HomeMy Public PortalAbout5000 ROSEMEAD BLVD_Building__ _APPLICAT ION FOR COUNTY OF LOS' ANGELES'
y ` MIT DEPARTMENT OF COUNTY ENGINEER
B U I L D I N U PER BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN ADDRESS Cv0 All $= /
BUILDING
ADDRESSQ ��!/' LOCALITY
CITY CiQ,�A-41' ZIP '9/ / il,, NEAREST
CROSS ST.
'NO.OF,BLDGS. ASSESSOR
SIZE•OF LOT �j.;�,�. NOW ON LOT MAP BOOK PAGE ' PARCEL
_ .dam DISTRICT GROUP TYPE FIRE PRO�jESSED BY
TRACT � BLOC,KJ LOT NO. �'�`��. CONST.�I���i ZON /j/��
OWNER.'' (Y �: A ��Na�Y �s. %. �, 1i l l/Vim"
'1� yam// A_ STATISTICAL CLLASS'IFICATION .SEWER MAP
-ADDRESS Q 10 CLASS No. 2_0
DWELL,UNITS BK PG '
USE ZONE MAP
ZIP 7NO,., (f
ARCHITECT OR n TEL. /�( SPECIAL - -
ENGINEER / /G NO• '! 3 CONDITIONS
ADDRESS ' - ROAD DEPARTMEN.T.APP ROYAL REQUIRED YES❑ NO ❑`�
CONTRACTOR - TEL: G.SETBACK FROM
NO, FRONT PROP.LINE OF (STREET)
LIC. _ ,.
ADDRESSXN NO: HIGHWAY } YARD -_ TOTAL SETBACK' FROM TYPE OF EXISTING
CITY. LIC,
FRONT PROP. LINE HIGHWAY WIDTH
CLASS
CONSTRUCTION LENDER }
NAME AND,BRANCH. BLDG.SETBACK FROM
a
ADDRESS CITY SIDE PROP.LINE OF (STREET) O
SQ. FT. NO. OF NO. OF 'CHECK. HIGHWAY } YARD p TOTAL SE T BAC K:FROM TYPE OF EXISTING O
SIZE STORIES FAMILIES ONE SIDE. PROP. LINE HIGHWAY WIDTH
DESCRIPTION OFWOR,K NEW - } — N
Z
0e / - - .ADD CORNER,CUTOFF YES ❑ NO E]
ALTER❑ IN.OPEN-SPACE YES ❑ NO.SE ❑ -
U �F I �REPA7R❑
EXISTING NG' BLDG. ,p yy� DEMOL ❑ IN COASTAL PERMIT ZONE YES ❑ NO ❑•
V a7�J�pC /`/ req y
A'P PL(IR
)NI ���. /[.✓ /L 4[�" L - X2-
BY
f� /
B Y (SIGN A T U R E) -! �J''i" " -• '�'"�_.- -
c
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND .LAWS REGULATING BUILDING CON- - 11
-,STRUCTION.-I CERTIFY .THAT IN DOING THE WORK Apr.RIZED
.HEREBY i WILL.NOT EM OY -ANY 'PERSON IN VIO'ATIOF THE -
LABOR -CODE 'OF THE S ATE �FORNIA. 1 TING TO -
WORKMEN'S COMPEN TI N INSU _ -
SIGNATURE OF FINAL BY -
PERMITTEE "DA-TE /q
ADDRESS, -
.LIALUAT11'�ON$
TEL.NO, - P.C. Fee$ Permit FeeIssuance Fee•/ �DC1 LL'�
Total Fee J
PLAN CHECK VALIDATION CK, M:0. CASH. PERMIT,VALIDATION CK. M.O. nsH
76A638A C15#8036 12/75- - - -
•1. b'
,76.A 638A CE #803 11.71 ��'� � �. •
APPLICATION F R' BUILDI PERMIT
COUNTY OF LOS ANGELES ,ASSESSOR
DEPARTMENT OF`COUNTY ENGINEER MAP.-BOOK PACE PARCEL'
' BUILDING AND SAFETY DIVISION DDRENG '
. AADDRESS-•"
y'
•'COLEfAAN W. JENKINS, SUv T.OF,BUILOING.
LOCALITY'
FOR APPLICANT TO FILL,IN NEAREST
Print or t e onl CROSS ST. 7
DIST CT O G U «TYPE PR ES BY
BUILDING'- • CONST. `
P (5
ADD_RESS_�� V .r:
`STATISTICAL CLjkSSIFICATION SEIWER P
LOT NO. BLOCK, - - .'CLASS NO.A DWELL,.UNITS BK. ,PG
TRACT- USE.ZONE MAP' -"v "
NO.OF LOGS. -NO.'., l/
.SIZE OF LOT.- NOW.ON LOT ' SPECIAL7.
USE OF - ".CONDITIONS - -
EXISTING BLDG, -
TEL. -
OWNER - 'NO.' BLDG.SETBACKYFROM
ADDRESS - FRONT PROP.LINE OF (STREET) "
i
• TYPE OF EXISTING 'SETBACK HIGHWAY } _' YARD = 'TOTAL
CITY - HIGHWAY WIDTH' FROM C.L. -
ARCHITECT.OR TEL. }' _
ENGINEER. '.G -NO... BLDG,SETBACK FR `
SIDE PROP.LINE OF - (STREET)
J TYPE OF EXISTING SETBACK_ HI Y } '• YARD = TOTAL
CONTRACT _ EL ;O HIGHWAY WIDTH - FROM'C.L. O
C7
LLC
ADDRESS. e' / `�. �oZ� O.
. _, - - _
LIC.
CORNERCUTOF.F YES �!
CITY - .. CLASS - LJ NO 0: W
CONSTRUCTION LENDER �-
"NAME,AND BRANCHSEE REVERSE SIDE ,FOR SPEC L APPROVALS z
ADDRESS "• - - ..
SO. FT. NO. OF. NO 'OF - NEN/
S6ZE•,,1 STORIES FAMILIES .❑
USE OF ADD I{
`,STRUCTURE ' : r -
A'LTER E] . -
" r .. .REPAIR❑ - -
SIGNATURE-OF
.APPLICANT ,,�r's�� - DEMOL'''•❑
�VALUATI.ON,S - .�Y - - APPROVALS DATE _ SINSPECTOR'S'SIGNATURE
PC. yy T. 'FOUNDATION: LOCATION - - - -
Fi:E.$ �o�J _ FEE $ tC .� •FORMS., MATERIALS
FRAME: FIRE STOPS .
„S I .HEREBY ACK NOW LEDGE,THAT.I HAVE 'READ THIS APPLICATION BRACING BOLTS
AND STATES THAT,THE ABOVE I'S'CORRECT.;AND-AGREE TO COMPLY FURNACE: LOCAT1ION', -
. WITH..ALL ORDINANCES' AND LAWS REGULATING -BUILDING CON- GAS VENT,-D UGTS -
STRUCTIONt. 1. CERTIFY -THAT IN DOING,THE .WORK,AUTHORIZil), ,
HEREBY:PWILL NOT EMPLOY ANY PERSON IN,VIOLATION OF THE 'LATH, INT.
LABOR; CODE OF THE.STATE,OF•;CALIFOR NIA IN RELATING,TO'.
Y". WORKMEN'S CQMPENSATION"INSURANCE.-, - 'LA.TH,-EXT
, '
: ...
SIGNATURE"OF�' '�' - �, � -•HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
' ADDRESS • FINAL _
" JOHN.F. LEWIS.*PRINCIPAL STRUCT RAL ENGINEER
PLAN'CHEC&VALIDATION :•. �K.' MO'J 'CASH _ �. ) ,•11,0. 'CASH
- PERMIT VALIDATION v
C-1 9'2 1-D
_, UG " 9 1. o3:52 5 N;
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 1104140038
PHONE: (626), 285-0488 EXT:.
LEGAL ID: - NO. OF CONST - BUILDING ADDRESS:
ON FILE - - SQ. FT STORIES TYPE �. •- 5000. ROSEMEAD BL
_ ISTRUCTURE: 1558 V-B I SGABCA 917762205
(ASSESSOR INFORMATION NUMBER:. NEAREST CROSS STREET: PENTLAND
5388-020-021. THOMAS PAGE: 596 GRID: H5 LOCALITY: TEMPLE CITY, Cl
(TENANT: IEXIST BLDG USE: HOUSE USE ZONE: R-2 11SSUED, ON: PROCESSED BY: - 1.
IEXIST OCC GRP: 104/14/11 SR
LOWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: I.FINAL .DATE FI Y: CODE: I"
ILUEVANO, RICHARD (626)- 285-6413-- 5,000
15000 ROSEMEAD BL
ISGAB 917762205 FEES PAID. IDESCR11PTION OF WORK �.
ITEAR OFF AND REROOF, FELT PAPER, INSTALL 30- YR COMPOSITION
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ISHINGLES HOUSE AND GARAGE 1
(APPLICANT: TEL.. NO:
ISAME AS OWNER - IAA BLDG PERMIT ISSUANCE - 27.80 1'
IAB STATE GREEN BLDG FEE 5000.00 VAL 1.00 ISPECIAL CONDITIONS:
IAC STRONG MOTION RESID 5000.00 VAL 0.50
ID2 PERMIT W/O EN-HC 5000.00 VAL 132.80
TOTAL FEES 162.10
(CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER � "- I
LIC. NOLOCATION- AND SETBACKS
I � I
ISOILS ENGINEER APPROVAL
1ARCHITECT OR ENGINEER: TEL. NO: IFOUNDATION/TRENCH FORMS
LIC. NO: (SLAB/UNDER FLOOR
IRAISED FLOOR FRAMING .
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: JUNDERFLOOR INSULATION
1144H265 3 001
I _I IFLOOR SHEATHING
INO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: .. �•. �'
NO - 21 IROOF SHEATHING
I- I.
1 SCHOOL WITHIN ` HAZARDOUS" ISHFAR PANELS
(AIR QUALITY: 1000 FEET %MATERIALS'
NO NO NO FRAME INSPECTION
z I,FIRE SPRINKLER' HANGERS
(INSULATION/WEATHER STRIP.
-- INTERIOR LATH/DRYWALL
IEXTERIOR LATH .
. I RATED FLOOR/CEIL ASSEM.
RATED WALL ASSEMBLIES
" - IRATED SHAFTS/OPENINGS.
• '
IT-BAR CEILINGS _
• I.LOT DRAINAGE
- IREPORT, ID: DPR261 ROUTE TO: BS0508 -
�