HomeMy Public PortalAbout4410TEMPLE CITY BLVD_Building (2) APPLICATION FOR BUILDING PERMIT
FOR APPLICANT TO FILL IN (Print or type only)
BDapIN COUNTY OF LOS ANGELES
ADDRESS DEPARTMENT OF COUNTY ENGINEER
clTyTemple CityZIP 91780 BUILDING AND SAFETY DMSION
NO OF BLDGS BUILDING
SIZEOFLOT Irregular NOW ON LOT None ADDRESS O +-
TRACT 12 8 BLOCK LOT NO 89 LOCALITY
Z4
NEAREST
OWNER CROSS ST67
ADDRESS 9606 N. Rio Hondo Ave. ASSER
MAP BBOOOK PAGE I PARCEL
CITY ZIP DISTRICT GROUP TYPE FIRE SSED BY
IF
AROIITECT TEL �f U Q T CONST ZONE
8 - 8 JT/` ii
1
ENGINEER N O
STAT{STICAL CIASSIFIC�AT101J SEWER MAIY
ADDRESS 41 Las Tunas, ,+ —
Temple Ci CLASSNO DWELL UNITS
EL -
CONTRACTOR TNQ44 ZONE NADP /
ADDRESS 6 O d LNp 6 _ SPECIAL
LIC - CONDITIONS
ciTyRosemead. CA nASS
CONSTRUCTION LENDER ROAD APARTMENT APPROVAL REQUIRED VES ❑ NO E]
NAME AND BRANCH First City Bank BLDG SETBACK FROM
ADDRESS 000 B'� V$ll Rosemead FRONT PROP LINE OF (STREET)
i50 FT '.^ NO TING
OF NO OF CHECK HIGHWAY + YARD TOTAL SETBACK
PROPKLIN�EM HGHWAY WIDTH
SIZE 4OO STORIES 1 FAMILIES 0 ONE _ yy¢
DESCRIPTION OF WORK NEW ® + O
BLDG SETBACK FROM n
2-Car G e ADD ❑ SIDE PROP LINE OF (STREET) rr0
ALTER ❑ TOTAL SETBACK FROM TV PE OF EXISTING
HIGHWAY + YARD SIDE PROP LINE HIGHWAY WIDTH JYL
USE OF - - REPAIR ❑
None
EXISTING BLDG DEQ C1 + _ _
APPLICANT TEL CORNER CUTOFF YES C] NO ❑
I PRI NT) Pq rav N0443-1579
IN OPEN SPACE YES 0 NO
BY(SIGNATURE( T
IN COASTAL PERMIT ZONE YR NO
VALUATION
HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAI THE ABOVE 15 CORRECT AND AGREE TO COMPLY MM ALL ORDINANCES
AND CAMS BUILDING CONSTRUCTION I CERTIFY T1UT IN DOING THE
WORT(AUIHORI DHE Y WILL NOT EMPLOY ANY PERSON IN VK)IATON OF
THE LABOR THE E OF CALIFORNIA IN RELATING TO MORKAIW S COM
PENSATION(N -
SIGNATURE 1-N,
- -
PERMITIEE
ADDRESS
FINAL BY
CITY Rosemead. CA TNA4 -1 DATE 4- 7 -7
MAKE CHECKS PAYABLE TO F E $ TPF��
HARVEYT BRANDT•COUNTY ENGINEER -
PLAN CHECK VALIDATION cK. r o c"M PERMIT VALIDATION CIE 110 c"N
668�DEC13 1D 35.25ea
CDs 74 MACEN903375