HomeMy Public PortalAbout5441 RYLAND AVE_Building__ JJC4k'P-JMXMdJl5nW OF BU1L.17LNG FUND SAFETY. ! awrLamat a Awn r va rJQMA as a
COUNTY OF COS ANGELES ' t
WM. J. FOX. CHIEF ENGINEER
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
BUILDING DISTRICT NO. PLAN OK.NO. PERMIT NO.
ADDRESS 10056E
LOCALITY Temple 01 RECEIVED BY DATE OF APPL. SO DATEE ISGU6D
.A080T.
se BT N. gyjand
OWNER John Douglas Reid ADD ESS �S
ADDRESS 109 SO First Sv9 MAIL
LOCALITY
NEAREST / Alt)
CITY NO '/DO 78121 CROBB BT. G.. /Y !J
FIRE NO.OF TYPE ORDUP
ARCHITECT OR TEL. ZONE ✓� PLANS �.. «!'�„
ENGINEER NO.
• BLDG. � ORD.ND.
ADDRESS SETBACK/LINE 2-.6 Pr /C P•L, I"URC037113'
APPROV D + � �
CONTRACTOR John. Douglas Rei DO 7-812 BY DATE
USE ft APPROVED
ADDRESS 109 Soo First Ave, Arcadia ZON BY DATE
LEG- DE CRIAL LOT NO.
BLOCK I n CORRECTIONS
TRACT See other side
SIZE OF LOT 68 X 108 I NOW ON LOTS' none -7-
USE
I BLD O. aI No.or NO.
_ FAMee I ROOMS
S
DESCRIPTION OF WORK C%D M j Aj
NEW X I ALTERATION ADDITION �] C7 L-/ '�� �^ •+��✓ O
REPAIR ,, MOVING DEMOLISH 0 -
SIZE 1150] Rooms 6 STORIES 1 i )q 4 -Q�t�( °y vel VC C'i
WALL ROOF
-COVERING ►S't'iU000 I COVERINO wo Rock ` A %Ak�+ (y I :F I f?10(e
USE OF NEW
BUILDING
Residence and detached gargee Na /6/444K��.- K;��
IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS
APPLICATION AND STATE THAT THE ABOVE IB DORRECT IN PEOTOR DATE
AND AGREE TOC MP WIT LL COUNTY ORDINANCES FOUNDAT AT LOCATION
AND STATE LAWS U TI UIL NBT CTION. FORME.MATERIALS ` yI
FRAME* FIRE STOPS. �,y,/,,, c/ �•
SIGNATURE OF BRACING,BOLTS
PERMITTE LATH. INT. Jnf r� � J
7�
AUTHORI D TLATH. EXT. y
76A638A-3 2-50 $ Z(rC7,":' P.C.R _ 2 PLASTER,INT.
3d
J- c1�0E .O / ! `'_ PLASTER.EXT.
VALUATION O FEE 33 —:30 FINAL L%�•l!Y ��`+ V�-
WORKERS'COMPENSATION DECLARATION `
I hereb athat I have a certificate of consent to self
insure`,offirmr a certificate of Workers'Compensation Insurance, "APPLICATION FOR BUILDING P E RM I T
ora certified copy thereof(Sec. 3800, Lab. C.)
_ COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. Company BUILDING
Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS
Certified copy is filed with the county building inspec- BUILDING s ■
tion department. ADDRESS Je. LOCALITY
Date ApplicantCITY ZIP Rl'7go
NEAREST
Date G�-
CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. ASSESSOR
COMPENSATION INSURANCE SIZE OF LOT �Q S NOW ON LOT MAP BOOK PAGE I PARCEL
(This section need not be completed if the permit is for one USE ZONE
hundred dollars($.100)or less.) TRACT BLOCK LOT NO. NO. C�
• TEL. 03 l SPECIAL
I cern that in the performance of the work for which this OWNER NO. CONDITIONS
certify P DIS RICT GROUP TYPE FIRE PROCESSED BY
permit is issued, I shall not employ any person in any manner S 1 CONST. Z�E ad
I _Ole
so as to become subject to the Worke 'Compensat vrs. ADDRESS JG
CITY ZIP STATISTICAL C IFIC MON APT. CONDO.
Date Applicant ARCHITECT OR TEL. U
NOTICE O PLICANT: If, after" king this Certificate•of ENGINEER NO. CLASS NO. id/ I.L..DWEUNITS
Exemption, you should become subject to-the Workers'
Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP
with comply with such provisions or this permit shall be TEL —
deemed revoked. CONTRACTOR NO. BK. PG, VALIDATION
LICENSED CONTRACTORS DECLARATION LIC.
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. VALUATION
(commencing with Section 7000)of Divisioft 3 of the Business and LIC.
Professions Code,and my license is in full force and effect. CITY 4,0 CLASS $ PooSQ.F7 NO.OF NO.OF ' CHECK
License Number Lic.Class SIZE STORIES ! FAMILIES
Contractor Date DESCRIPTION OF WORK -wa NEW $
W S I O ■ S ADD
I am exempt under Sec. ALTER FINAL
B.BP.C. for this reason Sskftdew. REPAIR C1DATE
USE OF [3 FINAL
Date: EXISTING BLDG. DEMOL By
Signature APPLICANT • • TEL.
OWNER-BUILDER DECLARATION PRINT NO.
I hereby affirm that I am exempt from the Contractor's License
Law for the following reason (Section•7031.5, Business and ADDRESS S R 1`E'17� , 00
Professions Code): PRE5ENT r
I, as owner of the property, or my employees with BUILDINGADDRESS � fl�
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). kADDRE
TEL. / 'Jy� 0 9 8 3 A
I, as owner of the property,am exclusively contracting TOR NO. Z"
with
�J
with licensed contractors to construct the project (Sec- /z_ +t o 0 0. 0 0 )
tion 7044, Business and Professions Code).
I YARD HWY TOTAL SETBACK FROM EXIST. ? ° ° 3 3 00
CONSTRUCTION LENDING AGENCY PROP. LINE WIDTH
I hereby affirm that there Is a construction lending agency for ® ° ° 3-4. ('r c=i
the performance of"the work for which this permit is issued tSec. 3097, Civ. C.). (� 0io ,Lender's Name Permit Fee 7 v
Lender's Address
I cern that I have read this application and state that the
Y' above information is correct. I agree to comply with all County Issuance Fee
9 P Y Investigation Fee
ordinances and State laws relating to building construction, Total Fee
and hereby authorize representatives of this County to enter
uPoruAke above-ment' ned property far inspection ur oses.
■ SEE REVERSE FOR EXPLANATORY LANGUAGE
I If
Agent � IBs
ignature o Applicant or Ag ,
i
COMPENSATION DECLARATION
WORKERS - '
herer' catCompensationp consent aelfpI fie of Workvars' urn APPLICATION FOR , BU I L D I N G PERMIT
insure, or a c
or a ertifie,copy therdof(Sec.?800, La . C')
COUNTY OF LOS ANGELES...- BUILDING AND SAFET
Pol' y NCompany ••
..ertified copy is hereby furnishe FOR APPLIC ADDRESS O FILL IN BUILDING
d /L
rJ Certified copy is filed with the 'unty bui inspec- BUILDING
I tion de rtment. ADDRESS f5
Date Applicant r CITY_—��� ZIP LOCALITY
RTI KATE OF EXEMPTION FROM WOR S' NO.OF BLDGS. NEAREST
COMPENSATION INSURANCE SIZE OF LOT NOW ON LO7 CROSS ST.
(This section need-not be completed if the p mit is for one ASSESSOR
-hundred dollars($100)or less.) TRACT BLOCK LOT NO. - MAP BOOK PAGE PARCEL
TEL. USE NE MAP
I certify that in the performance of the work for which this OWNER _ / 1iC1V0. NO — — �7-.� >_permit is issued, I shall not employ any person in any manner ADDRESS — SPECIAL IL
so as to become subject to the Workers'Compensation Laws. CONDITIONS V
�— Date Applicant CITY ZIP
NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE SED BY 0
Exemption, you should become subject to the Workers' ENGINEER NO. fes/ (j, ^� CONST. ` ZONE
Compensation provisions of the Labor Code, you must forth- ADDRESS l.J�19s `J /r/ LN
with comply with such provisions or this permit shall be- TEL, STATISTICAL CLASSIFICATION APT. CONDO. in
deemed revoked. z
CONTRACTOR .,, NO. -
LICENSED CONTRACTORS DECLARATION -• r /1 IC, CLASS NO. 9--/r UNITS
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 17
(commencing with Section 7000)of Division 3 of the Business and LIC. SEWER MAP
Pr6fessions Code, and my license i in full force and effect. CITY1 CLASS BK Z VALIDATION
CIT FT. NO.OF NO, F CHECK
License Number Lic.Class SIZE 6 STORIES FAMILIES ONE
❑ VALUATION
DESCRIPTION'OF WORK NEW
Contractor Date ; � ,
ADD —--
❑I am exempt under Sec. ALTER ❑
B.&P.C. for this reason REPAIR ❑ S
Date: USE OF DEMOL
EXISTING BLDG. ❑
Signature APPLICANT TEL. FINAL�
OWNER-BUILDER DECLARATION (PRINT) NO. DA.10,Z
I hereby affirm that I am exempt from the Contractor's License
Law for the following reason (Section 7031.5, Business and ADDRESS F
Professions Code): PRESENT y
❑ 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. l
❑ 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). •' `, 0584,4A
REQUIRED TOTAL SETBACK FRO T.
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH `
I hereby affirm that there is a construction lending agency for FRONT I •�y `• ;;_ •; �ri;' �, jf 0 0 0 0.o,1
the performance of the work for which this permit is issued P.L.
(Sec. 3097, Civ. C.). SIDE V- a 6 a,6 3
P.L. +; , a a a 6 8 6 3
Lender's Name ;
67
P.C. Fee$ Permit Fee / LD Ref.'# � f _. , '0 3-86
- Lender's Address ` '
r I certify that I have read this application and state that the Issuance Fee / d' LDMA P/C# •'
abo information is correct. I agree to comply with all County Investigation Fee
or n nces and State law relating to,building construction, Total Fee
a d ere authorizron7�d
sentatives of this County to enter LDMA Perm. #
3 po the hove-menproperty for spection Vt. -O-
<
C SEE REVERSE FOR EXPLANATORY LANGUAGE
w
Signature of A icant or Agent
e
y
f
u
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 0709070017
PHONE: (626) 285-0488 EXT:
LEGAL ID: NO. OF CONST BUILDING ADDRESS:
ON FILE SQ. FT STORIES TYPE 5451 RYLAND AV
STRUCTURE: VN TEMP CA 917802722
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: DAINES
18586-024-013 THOMAS PAGE: 597 GRID: B3 LOCALITY: TEMPLE CITY, Cl
[TENANT: IEXIST BLDG USE: RESID USE ZONE: R-1 (ISSUED ON: PROCESSED BY: EXPIRES ON:
(EXIST OCC GRP: 09/07/07 SR 03/05/08
ITOWNER: TEL. NO: JBLDGS. NOW ON IAT: VALUATION: (FINAL DAT D REDBY: CODE: [
HUANG, BONNIE (626) 298-2032- 1 3,500 J 1
15451 RYLAND AVENUE 1 I
ITEMP 917807584 1 FEES PAID [DESCRIPTION OF WORK
[ 1 [REMODEL KITCHEN, 2 BATHROOMS AND REPLACE 2 WINDOWS 1
[FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: I
[APPLICANT: TEL. NO: I I I
ISAME AS OWNER - IAA BLDG PERMIT ISSUANCE 27.75 1 [
[ IAC STRONG MOTION RESID 3500.00 VAL 0.50 [SPECIAL CONDITIONS:
1 JB2 PERMIT W/ENERGY 3500.00 VAL 127.38 I 1
1 JFR INV WORK W/O PERMIT 257.00 DOL 257.00 1
] TOTAL FEES 412.63 [ 1
ICONTRACTOR: TEL. NO: ] [APPROVALS DATE INSPECTOR SIGNATURE [
SAMB AS OWNER LIC. NO 1 (LOCATION AND SETBACKS 1 1
SOILS ENGINEER APPROVAL I I [
[ARCHITECT OR ENGINEER: TEL. N0: 1 [FOUNDATION/TRENCH FORMS I I
1 LIC. NO. 1 ISLAB/UNDER FLOOR I i I
(RAISED FLOOR FRAMING I [
I [ I I I I
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:[ [UNDERFLOOR INSULATION I J
1147H273 3 O1[ 1 1-1
I 1 IFLOOR SHEATHING I 1
INO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: 1 I I I
[ NO 21 1 ]ROOF SHEATHING I 1
SCHOOL WITHIN HAZARDOUS ISHEAR PANELS 1 1 I
AIR QUALITY: 1000 FEET MATERIALS 1 1 ] 1 1
[ NO NO NO 1 [FRAME INSPE IOEa Q
1
(REQUIRED TOTAL SETBACK FROM EXIST [ FIRE SPRINKLER HANGERS 1 ]
ISET BACK YARD: HWY: PROP LINE: WIDTH: I I I I
FRONT PL- i [INSULATION/WEATHER STRIPI ] [
I SIDE PL-
INTERIOR LATH/DRYWALL
EXTERIOR LATH [ 1 I
Iv, [ IRATED FLOOR/CEIL ASSEM. 1 J 1
[ RATED WALL ASSEMBLIES 1 1 I
(RATED SHAFTS/OPENINGS
I
1T-BAR CEILINGS I I 1
ILOT DRAINAGE 1 1 I
1
(REPORT ID: DPR261 ROUTE TO: BS0508
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 1004120017
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I NO. OF CONST I BUILDING ADDRESS: I
ON FILE I SQ. FT STORIES TYPE 1 5451 RYLAND AV
ISTRUCTURE: VN I TEMP CA 917802722 I
(ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: DAINES I
18586-024-013 1 I THOMAS PAGE: 597 GRID: B3 LOCALITY: TEMPLE CITY, Cl
I I I I
(TENANT: 1EXIST BLDG USE: RESID USE ZONE: R-1 ISSUED ON: PROCESSED BY: I
1 1EXIST OCC GRP: 104/12/10 SR 1
1OWNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: 1FI DATE FINAL BY: CODE: 1
1HUANG, BONNIE (626) 794-0288- 1 1,200
6743 LONGMONT AVE. [ [ M
SAN GABRIEL CA 91775 1 FEES PAID ` 15SCR TION OF WORK
I I ` IREPLACE 7 EXISTING WINDOWS WITH LOW-E RETROFIT WINDOWS
IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT:1 (PER JOE) I
(APPLICANT: TEL. NO: I I 1
SAME AS OWNER - 1AA BLDG PERMIT ISSUANCE 27.75 1 [
1AB STATE GREEN BLDG FEE 1200.00 VAL 1.00 ISPECIAL CONDITIONS: I
IAC STRONG MOTION RESID 1200.00 VAL 0.50 I I
ID2 PERMIT W/O EN-HC 1200.00 VAL 82.20 1 I
[ [FR INV WORK W/O PERMIT 257.00 DOL 257.00 1 [
CONTRACTOR: TEL. NO: 1 TOTAL FEES 368.45 1APPROVALS DATE INSPECTOR SIGNATURE 1
SAME AS OWNER - [ I [
I LIC. NO 1 ILOCATION AND SETBACKS I 1 1
I [ ISOILS ENGINEER APPROVAL 1 1 1
1ARCHITECT OR ENGINEER: TEL. NO: - 1 1FOUNDATION/TRENCH FORMS I I
1 LIC. NO: 1 (SLAB/UNDER FLOOR [ I [
I [RAISED FLOOR FRAMING 1 I
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:1 1 (UNDERFLOOR INSULATION I I
1147H273 3 001 I 1-1
I I [FLOOR SHEATHING I [
INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I I I I
1 NO 21 1 IROOF SHEATHING I 1 1
1 SCHOOL WITHIN HAZARDOUS I ISHEAR PANELS 1 I
[AIR QUALITY: 1000 FEET MATERIALS I I [ [ I
1 NO NO NO I IFRAME INSPECTION I [
IREQUIRED TOTAL SETBACK FROM EXIST I 1FIRE SPRINKLER HANGERS 1 I
ISET BACK YARD: HWY: PROP LINE: WIDTH: [ I [ [ [
IFRONT PL- I (INSULATION/WEATHER STRIP( [ [
1 SIDE PL- [ [ I [ [
11NTERIOR LATH/DRYWALL I I I
I 1EXTERIOR LATH I 1 [
[ I IRATED FLOOR/CEIL ASSEM. I 1 [
I I IRATED WALL ASSEMBLIES I [ [
1 I
IRATED SHAFTS/OPENINGS I 1 I
[
IT-BAR CEILINGS [ I [
[ (LOT DRAINAGE [ 1 I
I IREPORT ID: DPR261 ROUTE TO: BS0508 I [ I 1
COUNTY OF LAS 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 1309230034
PHONE: (626) 285-0488 EXT:
ILEGAL ID: NO. OF CONST I BUILDING ADDRESS:
ON FILE SQ. FT STORIES TYPE 5451 RYLAND AV
STRUCTURE: 20 V-B TEMP CA 917802722
ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET:
18586-024-013 THOMAS PAGE: 597 GRID: B3 LOCALITY: TEMPLE CITY CAI
TENANT: IEXIST BLDG USE: RESID USE ZONE: R-1 JISSUED ON: PROCESSED BY:
IEXIST OCC GRP: 109/23/13 SR 1
DOWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: IF AL F SY: CODE: I
ISOMASUNDARAM, RATHINASABAPAT - 1 4,900 I I
15451 RYLAND AVENUE 1 I
ITEMP 917807584 FEES PAID DEk9CRIPTION OF WORK 1
I I �REROOF HOUSE ONLY 20 SF. I STALL NEW 30 YRS CLASS "A" 1
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: SHINGLES
JAPPLICANT: TEL. NO: I I I
JISRAEL DEKEL (818) 652-2138- IAA BLDG PERMIT ISSUANCE 27.80 I
14924 BALBOA AVE JAB STATE GREEN BLDG FEE 4900.00 VAL 1.00 ISPECPAL CONDITIONS: 1
IENCINO CA 91316 IAC STRONG MOTION RESID 4900.00 VAL 0.50 1 1
CD2 PERMIT W/O EN-HC 4900.00 VAL 132.60 1
1TOTAL FEES 161.90 I I
ICONTRACTOR: TEL. NO: JAPPROVALS DATE INSPECTOR SIGNATURE 1
LA CONSTRUCTION AND ROOFING (818) 760-7575- 1 I
14924 BALBOA BLVD LIC. NO I JLOCAjION AND SETBACKS
1#606 983599 ! I I I
1ENCINO CA 91316 1 ISOILS, ENGINEER APPROVAL I I
(ARCHITECT OR ENGINEER: TEL. NO: - ! IFOUNONTION/TRENCH FORMS I I I
i
LIC. NO: SLAB/UNDER FLOOR 1
I i IRAISED FLOOR FRAMING J
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:; JUNDERFLOOR INSULATION I I I
I I I
3 OOI 1-1
IFLOOR SHEATHING I
I 1
INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I 1
NO 21 I 1ROOF SHEATHINGL..II
I
1 SCHOOL WITHIN HAZARDOUS 1SHEAIt PANELS I I I
JAIR QUALITY: 1000 FEET MATERIALS I II
1 NO NO NO I IFRAME INSPECTION I I
! (FIRE SPRINKLER HANGERS I I
I
1 IINSULATION/WEATHER STRIPI
INTERIOR LATH/DRYWALL I I
I ! EXTERIOR LATH I I
I I IRATED FLOOR/CEIL ASSEM. I I I
(RATED WALL ASSEMBLIES I I
IRATED SHAFTS/OPENINGS I I I
IT-BAR CEILINGS I I I
II I I
I I ILOT DRAINAGE
IREPORT ID: DPR261 ROUTE TO: BS0508
DEPARTMENT 1OP6 BUILDING AND SAFETY
COUNTY OF LOS ANGELES BUILDING-
WM.
U1LD1WM. J. FOX, CHIEF ENGINEER APPLICATION.
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
DISTRICT NO. PLAN CK.oR REQ.No. I PERMIT NO.
BUILDING
ADDRESS Pv •J 7 �7 / 7 �✓
RECEIVED BY DATE OFAPPL. DATE ISSUED
LOCALITY
02s-
NEA
REST �
CR089ST. BUILDING /J�,�
ADDRESS 0 r! /Y
OWNER
MAIL LOCAL Ty C/'?�ry
ADDRESS Q NEAREST
A.0. Cv% e J
CITY�p .I 2. No.
CEA
FIRE NO.OF TYPE 1/ GROUPT`
(/ �.
ARCHITECT OR TEL ZONE PLANS
ENGINEER NO. BLDG. 0 / /D? RD. NO.
SETBACK LINE s� 77
ADDRESS
USE � �/ APPROVED
TEL ZONE BY DATE
CONTRACTOR NO. rl HOUSE NUMBERING
ADDRESS V L p L� MAP NUMBER D O 9 NO. ASSIGNED BY
LEGAL
DESCRIPTION 64111&1
S�LOT NO.�$� CORRECTIONS
BLOCK �
TRACT�s��iALL F/
Q Ld/N Ie 14%
//
NO. OF BLDG9.
SIZE OF LOTSYY I NOW ON LOT
USE OF NO.OF
EXISTIN BLDG. FAMILIES
DESCRIPTION OF WORK
NEW ALTERATION ADDITION Z
a
REPAIR DCM13LIT11N r
Sq.FT. '7/� NO.OF
SIZE ! ROOMS STORIES
EXT.WALL[-r ROOF /�
COVERING] /( _, COVERING C6 3U A e
USE OFSTRU TU� r—
@ d 'Z..
8
6'e6 r map d
INSPECTION FOR APPROVALS
OCCUPANCYA13 INBPECTORFSSIGNATURE DATE
FOUNDATION: LOCATION `4
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FORMS, MATERIALS
PLICATION AND STATE THAT THE INFORMATION GIVEN IS FRAME: FIRE STOPS,
CORRECT. BRACING, BOLTS
1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION,
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. GAS VENT,DUCTS
SIGNATURE OF LATH, INT.
PERMITTE
r LATH. EXT. �
ADDRESS
PLASTER, INT.
AUTHORIZED AMT.
$ PLASTER, EXT.
D FEEP.C. d HOUSE NUMBER COR-
RECT AND
OR-
RECTAND POSTED
VALUATION
FEE 01-{1 � FINAL �?`� ulU
76AS38A 013S3 7-51