HomeMy Public PortalAbout4932TEMPLE CITY BLVD_Building (2) TEM' LE CiTy r1'1n11'11
TBABDA CE keOI]6J APPLICATION?
FOR BUILDINGPERM IT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST
WILLIAM A JENSEN BUR T OF BUILDING CROSS ST
DISTRICT NO GFftUP
TYPE ESSED BY
FOR APPLICANT TO FILL. IN %S
IN coNsr�r--�
BUILDING �— STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS F' 7 4:- _ZpPG
CLASS NO DWELL UNITS ��77
LOT NO BLOCK WATER NOT REQUIRED RECEIVED
CERTIFICATE
TRACT � HIGHWAY
+ NO OF SLOGS NOP .ZOO ......EI
SIZE OF LOT V 7 f NOW ON LOT STATE MAJOR ECOND LOCAL
USEOF ^ �S'A USE ZONE CONDITIONS
ONS
EXISTING BLDG ]� efC/
TEL
OWNER . NO BUILDING YARD HWY STREET NAME EXIST
ADDRESS 9s2 (_E CJ SETBACK WIDTH
FRONT 20 � 9O/
ARCHITECT OR TEL S L G o
ENGINEER NO SIDE /0-11
O I L
P L
ADDRESS O
TEL A /
CONTRACTOR NO4%4-
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ADDRESS * I Mpl J , 11 J�• / I J O
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DESCRIPTION OF WORK a
� N
NEW ADD ALTER REPAIR DEMOLISH
so FT NO OF NO OF
SIZEX�r STORIES FAMILIES
USE OF
STRUCTURE P
SIGNA URE OF
APPLICANT
VALUATION S OOa�o�
APPROVALS DATE INSPECTOR•SIGNATURE
PC PIAT Tno_ FOUNDATION LOCATION
FEE S FEE S —��- FORMS MATERIALS
FRAME FIRE STOPS
1 HEREBY AC K NOWLEDOE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE IR CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT D CTS
BUILDING CONSTRUCTION CERTIFY THAT IN DOING THE WORK
AUTHORIZED HERESY I WILL NOT EMPLOY ANY PERSON IN VIOLA • LATH INT _llyGJfMIDHHH"/(AALk'"rgj
TION OF THE LABOR CODC OF THE STATE OF CALIFORNIA RELAT
INO TO WORKMEN 8 COMPENSATION INSURANCE ' LATH EXT
SIGNATURE OF HOUSE NUMBER COR /
PERMITTEE ea ]0� ORECTUSE AND POSTED
ADDRESS FINAL i�jµ- v
JOHN F LEWIS PRINCIPAL ST_5j=TURAL ENGI EER
PLAN CHECK VALIDATION CK wo CASH
PERMIT VALIDATION DK w D CAB.
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