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HomeMy Public PortalAbout6240 SULTANA AVE_Building__ 76A638 CE#808 9-57 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING 6240 Sultana Avenue T. C. DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY , JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPT OF BUILDING NEAREST CROSS ST. FOR APPLICANT TO FILL IN DISTRICT NO. GROU T C#Ns O s BY Print or type only) lf_ / 0 BUILDING STATISTICAL CLASSIFICATION SEWER MAP ADDRESS 62 0 Sultana Temple Lilt CLASS NO. DWELL.UNITS BK PG,5 LOT NO. BLOCK USE Z NE MAP NO. TRACT SPECIAL CONDITIONS NO.OF BLDGS. i SIZE OF LOT NOW ON LOT USE OF EXISTING BLDG. L�p BLDG.SETBACK.FROM OWNS +Onax'd CZ,ChOn TEE 287-$620 FRONT PROP.LINE OF (STREET) 0 Sultana T m le Cit HIGHWAY TYPE OF EWIDTIHG FROMACK C.L, HIGHWAY } YARD = TOTAL 2 ADDRESS 4 � P Y CITY Temple City } �I BLDG.SETtAQK FROM 7 $3k5V,*H. L. Randol_7T&LiO. `Jr$$-A 0 IDE PROP.LI. (STREET) 2 E-. Valle Blvd.., HIGHWAY TYPE OF EWIDTIHG SETBA FROM C.L. IGHWAY } YARD = TOTAL ADDRESS 529 Y TEL. } = a CONTRACTOR NO. O ADDRESS NO. 2266 CORNER CUTOFF YES ❑ N v C-39 CITY CLASS SEE REVERSE SIDE FOR SPECIAL APPROVAL C' DESCRIPTION OF WORK oW z NEW ADD ALTER REPAID,g DEMOLISH SQ. FT. NO. OF NO. OF SIZE STORIES FAMILIES USE OF STRUCTURE SIGNATURE OF APPLICANT VALUATION$600..00 APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. FOUNDATION: LOCATION FEE$ FEE$ 9.00 FORMS, MATERIALS FRAME: FIRE STOPS, I HEREBY ACLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS AND STATE TM T THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL. COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT. LATH, INT. ING TO WORKMEN'S CO PENSATIO11 URANCE. LATH, EXT: SIGNATURE O -� HOUSE NUMBER COR- F. RECT AND POSTEDZI ADDRESS ' :FINAL Q /- i JOHN F. LEWIS. PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ I PERMIT VALIDATION CK. M.O. CASH LAC' 6.2 0.1 AUG 3 0 � Q.0 0 ' IT APPLICATION FOR BUILDI G PERMIT T F,QEt>APPLICANT TO FILL IN (Print or type only) _P-.0L l ADDRESS ( CO TY OF LO ANGELES DEPARTMENT OF COUNTY ENGINEER CITY ( ZIP fr 7?Z' BUILDING AND SAFETY DIVISION OF BLDGS. BUILDING ' f / !r ) SIZE OF LOT ,? ON LOT ADDRESS . o , W` �v © 7- TRACT Q BLOCK LOT NO.(20?— LOCALITY '� C TE EAREST M , OWNER NO ROSS ST. ,l/ 1 / ASSESSOR rn. ADDRESS AMAP BOOK PAGE PARCEL DISTRICTG OUP TYPE FIRE P SED BY CITY ZIP !`G p ,� CONST.� Z ARCHITECT OR TEL. ENGINEER NO. STATISTICAL CLASSIFICATION WERAP ADDRESS CLASS NO. DWELL.UNITS OF pG CONTRA CTO &7r&'jQLkVfa'q ko• a USE Z jNE NO (/ y� LIC. 5/J/ICJ�� SPECIAL ADDRESS , /�. NO. CONDITIONS CIT T LIC. ASS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ CONSTRUCTION LENDER NAME AND BRANCH BLDG.SETBACK FROM FRONT PROP.LINE OF (STREET) ADDRESS CITY _ TOTAL SETBACK FROM TYPE OF EXISTING SQ. FT. NO. OF NO. OF CHECK HIGHWAY + YARD - FRONT PROP. LINE HIGHWAY WIDTH Q SIZE STORIES FAMILIES ONE F + DESCRIPTION OF WORK NEW 1:1 p � " ADD BLDG.SETBACKFROM v 1M+RLWpcu SIDE PROP.LINE OF (STREET) ? ALTER ❑ HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF 1EXISTING REPAIR[] SIDE PROP. LINE HIGHWAYI WIDTH USE OF \A�� + _ EXISTING BLDG.RA�� /f,J DEMO L ❑ App -NF CORNER CUTOFF YES ❑ NO ❑ � _ BY (SIGNATURE) IN OPEN SPACE YES ❑ NO ❑ p� IN COASTAL ZONE YES ❑ NO ❑ VALUATION$ V D CATEGORICAL EXEMPTION YES❑ NO ❑ I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION ENVIRONMENTAL AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE) WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED - (DATE) HEREBY I WILL NOT EMP SO)1 IN VIOL ON• THE OF THE ATE OF CAL NIA I RELATIN TO WORKMEN'S CO ION INSURANCE. PERMITTEE ADDRESS FINAL TEL. DATES )p`0^ BY CITY NO. DATEtan MAKE CHECKS PAYABLE 7'Or � gEEP : �� FEE HARVEY T. BRANDY, COUNTY ENGINEER o 0 o No L PLAN CHECK VALIDATION CK. M.O. CASH.O`^N _N o Pt"IT VALIDATION CK. M.O. CASH v n I+ (YJ N o `7 �Vn-QAC-JL�v1// -] O O o T-- -0 O O —` CH 76AG38A CE88o3 12/72 . APPLICATION FOR BUILDING PERMIT • COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS I hereby affirm that I have a certificate of consent t0 self insure, BUILDING AD RES � �Z if a � A d or a certificate of Workers'Compensation Insurance,or a certified G 2'2 ��' �7�v� / copy thereof(Sec.3800,Lab.C.) C ZIP L Irf si G /` �I ara LOCALITY Policy No. Company SIZE OF LTJT NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. d Ir //k -t_ NEZEST CROSS T. ❑ Certified copy is filed with the county building inspection TRA6T BLOCK LOT NO. dN a/,J department. ASSESSOR o P BOOK PAGE ,y Z PARCEL A USE ZONE MAP NO. �®� 2 Date Applicant 3 S SPECIAL CONDITIONS 7 CERTIFICATE OF EXEMPTION FROM WORKERS' OWNE , _ TEL NO. COMPENSATION INSURANCE v ��?/ Z WITHIN 1000 FT OF SCHOOL? YES No (This section need not be completed if the permit is for one hundred ADDRESS {- �2(� DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY dollars($100)or less.) ///ill > IP I certify that in the performance of the work for which this permit c O(� y� �_ is issued, I shall not employ an y CITY N' �� Z9 / ✓ v '\ p y y person in an manner so as t0 ARCHITECT ENGINEER TEL NO. become subject to the Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT CONDO Date -/ t- Applicant �-^.�^ 0, C= ADDRESS CLASS NO, DWELL UNITS NOTICE TO APPLICANT If, after making this Certificate of REQUIRED' TOTAL SETBACK FROM EXIST Exemption, you Should become subject t0 the Workers' CONTRACTOR TEL NO. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the tabor Code, you must forthwith 04-P/.P0A4— FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL LICENSED CONTRACTORS DECLARATION SIDE CITY LIC.CLASS PL I hereby affirm that I am licensed underprovislons of Chapter 9 (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORIES NO.OF FAMILIES SEWER MAP CL Professions Code,and my license is in full force and effect. NEW ❑ BK PG C DESCRIPTION OF WQRK VALUATION _ License Number Lic.Class L � ? � ADD ❑ 00 a Contractor Date ALTER ❑ $ �' ;:;.— a li�_41 eF w k/i♦v do o_ ❑ 1 am exempt under Sec. REPAIR ❑ $ (;_ E.a=1l z BAP.C.for this reason DEMOL ❑ — LDMA P/C# i �TF Date: USE OF EXISTING BLDG. URM 1:1 _ _ Signature 1 I.i i AL. 68_ 4-0 APPLICANT(PRINT) TEL NO: LDMA Perm# ❑ I••as owner of the property, or my employees with wages as Z .}'i)_CK 6-5.4f their sole compensation, will do the work and the structure is ADDRESS 0 �I not intended or offered for sale (Section 7044, Business and FINAL DATE ':i i191��: +=1M= Professions Code.) MATD� _,,12 WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS ERIAL J ❑ 1, as owner of the y y g OR A MIXTURE CONDONING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE property, am exclusive) contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY licensed contractors to construct the project (Section 7044, 0701, i I- � � Business and Professions Code.) YES❑ NO ES WILL THE INTENDED USE'OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING 4 3:.4 1 A)'l 91a125 OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES I hereby affirm that there is a construction lending agency for YES❑ NOM Cq W the performance Of the Work for which this permit IS ISSUed(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING 3097,CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE. CM TITLE 2•CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. o Lender's Address 0 OWNER OR AGENT ' o I certify that I have read this application and state under penalty of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE ♦ ry. �� N with all county ordinances and State laws relating to building �( mconstruction, and hereby authorize representatives of this County ISSUANCE FEE . ato enter upon the above-mentioned pro erty for inspection purposes. 4—13—9 L. INVESTIGATION FEE TOTAL FEE O s�.�n Ii.AAw Dere f (G'fl ?- SEE REVERSE FOR EXPLANATORY LANGUAGE i � t WORKERS'COMPENSATION DECLARATION hereby affirm that I have a certificate of consent 'self I APPLICATION FOR BUILDING PERMIT insure, or a certificate of Workers'Compenstion Insurance,or ' g,,certified copy thereof (Sec. 3800, Lab. C.) i COUNTY OF LOS ANGELES BUILDING AND SAFETY PolicyNo.50/-4tCompany ���}%TF= �Ca• � BUILDING Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS o • . ��' ' Certified copy is filed with the county building inspec- BUILDING , tion department. _ ADDRESS /�•,�o S Ll L r A.— f LOCALITY NEAREST Date 'C '—Applicant CITY C p L� t T ZIP 7 CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for oney USE ZONE' MAP ®`Z hundred dollars ($100)or less.) TRACT BLOCK �� LOT NO. .C' I NO. l TEL. c✓ � SPECIAL CL I certify that in the performance of the'work for which this OWNER NO. CONDITIONS ,v DISTRICT )VP TYPE' FIRE PROCESSED BY V permit is issued, I shall not employ any person in any manner ADDRESS /4 A[ �" ` A 1 /4 /rCONST ZONE Ix so as to become subject to the Workers'Compensation Laws. s_51 3 CITY ,-t C -- C•�i ZIP j?S_0 a Date Applicant STATISTICAL CLASSIFICATION I APT. CONDO. V VOTIC.E TO'APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. Lu ENGINEER NO. CLASS NOLu :xemption, you should become subject to the Workers' s/! Zompensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP nrith comply with such provisions or this permit shall be2�j . / VALIDATION teemed revoked. ' CONTRACTOR L+^ AJ 4T N TEL BK. PG, 53 i LICENSED CONTRACTORS DECLARATION '+ LIC, CyGf Z hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS Zi L N NO. VALUATION - ®® 'commencing with•Section 7000)of Division 3 of the Business and LIC Irofessions Code, and my license is in full force--and effect. ; CITY :,7 [C-' C- t r $CLASS Gz J SQ. F . NO OF NO.OF CHECK ` .icense Number 3660_Z2 Lic.Class �+ SIZE 6-7,e? STORIES rFAMILIES ONE contractor- • Date �� Z- DESCRIPTION OF WORK C A-r C_ NEW ❑ $ I am exempt from the licensing requirements as I am a .v —'/ 5, CA 1Z,+C;_a ADD ❑ licensed architect or a registered professional engineer ( ALTER FINAL acting in my professional capacity (Section 7051, REPAIR ❑ DATE Business and Professions Code). USE OF FINAL EXISTING BLDG. R 61 DEMOL ❑ B .ic.or Reg.No. Date APPLICANT? EL."Z�� Y [• OWNER-BUILDER DECLARATION (PRINT)_s^ •/UL! �, �, N.f�� q, -L-2 ��� 49 hereby affirm that I am exempt from the Contractor's License !J .ow for the following reason (Section 7031.5, Business-and ADDRESS ce e--(FelIV,P 'mfessions Code): PRESENT �5441A Y� �(,�L 0 0 0 0 I, as owner of the property, or my employees-with BUILDING Af A- ADDRESS r 0# 1 wages as their sole compensation,will do the work and �,h�'L 7 Y the structure is not intended or offered for sale(Section [ADDR ITY r 2 0 - 4-3.00 7044, Business and Professions Code). NG TEL. RACTOR NO. I, as owner of the property, am exclusively contracting I o - 430005 with licensed contractors to construct the project (Sec- SS tion 7044, Business and Professions Code). 0 8,05-82 IRED TOTAL SETBACK FROM EXIST. I CONSTRUCTION LENDING AGENCY ACK YARD HWY PROP. LINE WIDTH hereby affirm,that there is a construction lending agency for iNT he performance of the work for which this permit is issued Sec. 3097, Civ. C.). I .ender's Name e$ Permit Fee .ender's Addresscertify that I have read this application and state that the Issuance Feeibove information is correct. I agree to comply with all County gation Fee rdinances and State laws relating to building construction, Total Fee ind hereby authorize representatives of this County to enter 2; ab?mention d property for in pection purposes. � Cfv 6 SEE REVERSE FOR EXPLANATORY LANGUAGE Signature plicant or Agent Date es . • APPLICATIONYOR�BUILDING PERMIT COUNTY OF LOS ANGELES �` BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADD R SS f I hereby affirm that I have a certificate of consent to self insure, BUILDING AADDRES '� a /t \dll.11 Ft AVI ! ^ or a certificate of Workers'Compensation insurance,or a certified CIT�f' zIP Tow W `it copy thereof(Sec.3800,Lab.C.) l ern e Q'78� LOCALITY Policy NO. Company � SIZE C�T NO.O BLDGS.NOW ON LOT El Certified copy is hereby furnished. � x X8,3r NEAREST CROS ST. ❑ Certified copy is filed with the county building inspection TRAA L, BLOCK LOT department. 5 USE ZONE J MAP NO. Date Applicant XASSESSO P BO K PAGE PARCEL ?z O©3 SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' � YES NO NER //yy COMPENSATION INSURANCE VI U/" • oSr� '✓I v� WITHIN 1000 FT.OF SCHOOL? (This section need not be completed if the permit is for one hundred ADORES , r DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY dollars($100)or less.) N CIT ZIP n p,��j� I certify that h the performance of the work for which this permit `�I (J [�W OP is issued, I shall not employ any person in an manner so as to ARCHITE OR ENGINE TEL NO. ✓ O J become subject to the Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT CONDO Date//- 47(4-173 Applicant }��_-A, C-_ 64 ADDRESS CLASS NO. ? DWELL UNITS NOTICE TO APPLICANT.• If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject t0 the Workers' CONTRACTOR TEL NO. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith FRONT comply with such provisions or this permit shall be deemed revoked. 1 ADDRESS LIC.NO. P L LICENSED CONTRACTORS DECLARATION SIDE CITY LIC.CLASS PL } I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP p, (commencing with Section 7000)of Division 3 of the Business and SO.FT.SIZE NO.OF STORIES NO.OF FAMILIES C Professions Code,and my license is in full force and effect. NEW BK PG , C: License Number Lic.Class DESCRIPTIONTItOF RK J ADD ❑ VALUATION Contractor Date '"� ALTER dk LN h3Jh A REPAIR ❑ 1­ I❑ am exempt under Sec. I $ m� L B.&P.C.for this reason DEMOL ❑ W LDMA AIC# rL Date: USE OF EXISTING BLDG. URM ❑ z Signature A LICANT( NT LDMA Perm# - -- 9 E ri, as owner of the property, or my employees with wages as D� Z their sole compensation, will do the work and the structure is I A D ,1 (',,t y � /1,i� I a tiff':• .II:+:1- not intended or offered for sale (Section 7044, Business and �( �J 1. 1"(11 FINAL DATE qq Professions Code.) I 0.110. WILL THE APPLICANT OR FUTURE BUILDING OCCURT HANDLE A HAZARDO TERIAL i OR A MIXTURE CONTAIMNG A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE ❑ 1, as owner of the property, am exclusively contracting With I• AMOUNTS SPEC[ D ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? V licensed contractors to construct the FINAL BY project (Section 7044, YES❑ N Business and Professions Code.) _ WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING ;.3-i•1J _ c 1- OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTHy CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR 1 i P 1I= GUIDELINES. _ _ YES❑ NO 1 hereby affirm that there is a construction lending agency for X TOTH -_94_6'v a the performance of the work for which this permit is issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING 7�l-•',, 3097,CIV.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE IAS ANGELES COUNTY CODE, CHECK !ECC -• '°'-- TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. CHANGE �Ir ti o Lender's Address O gNNER OR AGENT c I certify that I have read this application and state under penalty o P.C.FEE ,- PERMIT FEE 'E]1*`'— of perjury that the above information is correct.I agree to comply C U j._0 I�!10 cm with all county ordinances and State laws relating to building ��' 917, 71 , construction, and hereby authorize representatives of this County ISSUANCE FEE �l 2 f i til Ar. °(,f` co to enter upon the above-mentionedpropro ert for inspection purposes. `A �, )I f INVESTIGATION FEE TOTAL FEE Lq 0 �-- r„ Clpmwm m ea Apmm m Ags, W 4 SEE REVERSE FOR EXPLANATORY LANGUAGE COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS NEW RESIDENTIAL BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0111280035 PHONE: (626) 285-0488 EXT: LEGALCONST TR: 5904 LT: 202 SQ. FT STORIES TYPE OCCUP GROUP 6240 SULTANA AV ADDRESS: STRUCTURE: 601 1 - VN R3 TEMP CA 917801553 ASSESSOR FOR 0 NUMBER: GARAGE: NEAREST CROSS STREET: LONGDEN 5384-007-007 OTHER: THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY TENANT: USE-MNE: R-1 ISSUED0N: PROCESS ED BY. XP RSO : 12/03/01 JK 06/01/02 OWNER: TE 0: B DGS. NOW ON LOT: VALUATION: :FINAL DAT BY: COD : KUO- WEI-NIN WARNER (626) 285-5230- 45,000 6245 SULTANA AVTEMP 917801553 F S P D XERM PT ON 0WORK ADD LIVING RM, MASTER BD & BATH APPLICANT: T 0: FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION REBI.D 45000.00 VAL 4.50 SPECIAL CONDITIONS: AX BUILDING EV-IEQ=FEE 54.70 B2 PERMIT W',ENERGY.. y5.000t00 VAL 805.70 ��, �, LES al?AU�EES� 892.65 CONTSAMERASTOWNER TEL. NO: - /` boy /1VAPPROVALS DATE INSPECTOR SIGNATURE LIC. NO J � LOCATION AND SETBACKS SOILS ENGINEER APPROVAL ARCHITECT R ENGINEER: T .t 1`1 O D 0 C FORMS LIC. N0.0SLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP NO:153H265 SEWER MAP BOOK: PAGE: FIRE ZONE: A Uu �! n �� n /rte �, ,�j]��1 i_� n�/ UNDERFLOOR FINSULATION T 0. 0 I L S: DWELLING UNITS: T CO , STA C - U I I� �, \111I� 1 f��J►1 ILJ C31ST LEVEL NO 001- f l On � ND LEVEL FLO-O-R-SffE-A-Tff- SCIlOOL WITHIN R j T"r f r., 0 SHEATH AIR QUALITY: 1000 FEET MATERIALS Z7 ❑ ` =r�%f NO NO NO /-/ �I FIRE DEPT. FRAME INSPECT REQUIRED TOTAL SET BACK YARD: HWY: PROP LINE:FROM EXIST WIDTH: 46/jC El1 �O %/ BLDG T. INSPECT FRONT PL- SetVICe Tha� SHEAR PANELS SIDE PL- INSULATION/WEATHER SR INTERIOR LATH/DRYWALL EXTERIOR LATF LOT DRAINAG SMOKE D C 0 E C 5 FIRE DEPARTMENT APPROVAL REPORT ID: DPR261 ROUTE TO: BS0508