HomeMy Public PortalAbout5238TEMPLE CITY BLVD_Building (2) IB, 7EA638A -
CE#8D3(REV RT >e) _ CITY OF TEMPLE � CITY
APPLICATION FOR -BUILDING PERMIT
COUNTY OF LOS ANGELES __ BUILDING AND SAFETY,
FOR APPUCANT_TO FILL IN ADDRes"s C. —
I BUILDING ,
ADDRESS LOCALITY + _
NEAREST
CITY ZIP CROSS ST
// NO OF BLDG$
ASSESSOR - _
SIZEOFLOT (O� -NOWONLOT - — - MAP BOOK=-`—=• 'rt =-+ PAGE �` PARCEL - - - -
? DISTRICT GROUP TYPE -' FIRE P ESSED BY
TRPCT 3 BLOCK LOT NO 6 I CONST - f ', ZNE
TEL. - mor [/
OWNER N
_ STATISTICAL CLASSIFICATION - SEWER MAP
ADDRESS QASSNO DWELL UNITS BKfZ�G
OTYZIP
ARCHI TECTO TEL VALUATION $ 961. 00,
ENGINEER - NO ,
ADDRESS _ BL ETBA K FROM
TEL FRONT PROP LINE OF (STREET)
CONTRACTO N — TOTAL SETBACK FROM TYPEOF EXISTING
LIC HIGHWAY r+ YARD FRONT PROP LINE HIGHWAY WIDTH
ADDRESS
LIC - +
CITY CLA55 — - - - -
- BLDG SETBACK FROM
CONSTRUCTION LENDER '
NAME AND BRANCH SIDE PROP (INE OF (STREET(
_ HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING
ADDRESS CITY SIDE PROP LINE HIGHWAY WIDTH {O.1
50 FT NO OF NO OF CHECK j- + - - -
SIZE I STORIES FAMILIES _ ONE '
USE LONE
DESCRIPTION OF WORK Rp—ronf hnllqP NEW -- A--( . L
J..— PECIAL
L�Gyj
JYp' Sa
& attached gar. comp12x 80D_ Cl 9�� �P.oa CONDITIONS
ALTER FINAL y p BV
REPAIR- DATE ¢l -�Q �O
USE OF DEMOL -
EXISTING BLDG
APPLICANT
TEL
- - N
q.
N288-404F '
- nn ;k 9 9 4,'8 A-
BY(SIGNATURE G7 -_ - 1 - _ ; # 1
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES 2 • • 250 0
AND LAWS REGULATING BUILDING CONSTRUCTKIN I CERTIFY THAT IN DOING THE
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF KI2 O O T a I
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TOWORKMEN SCOM _ • 0 •
PENSATN INSURANCE ._ _
04. 1 7-80
SIGNATURE - - - L p ✓A ,
PERMITTE -
ADDRESS 5118 R. Valley B lVd•
CITY San Q h3'1 -T - - - TEL NO —404
Q
t^
PC Fee S Permit Fee j a
Issuance Fee 7 . 00T- - • - - ----' -+
Total Fee 25.00