HomeMy Public PortalAbout4343TEMPLE CITY BLVD_Building (2) .- APPLICATION FOR COUNTY OF LOS ANGELES
GINEER
BUILDING PERMIT_
DEPARTMENT ND SAFETY DI�MION
FOR APPLICANT TO FILL IN ADDRESS 3
BUILDING 3 Al. 'r wpt c r Qi L�]�A LITY
ADDRESS N �CF�
NE REST
CITU PLt C p -7 ZIP / / O CROSSST
NO OF BLDGS
AS
SIZE OF LOT NOW ON LOT MAP BOOK I PAG PARCEL
�-y DISTRICT GROUP TYPE FIRE P SSED BY
TRACT v LOCK LOT NO ry 5 09
O /�' CONST . ZONE
OWNER LU NOL 91-760 STATISTIICCAL /CL_LAS''SIIFICATI O�N, 5 WER P'
ADDRESS Nr PLe C LV CLASS N012 —DWELL UNITS 85,�-3PG
CITY f dr ZIP USE ZONE NNOOP�O
ENG NIEERARCHTECT O {� V Q AI NOL f� -�, SPECIAL J
CONDITIONS
ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES 0 NO
CONTRACTOR BUILDE - BLDG S BACK FROM
LIC FRONT ROP LINEOF (STREET)
ADDRESS NO HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF 1EXISTING
CITY
LIG FRONT PROP LINE HIGHWAY1 WIDTH
CLASS
CONSTRUCTION LENDER
NAME AND BRANCH BLDG SETBACK FROM p
ADDRESS CITY SIDE PROP LINE OF TREET) G�
SO FT NO OF / NO OF CHECK HIGHWAY + YARD = TOTAL SETBACK FROM TYPE O EXISTING
812E STORIES FAMILIES Of
SIDE PROP LINE HIGHWAY WIDTH �
DESCRIPTION OF WORK NEW + _ y
DDCORNER CUTOFF YES ❑ NO Z
Q c G� ALTERPEN SPACE YES O NO
[-
—REPAIR
USE OF OASTAL PERMIT ZONE YES 0 NO ❑
EXISTING BLDG EM
APPLICANT
(PRINT) E 'tW NOL _
BY (SIGNATURE) t I HEREBY ACR L THAT I HAVE C D TNI[ APPLIAND STAT[ THAT THE ABOVE 1[ CORRECT AND AGREE TO CWITHALL ORDINANCES AMD LAWS REGULATING BUILDINSTRUCTION I CERTIFY THAT IM DOING THE WORK AUTHHSREBY I WILL NOT EMPLOY ANY'PCRSON'IN VIOLATION LABOR CODE OF THEZSTATE OF CALIFORNIA IN RELAT
WORKMEN a COMPENSATI INDGRANC[ '
SIGNATURE OF FINAL /D � BY
PERMITTEE DATE
ADDRESS
clTrp�E �[Ty NOL _ PC Fee$ r d Permit Fee Z
G •� (eluents Fee �
VALUATIONS OoO —
Total F
PLAN CHECK VALIDATION cN M o Ae PERMIT VALIDATION CN D _CA[H
271i°mp 423 0 1 4-40
0&19'Su0 Iq 230 �� 0. 0
7Ql6Aa*,gW IIS 2 3 L j - ,1 0.8 0 qq -11 N I I / D 4.2 (tri
B � 8 _ _ �� 9�� 19 ,1 a 42A0!