILS ENGINEER APPROVAL I I I ]ARCHITECT OR ENGINEER: TEL. NO: I (FOUNDATION/TRENCH FORMS I ] LIC. NO: ] ISLAB/UNDER FLOOR I ] I ] I I I ] ] I iRAISED FLOOR FRAMING I [ IMP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( (UNDERFLOOR INSULATION 3 001 ] I IFLOOR SHEATHING [NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I I I ] NO. 21 I (ROOF SHEATHING I I ] I I I I I SCHOOL WITHIN HAZARDOUS I (SHEAR PANELS I I [AIR QUALITY: 1000 FEET MATERIALS ] I ] I NO NO NO i FRAME INSPECTION I ] I I FIRE SPRINKLER HANGERS I ] I INSULATION/WEATHER STRIP( [ I ] (INTERIOR LATH/DRYWALL ] I I ] (EXTERIOR LATH ] I [ I (RATED FLOOR/CEIL ASSEM. ] ] [RATED WALL ASSEMBLIES ] [ I ] ] RATED SHAFTS/OPENINGS [ [ [ [ IT-BAR CEILINGS I I [ I [ [LOT DRAINAGE [ [ [ I [ I I I [ IREPORT ID: DPR261 ROUTS TO: BS0508