HomeMy Public PortalAbout5232TEMPLE CITY BLVD_Building 76A638 GE rlOy 3.69
'4 APPLICATION FOR BUILDING PERMIT �I
COUNTY OF LOS ANGELES BUILDING
' DEPARTMENT OF COUNTY ENGINEER ADDRESS -
t
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LA MBI E, COUNTY ENGINEER
COLEMAN W JENKINS SUPT OF BUILDING NEAREST - -
CROSS ST zi
FOR APPLICANT TO FILL IN DlsrRlcr No GR ry r E
(PRINT OR TYPE ONLYI
STATISTICALC S IF ICAT ION SEWlER MAP
ADDRESS e( `• -- - - I/
CLASS NO DWELL UNITS - . BK PG
LOT NO 0 BLOCK USE ZONE I MAP
NO
TRACT -OGS 922 011k'
SPECIAL
NO OF BCONDITIONS
SIZE OF LOT NOW ON LOT t USE OF
EXISTING BLDG BLDG SETBACK FROM
OWNER J C XML FRONT PROP LINE OF - -(STREET)
p/ TYPE OF jEXI5TIW4 SETBACKHIGHWAY + YARD = TOTAL
ADDRESS �a Cif A,)/r HI HWAY ,WIDTH
//I f�DD TTTHH FROM C L
CITY
ARCHITECT TEL BLDG SETBACK FROM
ENGINEER NO SIDE PROP LINE OF (STREET)
TYPE OF EXSTK SETBACK HIGHWAY a YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C L
CONTRACTOR TEL _
(l/ NO
LIC
ADDRESS NO - CORNER CUTOFF YES ❑ - - NO ❑ - C
ETC-
V
CITY CUSS SEE REVERSE SIDE FOR SPECI APPR V LJi y
CONSTRUCTION LENDER v C
NAME AND BRANCH 7 ;Srl'
ADDRESS
v
SO FT NO OF NO OF
SIZE 3 & STORIES FAMILIES NEW ❑
USE OF STR CT URE it;'- ADD ® i
ALTER ❑ filly
d REPAIR [1I �Z
SIGNATURE OF DEMOL ❑ V
APPLICANT
VALUATION APPROVALS DATE INSPECTOR'S SIGNATURE
P C PMT p� FOUNDATION LOCATION
FEE S FEE S / � O F MATERIALS
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION FRAME FIRE STOPS,
SPACING. 7<'
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION, O
WITH ALL ORDINANCES ANO LAWS REGULATING BUILDING [ONSTRUC- CT
TION I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I
WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE LATH INT Q
OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM-
PENSATION INSURA E
SIGNATURE OF LATH, EXT O
PERMITTEE HOUSE NUMBER CORRECT
AND POSTED
ADDR ES FINAL
JOHN F LEWIS PRINCIPAL ST URAL ENGINEER
PLAN CHECK VALIDATION CK M 0 CASH _ PERMIT VALIDATION Cn M O CAB"
I �� 3566R FEB 2 1 D 2250` a