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HomeMy Public PortalAbout6253 RENO AVE_Building__ ,APPLI•CATION• FOR BUILDING PERMIT � FOR.,APPLI,P.AN;T TO FILL'IIV (Print or type only) BUILyr1..1NG` 3 COUNTY OF LOS'ANGELES ADDRESS DEPARTMENT OF COUNTY-ENGINEER CITY P, ZIP / 9 go ( BUILDING•AND SAFETY DIVISION' OF BLDGS. BUILDING SIZE OF LOT NOW ON LOT ADDRESSy/�. L dT TRACT Ca BLOCK LOT NOD rr LOCALITY '7-e AM4 Cj 14/ ' TEL.nn f� NEAREST P / OWNER No.�C�GCROSS ST. 4' V'NG ASSESSOR - ADDRESS MAP BOOK PAGE ]PARCEL DISTRICT GROUP TYPEFIRE PROCESSED BY CITY ZIP CONST ZON ARCHITECT OR. TEL. �!) a --r— _ � �3 ( ENGINEER NO. STATISTICAL CLASSIFICATION SEWER MAP ADDRESS CLASS N0,21 DWELL,UNITSBK PG- T G• TEL. CONTRACTOR NO USE Z NE MAP -LIC: r /� NO.' ADDRESS NO. (r" CONDITIONS SPECIAL - CITY. _ LIC.CLASS ROAD DEPARTMENT ARPROVAL REQUIRED YES NO❑ CONSTRUCTION LENDER NAME AND BRANCH BLDrq,.SETBACK FROM C FRO„N PROP.LINE OF —(STREET) c ADDRESS CITY ` TOTAL SETBACK FROM TYPE OF EXISTING C HIGHWAY YARD SQ. FT. NO. OF' NO' OF CHECK FRONT PROP. LINE HIGHWAY WIDTH SIZE Q STORIES FAMILIES ONE - + _ c DESCRIPTION OF WORK NEW y� ADD�,�� BLDG,SETBACK FROM s fh+ SIDE PROP.LINE OF (STREET) ALTERI ❑ __•TOT S` ACK FROM TYPE OF EXISTING IS HIGHWAY •F YARD TEPAIRSIDE LINE HIGHWAY WIDTH USE OI- EMOL ❑ + EXISTING BLDG. ' APPLICANT - TEL CORNER CUTOFF' YES ❑ NO ❑ (PRINT) NO. , BY (SIGNATURE) IN OPEN SPACE YES ❑ ❑ Q IN COASTAL ZONE "' YES.[] NO VALUATION•Y �aG O� CATEGORICAL EXEMPTION '• - YES❑ O ❑ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL AND STATE THAT THE ABOVE.IS CORRECT AND-AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED— WITH IGNED WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- I STRUCTION. I CERTIFY THAT• IN.DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED i (DATE) -HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE - •LABOR CODE OF .THE STATE OF CALIFORNIA IN RELATING TO 7 / ' WORKMEN'S COMPENSATION INSURANCE. -� R / .:r /`:•�• p0�''•..u`''�"'�'d].�'l C Q !.•/':'.h' SIGNATURE OF I �.i�%t��c%CLe'a a PERMITTEE' / ADDRESS d FINAL TE CITY ��. V� NOLJ( DATE �DjBY MAKE CHECKS PAYABLE TO: FEE $ !� FEE HARVEY T. BRANDT, COUNTY ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH m PERMIT'VALIDATIO• CK. M.O: CASH 6 s:o: tB 1 0 -'2 8.5'0 e�k 76A638A CE9803 7/73 _ - TEMPLE CITY 76A638A CE 0803 4,7APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION BUILDING 5 V JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS ((/�`:� . Zee COLEMAN W. JENKINS, SUPLOCALITY T OF BUILDING � " � FOR APPLICANT TO FILL INI ST. NEAREST Print ort a onl BUILDING ICT NO. GROU TYPE ESSED BY ADDRESS 6253 Reno Avenue 0S-' - CONST, L ISTICAL CLASSIFICATION SEWER MAP LOT NO. �7 7 BLOCKSS NO.�DWELL.UNITS BK/ PG? TRACT ONE MAP - . NO.OF BLDGS. NO. Q-Z 0 SIZE OF LOT NOW ON LOT SPECIAL - USE OF O CONDITIONS EXISTING BLDG. TEL.OWNER - NO. - .SETBACK FROMADDRESS T PROP.LINE OF (STREET) F EXISTING SETBACK HIGHWAY + YARD = TOTAL CITY Tem le Ci[t Y WIDTH FROM C.L. ARCHITECT OR TEL. } pZ.O = ENGINEER NO, SETBACKFROM ADDRESS ROP.LINE OF (STREET) TEL TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL CONTRACTOR NO. _40 4n HIGHWAY WIDTH FROM C.L. ADDRESS 529 E Valle rLio' 8341 + = c CITY San G a 6 r t e 1 CLASS C 3 9 CORNER CUTOFF YES ❑ NO ❑LIC. C CONSTRUCTION LENDER u NAME AND BRANCH S B 1 SEE REVERSE SIDE FOR SPECIAL APPROVALS n ADDRESS Z SQ. FT. NO. OF NO. OF NEW ❑ SIZE STORIES FAMILIES El OF ADD STRUCTURE Rerocif w/ USG 150 shingles ALTER ❑• SIGNATURE OF f // REPAL • APPLICANT C��•!�.•`�� t DEMOL ❑ VALUATION S 700 . 00 APPROVALS DATE I.1P1.TO.'.,7;rA.ATURE //�� FOUNDATION: LOCATION • FEE 5 FEES 12. 00 FORMS, MATERIALS 73 FRAME: FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY FURNACE' LOCATION, WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS STRUCTION. IC THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT. LABOR CODE OF THE STATE OF •CALIFORNIA IN RELATING TO WORKMEN'S COMPENSATION INSU)ANCE. LATH, EXT. SIGNATURE OF ` Q�� r/; A HOUSE NUMBER COR- PERMITTEE wv' RECT AND POSTED ADDRESS 529 E Valley ,San FINAL JOHN F. LEWIS. PRINCyFL STRU TU RAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDA�'rON aK.) M.O. CASH n 6 6 6 J JI'll c 1D 12..CON l� � lz'F COU YOFLOSANGELES APPLICATIOV#ORDEPART NT OF COUNTY ENGINEER BUILDING PEFIMIT BUILDING AND SAFETY D ISION FOR APPLICANjf2 FILL N ADIDRESS BUILDING 02 ADDRESS iZ) )-:J !, 3 �('�C3 LOCALITYNEAREST P�-rj'►'� /� �( CITY_r F C ZIP CROSS ST. �- NO.OF BLDGS. ASSESSOR SIZE OF LOi `�b � NOW ON LOT MAP BOOK PAGE PARCEL DISTRICT G OUP TYPE kFIREffCSED ey D �� TRACT BLOCK LOT NO. �� C CONST. --� � TEL. _ OWNER t[`5' c <<. ( � 0• �� STATISTICAL CLASSIFICATION SEWER MAP ADDRESS CLASS NO. DWELL.UNITS BK M PGJ CITY ZIP USE ZO E NOP 62 OO d. ARCHITECT OR TEL. SPECIAL ENGINEER NO. CONDITIONS ADDRESS -T� ' /- ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ CONTRACTOR (7'Zl - l [( NO. qgs�J C. BLDG.SETBACK FROM C. FRONT PROP.LINE OF (STREET) ADDRESS LJ 1 J NO. 33 6-7�s� TOTAL SETBACK FROM TYPE OF EXISTING t, [� LIC. '/ HIGHWAY + YARD = FONT PROP.LINE HIGHWAY WIDTH CITY Artcet [c (�` `�/' CLASS � Lr• _ + CONSTRUCTION LENDER _ } NAME AND BRANCH -- IJ BLDG.SETBACK FROM ADDRESS CITY SIDE PROP.LINE OF ISTREETI � O SQ.FT. / NO.OF NO.OF CHECK HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING U SIZE k7 STORIES— FAMILIES ONE SIDE PROP.LINE HIGHWAY WIDTH a N `� + = Z DESCRIPTION OF WORK CZ. \ ZC +L &{2 NEW ADD ❑ CORNER CUTOFF YES ElNO ❑ -e ALTER ❑ REPAIR ❑ IN OPEN SPACE YES ❑ NO ❑ USE TI _� DEMOL ❑ IN COASTAL PERMIT ZONE YES ❑ NO ❑ EXISTING BLDg-­, ��"''���• `�-� +!�/ �f --7: e- -a0 /� APPLICANT h ��{�I=l \Ft NO. IVY./S L .� C... 0 D BY(SIGNATURE) I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE WORK AUTHORIZED�i BY I WILL NOT EMPLOY ANY PE ON IN VIOLATION OF THE LABOR CODE OF THE TATE OF CALIFORNIA IN RELATI TO WORKMEN'S COM. PENSATION INSURA CE. SIGNATURE OF . T f FINAL BY PERMITTEE �tt`L L DATE ADDRES5 C ITYXI 2C 6��CL Np ) �, l; P•C.Fee$' ���✓ Permit Fee Issuance Fee 9 Total Fee 00 PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH 6 2 9�c..iB J. 3 •D 722 .0 ,&` .�u - ®S 76A636A GE/e03A 6/76 WORKERS'COMPENSATION DECLARATION D U i-Fiareby-affirm that I have a certificate of consent to self L I��� ® FOR I L®I N G PERMIT inside, or a certificate of Workers'Compensation Insurance, or a certified copy thereof(Sec. 3800, Lob. C.) �• COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING ADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING/a� tion department. ADDRESS I/ i Axe. 11 Date Applicant CITY ! ZIP ® LOCALITY A/A CERTIFICATE OF EXEMPTION FROM WORKERS' X ��QNO.OF BLDGS NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. OR (This section need not be completed if the permit is for one TRACT V BLOCK LOT NO. , MAP BOOK PAGE PARCEL hundred dollars ($100)or less.) USE ZONE MAP �J I certify that in the performance of the work for which this OWNER OS I�� NO. '80? v�:� Q . NO. S.3" Zs permit is issued, I shall not employ any person in any manner SPECIAL 8 so as to become subject to the Workers' pensation Laws. ADDRESS /V AV l CONDITIONS O CITY /� ZIP V Date Ap lic ARCHITECT OR' TEL. 1 / DISTRICT GR UP TYPE FIRE PROLE ED BY O NOTI TO APPLI NT: I fter aking this Ce=orkers!' CONST ENGINEER NO. i Exemption, you shoul ecome subject to the . ZOAJE U Compensation provisions of the Labor Code, you must forth- ADDRESSW with comply with such provisions or this permit shall be n IL deemed revoked. "TEL. STATISTICAL CLASSIFICATION APT. C NDO. N CONTRACTOR NO. Z LICENSED CONTRACTORS DECLARATION LIC, CLASS NO. �If DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. 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 / CLASS BK PG VALIDATION SQ. FT. NO.OF NO.OF CHECK License Number Lic.Class SIZE STORIES FAMILIES ONE VALUATION DESCRIPTION OF WORK : (iP!/ S NEW ❑ Contractor Date ADD $ ❑ 1 am exempt under Sec. ❑ ®� ALTER ❑: c G B.BP.C. for this reason 00NE 0 REPAIR $ 8 3 5 01 USE OF # 0 0 0 0 Date: EXISTING BLDG. Ol91� DEMOL ❑ Signature APPLICANT(PRINT) � S//f- v $ NOM��G .4y FINAL I ° - 40.50 OWNER-BUILDER DECLARATION //aJ'�3� �� p DATE I hereby affirm that I am exempt from the Contractor's License ADDRESS!/ /i`1•!u'/y4 j.� FIN o o o 4 Q 5 05 Law for the following reason (Section 7031.5, Business and r� Professions Code): PRESENT By „1 2 -87 ❑ 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). CONSTRUCTION LENDING AGENCY SET BACK YARD HWY TOTAPROP.AL 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 P.L. Lender's Name LDMA Ref. # Do P.C.Fee$ Permit Fee 3 .019 Lender's Address is I certify that I have read this application and state that the Issuance Fee ! t+ r� It P/C# above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, Total Fee LDMA Perm. # N and y authorize representatives of this County to enter $ u nth _ bove-rrppioned property for' spection purposes. $ / SEE REVERSE FOR EXPLANATORY LANGUAGE m Signature of Applicant or Ag M Date 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 0811250027 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: [TR: 5904 LT: 57 UN: .002 SQ. FT STORIES TYPE 6253 RENO AV STRUCTURE: 191 V-B TEMP CA 917801535 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LONGDEN 15384-001-023 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY, Cl TENANT: (EXIST BLDG USE: RESID USE ZONE: R-1 JISSUED ON: PROCESSED BY: [ 1EXIST OCC GRP: 101/05/09 SR OWNER: TEL. NO: [BLDGS. NOW ON LOT: VALUATION: IF NALTE FIN�}�BY: CODE: ] - ���D i" ]GARCIA-NUNEZ JOSE;ELVIRA V;MANUEL;D (626) 286-2340- [ 21,000 6253 RENO AV I TEMP 917801535 FEES PAID IDESCRIPTI N OF WORK IICCER-2640P & ICBO ER-5888P 101X 71X 19' ALUMINUN PATIO IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT:ICOVER & ENCLOSURE 1 APPLICANT: TEL. NO: I IMCCANN (949) 933-5153- ID1 PLANCHECK W/O EN-HC 21000.00 VAL 341.19 1 12081 BUSINESS CENTER [AA BLDG PERMIT ISSUANCE 27.75 ISPECIAL CONDITIONS: IRVINE, CA 92612 JAC STRONG MOTION RESID 21000.00 VAL 2.10 1 ID2 PERMIT W/O EN-HC 21000.00 VAL 401.40 TOTAL FEES 772.44 ] CONTRACTOR: TEL. NO: • JAPPROVALS DATE INSPECTOR SIGNATURE PATIO WAREHOUSE (949) 660-0660- 12081 BUSINESS CENTER DR. #165 LIC. NO [LOCATION AND SETBACKS IRVINE, CA 92612 875966 B 1 SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: IFOUNDATION/TRENCH FORMS I I [FOX, GREGORY G (562) 806-1337- [ I 8060 TELEGRAPH ROAD LIC. NO: SLAB/UNDER FLOOR IDOWNEY, CA 90240 875966 B I iRAISED FLOOR FRAMING 1 1 1 IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( (UNDERFLOOR INSULATION I 1 I15OH265 3 001 I 1-1 I I IFLOOR SHEATHING INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS:-J I I I I 1 NO 21 1 IROOF SHEATHING I 1 SCHOOL WITHIN HAZARDOUS I ISHEAR PANELS I I I ]AIR QUALITY: 1000 FEET MATERIALS I I ] NO NO NO I IFRAME INSPECTION ] I I IREQUIRED TOTAL SETBACK FROM EXIST ] IFIRE SPRINKLER HANGERS I I I ISET BACK YARD: HWY: PROP LINE: WIDTH: I I I I IFRONT PL- I 11NSULATION/WEATHER STRIP( ] SIDE PL- I I 1-1 ] ] 1 [INTERIOR LATH/DRYWALL I I ] 1 I 1 1EXTERIOR LATH 1 1 1 1 1RATED FLOOR/CEIL ASSEM. I [ [ [ I IRATED WALL ASSEMBLIES I [ I 1 1 1RATED SHAFTS/OPENINGS [ [ [ [* ADDITIONAL DATA ON FILE 1T 'B CEILINGS 1 I [ [ ILOT DRAINAGE [ [ 1 1REPORT ID: DPR261 ROUTE TO: BS0508 I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BULLD.I.NG-PERMI-T,— rr�` " DEPARTMENT OF PUBLIC WORKS ! 9701 LAS TUNAS CALTERATION/REPAIR" BUILDING AND SAFETY / LAND DEVELOPMENT I TEMPLE CITY CA 91780 BL 0508.9910250028 PHONE: (626) 285-0488 EXT: LEGAL D: NO. OF CONST !BUILDING D SS: TR: 5904 LT: 57 UN: .002 SQ. FT STORIES TYPE 6253-RENO-AV­--- i STRUCTURE: 0 VN EMP-C"17801535 S SSO I 0 A ON UMBE NEAREST CROSS STREET: LOGNDEN 5384-001-023 ' THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY TEN NT: ST BLDG . S S ZONE: - WEEP ON: PROCESSED BY: EXPIRES . S i EXIST OCC GRP: 10/25/99 UT 04/22/00 . OWNER: TEL. N0: 7 BLDGS. NOW ON LOT: VALUATION: FINAL!DATE FINAL BY: CODE: GARCIA-NUNEZ JOSE;ELVIRA V;MANUEL;D - 1 5,100 40T tt-2 6253 RENO AV , tmp TEMP 917801535 FEES PAID DESURUMON OF WORK T/0 ROOFING, APPLY 1/2" CDX, INSTALL ASS A COMP SHINGLE APPLICAN FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: GAF-HiOUSE ONLY CHAMPION ROOFING (909) 629-4421- AA BLDG PERMIT ISSUANCE 27.75 3257 VERDUGO AC STRONG MOTION RE�§_Ip 5100.00 VAL 0.51 SPECIAL CONDITIONS: LOS ANGELES, CA D2 PERMIT W/0 EN='fl-- �5 00.00 VAL 149.40 P��yIELES ��fL� E 177.66 ' CONTRACTOR: TEL. N0: �O�j APPR . ALS DATE INSPECTOR SIGNATURE CHAMPION ROOF (213) 259-0417- 3257 VERDUCO RD LIC. NO LOCATION AND SETBACKS LOS ANGELES, CA 90065 429481 C39 SOILS ENGINEER APPROVAL ARCHITECT OR NGINEER: —TE—.R0: - �/ FOUNDATION/TRE C FORMS LIC. N SLAB/UNDER FLOOR RAISED00 1253H265SEWER MAP BOOK: PAGE: FIRE ZONE: M n (� D ��G W O n/� S NDERFLOOR INSULATIO I U lu^Su lu�wFLOORSHEATHING 0. OF MUMS-- WETEING UNITS: AP COND: STAT CL 5S; NO 21 \ O 0 ROOF SHEATHING i SCHOOL WITHIN HAZARDOUS \\ El �I�. SHEAR AIR QUALITY: 1000 FEET MATERIALS e Q ❑ W1 I./J NO NO NO El yRAM INSPECTION REQUIRED TOTAL SETBACK FRO IS 4� Q� SPRINKLERHANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- C aS'@p-ylce'6bai INSULATION/WEATHER STRIP SIDE PL- TROR A EXTERIOR LATH f RATED 00 /CEIL SSE . RATED WALL ASSEMBLIES I i RAE SHA SOP INGS T-BAR CEILINGS LOT DR INAG REPORT ID: DPR261 ROUTE TO: BS0508 p c 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 0512010008 PHONE: (626) 285-0488 ERT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: TR: 5904 IT: 57 UN: .002 SQ. FT STORIES TYPE 6253 RENO AV STRUCTURE: VN TEMP CA 917801535 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LONGDEN 5384-001-023 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY, C TENANT: EXIST BLDG USE: RESID USE ZONE: R-1 ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 12/07/05 JK 12/02/06 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FIN L DA FINAL BY: CODE: GARCIA-NUNEZ JOS8;8LVIRA V;MANUBL;D (626) 286-2340- 7,550 ; 6253 RENO AV TEMP 917601535 FEES PAID DBSC.IPT W CONVERT EXISTING CLO38T INT KITCHEN SPACE, AND CONSTRUCT FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: NEW BEDROOM CLOSET APPLICANT: TEL. NO: SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION REBID 7550.00 VAL 0.76 SPECIAL CONDITIONS: AX BUILDING REVIEW FEE 54.70 S2 PERMIT W/ENERGY 7550.00 VAL 201.30 TOTAL FEES 284.51 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO LOCATION AND SETBACKS SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS LIC. NO: SLAB UNDER FLOOR RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION 153H265 3 01 FLOOR SHEATHING NO. OF FAMILIES: DWELLING UNITS: APT COND: STAT CLASS: NO 21 ROOF SHEATHING SCHOOL WITHIN HAZARDOUS SHDP4 PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME INSPECTION REQUIRED TOTAL SETBACK FROM EXIST FIRE SPRINKLER HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- INSULATION WBATHER STRIP SIDE PL- _ INTERIOR LATH/DRYWALL EXTERIOR LATH ) - RATED FLOOR CBIL ASSEM. RATED WALL ASSEMBLIES RATED SHAFTS OPENINGS T-BAR CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508