HomeMy Public PortalAbout5120TEMPLE CITY BLVD_Building 'rOASOSA CENS03945
7
APPLICATION-FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDREss ?F
BUILDING AND SAFETY DIVISION LOCALITY i% G
JOHN A LAMBIE, COUNTY ENGINEER NEAREST
COLEMAN W JENKINS, SUP TOP BUILDING CROSS ST
DISTRICT NO GROUP TYPE PROCESSED BY
FOR APPLICANT T FILL IN O cONST
Print or a onl
BUILDING STATISTICAL CLASSIFICATION SEWER MAP
AODRESS �[
1 CLASS NODWELL UNITS_ BK PG
LOT NO BLOIC USE ZONE MAP /
NO Y
TRACT SPECIAL
NO OF BLDGS CONDITIONS
SIZE OF LOT65A lelbNOW ON LOT
USE OF
EXISTING BLDG BLDG SETBACK FROM
Q TEL n o FRONT PROP LINEOF — STREET)
OWNER ^ l TWE OF E%ISTING SETBACK XIGXWAY } YARD — TOTAL
ADDRESS HIGHWAY WIDTH FROM C L
we / } / _ /
M
BLDG SETBACK FROM
CITY -
ARCHITECT OR TEL SIDE PROP LINE OF (STREET)
ENGINEER NO
TYPE DF EXISTING SETBACK HIGHWAY } YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM'L
TEL ;
CONTRACTOR NO LIU0
ADDRESS NO
CORNER CUTOFF YES ❑ NO U
CITU CLIC
SEE REVERSE SIDE FOR SPECIAL APPROVALS v
DESCRIPTION OF WORK y
?
NEW ADD ALTER REPAIR DEMOLISH
SO FT NO OF NO OF
SIZE STORIES FAMILIES
USE OF
STRUCTURE
SIGNATURE O
APPLICANT A00
VALUATION VDO, 92 6/1 APPROVALS DATE� INe1[cTaK a vlaewruAc
PC PMTFOFORMSION MATERIAALION
IN
FEES FEE
FRAME FIRE STOPS
1 N[R[er ACKNOWLEDGETHEABOVE
THAT I HAVE ANDD THE ATO COMPLY
BRACING,
RACING BOLTS
AND BALL "AT THE DIVA Ie cAND S TE ACRS[REGULATING COMPLY FURNACE LOCATION
WITHBUIL ,G O SNTYTRU GemNI CER ANo [TAT[ LAWN THEWRK GAS VENT DUCTS
AUTHORIZED
D HERESY
I CERTIFY THAT IN PERSON
THE WORK
TION
TH MLABOR I WILL NOT EMPLOY ANY OM IN VIOLA
TION OF THE LABOR COO[ OI THE [TAT[ 01 CALIFORNIAALRELAT LATH INT
IND TO WORKMEN[COMPENSATION I URANC[
LATH EXT
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESN. Ile FINAL
JOHN F LEWIS PRINCIPAL STRUCTURAL
PLAN CHECH VALIDATION CK N O CASH - PERMIT VALIDATION CK M CABH
LAL,04 6 2 54 MAY27 1 D 9.00-