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••�+•m••• APPLICATION FOR BUILDING PERMIT I
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDREss
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST jr
CASYATT O GRIFFIN BUP T OF BUILDING CROSS ST
DIST NO GROUP
TYPE ED BY
FOR APPLICANT TO FILL IN CMT
BUILDING STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS BK
CLASS NO ELL UNI
LOT NO / BLOCK MAP NUMBER H ATE YES NO
TRACTfr. USE ZONE SPECIAL
NO OF BLOG3 /I./ CONDITION
SIZE OR LOT NOW ON LOT J-T _
USE OF
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SETBACK WIDTH
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IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LAT}{ INT
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATE LAWS REG T BUILDING CONSTRUCTION LATH IXT
SIGNATURE OP HOUSE NUMBER COR-
PERMITT RECT AND POSTED 4- D
ADDR Z FINAL i4O
CLYDE N DIRLAM PRINCIPAL STRAL ENGINEER
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COUNTY OF LOS ANGELES TEMPLE CITY A' 0508 ^ BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD/ALT/REP
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0008150020
PHONE (626) 285-0488 EXT
LEGAL ID NO OF CONST NEW BUILDING ADDRESS
ON FILE SO FT STORIES TYPE OCCDP GROUP 5112 SERENO DR
STRUCTURE 0 1 VN R3 ITEMP CA 917803039
ASSESSOR INFORMATION NUMBER GARAGE 0 1 NEAREST CROSS STREET ROSEMEAD
5388-011-040 OTHER ,THOMAS PAGE 596 GRID H5 LOCALITY TEMPLE CITY
TENANT EXIST BLDG USE USE ZONE ISSUED ON PROCESSED BY
EXIST OCC GRP 08/15/00 UT 02/ 01
OWNER
L No
BLDGS NOW ON LOT VALUATION
FINAL DATE CODE
5LIN 112PSERENOHDR (626) 285-5879- 1 200 Q
TEMP 917803039 UtbLKIVIII
\ , INSTALL SKYLIGHT IN GARAGE
FEE DESCRIPTION QUANTITY DAM AMOUNT
APPLICANT TEL NO
SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27 75 I
j AC STRONG MOTION RESID 200 00 VAL 0 50 SPECIAL CONDITIONS
D2 PERMIT W/O EN-MC— -200 00 VAL 43 65 1
S P(•IGELE
TOT EES 71 90 1
CONTRACTOR eLo APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER - VD Ty ` I
LIC NO LOCAIION AND SETBACKS
ARCHITECT OR ENGINEER TEL -90--1 FOUNOATION/TRENCH FOW
LIC N0 SLAB/UNDER FLOOR
MAP NO SEWER MAFIMZ— PAGE FIRE ZONE UNDERFLOOR INSULATION
3 TPUBLIC WORKS) IST LEVEL FLOOR SHEATH
NO OF FAMILIES DWELLING UNITS APT/COND STAT CLASS- i
NO 21
1�'SCHOOL WITHIN HAZARDOUSI�D.
ROOF SHEATHING
AIR QUALITY 1000 FEET MATERIALS 1
NO NO NO � FIRE DEPT FRAME INSPECT
REQUIRED TOTAL SETBACK7ff5r—UnYr--, m
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INSULATION/WEATHER
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EXTERIOR LATH
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REPORT ID DPR261 ROUTE TO BS0505