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16A686A CF#60970-66 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS r
: BUILDING AND SAFETY DIVISION LOCALITY /
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST.
DIST�R CT N GROUP TYPE P SSED HY
FOR APPLICANT TO FILL IN SI U � j _ mmST.
BUILDING5512 STATISTICAL CLASSIFICATION SE RMAP
ADDRESS O land - y.I
K
CLASS.NO MAP �DSW�Ey,L,�L..USN`IITS
LOT NO. BLOCK NUMBER �s(/ / STATE YES CKO
USE ZONE SPECIAL
TRACT CONDITIONS
�/ NO.OF.SLOGS
SIZE OF LOT (J I NOW ON LOT
USE OF
EXISTING BLDG. BUILDING YARD HWY STREET N E EXIST.
SETBACK WIDTH
OWNER FRONT
MAIL. P.L:
ADDRESS Same s SIDE Ff
TEL P.L.
CITY NO. INSPECTION RECORD'
ARCHITECT OR TEL.
ENGINEER NO.
ADDRESS
CONTRACTOR F C`!11 C! Insl;ia" 0. ('i�.
" .ADDRESS I S0, FAIR OAKS AVE.
in
DESC 4?&. f ikbRK
NEW ADD ALTER REPAIR DEMOLISH'
SQ.FT. NO.OF NO.OF
SIZE STORIES FAMILIES
USE OF
STRUCTURE Reroof residence & garage
h 2 " ads lit tapered shakes ,
SIGNATURE OF
APPLICANT
. APPROVALS DATE INSPECTOR'S SIGNATURE
" ADDRESS � FOUNDATION:LOCATION
FORMS,MATERIALS
' VALUATION s 13W.00 FRAME:FIRE STOPS,
BRACING,BOLTS
FURNACE:LOCATION.
FEE. S I FEE 9_nn I GAS VENT,DUCTS
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH.INT.
PLICATION AND STATE THAT THE ABOVE 1S CORRECT-AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATE LAWS REGULATING BUILDING CONSTRUCTION. LATH,EXT.-
SIGNATURE OF./� HOUSE NUMBER COR-
PERMITTEF -1 Lb¢Qo RECT AND POSTED --//
.-ADDRES FINALd (9O Cif
CLYDE N.DIRL:AM,PRINCIPAL ST RAL ENGINEER
PLAN-CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION OK. M.O. CASH
J .v OF
• COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BLALTERATION/REPAIR
O 08 0120612 008
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I NO. OF CONST I BUILDING ADDRESS: 1
ITR: 6561 LT: 393 UN: .002 SQ. FT STORIES TYPE 1 5812 ROWLAND AV I
I (STRUCTURE: 2000 V-B I TEMP CA 917802238 1
(ASSESSOR INFORMATION NUMBER: [ I NEAREST CROSS STREET:
18587-033-010 I I THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY, Cl
ITENANT: (EXIST BLDG USE: RESID USE ZONE: R-1 ISSUED ON: PROCESSED BY: [
[ [EXIST OCC GRP: 106/12/12 SR 1
(OWNER: TEL. N0: [SLOGS. NOW ON LOT: VALUATION: [FI L T FI CODE: 1
ICHITUVEVICK, BARBRA - 1 ON:
15812 ROWLAND AV 6,200
ITEMP 917802238 I FEES PAID IDESG PTIO�F WORK [
I I IREMOJE COMP SHINGLE INST 30 YR COMP SHINGLES OVER EXISTINI
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:IG PLYWOOD HOUSE AND GARAGE 1
APPLICANT: TEL. NO: I 1
IKEEFER, BRIAN (909) 608-0622- IAA BLDG PERMIT ISSUANCE 27.80 1
I IAB STATE GREEN BLDG FEE 6200.00 VAL 1.00 ISPECIAL CONDITIONS: [
AC STRONG MOTION RESID 6200.00 VAL 0.60 I 1
[ [D2 PERMIT W/0 EN HC 6200.00 VAL 166.20
1 TOTAL FEES 195.60 I_ 1
ICONTRACTOR: TEL. NO: I APPROVALS DATE INSPECTOR SIGNATURE
IKEEFER'S ROOFING (909) 608-0622- 1
1216 BEGONIA COURT LIC. NO 1 LOCATION AND SETBACKS I I I
(UPLAND CA 91784 760903 C39 ]
I 1 ]SOILS ENGINEER APPROVAL I I I
[ARCHITECT OR ENGINEER: TEL. NO: - 1 IFOUNDATION/TRENCH FORMS I I I
1 LIC. NO: ] ISLAB/UNDER FLOOR I [ [
1 i iRAISED FLOOR FRAMING [ I I
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( (UNDERFLOOR INSULATION I I I
115OH269 3 001 1-1 I
I [FLOOR SHEATHING I I I
1
INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: ] I-
0
0 NO 21 IROOF SHEATHING I I I
SCHOOL WITHIN HAZARDOUS I ISHEAR PANELS I I I
[AIR QUALITY: 1000 FEET MATERIALS [ 1
NO NO NO (FRAME INSPECTION I [
[FIRE SPRINKLER HANGERS [ [ [
i [INSULATION/WEATHER STRIP( I I
[ [ 11NTERIOR LATH/DRYWALL 1
I [EXTERIOR LATH 1
1 I (RATED FLOOR/CEIL ASSEM, 1 I ]
RATED WALL ASSEMBLIES
]
RATED SHAFTS/OPENINGS I I I
I IT-BAR CEILINGS I I I
I I I
[ I ILOT DRAINAGE 1 ] I
[ 1REPORT ID: DPR261 ROUTE TO: BS0508 1 I I ]
I I I I I