HomeMy Public PortalAbout5025TEMPLE CITY BLVD_Building DEPARTMENT OF BIIII.DING AND SAFETY • APPLICATION FOR PERM 1 '
COUNTY OF LOS ANGELES J. BUILDING
■-
WM . PDX. CHIEF ENGINEER
�p FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
ADD IREBB�- s J` DIS FTNO PLA`K 3 HO MIT
NO
� .f `Y
LOCALITY, UED
RIVED/BµV DATE OF APPL D/�=E
CROSS ST BUILDING �- �— •N/—' Y
ADDRHBY O'�. N .Tb" M PL CI Ty
OWNER
MAILLOCALITY T C .
ES
ADDRS NEARE/T ��//�� A
TEL CROHS ST •T
CITY NO FIRa NO OF ,� TYPQ�Tr OROUP.T
ARCHITECTOR TEL ZONE PLANS .,,�i��
WGINEER NO BLDG
SETBACK LINE
ADDRESS APPROVED
TEL BY DATE
CONTRACTOR NO �" Y US PPROVHD
ZONE BY DATE
ADDRESS - / y'USE NUMBERING
LEGAL `
DESCRIPTION I LOT NO BLOCK MAP NUM BQR FIELD CHECK BY
TRACT NO ASSIGNED BY Y'~y AT
NO of SLDGS .� COBBECMONS
SIZE OF LOT it 3 NOW ON LOT
USEOF NO OF
QXISTINO BLDG, FAMILIES
DESCREMON OF WORK _
NEW ALTERATION I ADDIf10N
0
REPAIR DEMOLITION
BQ FT NO OF
IFLICATION
ROOMS STORIES Z
1
EI[T WALL ROOF r
COVERING C COVERING
USE OP STRUCTURE
APPROV]l78
INBPECTO SSIGNwTUR[ DATA
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AR FOUNDATION LOCATION
AND STATE THAT THE INFORMATION GIVEN 18 FORMS, MATERIALS '4--o- ? 'T
ORRECT
1 AGREE TO COMPLY WITH THE CORRECTIONS LISTED FRAME FIRESTOPIL r f
�QIEONAND WITH ALL COUNTY ORDINANC AND STATE BRACING, BOLTS
LAWS REGULATING BUILD NO CON UCTIO FURNACE LOCATION,IGNATURE OF GAS VENT, DUCTS
PERMITTLATH. INTDOLAT -a /
H MITl
AUTHORIZED AQT
PLASTER, INT
YM DOp MYEO j V O_ P C V.
I1 f � Psa PLASTER. EXT
VALUATION FEE , O.�'V FINAL 1 J"�