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7,A638A CE#8035-„ APPLICATION FOR BUILDING PERM T ,
COUNTY OF LOS ANGELES BUILDING II
DEPARTMENT OF COUNTY ENGINEER ADDRESS ! j
BUILDING AND SAFETY DIVISION LOCALITY' Z_
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN UP•T Or BUILDING CROSS
ME :ECT!Z I GROUP TYPE R C sob U/
FOR APPLICANT TO FILL IN CONST.
BUILDING / 3 ( STAT STICAL CLASSIFICATION SEWER MAP
ADDRESS v /K7 i R1��11�C�`�L~ //'``��
CLASS.NO.SLDWELL.UNITS SK PG
LOT NO. BLOCK WATER NOT REQUIRED RECEIVED
CERTIFICATE:
TRACT C� `T H G� MAP 20 C(1 l� HIGHWAY STATE MAJOR SECOND. OCAL�
NO.OF BLDGS. NO. (CIRCLE)
SIZE OF LOT -b 141 Off” I NOW ON LOT US-- ZONE SPECIAL
USE OF CONDITIONS
EXISTING BLDG.
'- �-TEL. I `�
OWNER IT"I lit- V!041
U
?.ZiCL=. eY- loa_t 'NO. r YBUILDING YARD HWY STREET NAME EXIST.
ADDRESS r 3Z ) N'• SETBACK tWIDTH
le CA FRONT
I
ARCHITECT OR TEL. P. L. 44ka
ENGINEER NO. SIDE 0�
P.L.
ADDRESS L,7
TEL. INSPECTION RECORD
CONTRACTOR �'•Y'+->COL NO. or
ADDRESS
DESCRIPTION OF WORN
f z
(17F.W ADD ALTER REPAIR DEMOLISH
SQ.FT. NO.OF NO.OF
.!
PE
I c, 2,— STORIES FAMILIES
USE OF
STRUCTURE
SIGNATURE OF I C
APPLICANT
VALUATION$
APPROVALS Ed INSPECTOR'S SI"AfilRE
P.C. //ccPMT.$ �— FOUNDATION:LOCATIONli
FEE $ (J FEE FORMS,MATERIALS I /
FRAME:=BOLTS 7 ? Q
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE:LOCATION, y
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT
BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH,INT. �'''�� -lo ✓ "'�'` -'
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT-
ING TO WORKMEN'S OMPENSATION INS ANCE. A+t�trj
(y'$) LATH,EXT.
SIGNATURE OF0 •h`t f v '1+� _ HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADORESS` 7�-) lY *'+-.rt• •d, � ••' ,% - •� `O
FINAL
CLYDE N. DIRLAM,PRINCIPAL STR URAL ENGINEER
PLAN CHECK VALIDATION � M.O. CASH PERMIT VALIDATION (cie Y.O. CASH
Q
,,`"l 4 8 5c.01 JUL 1.2 2 3 D . 3 0251
�2 1 0 1:o JUL 2 4 1 D 6 0."Y0— ���
r COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR
BUILDdNG AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0107020002
PHONE: (626) 285-0488 EXT:
LEGAL ID: NO. OF CON51 SUrLDINGSS:
TR: 20748 LT: 2 SQ. FT STORIES TYPE 6316 PRIMROSE AV
STRUCTURE: 2700 VN TEMP CA 917801345
ASSESSOR-1 OR BER: NEAREST CROSS STREET: LONGDEN
5382-022-041 THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY
TENANT: , E B G S F S 0 ISSUED ON: PROCESSED S N:
EXIST OCC GRP: 07/02/01 UT 12/29/01
OWNER: —TEL.--NO: BLDGS. NOW ON LOT: VALUATION: FI DATE CODE:
KURODA ROBERT E;JUNKO (626) 447-5914- 3,150
22 CORTO RD 'I b
ARCADIA CA FEES PAID [ TIO 0
TEAR-OFF INCLUDING SHEATING, RE-R F W/COMP. SHINGLES, 25YRS
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: CLASS 'A'
A TE .
SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75
AC STRONG MOTION RESID 3150.00 VAL 0.50 SPECIAL CONDITIONS:
D2 PERMIT W/0•EN-HC 315.0.00 VAL 115.80
TOTAL FEES 144.05
CONTRACTOR: TEL. N0: ,f:'; - APPROVALS -DATE INSPECTOR SIGNATURE
SAME AS OWNER -
LIC. NO LOCATION AND SETBACKS
{ SOILS ENGINEER APPROVAL
ARCHITECT 0 GI 0: FOUNDATION/TRENCH F0 S
LIC. NO: SLAB/UNDER FLOOR
RAISED-FLOOR RAMING
MAP NO: SEWER MAP BOOK:- PAGE: FIRE ZONE: CMP11 UNDERFLOOR INSULATION
XX 3 01
FLOOR SHEATHING
0. OF FAMILIES: L I G N S: P CO D: STAT CL .'
NO 21 ROOF SHEATHING •-� ��
SCHOOL I HAZARDOUS SHEAR PANELS
AIR QUALITY: 1000 FEET MATERIALS UV
NO NO NO i FRAME INSPECTION
REQUIRED- TOTAL SETBACK 0 EXIST RE S R LER G S
SET BACK YARD: HWY: PROP LINE: WIDTH:
FRONT PL- INSULATION/WEATHER STRIP
SIDE PL- "' _
INTERIOR LATH/DRYWALL
EXTERIOR LTH
RATEDLOOR/CE AS .
RATED WALL ASSEMBLIES
RATED S S 0 S
T-BAR CEM—NGS-
LOT DRAINAGECEM—
REPORT ID: DPR261 ROUTE TO: BS0508