HomeMy Public PortalAbout4425TEMPLE CITY BLVD_Building (2) TEMPLE CITY
.M....a�w. .I APPLICATION FOR BUILDING PERMIT Cti
COUNTY OF LOS ANGEIIE3 BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
RUIMING AND SAFETY DrMON LOCALrry
JOHN LIB
A LAMB1E. COIUNTY ENGINEER PT OF BUILDING CNEAR
ROSS ST .(.!
DISTRICT NO 6 P TYPE P yr�Y
FOR APPLICANT TO FILL.IN J`. 0 CONST
BUILDING STATISTICAL CLA881 (CATION SEWER MAP
ADDRESS . BK PO
CLASS NO DWELL UNITE O
LOT NO BLOCK WATER NOT REQUIRED RECEIVED
/ CERTIFICATE
TRACT I MAP HIGHWAY TATE MAJOR SECON LOCAL
NO OF SLOGS NO ¢iRCLu
SIZE OF LOT NOW ON LOT USE ZONE SPECIAL
USE OF CONDITION6
EXISTING BLDG 1
TEL
OWNER NO I - BUILDING EXIST
I SETBACK YARD STREET NAME WIDTH
ADDRESS aZ `IJ ua FRONT
ARCHITECTOR TEL P L
ENGINEER NO SIDE
ADDRESS L o' d
CONTRACTOR 15 TEL NO INSPE '(ZION RECORD O
V
ADDRESS O
DESCR PTION OF WORK r
O
ADD ALTER REPAIR DEMOLISH N
SO-FT NO OF NO OF ?
IZE kx A Q, STORIES FAMILIES
USE OF
STRUCTURE
SIGNATURE OF
APPLICANT
VALUATION E 3 ��
APPROVALS T8 INSPEMb$.SIGNA URE
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FEE FEE V(/ FORME MATERIALS ' / / f I/' A/�y'
FRAME FIRE STOPS
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS 1 10
4 z
AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING OAS VENT DUCTS
BUILDING CONSTRUCTION 1 CERTIFY THAT IN DOING THE WORK
ALITHORIZZO HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT
INO TO WORKMEN E COMPENSATION INSURANCE
LATH EXT /
SIGNATURE OF u �/ MOU86NUMBERCOR-
PERMITTE RECT AND POOT90
ADDRES FINAL r w
CLYDE N DIRLAM, PRINCIPAL STRucruRAL ET�e�R
PLAN CE= VALIDATION cm. BIG DABR PE M= VALIDATION ex.
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