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FRONT'PROP.LINE OF (STREET)
ADDR/ES� / NO S" HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING
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SIDE PROP.LINE OF (STREET) z
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SQ.FT NO.OF NO.OF CHECK HIGHWAY + YARD TtKA SETBACK FROM TYPE OF EXISTING U
SIZE S72,10 I STORIES f FAMILIES ONE IDE PROP.LINE HIGHWAY WIDTH N
❑ t = Z
DESCRIPTION OF WORK NEWJ?eji •�
I ? �., � ADD LS.J CORNERCUTOFF YES ❑ NO ❑
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IN OPEN SPACE YES ❑ NO
REPAIR 1:1 ❑
USEOFXISTINBLDG. DEMOL ❑ IN COASTAL PERMIT ZONE YES ❑ NO ❑
APPLICANT TEL —/',-��—O �� U�S IT'lS1� rJ�✓lJ
(PRINTI4/v/SC./v. NO.-
BY(SIGNATURE(
• I HEREBY ACKNOWLEDGE THAT I HAVE READ HIS APPLICA ON AND STATE 43/9-0
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES' f c -
AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE T •4 ( -� I
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF
HE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'SCOM- -
ENSATION INSURANCE.
SIGNATURE OF % FINAL �y /D BY
PERMITTEE DATE �
ADD
RE
TEL. P.C.Fee$ Permit Fee o� tia
CITY NO. �-y
•
VALUATION$ Issuance Fee
�� Total Fee / 3.3
PLAN'CHECK VALIDATION CK. M;O. CASH L PERMIT VALIDATION CK. O. CASH
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bS 76A8380 CE/8038 8/77 6 7 3 n t1UG �`•� '�- 9' 1 �' 3 �'v
76AS38A CEIIS03 B-64 APPLICATION FOR••BU ILD[ G PERMIT
c. CO3JNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS r
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE•. COUNTY ENGINEER NEAREST / t
COLEMAN W. JENKINSAUP'T.OF BUILDING CROSS ST.
DIS TRI T NO. GROUP TYPE. P E SED BY
FOR APPLICANT TO FILL IN
BUILDING y� `�� STATISTICAL CLASSIFICATION S BK R MAG
ADDRESS ��(/ CLASS NO._ DWELL UNITS je"
LOT NO. _ 1/4 BLOCK USE ZONE MAP
NO.
TRAC � ! SPECIAL
. OF BLDGS.
MCONDITIONS
SIZE OF LOT oN LOT
USE OF
EXISTING SLOG. SETBACK FROM
TEL. // FRONT PROP. LINE OF (STREET)
OWNER ,,7 NO. (- TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADD SS 49 �ZOIA79 HIGHWAY WIDTH .R OM C.L.
M d + ) _
CITY BLDG. SETBACK FROM
ARCHITECT O TEL. SIDE PROP. LINE OF (STREET)
ENGINEER NO.
TYPE OF EXISTING SETBACK HIGHWAY } YARD = -TOTAL
ADDRESS HIGHWAY WIDTH FROM C.L. d
TEL. + = 0
CONTRACTOR NO V
ADDRESS
LIC CORNER CUTOFF YES NO O
NO
CITY CL s SEE REVERSE SIDE FOR-SPECIAL APPROVALS IIC V
DESCRIPTION OF WORK y
Z_
ADD ALTER, . REPAIR DEMOLISH
SQ,FT. NO. OF r NO. OF
SIZE STORIES/ FAMILI 5
USE OF
STRUCTU
SIGNATURE OF
APPLICANT
VALUAT10NAPPROVALS DATE INSPECTOR'S SIGNATURE
P.C. PMT. FOUNDATION, LOCATION .
FEE$ FEE$ f-- FORMS, MATERIALS 19
FRAME, FIRE STOPS,
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS
9UILOI NG CONSTRUCTION. 1 CERTIFY THAT. IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT.
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT-
ING TO WORKMEN'S COMPENSATION INSURANCE.
LATH. EXT.
SIGNATURE O HOUSE NUMBER COR=-
PERMITTEE RE T AND POSTED
ADDR �tC FI NAL
JOHN F. LEWIS. PRINCIPAL STRUCTURAL EN 1
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH
;ALO 2 9 1 9- j021 1 D 6,d O N Q
X
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 BLO 08 ALTERATION/REPAIR10450016
PHONE: (626) 285-0488 EXT:
LEGAL ID: NO. OF CONST BUILDING ADDRESS:
ITR: 5904 LT: 313 BL: .001 SQ. FT STORIES TYPE 6010 SULTANA AV
STRUCTURE: 2500 V-8
TEMP CA 917801549
ASSESSOR INFORMATION NUMBER:
NEAREST CROSS STREET: 1
15384-015-007 1 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY CA[
TENANT: EXIST BLDG USE: RESID USE ZONE: R-1 ISSUED ON: PROCESSED BY:
1
1 1EXIST OCC GRP: 104/15/13 SR
(OWNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: 1F T FIN Y: CODE:
Imo. ANDY (626) 560-0415- 15,000 1 � 1
6010 SULTANA AVENUE 1 ���jjj///'/ 'i
TEMPLE CITY CA 91780 FEES PAID 1DESCR PTI OF WORK Id
I I KITCHEN, BATHROOM REMODEL AND TEAR OFF RE-ROOF 2500 SO-FT.
[FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:IINSTALL 1/2 OSB WITH 30 YEAR COMPOSITION SHINGLE
(APPLICANT: TEL. NO: 1
IKATIGBAM, MAGNO (909) 267-8749- IAA BLDG PERMIT ISSUANCE 27.80 I I
1961 CALLE HERMOSA IAB STATE GREEN BLDG FEE 15000.00 VAL 1.00 ISPECIAL CONDITIONS: 1
ISAN DIMA CA 91773909 1AC STRONG MOTION RESID 15000.00 VAL 1.50
I 1B2 PERMIT W/ENERGY 15000.00 VAL 330.70 1 1
I 1 TOTAL FEES 361.00 1
ICONTRACTOR: TEL. NO: 1 (APPROVALS DATE INSPECTOR SIGNATURE
IMSK BUILDERS (909) 267-8749- 1
1961 CALLE HERMOSA LIC. NO 1 1LOCATION AND SETBACKS I I
ISAN DIMAS CA 91773 720840 1
1 I ISOILS ENGINEER APPROVAL I I I
1ARCHITECT OR ENGINEER: TEL. NO: - 1 IFOUNDATION/TRENCH FORMS I I I
1 LIC. NO: 1 1SLAB/UNDER FLOOR 1 1 I
I 1RAISED FLOOR FRAMING 1
I I
1MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:1 /' (UNDERFLOOR INSULATION I I
, 1
1 3 001 IFLOOR SHEATHING I I I
INO. OF FAMILIES: DWELLING UNITS: APT/CONDI STAT CLASS: 1 I I
1 NO 21 1 1 ROOF SHEATHINGIAT
SCHOOL WITHIN HAZARDOUS 1 I SHEAR PANELS
(AIR QUALITY: 1000 FEET MATERIALS I I
NO NO NO 1 1FRAME INSPECTION I I
1 IFIRE SPRINKLER HANGERS 1 1 I
(INSULATION/WEATHER STRIP( I I
I 11NTERIOR LATH/DRYWALL I 1 I
I 1 I
1 1EXTERIOR LATH 1 I 1
1 1 1RATED FLOOR/CEIL ASSEM. 1 I I
IRATED WALL ASSEMBLIES 1 I I
1 1RATED SHAFTS/OPENINGS 1
IT-BAR CEILINGS I I I
1 1 1LOT DRAINAGE I I I
1 IREPORT ID: DPR261 ROUTE TO: BS0508 I I I I
I I I I I