HomeMy Public PortalAbout4927 WILLMONTE AVE_Building__ 76A888A CE 980911-57 APPLICA`fION FOR BUILDING PERMIT. �.
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BU=ING AND SAFETY DIVISION LOCALITY 1001 o
JOHN A.LAMBIE,COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST.
DISTRICT NO. GROUP TYPE SEWER MAP .
FOR APPLICANT TO FILL IN E K
BUILDING CONST.
ADDRESS ! . STATISTICAL CLASSIFICATION
LOT NO. ry " v "/+(LBLOCK CLASS.NO DWELL.UNITS
MAP STATE YES O
TRACT NUMBER xold 06 HWY.
USZ E SPE AL
NO.OF BLDGS. CONDITIONS \
SIZE OF LOT Ja NOW ON LOT
USE OF
EXISTING BLDG.. BUILDING EXIST.
? SETBACK YARD HWY STR• T NAME WIDTH
OWNER AA; FRONT
MAILP:L:
ADDRESS a SIDE v yo
TEL.� P.L.
CITY No. 9
ARCHITECT INSPECTION RECORD
R � T
ENGINEER
ADDRESS
TEL
CONTRACTOR NO.
ADDRESS
SCRIPTION OF WORK r I
`3Vz E,, -�
NEW ADD ALTER REPAIR DEMOLISH '
SQ.FT. NO.OF NO.OF ,10 Q (S�P�.��� A -6 ;--Z) �
SIZE STORIES �� FAMILIES
USE,OF STRUCTURE 'L r''� ✓).iS Y�. fgg
SIGNATURE OF ` APPROVALS
APPLICANT
_ DATE INSPECTOR'S SIGNILFURE
:
ADDRESS FOUNDATIONLOCATION
FORMS,MATERIALS 1O
J� �®
P.C. $ FRAME: FIRE STOPS.
FEE BRACING.BOLTS
VALUATION $ FURNACE: LOCATION.
FEE flo �' PAS VENT.DUCTS
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- i 1`
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND LATH,INT. �^
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATE LAWS REG U TING SUILDI CONSTRUCTION. LATH,EXT. :3 , fj
SIGNATURE OF HOUSE NUMBER COR_
PERMITTFE RECT AND POSTED
ADDRESS. FINAL A t'
I CLYDE-N.DIRLAM,PRINCIPAL STRUCTURAL ENGIIMER
PLAN CHECK VALIDATION CK. M.O. CASH P.EHMIT VALIDATION CK. M.O. sH
� LAC03 8 0 8 AUG 13 l A 6.00 ,�
B O I L IN
G BUILDING //
ADDRESS Vn �.
!
APPLICATION
LOCALITY
l✓.,4`�r-`` `'�'4�:7
. . - . I
NEA REST V
DIVISION OF BUILDING AND SAFETY ceo99 BT.
T?e�9S�eIIt Of OoaIIty EIIgiIIeer DISTRIOT NO. RECEIPT NO� PE MIT NO.'
Couaty of Los Angeles v Q 6/ 0 3
WM. J; FOX, COUNTY ENGINEER GROUP DATE RECEIVED DATE IBBUED
CASSATT D. GRIFFIN. SUPT OF BUILDING
FOR APPLICANT TO FILL IN TVPE caNBT. !RECEIVEDaBY� / ISSUED BY
'
OWNER MAP STATE YE9 N
MAIL / Ti�G� �T :NUMBER 0 HWY
ADDRESS
UBE ZONE SPECIAL
TEL ! OC OITIONE
CITY E lDLE Cl T/r=
mo. Q7 /'� A
ARCHITECT OR TEL. $QOO
ENGINEER NO.
� BUILDING YARD FI1hIY STREET NAME -EXIST.
ADDRESS
SETBACK WIDTH
y FRONT
CONTRACTOR ,.LFSYE(II&SA C:A NO. D / BIDE
T �
ADDRESS �Sc ' FOU?�H/W , ✓LJ /i fC��J�P'f P.L.
BUILDING DATE COR/REE//C/TIONS INBPECTOR
ADDRESS �i LzdwaV72 / (rl` p��p
LOT NO. mi, e`/ t9r BLOCK 6Uf <LyL. 7
TRACT � P' EL'1 pwr
NO.OF 1,31.038.
BIZE OF LOT .SU Y IZo I NOW ON LOT D ^ / ,�•�•
UBE OF Fl/GtVE � •7�.dA/L.R ,{iSlt/T'eDt�C..7"' a�/Cle�`f�
ISTI G7'..A/Ax C = �p
ha rr P �AAaJ M.;
DESCRIPTION OF WORK •
NEW ✓ ADD ALTER REPAIR DEMOLISH -
Bp.FT. NO.OF No.OF !�/7h ���r��r ID'
SIZE ��/^'"1 STORIES FAMILIES
USEOF6TRUCTURE �� A.L.4/v
7
401049*do
No.OF
-IM-Oulli
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS;AP- 1
PLICATION AND STATE THAT THE INFORMATION GIVEN IB APPROVALS
CORRECT. �NBPECYOR'B 81GNAl'URE DATE
f�
IAGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATIONT LOCATION� ���rr/ <
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FORMS,MATERIALS/ LL=Gtis^
P ' jr FRAME: FIRE STOP9i �)-,r
SIGNATURE OF L/t `•��b`� ,•' BRACING.BOLTS l/ J//^!A r�..�. l7.nl GN
PERMITTED l k FURNAI-EL LOCATION.
GAB VENT.DUCTS
ADORES�+ �� --•� r I
AUTHORIZED AST.
LATH, IN—r.
LATHr EXT.
O p j P.C 0,41 J� HOUSE NUMBER COR'
/) s/�
e,J O J O FEE u RECTAND PORTED �1� O.s. — kv
96
VALUATION - D G
FEE FINAL
/��SY
7GA6393A DBS 3 4-54
-A
'BA68BA CE(!80810.48 APPLICA'T'ION FOR BUILDING PERMIT-
COUNTY OF LOS ANGELES BLI DING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A.LAMBIE.COUNTY ENaiNEER NEAREST
CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST.
DISTRI 71
NO. GROU -TYpE' PR SS
FOR APPLICANT TO FILL IN e , �� I CONST.
BUILDINGS WER MAP
ADDRESS STATISTICAL SIFICATION _ BK
CLASS.NO. DWELL.UNITS '•'
LOT NO. BLOCK
MAP STATE
YES O.
NUMBER HWY.
TRACT m USE ZONENO.OF BLDG .
�P,ECIAL
SIZE.OF LOT Q I NOW ON LOTS CCDITIONS
USE OF
EXISTING BLDG. TNG YARD' HWY STREET NAME EXIST.
t' �y SETBACK WIDTH
OWNER g M C Z FRONT /
MAILsus P.L. L.
ADDR�ya �, ra A SAF. SIDE
TELNO7 P.L.
ARCHITECT R t��. TEL.
--INSPECTIONRECORD
ENGINEER ll..:. kA - NO. ,y,�`„ _ �pXGF %,���.• �G.L�S/C�_
ADDRES ff y4
TEL. �./d — -p,..s �•
CONTRACTOR F NO.
ADDRESS.
DESCRIPTION OF WORK
NEW ADD
p� ' ALTER REPAIR DEMOLISH p f
S I FT.
♦ �dS ii STORIES FAMILIES d ('_/D/�:,G (jl� .fi,.:�1. '�Y !K�
.USE'OF STRUCTU E pj F" t 6C�/ /b /�G� -
t�.
B a APPROVALS
-` D v DATE INSPECTOR'S S1GNA7'URE.
i•QJ . FOUNDATION: LOCATION 3 2,_Z e�
A FORMS,MATERIALS �Y!
$ ^ P.C. $ - FRAME:FIRE STOPS; A
' /� FEE BRACING,BOLTS
VALUATION o� V FEE $ FURNACE: LOCATION.
GAS VENT,DUCTS
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LAT- H.-INT.INT. ,
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND r\
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND LATH;EXT.
STATE-:LAWS REGU TING BUILD! G .CONSTRUCTION.
SIGNATURE HOUSE NUMBER COR-
PERMITTE RECT AND POSTED 2,A7 G/
ADDRES FINAL
CLYDE-N.DIRLAM, Euermrmi
PLAN CB=VALIDATION ctt. m.o. cAss PESMIT VALIDATION cm I m.o. CASH'/.
F
D1:
APPLICATION FOR BUILDING PERMIT
FOR APPLICANT TO FILL IN (Print or type oH.IV) 1 1
BUILDING I BUILDING IJ
ADDRESS atl p'} �' ADORES S /✓`�
CITY'S L ZIP " LOCALITY
NO.OF BLDGS. NEAREST
SIZE OF LOT NOW ON LOT rr
�� CROSS ST. /�rlee '
TRAC BLOCK LOINCr'' L'r-p MAP BOOK PAGE PARCEL
ASSESSOR
TE // DISTRICT GROUP TYPE FIRE PROCESSED BY
OWNER f —10AI NO. 16 CONST. ZONE
/1 �4r
'
ADDRESS f(J%4,
STATISTICAL CLASSIFICATION SEWER MAP
CITY Qlle_ �'j ZIP / � CLASS NO. _DWELL•UNITS BK PG
ARCHITECT bR TEL.
ENGINEER j kj cn NO. . USE ZONE MAP
.NO.
ADDRESS SPECIAL
TEL. s1 CONDITIONS
CONTRACTOR NO
LIC. ROpD DEPARTMENT APPROVAL REQUIRED YES❑ NO E]
ADDRESS NO. BLDG.SETBACK FROM
CITY
LIC. FRONT PROP.LINE OF (STREET)
CLASS
CONSTRUCTION LEN ERHIGHWAY + YARD = TOTAL SETBACK FROM TY E OF EIGHWAY X�ISDTHG
NAME AND BRANCH FRONT PROP. LINE
ADDRESS CITY
SQ. FT. NO. OF NO. OF CHECK BLDG•SETBA FROM C)
SIZE STORIES FAMILIES ONE SIDE PROP.LIN F (STREET) v
DESCRIPTION OF WORK NEW ❑ HIGHWAY + YARD - O AL SETBACK FROM -TYPEH GHWAY EXISTING
CD
S
r•y� IDE PROP. LINE F
14 r` ' i ADD Ill + _ �' d
ALTER ❑ y
CORNER CUTOFFES ❑ NO ❑ Z
EPAIR[:1R
USE OF � +fti '
EXISTING BLDG. ( r l[� DEMOL ❑ IN OPEN SPACE Y ❑ NO .❑
APPLICANT, T,EL IN COASTAL ZONE YES NO ❑
(PRI NT) o L. 7!!j(,NO. LIL{
BY (SIGNATURE) ENVIRONMENTAL CATEGORICAL EXEMPTION S❑ NO ❑
IMPACT EXEMPTION DECLARATION SIGNED (OATS)
VALUATION ® IMPACT REPORT PROCESSED (DATE)
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION y
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION. 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO
WORKMEN'S COMP SATION IN RANGE.
SIGNATURE O
FINAL BY
BY f �
PERMITTEE• DATE i
ADDRESS - P•C• Q PMT•$
TEL ,® FEE �P ��,EE •F
CITY d NO. I � .
'PLAN CHECR VALIDA K. M.O. CASH PERMIT VALIDATION - CK. M.O. CASH
76p638B CEttB09p 5/73 3 0 3i`�1ltR ;&4 1 D
12.00
•� O'® �
AP 13 L I CATION FOR COUNTY OF LOS ANGELES
OF COUNTY
. ...t-BUILDING PERMIT DEPARTMENT
BUILDING AND SAf ETY DIVISION ENGINEER
FOR APPLICANT TO FILL IN ADDRESS . s
BUILDING,.
ADDRESS V LOCALITY
CITY _ C NEAREST
ZIP Q CROSS ST.,• _
NO.OF BLDGS. ASSESSOR
SIZE OF LOT NOW ON LO MAP BOOK PA PARCEL
TRACT BLOCK LOTNO.JiDISTRICT UP YPE FIRE PRO SED
�� Z
Q %�
OWNER NOL STATISTICAL CLASSIFICATION SEWER>KP
ADDRESS — CLASS NO. DWELL.UNITS BK PG
CITY h C-1-TY ZIP
UfNE MAP
ARCHITECT OR TEL. /_/J NO• D
ENGINEER J yG NO. ft77(("�� I SPECIAL
CONDITIONS.
ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑
TEL.
CONTRACTOR NO. BLDG SETBACK FROM
LIC. FRO PROP.LINE OF (STREET)
ADDRESS NO. HIG WAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING
LIC = FRONT PROP.LINE HIGHWAY WIDTH
CITY CLASS _
CONSTRUCTION LENDER +
NAME AND BRANCH 14 BLDG,S O CK FROM U
ADDRESS CITY SIDE PROP.LI � F (STREET) 00
SQ.FT. NO.OF NO. CHECK HIGHWAY + YARD = TCI L T K FROM TYPE OF EXISTING
SIZE STORIES FAMILIES ONE LINE HIGHWAY� WIDTH CL
+ _ Z
DESCRIPTION OF WORK NEW ❑
i3 p� ADD CORNER CUTOFF YES ❑ NO ❑
ALTER IN OPEN SPACE YES ❑ NO ❑
REPAIR ❑
USE OF IN COASTAL PERMIT ZONE' YES [_1 NO ❑
r
EXISTING BLDG.1 � DEMOL ❑ f/ �Q
APPLICANT -fL(PRINTI NA L- Q O. 9 ' V.- /IEf125 I�VD(ZIC� Il gZ
BY(SIGNATURE)
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES
AND LAWS REGULATING BUILDING CONSTRUCTION.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 WORKMEN'S COM-
PENSATION INSURANCE.
SIGNATURE.OFINAL BY
PERMITTEE – DATE '
ADDRESS
TEL.' P.C.Fee$ Permit Fee J
CITY NO.
/y � Issuance Fee ,�✓
VALUATION$ ][ V Total Fee /J
PLAN CHECK VALIDATION CK. M.O._. CASH _ PERMIT VALIDATION CK. M.O. CASH
6 '14 SEP 6 1 D 1 5.0 0
IIS 76A638A CIS/803A 6/76
APPLICATION FOR BUI-L-DING PERMIT ]
AOR AP-PLICA14T TO FILL IN (Print or type only)
I
DRESS J w3- COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
TY-tfV ZIP o BUILDING AND SAFETY DIVISION
NO.OF BLDGS. BUILDING r
ZE OF LOT NOW ON LOT ADDRESS
T B LOT NO. LOCAL GTENEAREST NER N] �'QM NO. y ` CROSS ST.
ASSESSOR
ADDRESS L'1@,) AV f. MAP BOOK PAGE PARCEL
DISTRICT GROUP ITYPE I FIRE ESSED BY
CITY-TQt� ` ZIP 1 OG� CONST. ZO,
ARCHITECT OR TEL.
ENGINEER • @ NO.
STATISTICAL CLASSIFICATION SEWER AP
ADDRESS • CLASS N04�`�DWELL.UNITS====j BPG
CONTRACTOR 0Wj%jQ$ NOL ZONE NOP
LIC. SPECIAL
ADDRESS NO. CONDITIONS
CITY LIC.
CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO
CONSTRUCTION LENDER
NAME AND BRANCH y• BLD SETBACK FROM C
FR T PROP.LINE OF (STREET)
ADDRESS CITY C.
C
TOTAL SETBACK FROM TYPE OF EXISTING
SQ. FT ._ NO. OF NO. OF CHECK HI WAY + YARD - FRONT PROP. LINE HIGHWAY WIDTH p
SIZE STORIES FAMILIES ONE FC
t = t
DESCRIPTION OF WORK NEW ElG
I1) BLD ETBACK FROM v
r ADD IBJ
A90 go-olpm% � wr SIDE PR (STREET)
ALTER ❑ HIGHWAY + YARD TOTAL TBACK FRO PE OF EXISTING
REPAIR❑ SIDE PROP. LINE HI AY WIDTH
USE OF t =
EXISTING BLDG 1y ` i j),e C,,DEMOL ❑
APPLICANT TEL �� CORNER CUTOFF YES ❑ NO ❑
(PRINT) JU4 J NO.
BY (SIGNATURE)t IN OPEN SPACE YES ❑ NO ❑
IN COASTAL ZONE YES ❑ NO ❑
VALUATIONr�•'n I CATEGORICAL EXEMPTION YES❑ NO ❑
I HEREBY ACKNOWLEDGE THAT I 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 EMPLOY ANY PERSON IN VIOLATION OF THE
LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO
WORKMEN'S COMPENSATION INSUR CE. +�
SIGNATURE O 3
PERMITTEE
14 al
ADDRESSTE
CITY 4L Z NOL
DATE
ATE ' ` / 7A11zt ff sa
CHECKS NECKS PAYABLE7'O: FEE $ FEE
PLANHARVEY T. BRANDT, COUNTY ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION C M.O. CASH
I . (r,, 3 0 6 873 SEP 5 1 D 3 cJ.2 Jr A v
75AG38A CE NS03 12/72 ��+
APPLICATION FOR B ..SIG PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS ,I' _
I hereby affirm that I have a certificate of consent to self insure, BUILDING ADD
R L�90 r�
or a certificate of Workers'Compensation Insurance,or a certified CITY ZIP
zc
cox e)aof�S 3800,Lab.C.)y_ /� LOCALITY t
IT31ic6. /Companyi�C
NO.OF BL NOW NEAREST CROSS ST.NOW ON LOT
Certified copy is hereby furnished. .7 � �fl�!/C-� z i/.S �
El Certified copy is filed with the county bu'ding Inspection TRACT BLOCK LOT NO.
depar m t. ^ USE ZONE MAP NO.
Date Applicant ASSESSOR MAP OK P PARC��
PIP
SPECIAL CONDITIONS
CE IFICATE OF MPTION FROM WORKERS' OWNER TEL N
COMP SATION INSURANCE D 70w WITHIN 1000 FT.OF SCHOOL? YES No
ADDRESS
(This section need not be completed if the permit is for one hundred DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY
, ��
dollars($100)or less.) s
I certify that in the performance of the work for which this permit CRY ZIP ,OG 0 1`
is issued, I shall not employ any person in any manner so as to ARCHIT OR ENGINEER14.& TEL NO. -
become subject to the Workers'Compensation Laws.
STATISTICAL CL�JASS(/F(CATION 1 •AP.tt'E' CONDO
Date Applicant ADDRESS CLASS NO. �-7 DWELL UNITS �1 812.33
NOTICE TO APPLICANT.• If, after making this Certificate of REQUIRED TOTAL SETBACK EXIST
Exemption, TJA�CT/O TT F
you should become subject Y the Workers' CONW�[ TEL — Z �� SET BACK YARD HWY PROP LIN WIDTH
Compensation provisions of the Labor Code, you must forthwith 7� FRONT I
comply with such provisions or this permit shall be deemed revoked. ADDR S Q« LIC NO. PL T,WkIt k
LICENSED CONTRACTORS DECLARATION ��� 4��� c el, SIDE
CITY uPc.class � L
I hereby affirm that I am licensed underprovislons of Chapter 9 SEWER MAP
(commencing with Section 7000)of Division 3 of the Business and SQ. SIZ NO.O ORIE NO.OF FAMILIES NEW ❑ BK PG a
Professions Code,and my license is in full force and t. V
License Number 7 ! 2 Lic.Class DESCRIPTION OF WORK ADD VALUATIO , / j f 9,10
,�c D/Tid B-C' t�C��t E-IfS�fi 1 � c
Contractor:16 AW W1 LAE Date+ J— ALTER ❑ $ y °'
❑ I am exempt under Sec. REPAIR ❑ $ O
B.&P.C.for this reason DEMOL ❑ LDMA P/C#
te: USE OF EYASTING BLDG. URM ❑ 0_
Signature i {.s $ Z
f APPLICANT(PAINT) NO. LDMA Perm# A(C t■
❑ I, as ov�.rf- of the property, or my employees with wages as << Z
their compensation, will do the work and the structure is ADDRESS �7- O
not tended Or offered for sale (Section 7044, Business and ��� 6t11� / L / ) FINAL DATE 1.503 991''"'
Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL �- L J L
ITEM
OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE _ °••„•
❑ 1, as owner.of the property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY 3 I I ��,,e9 P i
licensed contractors to construct the project (Section 7044, YES❑ No❑ TOTAL Ft_ �991.5'.3-� i
Business and Professions Code.) WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING CHECK '
OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR FROM THE SOUTH
COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD) EDCATION PEI
CONSTRUCTION LENDING AGENCY EEO
PERMITTING CHECKLIST R )
GUIDEUNES CHANGE
I hereby affirm that there is a construction lending agency for YES❑ NO❑
CM the performance of the work for which this permit is issued(Sec.
I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING � � d 6/2?/95
�sj.��n'p 3097,CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE.
a ]
TITLE 2.CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS ��� (}
aLender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. A II) °•:.(
o Lender's Address
C OWNEA OR MENT
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 /a.33 PERMIT FEE - 61fN with all county ordinances and State laws relating to building
construction,and helppy authorize representatives of this County ISSUANCE FEE
to entepob-n—jhe I - e i y for inspectio p o es.
% xyn� INVESTIGATION FEE TOTAL FEEgp
/1
/ SEE REVERSE FOR EXPLANATORY LANGUAGE
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 _BUilDi•NS-PERMtT---t
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS . RESIDENTIAL ADD/A ./REP
T BUII.IING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA R `, 8L 0508 971105005,4
PHONE: (818) 285-0488 EXT: eve
LEGAL I 0. OF CONST NEW
TR: 9848 LT: 5 SQ. FT STORIES TYPE OCCUP GROUP 927 WILLMONTE AV j
STRUCTURE: 0 1 VN R3 '--lillP CA 917804045
ASSESSOR I OR ION NUMBER: GARAGE: NLUEST CROSS STREET:
8589-023-024 OTHER: 0 2 THOMAS PICGE 59T`—GitID: 85 LOCALITY: TEMPLE CITY
TENANT: EXIST LDG USE: USE 0 : I S . P OC SSED B EXPIRES ON:
EXIST OCC GRP: 11/05/97 UT 11/05/98
OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: ODE:
4927 DALTON DONALD LAVETTY A (626) 444-6498- 1 7,500 l
TEMP 917804045 FEES PAID
ENLARGE GARAGE ATTIC FOR STORAGE ONLY•CONVENANT RECORDED
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:
APPLICANT: TEL. NO:
WILDE'S CONSTRUCTION (626) 448-2175- AA BLDG PERMIT ISSUANCE 27.75
AC STRONG MOTION RESID 7500.00 VAL 0.75 SPECIAL CONDITIONS:
AX BUILDING REVIEW EF E 54.70
D2 PERMIT W/O EN-HC� �L j� 7,500,:00 VAL 183.90
-TOTAL fEtS- 267.10
CONTRACTOR: TEL. NO: a _ '_ APPROVALS DATE INSPECTOR SIGNATURE
WILDE'S CONSTRUCTION (818) 448-2175- 4 � �, CATION AND SETBACKS
4905 BALDWIN AVE LIC. NO V ff _
TEMPLE CITY CA 91780 401407 B y��'$` ♦ �+
SOILS ENGINEER APPROVAL
ARCHITECT OR ENGINEER: TEL. 0: ;� �� /��, �' ,•;j'`t!�1 '+�' FOUNDAIIONARENCH FORMS
LIC. N0: "i i �= __ '+` p, SLAB/UNDER F
FUSPE—D—FEWR FRAMING
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: ti _ 4 :• UNDERFLOOR INSULATION
3 01 IST LEVEL FLOOR SHEATH
0. OF AMILIES: DWELLING UNITS: APT CO D: STAT CL SS:
NO 21 2ND LEVEL FL 0R H �I
SCHOOL WITH -HAZARDOUS R OOF SH M II N G
AIR QUALITY: 1000 FEET MATERIALS
NO NO NO FIRE DEPT. FRAME INSPECT
REQUIRED TOTAL SETBACK FROM EXIST BLDG DEPT. FRAME INSPECT
SET BACK YARD: HWY: PROP LINE: WIDTH:
FRONT PL- SHEAR PANELS
SIDE PL-
I SULA ION/ AT RST IP
NTERIOR LATH/DRYWALL
EXTERIORLATH
LOT DRAINAGE / LJ
SMOKE DETECTION DEVICES-
FIRE
E SFIRE DEPARTMENT APPROVAL
* ADDITIONAL DATA ON FILE
REPORT ID: DPR261 ROUTE TO: BS0508