HomeMy Public PortalAbout5442 TEMPLE CITY BLVD_Building__ I I
DMBION OF BUILDING AND SAFETYD*pmftmant of County M2g%em BUILDING
COInty
of
WM J Fox
vAN. APPLICATION
��COOUUem ENGINEER "
FO"B��'. APPLICANT TO ���/// IN AD"We"s
BUILDING z Tei /' (/ LOCALITY
ADDRESS
LOCALITY ROBS ST f�D
NEAREST . "6--DISTRICT NO PLAN CK OR RK0. No PERMIT NO
CFK"ST //3 Z
OWNER REC1,1(y=.BY DATE OF APPL D E IB ED
MAIL ` t„J //,5z77-,/
ADDRESS J USSZO"K PLANO OP TYPE GROUP FIRE ZONE
ARCHITECTOR TRL / ZONING yw
ENGINEER NO A R YKRBTADDRESS -
BUILDING 7 n F
SETBACK LINEt
CONTRACTOR NO TEL �KOYKO '
''7 HO E�NUMBERING C
DD LEGAL �SZ BLOCK MAP NUMBER L� 62 ` �IO-ASSIGNE)SY V`+
DESCRIPTION NO
/� - SO DATE CORR=ONS I INSPECTOR
TRACT I
SIZE OF LOT O-1 . 4/ NO NOW O BL T
F LOT
USE OF B L� I/rjn OF I I
ILIO
DESCHIPTIONOFW
D
z
NEW ALTERATIONADDITION 91-41 r
REPAIR �J DEMOLITION _
NO or
SIZE 0',0/ ��/ ROOMS / STORIES _
C�OVWALLBRING WOOL// COVERING J I
USE OF STRUCTURE
oe
APPROVALS
INSPECTOR'S SIGNATURE DATE
61 FOUNDATION LOCATION
FORMS MATERIALS
I HEREBY D STATE EDGETHAT THAT 1 HAVEORM READ THIS AP- FRAME FIRE STOPS.
PLICATION AND STATS THAT THE INFORMATION GIVEN IB
CORRECT BRACING BOLTS � !!
AND AGREE TO STATE LAWS RE WITH A UILAIN CWiBTRUCTION GASLL COUNTY ORDINANCES VE LOCATION
GAS PENT DUCTS
SIGNATURE OF LATH INT
PERMITTKIZ
ADDRESS 2;," v LATH KIT
AUTHORIZED AST PLASTER INT
P C . PLASTER IRT - -
FgE HOUSE NUMBER COR
RECT AND POSTED
VALUATION ■eE FINAL
4.
t 1
7GA63M CE OM3 2 62APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUHMING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST _
WILLIAM A JENSEN SUP T OF BUILDING CROSS ST
DISTRICT NG P TYPE OCES BY
FOR APPLICANT TO FILL IN coN6r
BUILDING � a STATISTICAL''CL��LAASSSIFICATION EWER MAP
ADDRESS �% N T.C/17 Q u I� BK
CLASS NO DWELL UNITS
LOT NO Z / / LO K WATER
CERTIFICATE NOT REQUIRED RECEIVED
TRACT MAP, HIDHWAv
NO OF BLOGS NO ICIRCLEI STATE MAJO SECON OCAL
SIZE OF LOT NOW ON LOT USE ZONE SPECIAL
USE OF CONDITIONS
EXISTING BLDG
TEL
OWNER NO BUILDING EXIST
SETBACK YARD HWY STREET NAME WIDTH
ADDRESS _- FRONT
,ARCHITECT OR TEL f
ENGINEER NO SIDE
P L N
ADDRESS d
TEL Q
CONTRACTOR /4 NO �/
ADDRESS 07
O.
Tr C / DESCRIPTION OF WORK
NEW ADDP" ALTER REPAIR DEMOLISH
SO FT NO OF NO OF
SIZE v STORIES FAMILIES
USE OF
STRUCTURE PAC, '
SI ATURE O
PP LICANT
VALUATIONalp '
�Ud APPROVALS DATE INS E OR BBIONATURE
S. FOUNDATION LOCATION
FEE S FEES2 6 FORMS MATERIALS /
FRAME FIRE STOPS
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT TAC ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION /
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
SUILOIN0 CONSTRUCTION 1 CER/I FY THAT IN DOI NO THE WORK
AVTNORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT
TION OF THC LABOR CODC OF HE STATE OF CALIFORNIA RELIT
ING TO WORKMEN S C PENS N IN6U NCE
LATH EXT
SIGNATURE OF HOUSE NUMBER COR
PERM ITTEE RECT AND POSTED
ADDRESS FINAL / I
PLAN CHECK VALIDATION cK M O CABM _ 7 JOHN F LEWIS V PRIN IP L S RAL ENGINEER
PERMIT VALIDATIO CK M O GBH
LJLI09 9 6 7!2 SEP10 2 3 D 14501
^ LAC00730,2 -w26 1 0 29.00- q
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
WORKER S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN lxjlLDwO ADDREss
I hereby affirm that I have a cMnccate of consent to sed Insure'
a e certificate of Workers Compensator Insurance or a certified ,
copy thereof Sec 3800 LSD G) gXSS 101-
llO LOCALITY Policy >
No CormPeM 917E OF LOTB 5 NOW ON LOT
❑ Certhed copy seby herfurmshed NEAREST CROSS ST
❑ Caddied copy it filed with the county building inspection TRACT BLOCK LOT NO
deparbrem I USE NNE MAP NO -
Date App4Xmnt ASSESSOR MAP BOOK PAGE PARCEL _
SPECIAL CONDITIONS
CERTIFICATE OF EXEMPTION FROM WORKERS' OWtE
COMPENSATION INSURANCE WITHIN 1000 FT OF SCHOOL? YES ra
(The Section need not be completed d the permit s for one hundred
d9TRICT OHOIIP TYPE CONST FlRE NNE PROCESSED By'
tlo8era IS 100)or less 1 LP p //
I certdy that m the performance a the work for which the permit ��A
a issued I Shall not employ arg' person in arty manner so as to �GAcG.Gr/
become Subject to the Workers Cornpenaatm Laws ARGHZ� E EEP TEL NO
/T/ sunSTICAl T10N APT CONDO ,
Date Applxant ADORE - CLASS NO DWELL UNTIE
NOTICE TO APPLrANT If after nmkNg M® Certs tate of RECUIRED TOTAL SETBACK FROM EXIST
Exemption you stculd became Subject to the Workers CONTRACTOR TEL NO
Compensation provision a the Lebo, Cade ? ��SET BACK YARD HWY PROP L9E WOTH
you must IattsATth
comply with inpns Such provss this permit shell be deemed revoked ADDRESS uc NO PL
FRONT }
LICENSED CONTRACTORS DECLARATIONcrry LIC CLASS PDE I a
O
1 hereby affirm that I am licensed wderproveons of Chapter 8 U
SEWER MW(Commencing With SMhOn 7000)of Dwsion 3 a the Business and SO FT S1ZE NO OF
Professions
ND OF FAMILE9 NEW ❑ BPG OProfessions Code and my Ixxirse s in full face and effect
Llc n Number Lx; Class DESCRI ADD ❑ VALUATION Qr p ► U
Contracts Date y ALTER ae $ 6 r EL
in
❑ I am exempt under Sec Iff REPAIR ❑ $ z
BdPC for the reason D fy L�[(/ DEMOL ❑ LDMA Pic I1 '
Date OSE % n BLDG URM ❑
Spnatule 1 L —
L"Farm• 23
tr`I ae OWrler of the Property a my employees Wlth WhgB9 88 NI z ACCT.-
their sole compereatron will do the Work and the Structure is
not Intended s offeree for sale (section 7044 Business; and ' FINAL DATE 3303 50.50
Professions Code) WL TIE APkI OR FUTUREBMLIINe pCCUw+T HAICIE A HAIARIUTa WTE
❑ I as Ov,w Of the Property am exclusNBhy contracting With OR A MURLRE CONTNRx1 A HAZAN S WTEAYL EpA.L TO OR GREATER TM THF
AMOUNTS SFEL9l THE HATARWIA WTERAS 11FORMAnprR Gum? FINAL BY � ry�`T.i
BuMmes contractorsPrOaS o Code)t the project Section 7044 YEs❑ ,
Buainea9 and Profesecns Code)
war Nni�o OUIRE LIGE MI THE eU0.NG BY THE AP0.1rlM OR FROM SOLFTi 3303 142.20
OOA TYAS CUAUTY A PERMIT FOR STRK7T( NXJ OR EE PB ATxN FROM TIE T FOR
CONSTRUCTION LENDING AGENCY COAST An ouulTr ARAWGEAErn dSTPoCi iscAOMoi SEE FERAanuo cHEcxusT FOR 2 ITEMS
puoEu es
I hereby affirmnc that there s o c which
tN3 p lending agency ac vEs❑ No
the performance of the work for whxYR tfus permit s issued(Sec TOTAL
tI 1'92 . 70
3087 CN CI iHRfEAOTIEIM=AApOIeWTERILhgFaWATiONOUDEANDTIE9CAOA0PEPAfTTNO ll1G�n 192.70
OHECKL6r 1 UIDERRTAND W REOLIREI NTa Um R LOB N1oe.FS COUNTY COPE
•1 Lenders Name mIE z a a a recn nip z x o T �o iAo coNr�RNNG rvirmpjs
�IXY , �� RpM HE ac.a.o GRANGE .00
B} LerRder a Adtlreee �T
I I perfidy y that
have read the appinformation
a and State oder Density EINVESTIGATION
E �D. PERMIT FEE - 0000-0001 5/28/96
Of lxrrWY tial gs above inbrmatlon s LYlrrefd I agree ro canpfy �C7 b
9
with all county ordinances and state haws restuq to bulWing L L p rq
d{ construction and hereby aWhO a representatives a the County I ISSUANCE FEE 0020 1 PM 4%5�
ro
qr�upon the ren wed p 6 of a mnpBCIKx1I FEE TOTAL FEE
/Y SEE REVERSE FOR EXPLANATORY LANGUAGEo`
I WORKERS COMPENSATION DECLARATION
III I hereby affirm that I
mhavecertificate of consent to ,elf _ APPLICATION FOR BUILDING PERMIT
iurQ or a cepificote of Workers' Compensation Insurance, - � r
or a certified copy thereof (Sec 3800, Lab C ) _ - COUNTY OF LOS ANGELES - BUILDING AND SAFETY
Policy No Company
BUILDING
L] Candied copy is hereby furnished FOR APPLICANT TO FILL IN ADD
� -
❑ Cemfied copy is filed with the county building inspec- DIN i~
Tion department
1 Date Applicant CITY / ZIP LOCALITYNO OF
REST
CERTIFICATE OF EXEMPTION FROM WORKERS SIZE OF LOT 40 NOW ON BU
O S CROSS ST
COMPENSATION INSURANCE _
,,(This section need not be completed if the permit is for one TRACT -- - BLOCK LOT NO MAP - PAGE PARCEL
ASSESSOR
hundred dollars ($100) or leu ) - �9 NO
OWNER USE ZONE MAP
NO
iI certify that in the,performance of the work for which this i " r - - y
permit is issued, I shall not employ any person in an manner ADDRESS - SPECIAL O
Y CONDITIONS O �'
so as to become subject to the Workers Compensation Lows
CITY -ZIP V
T Date a
Applicant , OR TEL DISTRICr GROUP PR
TYPE FIRE OCESSED BY O
NOTICE TO APPLICANT If after making this'Certifcate of ENGINEER - NO CO ZOf1E
Exemption, you should become subject to the Workers _ .f'Q� _ Q
Compensation provisions of the Labor Code, you must forth ADDRESS v �J
with comply with such provisions or this permit shall be TEL STA76TlCAL CLASSIFICATION APT I CONDO N
deemed revoked - CONTRACTOR NO _ - Z
LICENSED CONTRACTORS DECLARATION UC CLASS NO DWELL UNITS_
l hereby affirm that t am licensed underproviaiom of Chapter9 ADDRESS NO SEWER MAP
,
(commencing with Section 7000)of Diviuon 3 of the Business UC I
sand Professiam Code,and my license rs in full force and effect CITY ' CLASSSK PG
VALIDATION
SO FT Q NO OF NO OF CHECK �
License Number Lic Class SIZE - STORIES FAMILIES ONE yALUATION
Contractor Date DESCRIPTION OF WORK L(/ ' NEW ❑❑ s.;?
`�O O. f'-
0
�n� <-.
❑1 am exempt under Sec i oL / ►r W
_ t ALTER ❑ �0
B 8P C for this reason 115E - REPAIR S _Date EXISTING BLDG ❑ 3
Signature �jPRINT) NO FINAL ICANT TEL 3 3
OWNER-BUILDER DECLARATION _ DATE �� s•% ER
I hereby affirm that I am exempt from the Contractor s License ADDRE FINAL
Law for the following reason (Section 7031 S, Business and 3
Profeuions Code) FK5EW I By '
QI, m owner of the property or my employees with BADDRESS 1
wages as their sole compensation,wil l do the work and LOCALITY ACCT.i
44
the structure is not intended or offered for sale(Section
70 , Business and Professions Code ) MOVING TEL , - 7O SS
❑ I, as owner of the property,am exclusively contracting CONTRACTOR NO _
with licensed contractors to construct the project (Sec- ADDRESS - , 1 ITEMS
tion 7044, Business and Professions Code )
CONSTRUCTION LENDING AGENCY SET j!A ED YARD TOTALHWY P LINEFROh1 I v TOTAL 12S SJri
I hereby affirm that there so construction lending agency for FRONT MCK _ _125.55
the performance of the work for which this permit is issued P L' - .00(Sec 3D97, Civ C ) SIDE i WNE _
PL
Lender's Name
• pRef N
P C Fee S Permit I"Z Lender's Address - =-DOO1 66/L17/96
g I certify that I have read this application and state that the Issuance Fee ��O LDMA P/C N Poo 6955 1 PM 12
above information is correct I agree to comply with all County - - Investigation Fee �..f _ _ ,.
ordinances and State jaws relating to budding construction Total Fee OO LDMA Perm N
` and hereby auth ae rep olives of Zhu County to enter
R$n4po e v menho perry for mapecti purposes
SEE REVERE FOR]EXPLANATORY LANGUAGE
Si n urea Api tit Agent Dote
\1
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
WORKER S COMPENSATION DECLARATION
FOR APPLICANT TO FILL IN .001 ADORE d
I hereby aHrrm that I have a certdoate of consent to sell insure ADDRESS
or
or a certificate of Woke a Compensation Insurance or a certified p
copy thereof(Sec 3800 Lab C) IZIP
Policy NoCompanyL v i
LOT I NO T BUDGE NOWON LOT M ��
❑ Certified copy s hereby fumshedNEAR DA ST
❑ copy s filed with the county bulldog 1nspecton TRACT BLOCK LOT N; Aydeparmtent �
USE LONE , MPP
Date Applicant SSOR PAGE
O SPECIAL CONDRIONS i
CERTIFICATE OF EXEMPTION FROM WORKERS' R TEL No
COMPENSATION INSURANCE y — VOMIN 1000 FT OF SCHC00 YES NO
(This section need not be completed d the permit B for one Hundred S� �I A DISTRICT GROUP TYPE CONST FIRE 4ZONEESSED BY
dollars,($100)or less) GT A TLP
I certify that In the performance of the Mork for which Mm permit _
151,ued 1 shall not employ any person m any manner so m to ECi ODI ENGINEER / TEL become mnb)ect to ffp YAorkers t I STATISTICAL CLASSIFICATION CONDO
Date .2 _a q Appinl _ ADDRESS CLASS NO � DW'ELL LOOM
NOTICE TO APPLICANT If after making Ihs C;Ificate of REOUIRED TOTAL SEEXIST
Exemphon you shoudd become subject to the Ubrkere CONTRACTOR TEL NO SET BACI( YARD RWY PROM'DTR
Conpen tamn Provlsons of the Labor Code you must for01w1m 0 WWER _ 1
FROM
ccnnPy with such provBpne or this Permit shell be deemed revoked AGGRESS LK; r10 P L �>
.a
LICENSED CONTRACTORS DECLARATION tiny LIC CLASS PILME '.� U
1 hereby affirm that I sm licensed underprovsons of Chapter B SEWER MAP 0:
(commencing wdh Sect m 7000)of DNson 3 of the Business and So NO O�STOPoES NO OF FAMIJES
Professors;Code and my license Is In full Iota and effect �L T NEW ❑ BK PG , O
Lmerse Number Lc Class DE wDR ADD wLUA71DN U
/I/— $ z5- - wa
Contractor I DaleALTER ❑
❑ 1 am exempt under Sec REPAI ❑ z
BAPC for this reason LO AA P/C
Dale USE xlSJefG nMI , tet. URM ❑ ,
datura •.0
7M/M12
) LOW Perm 23
I es owner of the property or my employees with wages as O = ACCT•i
their sole compensation will do the work and the structure 1s /— n KCp 330j 50.50
not Intended or offered for sale (Section 7044 Btsrrssa and �%y/P'Y e FINAL pATE
Professions Code) MRL T,E APPGUHT OR FUTURE BUILDING CeGUnA1nT NIJ1aLE A NAZARDGUS MATEidLL '�2 C 1
❑ 1 as owner of the property am exclusively, contracting wIN oR A MIXTURE coNnP�++G A NAZuaas AUTEF EQUAL To OR EIREATER Ti W,TIE i
licensed contr8C0ors to Construct the project (Becton 7044 AMOUNTS s CEEO ON TIE RAiAaaous WnRA s WOSRAMON GUce+ FINAL BY > 'ACCT.r
res❑ WEE
Busmai and Professions Code) 33 3 108.9
Oi TIE EQLtRETENDED USE 6 T11E eu STR Br N O APIUGIlL OR FROu r E EMTTO
CONSTRUCTION LENDING AGENCY COA SQUAUT E A PE�NAMu FOR ETRICT CONSTRUCTION aA WG9CATMY,FRIM TIE SOIfnHGUID2 ITEM
CWm AIR OUAUTY NNMGEAENi p£miCT lSGAOi.A'JI 8EE{4RALiTNO CIEGtIIST FOR
I ha®by affirm that there is a constructon lending agency fm vi:s❑ NoJN TOTAL 159 40
3efperformance
erma�dtheworkforwhlOh1119permnrs0m*d(Se0 IIYYEREADTIE14VAf>DOUSMAIERMLsIEORMAIK)NOLOENOTIESGpAdPEFAYTTW CHECK 159.40
n1E(1alaT I Nf1E0.3eJp 11EOUl1EI.ENr6 UNDER TME L09 ANGELES LOuriY CODE
Lenders Name z rwPreR z zo z 11 r�iGT/A��F N Frau iwm ( E .00
L Lender AddrasaIV be—
�
I certify that I have read the appllcaton and state oder penalty '
of perjury that Ifs above mformaton Is correct I agree to cm* PC FEEJ.-�.j PERMT FEE �. G o 0000-CMI 2/29/96
q wllh all county ordinances and State laws relifli g to budding
0 �1 L5y p
constriction alld uMpnze representatives of this C �
County ISSUANCE FEE � 089, 1 rl l 6:18
QssQ b upon - y la inspection purposes
F
NVESTgATICN FEE TOTAL FEE /h O
r Aey,vr a !�
SEE REVERSE FOR EXPLANATORY LANGUAGE
i
• • COUNTY OF LOS ANGELES TEMPLE CITY N 0508 BUILDING PERMIT
DSPART14ENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0010240010
PHONE (626) 285-0488 EXT
LEGAL ID. NO OF CONST BUILDING ADDRIESS
ON FILE SO FT STORIES TYPE 5442 TEMPLE CITY BL
STRUCTURE 0 VN TEMP CA 917803150
ASSESSOR INFORMATION NUMBER' NEAREST CROSS STREET BROADWAY
8588-023-026 THOMAS PAGE 597 GRID A4 LOCALITY TEMPLE CITY
TENANT EXIST BLDG USE RESIF_ _M ZONE R-I ISSUED ON. PROCESSED BY EXPIRES ON
EXIST DCC GRP 10/24/00 UT 04/23/01
OWNER TEL NO BLDGS NOW ON LOT VALUATION FINAL DATE FINAL BY CODE
9KAELBLE
554 LIVE
ONOAKDAV,IRMGARD (626) 286-5574- 3 15,000 �F
TEMP 917802513
VC MMR
SECOND FLOOR REMODEL-ADD FULL BATHROOM AND HOBBY AREA (ALL
FEE DESCRIPTION QUANTITY: LICH AMOUNT IN EXISTING SQ. FOOTAGE)
APPLICANT TEL NO-
SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27 75
AC STRONG MOTION RESID 15000 00 VAL 1 50 SPECIAL
AXBUILDING REVIEWAFEE� 54 70
D2 PERMIT�W/0/ER'HC5 �E LE S ,15000.00 VAL 300 60
CONTRACTOR TEL NOP1V TOTAL11FEES 384 55 APPROVALS DATE_____nffFFErdW7fr5iKlaffF_
SAME AS OWNER - �O NTy
LIC NO LOCATION AND SETBACKS
1
ARCHITECT OR ENGINEER IEL NO FOUNDATION/TRENCH F6Mg
LIC N0 1111111SLAB/UNDER FLOOR
RAIJ
ED FLOOR FUMING
MAP NO: SEWER MAP BOOK: PAGE: FIRE ONE Cmp
147H269 3 I07 '��' . ' ` - ` _ ■ <>o
47H 1
r...r v v VV r + �7FLOOR SHEATHING
NO Of FAMILIES DWELLING UNITS APT/L;UNv STAT CLASS
NO 21
AIR QUALITY 1000 FEET MATERIALS
NO NO MOFRAME INSPECTION
REQUIRED TOTAL SETBACFTWffiF_T7r§T_
q �y
SET BACK YARD HWY PROP LINE: WIDTHGb//C e Th �0
FRONTSIDE PL- SerVICal,
L5ME RTWLATH
a�
RATED FLOOR/CELL ASSEW_
RATED WALL ASSEMBLIE9—
RATED SltAFTS/OPEMIMG9_
T-BAR CEILINGS
LOT DRAINAGE
REPORT ID DPR261 ROUTE TO 3S0508
_ COUNTY OfF IJS AWGELES - TEMPLE CITY _ N 0508 BUILDING PERMIT
DEPARTMENT LF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0004110004
PHONE (626) 285-0488 EXT
LEGAL ID. NO OF CONST NEW BUILDING ADDRESS
ON FILE SO FT STORIES TYPE DCCUP GROUP 5442 TEMPLE CITY BL
STRUCTURE 0 1 VN R3 TEMP CA 917803150
ASSESSOR INFORMATION NUMBER GARAGE 380 1 NEAREST CRDSS STREET BROADWAY
8588-023-026 OTHER THOMAS PAGE 597 GRID A4 LOCALITY TEMPLE CITY
TENANT EXIST BLDG USE USE ZONE ISSUED ON PROCESSED BY EXPIRES ON
EXIST OCC GRP D4/11/00 UT 10/08/00
OWNER TEL NO BLDGS NOW ON LOT VALUATION FINAL DATE CODE
KAELBLE RONALD R,IRMGARD (626) 286-5574- 1 9,120
9554 LIVE OAK AV
TEMP 917802513 FEES PAID DESCRIPTION OF WORK
NEW RESIDENTIAL GARAGE
FEE DESCRIPTION QUANTITY UOM AMOUNT:
APPLICANT TEL NO
SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27 75
AC STRONG MOTION RESID 9120 00 VAL 0 91 SPECIAL CONDITIONS:
AX BUILDING REVIEW.FEE-1 54 70
D2 PERMIT W/0 PN EL0TA9120'00
FEES VAL 2� 960
6
CONTRACTOR TEL NO E�
- �0 vAPPROVALS DATE INSPECTOR SIGNATURE
�Ty
SAME AS OWNER
LIC NO
ARCHITECT OR ENGINEER ItL NU tpummi ION/TRENCH_ECIRNS
LIC NO// 1111111 R
MAP NO. SEWER MAP BOOK. PAGE FIRl-Tl'
3 �r 'UBLIC WORKS)ORKSISTULEVEL sNo OF FAMILIES DWELLING UNITS APT/COND STAT CLASS 5�
NO 21
AIR QUALITY 1000 FEET MATERIALS -I,
ROOF SHEATHIN
NO NO NO D FIRE DEPT FRAME IN§n'ff
REQUIRED TOTAL SETBACK FROM EXIST
SET BACK YARD HWY PROP LINE WIDTH
FRONT PL-SIDE PL- C Service Tha'L�
INTERIOR LATH/DRYWALL
EXTERIOR LATH
J�y�
SMOKE DETECTION DEVInr
FIRE DEPARTMENT APPRO W
I
REPORT ID DPR261 ROUTE TO BS0508