HomeMy Public PortalAbout5023TEMPLE CITY BLVD_Building (2) TnAeae• eE:soae-eA APPLICATION FO BUILDIN PERMIT
COUNTY OF LOS ANGELES UILDIN
DEPARTMENT OF COUNTY ENGINEER DDRESS
BUILDING AND SAFETY DIVISION LOCALITY /ALE CiT
JOHN A LAMBIE COUNTY ENGINEER NEAREST. .. �`--
COLEMAN W JENKINSAUP T Of GWLDINO CROSS ST
DISTR CT O OU► TYPE P C SSeD BY
FOR APPLICANT TO FILL IN ;� CONST
BUILDING ` STATISTICAL CLASSIFICATION SE ER MAP
ADDRESS SO 3 E E T ✓y
CLASSNO DWELL UNITS BK O
LOT NO BLOCK USE ZONE MAP _�'/`
TRACT 3 SPECIAL
MO
OF SLOBS
SIZE OF LOT MOW ON LOT
USE OF
EXISTING BLDGp BLDG SETBACK FROM
OWNFR /C SO TEL FRONT PROP LIN[OF / A (STREET)
NO �f TYPE OF_ EXISTING S[T_BACK HIGHWAY YARD = TOTAL
ADDRESS SOY /Y L`T Cl LUQ S C L
CITY EK/I0eC- C �T +
RCHITECT OR TEL BLOO SETBACK FROM _
ENOINEER NO SID[ PROP LIN[ OI STREET
TYPE OI' EXISTING SETBACK NISNWAY + ' YARD = TOTAL
ADDRESS NISNWAY WIDTH FROM C L d
CONTRACTOR A014414'~1 L /}r Vt1j4;
ADDRESS-3✓G W [�i9LL c NO LIC 9pr � CORNER CUTOFF YES NO O
CITY asRdJriGL
LIC CI -C.I.o SEE REVERSE SIDE FOR SPECIAL APPROVALS
DESCRIPTION OF WORK w
Z_
NEW ADD ALTER REPAIR DEMOLISH
9O FT NO OF NO OF
SIZE STORI S FAMILIES
USE OF
STRUCTURE O K
SIGNATURE OF
APPLICANT
VALUATION$ l
APPROVALS DATE INSPECTOR'S SIO NATUA[
P C PMT Q- FOUNDATION, LOCATION
FEES FEES I
FORMS, MATERIALS
P AME FIRE STOPS, ✓
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITH ALL COUNTY ORDINANCES ANO STATE LAWS REGULATING GAS
A VENT DUCTS
•UILDING CONSTRUCTION I CERTIFY THAT IN DOINO THE WORK
AUTHORIZED HERESY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT
TION OF THE LABOR CODE OF THE STATE OP CALIFORNIA RELAT
INO TO WORKMEN COMPENSATION SURANCE LATH EXT
SIGNATURE OFH USE NUMBER COR-
PENMITT E / POSTED
ADDRES4� • V I NAL L?
JOHN F LEWIS PRINCIPAL STR)A5URAL ENGINEER
PLAN CHECK VALIDATION CK M D CASH PERMT VALIDATIONCK MO CASH
U-,t, 0 µ 3 OG Fra 12 1 IDA 4.0 0— v
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