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APPLICATION�FOR ILDIN OERM1T �
COUNTY OF LOS ANGELES ASSESSOR
DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL
BUILDING AND SAFETY DIVISION BUILDING '-
ADDRESS
COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY GG
FOR APPLICANT TO FILL IN NEAREST -
Print or tvoe on,10 GROSS ST.
BUILDING ////��� y ..I �j ,C� DIST CT O. G OUP TYPE ^{ P ESSED BY
ADDRESS S_AOU I 1 7II J ,FJJ A �V k.� � � CONS
STATISTICAL CLQT`A�IFICATION SEWER MAP
LOT NO. BLOCK CLASS NO. DWELL•UNITS � BK PG
TRACT USE ZONE[CONDITIONS
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NO.OF BLDGS. O.
SIZE OF LO NOW ON LOT PECIAL
USE OF
EXISTING BLDG.
n TEL
OWNER e4, 1UP NO. BLDG.SETBACK FROM
ADDRESS ` erj F AJC-& FRONT PROP.LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
CITY ®£,(f�� J HIGHWAY WIDTH FROM C.L.
ARCHITECT Ae d C t NEO ,r, ` /l� + r� = /
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CONTRACTOR •/L �/L j'U NO. � + 3 HIGHWAY WIDTH FROM C.L. V
ADDRESS ✓L Q 2ac��(a NO. f = C
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CITY W jJ�✓' CLASS CORNER CUTOFF YES' NO ❑ Lu
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CTION LEND ♦ C-
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/� APPROVALS -DATE INSPE OR'S SIGNATURE
P,C. Lr �4 FEES ZQn. +j'b FOUNDATION:
MATERIALS ON SI/7� �� 4,
FEE 5
FRAME: FISTOPS,
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACIRE NG BOLTS
AND STATE THAT THE ABOVEI'S CORRECT AND AGREE TO COMPLY FURNACE: LOCATION,
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS
STRUCTION. I CERTIFY THAT IN' DOING THE WORK AUTHORIZED /
HEREBY IWILL NOT EMPLOY ANY PER 50h IN VIOLATION GF THE LATH, INT.
LABOR CODE OF THE STATE OF -CALIFORNIA IN RELATING TO
WORKMEN'S COMP TION INSURANC , LATH, EXT, R//V7 3
SIGNATURE OF `r a HOUSE
R CT ANDE
EPOSTED A 3
PERMITTEE
ADDRESS ?� P � �+ce� b[_ FINAL
7 .
' JOHN F. LEWIS. PRINCI A gTRUCTURAL ENGINEER
PLAN CHECK VAtD
N CK. M.O. CASH PERMIT VALIDA CK. M.O. CASH
LAf
.6,;_774 238.204 r
LAL;o 7 7 1 8- 'Aug 2 4 1 D 42 .5 0-
'C75A638A CE/11802 1/71O
' APPLICATION FOR `6D N QPERI1iT
COUNTY OF LOS ANGELES ASSESSOR
DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL
BUILDING AND SAFETY DIVISION BUILDING _
ADDRESA5_6 LL
COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
Print or tvoe only) CROSS ST.
�j qq ,o DISTR T NO. GR P TYPE PRO SSED BY
ADDRBUILDESS e?(/J6�'r AAjird .V � � CONST.
1.
STATISTIC A C SSIFICATION E E
LOT NO. BLOCK `CL,A_SS N DWELL.UNITS B6
TRACT USE NE MAP 0
-2
NO.OF BLDGS. NO. GS.
SIZE OF LOT NOW ON LOT SPECIAL
USE OF CONDITIONS
EXISTING BLDG.
OWNEOAI NO.
BLDG.SETBACK FROM
ADDRESS ,li FRONT PROP.LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
CITY ()—(�/.�!'�• HIGHWAY WIDTH FROM C.L.
ARCHITER / TE + _
ENGINEE 6 at�G� S NO. I
/ G.SETBACK FROM
ADDRESSe/. , r �� S E PROP.LINE OF (STREET)
TE TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL C
CONTRACTOR NO HIGHWAY WIDTH FROM C.L. V
ADDRES pLjp, } _
f F
CITY CLASS / CORNER CUTOFF Y NO ❑ LL
CONSTRUCTION LENDfM Col.
NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL A ROVALS
ADDRESS
SIZE T 5-3. NO OF STORIES FAMIOLFIES NEW � /O r� -
USE O l DD ❑ !J
STRUCTURE I� 171_ / yj
1 a (�>✓ ALTER ❑ fq
SIGNATURE OF REPAIR El
APPLICA dZ&/ MOL ❑
VALUATIONS �E/eJ APPROVALS DATE INSPECTOR'S SIGNATURE
FOUNDATION: LOCATION 1
FEE FEES 6J��Jlb FORMS, MATERIALS �' 3/ L �' _
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLYFURNACE:.LOCA TION, r
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
LABOR CODE OF THE STATE OF .CALIFORNIA IN RELATING TO LATH, INT.
✓ P/%_� ,�� I .I
WORKMEN'S COMPE .TION INSURANCE. LATH, EXT,
SIGNATUREOF i� HOUSE NUMBER COR-
PERMITTEE y RECT AND POSTED
ADDRESS /21 ` ' �"!ce " FINAL
JOHN F. LEWIS. PR INC PA STR TURAL ENGINEER
PLAN CHECK V cK. CASH _ PERMIT VALIDA N' CK. M.O. CASH
6773 323 D '265.206
I I. 7 7 , 4N Auc24 ' 0 4 7 .50-
4
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
D6RART74ENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR)
BUILDING AND SAFETY / LAND DEVELOPMENT r TEMPLE CITY CA 91780 BL~9508 9912140028
PHONE: (626) 285-0488 EXT:
LEGAL I • NO. OF CONST B I DAG-ADDRES
TR: 10898 LT: 9 BL: A SQ. FT STORIESar• TYPE•. 5625 SANTA ANITAIAV
STRUCTURE: 0 VN TEMP CA 917802949
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LIVE OAK
8573-020-005 I THOMAS-PAGE-597 GRID: D3 LOCALITY: TEMPLE CITY
TENANT: EXIST BLDG USE: RESID USE ZONE: R-3 0 PROCESSED BY: EXPIRES ON:
EXIST OCC GRP: 12/14/99 UT 06/11/00
OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE 2 w B' : CODE:
SAID ONSY I;MAGDA S - 1 5,000
498 ROSEMEAD BL
PASO 911074940 FEES PAID DESCRIPTION OF WORK
NEAR OFF-EX'I•STI'NG—INSTALL CLASS A SENTINEL 3"TAB?COMP.
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: SHINGLE, REINSTALL TILE RIDGE
APPLICANT: TEL. NO:
- - - "-
CHAMPION ROOFS (323) 259-0451- AA BLDG PERMIT ISSUANCE 27.75
3257 VERDUGO RD. AC STRONG MOTION RE- D�5000.00 VAL 0.50 SPECIAL CONDITIONS:
LOS ANGELES, CA D2 PERMIT W/0 EIL`�fG—�5Q0.00 VAL 132.60
�, 'GELEST • ® 160.85
CONTRACTOR: TEL. N0: APPROVALS DATE INSPECTOR SIGNATURE
CHAMPION ROOF, INC. (323) 248-0803-
3257 VERDUGO RD LIC. NO LOCATION AND SETBACKS
LOS ANGELES CA 90065 429481/C39
® SOILS ENGINEER APPROVAL
ARCHITECT OR E GINE R: TEL. NO: - 0 NDAT I ON/TRE C FORMS
LIC. N 1111111 SLAB UNDER FLOOR
RAISET FLOOR FRAMING
*aN-D—ERFLOOR
INSULATION NO: SEWER MAP BOOK: PAGE: FIRE ZONE: MM, � p150H277 3UC CRT- Kf-LORSHEAT
0. OF FAMILIES: DWELLING UNITS: APT/CO D: STAT CLASS—
YES 21 V\i TIL ROOF SHEATHING
SCHOOL WITHIN HAZARDOUSSHEAR PANELS
AIR QUALITY: 1000 FEET MATERIALS 0 ❑
NO NO NO ® FRAME INSPECTION
�O El 5
REQUIRED TOTAL SETBACK FROM EXIST �16� El 0FIRE SP I K ER HANGERSFRSET ONTPL-
SIDEPL-
YARD: HWY: PROP LINE: WIDTH: �C �+ervic a ThO INSULATION/WEATHER STRIP
SIDE
INTERIOR LATK/DRYWALL
EXTERIOR LATH
RATED F OOR/CEIL ASSEM.
RATED WALL ASSEMBLIES
RATED SHAFTS/OPENINGS
T-BAR CEILINGS
LOT-DRAINAGE
REPORT ID: DPR261 ROUTE TO: SS0508