HomeMy Public PortalAbout5313TEMPLE CITY BLVD_Building 76AS38A CC Rea 5 BTAPPLlCATION FOR BUILDING ERM T, e�
COUNTY OF LOS ANGELES AUILD
DDRING
ESS / (/
DEPARTMENT OF COUNTY ENGINEER _
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST /
COLEMAN W JENKINSAur T OF BUILDING CROSS ST
DISTRICT NO GROUPTYPE PRO SSED BY
FOR APPLICANT TO FILL IN CONST
BUILDING �� L c e � STATISTICAL CLASSIFICATION SEWER MAP
/
ADDRESS /- CLASS NO DWELL UNITS BK PG -
LOT NO SS F BLOCK USE ZONE MAP I,WN O
NO
TRACT I / SPECIAL
l / DO �1 ( CONDITIONS
SIZE OF LOT O ' �� "1MOW NO OFIN
N LBLOTS G�
USE OPDuJ6LLInI6 SJ95PARAVE
LOG SETBACK FROM
,^ EL FRONT PROP LINE OF (STREET)
OWNER Oc%cIQ 14- L a)' TNO TYPE 01 EXISTING SETEACR XIOX WAY YARD = TOTAL
ADDRESS J C/' C/ (--6' ! HIGHWAY F E L
CITY Eir L ' 0—
ARCHITECT OR TEL BLDG SETBACK FROM
ENGINEER QW'/� NO SID[ PROP LIN[ OF (STREET)
TYPE OF [RISTINO SETBACK HIONWAY + YARD - TOTAL
ADDRESS HIGHWAY WIDTH FROM C L
TEL }
CONTRACTOR CJ LU NO
C
LICORNER CUTOFF YES NO OV
ADDRESS LNO I
CITY LIC SEE REVERSE SIDE FOR SPECIAL,APPROVALS O
DESCRIPTION OF WORKi
d
NEW ADD X ALTER REPAIR DEMOLISH z
Z
SO PTNO
7 OF
SIZE � a /3 STORIES ES FAM(LIF
USE OF /7 ID'
STRUCTURE
SIGNATURE OF
APPLICANT ok) q1 -G/ 4.11
VALUATION
PPROVALS PATE. INSPECpR'S SIa
P C PMT FO ATION LOCATION O /�'
FEE$ FEES FO MS MATERIALS Y7
Fq AM FIRE STOPS
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THI6 APPLICATION BRA ING BOLT
AND STATE THAT THE ABOVE IR CORRECT AND AGREE TO COMPLY tAT
LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATINGV NT DUCTS
'IUILDING CONSTRUCTION 1 CERTIFY THAT IN DOING THE WORK
AUTHORIZCD HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA IN
TION OF TME LABOR CODC OF THE STATE Or CALIFORNIA RELAT
ING TO WORKMEN SCOMPENSATION INSURANCE E%T
SIGNATURE OF /1 HOUSE NUMB COR-
PERMITTEE I V. RE T AND P ED
ADDRESS C� FINAL
PLAN CHECK VALIDATION CK wO CASH _ JOHN F LEWIS IS PRINCIPAL STRUCTURALM O ENG
PERMIT VALIDATION LK CABH
LQ67082 OCT22 1 D 4.00- 4