HomeMy Public PortalAbout5011TEMPLE CITY BLVD_Building 1 1
„ 76Ae38A EE Peooao APPLICATION FOR BUIL-DING'-PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY '
' JOHN A'LAMBIE COUNTY ENGINEER NEAREST
WILLIAM A JENSEN SUP T OF BUILDING CROSS ST L
DISTRI T NO GROUP TYPE SSED BY
FOR APPLICANT TO FELL IN TCONST
YP
BUILDING _ STATISTICAL CLASSIFICATION S WER MAP
ADDRESS
_ CLASS NO DWELL UNITS �� K G
LOT NO SBL K WATER NOT REQUIRED RECEIVED
CERTIFICATE
TRACT AP HI OHWAY
NO OF BLDG' NO ICIwcLfl STATE MAJO ECO LOCAL
SIZE OF LOT NOW ON LOT USE ZONE SPECIAL "^
USE OF M 0. CONDITI
EXISTING BLDG
TEL
OWNER NO BUILD G YARD HWY STREET NAME EXIST
SETBACK WIDTH
ADORES' FRONT
ARCHITECT OR TEL P L
ENGINEER 'NO SIDE 1
ADDRESS P L
1
TE � 0
CONTRACTO NO w
ADDRESS Ay 0
DESCRIPTION OF WORK
y
NE ADO ALTER REPAIR DEMOLISH Z
90 FT NO OF NO OF
SIZE STORIES FAMILIES
U ,
SE OF
STRUCTURE A
SIGNATURE OF' `
APPLICANT
VALUATION E III
a O
APPROVALS DATE INSPECTOR[SIGNATURE
PC PMT FOUNDATION LOCATION
FEE S FEE S FORMS MATERIALS
FRAME FIRE 'TOPS
I HERESY AC K NOWLEOGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AORE[ TO COMPLY FURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CONSTRUCTION 1 CERTIFY THAT IN DOING THE WORK _
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT _
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAY
'NO TO WORKMEN C MPENSATION INSURANCE LATH EXT I(
SIGNATURE O HOUSE NUMBER GOR
Pwq
ERMITTEE RECT AND POSTED ,!/
ADDREss FINAL (� /O`er.
' JOHN F LEWIS P INCIPAL STRU RAL ENGINEER
PLAN CHECK VALIDATION CK M D CASH _ Y PERMIT VALIDATIO CK M D CASH
"fCj4 8 8 6 JAI!27 1 D 11.50-
���