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HomeMy Public PortalAbout5318TEMPLE CITY BLVD_Building CIS Awaunv enol APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY BU LUIN(J FOR APPLICANT TO FILL IN ADDRESS 1 ` BUILDING ADDRESS LOCALITY _\ Lam^ CITY L,� LI NEAREST ZIP CROSS Si __NO OF BLDGS _ ASSESSOR_ — SIZEOFtOT .SSX/�'-� NOW ON LOT, MAPBOOK PAGE PARCEL /i-43b DISTRICT GGGgggOOOUP TYPE FIRE ED BY T BLOCK LOT ,0� k1� CONS], �E �+ OWNER , LLA IW N � \J J;�1— STATISTICAL CLASSIFICATION SEWER MAP ADDRESS ^� , CLASS N0 DWELL UNITS r B PG CITYER iij�,, ZIP ARCENGH OC. <„ ATO �� , VALUATION S OO ADDRESS \ _ LUG SETBACK FROM TEL FRONT PROP LINE OF (STREET( CONTRACTOR NO TOTAL SETBACK FROM TYPE OF EXISTING +� HIGHWAY + YARD FRONT PROP LINE HIGHWAY WIDTH ADDRESS J C�. C � WO�LIC - CITY /l CIA L'.� .� C ONS TRLKTION(ENDER BLDG SETBACK FROM BRANCH SIDE PROP LINE OF (STREET) NAME AN71ONLE HIGHWAY + YARD TOTAL SETBACK FROM TYPEOF E%ISTING ADDRESS CITY SIDE PROP LINE HIGHWAY WIDTH O SO FT NO OF NO OF CHECK + V SIZE STORIES FAMILIES ONE z / O DESCRIPTION OF WORK NEW PC Fee E Permit Fee 3 Y ADD Issuance Fee 7 -1 V� ALTER ❑ Z_ REPAIR Total Fee USE OF EXISTING BLDG DEMOL /) EXISTI �'uWR(/ // /f APPLICANT TEL `il+�/'�� Z G 3417. 1A (PRINT) BY ISIGNATUREI j HERETY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE OO p THAI THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCE 2 • 2 p 8 0 AND LAWS REGULATING BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF O Q 0 THELABORCMDFTHESTATECIFCALIFORNIAINRE TINGTONVWK S O • • 21R805 PENSATION INSURANCE ' SIGNATURE OF 1 0 6 0 PERMITTEE �` —44 17 2A ' ADDRESS � _ # • •'� • • � TEL F CITY NO < 2'- R, 4300 TAE ZONE [SWEI.AL a L'1$ �• • • 400 _ONDITIONS r y FINAL / Q BY DATE 7+/2'7 /