HomeMy Public PortalAbout4903TEMPLE CITY BLVD_Building (2) -16Ae9fiA Ce gEDO E E3 APPLICATION FOR'BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS 4903 Temple Cit Blvd
BUILDING AND'SAFETY DIVISION LOCALITY
JOHN A •LAMBIE COUNTY ENGINEER NEAREST I
WILLIAM A JENSEN SUP T OF BUILDING CROSS ST , Tmr
FADDRDISTRI NO GR UP TYPE ESSED BY
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APPLING ICANT TO FILL IN CONSTXf
LEEING
T le Celt ,B1Vd. ., STATISTICALC� (CATION KR MAP
CLASS NO DWELL UNITS' 3
BLOCK WATER NOT REQUIRED RECEIV
CERTIFICATE
' MAP ,HIGHWAvSTATE MAJO ECON LOCAL
NO OF BLOGS NO (CIRCLE)NOW ON LOT USE ZONE ECIAL CONDITIONS�
EXISTING BLDG residence ,
TEL
OWNER NO a.68336BUILDING YARD HWY REET NAME 1 0, EXIST
SETBACK WIDTH
ADDRESS same- 1 FRONT
ARCHITECT OR TEL P L
ENGINEER NOSIDE
P I y
ADDRESS n 0
CONTRACTCJR C i alleys NO 2— 2 1 - V
K
ADDRESS _ W
DESCRIPTION OF WORK
a
N
NEW ADO LTER REPAIR DEMOLISH + Z
SO FT NO OF NO OF -
SIZE STORIES FAMILIES
USE OF
STRUCTURE
SIGNATURE OF
APPLICANT
VALUATIONS 702.00
rFURNACE
OVALS DATE INSPECTOR 581ONATURE
PC G PMT ON LOCATION +
FEE S FEE $ MATERIALS
RE STOPS
1 HEREBY AC K NOWLCDOE THAT I HAVE READ THIS APPLICATION BOLTS
AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLYLOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATINGT DUCTS
BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA
TION OF THE LABOR CODC OF THE STATE OF CALIFORNIA RCLAT
ING TO WORKMEN 6 C/O�MPC'A/KATION INSURANCE ///� LATH EXT
SIGNATURE OF /A / s V A Y / HOUSE NUMBER COR
PERMITTEE !�l/ !�-���— RECT ANO POSTED
ADDRESS FINAL
JOHN F LEWIS PRINCI AL STA RAL ENG( EER
PLAN CHECK VALIDATION CK M o CASH _ PERMIT VALIDATION cK M o CASH
Ljj05244G FEB 4 1 D 8,G 0, v