HomeMy Public PortalAbout4430TEMPLE CITY BLVD_Building 7GAa$"CK*803 T,! APPLICATION FOR BUILDING PERMIT A1
BIIRDRYG AND SAFETY DTJISION BUILDING
D� 0f County EBpIB�
^�_e`1 ADDRESS
`+�I Of Los AngelM LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST
CAEEATT D GRIFFIN SUP T OF BUILDING CROSS ST
DIBTRINO G P TY EWER MAP
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FOR APPLICANT TO FILL IN S CON �_ Pa
BUILDING
ADDRESS �/'Y'9O TF PGE LVO STATISTICAL LASe1FICATION
CLASS NO DWELL UNITS-D
LOT NO BLOCK MAP � STATE
NUMBER HWY YES O
TRACT USEZONH SPECIAL
y//OB NO OF SLOGS CONDITIONS
SIZE OF LOT V NOW ON LOT
USE OF
""TING BLDG S/O NLQ+ BUILDING "'STSETBACK YARD HWY STREET AME WIDTH
OWNER PTO L FRONT
MAIL P L �I 1
ADDRESS D / SIDE
TEL P L
NO
INSPECTION RECORD
ARCHITECT OR TEL
ENGINEER NO
ADDRESS / SJ
TEL
CONTRACTOR NO I C
ADDRESS ffi C
DESCRIPTION OF WORK V
ADD ALTER REPAIR DEMOLISH
80 FT NO OF NO OF C
SIZE STORIES I FAMILIES A + +
USE OF STRUCTURE
OVA
SIGNATURE OF
APPLICANLT,` DATE INSPECTOR S SIGNATURE
ADDRHSS7, 7 GLr / (/ FOUNDATION LOCATION
FORMS MATERIALS
S p C s FRAME FIRE STOPS
FEE BRACING BOLTS
VALUATION / /VD • , � FURNACE LOCATION
FEZ OAS VENT DUCTS
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH INT
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND LATH E%T
STATE LAWS RE U ING B LD1 G NHTRUCTI
HOUSE NUMBER COR-
SIGNATURE OF
PERMITTEB RECT AND POSTED
ADDREBB FINAL
JOHN A LAMBIE COUNTY ENGINEER CLYDE N DIRLAM PRINCIPAL STR RAL ENGINEER
PLAN CHECK VALIDATION CK No CASH PERMT VALIDATION U M O CMH
Lp 2 6 4 9 0R' APR 7 IA 8.5 0
m
Ave"