HomeMy Public PortalAbout4303TEMPLE CITY BLVD_Building (2) 7eA838A CERSOE 5.63APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING _
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DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST
WILLIAM A JENSEN BUR T OF BUILDING CROSS ST i [l4Lr
DI5TRI T N G TYPE P SSED BY
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FOR_APPLICANT _TO'FILLIN Q coNST �LDING .� STATISTICAION S ER MAP
RESS a / BKPG�rCLASS NO DWELL UNITS NO BLOCK WATER NOT REQUIRED RECEIVED- CERTIFICATE
CT MAP �( HIGHWAY�f ^ NOONO (CIRCLE) STATE MAJOR ONLOCAL
OF LOT ,� F}C r,S NWON LOT USEZONE SPECIAL
OF .../TEL �T CONDITIONSSTING BLDG O Vr✓/ P (/'.ER �, ,6J It/ NO .4 LI- J7L BUILDING EXIST
_ SETBACK YARD HWY STR ET NAME WIDTH
RESS J LJ �[ roF J FRONT
HITECT OR TEL P LINEER NO SIDE
RESS TRACTOR �� NO TEL 4 / 1 V
RESS ODESCRIPTION OF WORE
K ADD ALTER REPAIR DEMOLISH
FT NO OF NO OF
(� STORIES FAMILIES
OFUCTURE /
SIGNATURE OF
APPLICANT
VALUATIONS �
APPROVALS JDATF INSFECTOFJ SIONVUJV
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PC PMT O FOUNDATION LOCLSATION / ^ ✓/
FEE S FEE S FORMS MATERIAY'
FRAME FIRE STOPS
IT
ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT 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 LATH INT
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT
ING TO WORKMEN S C RENSATION INS ANC LATH EXT
SIGNATURE OF HOUSE NUMBER COR
PERMITTEEu ((( RECT AND POSTED
ADDRESS f O FINAL
JOHN F LEWIS PRINCIPAL ST URAL ENGINEER
PLAN CHECK VALIDATION CK M O CA3M PERMIT VALIDATION CK No CASH
Lr1Lo 7 1 5 4 Z DEC 3 0.2 3 D 17.5 0 A
LCLo7 4 6 6�2 All 12 1 D 1 5.00-