HomeMy Public PortalAbout5032TEMPLE CITY BLVD_Building (2) TEMPLE CITY - -
TSASSSA CE 4 SGS I SZ APPLICATION FOR BUILDING PERMIT � �►•
COUNTY OF LOS ANGELES BUILDING pe E
DEPARTMENT OF COUNTY ENGINEER ADDRESS 1
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST
WILLIAM A JENGEN SUP T OP BUILDING CROSS ST
DI RIOT O G O P TYPE C S BY
FOR APPLICANT TO FRI. IN . o CONST
BUILDING / STATISTICALC SIFICATION SEWER MAP
ADDRESS
S E E CLASS NO DWELL UNITS BK PG
LOT NO 'S' BLOCK WATER NOT REQUIRED ® RECEIVED
q 7- CERTIFICATE
TRACT MAP HIONwAY STATE MAJOR SECOND(LOCA
NO OF SLOGS NO ICIRCL6)
512E OF LOT (� x .j NOW ON LOT USE ONE SPECIAL
USE OF CONDITIONS
EXISTING SLOG
TEL
[ARCHITECT
NER m n NO T-737 BUILDING YARD HWY STREET NAME EXIST
DRESSSD ZTE LE !./T &� SETBACK WIDTH
FRONT
OR TEL P LGINEER NO SIDEDRESS P L
aTELA �
NTRACTOR NO DRESS _ Q
DESCRIPTION OF WORK
a
N
NEW ADOREPAIR DEMOLISH Z
ALTER
SQ FT NO OF NO OF
SIZE STORIES FAMILIES
USE OF
STRUCTURE /
SIGNATURE OF
APPLICANT
VALUATION S //i•�. 00
PFOUNDATION
DATE INCI•ECTOR a SIGNATURE
PC PMT V ION
FEE S FEES ♦Q S
1HKRKBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE MOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BU ILOINO CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT
TION OF THE LABOR CODE OF THE STATE 01 CALIFORNIA RELAT
ING TO WORKMEN S COMPENSATION INSURANCE IT EXT
SIGNATURE OF -^ ' /¢�� //J.�� HOUSE NUMBER COR
PERMITTEE !X-/VI^_ ^-' V IRECT AND POSTED
ADDRESS FINAL
I JOHN F LEWIS PRINCIPAL STRUCTURAL EN R
PLAN CHECK VALIDATION CK NO CASH _ PERMIT VALIDATION CK NO CASH
b"4 2 7 7Q� SEP13 1 D 4.00-
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