HomeMy Public PortalAbout5404TEMPLE CITY BLVD_Building (2) �K lr I MA CITY OF TEMPLE CITY
CE IOW IRev anal
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUILDING ,{
ADDRESS
Bl 1
A LOCALITY
NEAREST
C ZIP CROSS Si
NO OF BLDGS ASSESSOR
SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL
/� DISTRCT GROUP TYPE FIRE ESSED BY
TRACT/'/ 14' BLOCK - LOT .�j'Z CONST ZONE
EL 5a8Q11
OWNER NO
STATISTICAL CLASSIFICATION SEWERAl5kP
ADDRESS 54G4 Temple CltrCLASS NO DWELL UNITS BK PG
C ZIP
E ^
H R i VALUATION $
ENGINEER NO -
ADDRESS BLDG SETBACK FROM _
TEL FRONT PROP LINE OF ISTREETI
CONTRACTOR NO 298,404 TOTAL SETBACK FROM TYPE OF E%ISTING
LIC HIGHWAY + YARD = FRONT PROP LINE HIGHWAY WIDTH
ADDRESS NO
+
CIiel CLASS C,34 BLDG SETBACK FROM
C E '
NAME AND BRANCH SIDE PROP UNEOF ISTREETI
-�
HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF E%ISTING
ADDRESS CITY SIDE PROP LINE HIGH WAV WIDTH G
SO FT NO OF NO OF CHECK + V
SIZE STORIES FAMILIES ONE 1
O
DESCRIPTION OF WORK NEW PC Fee$ Permit Fee -15. 00�l r
[Lo U s e only ADD _ Issuance Fee .QQ
ALTER
compo shingle 12xig REPAIR Total Fee 22 . 00
USE OF DEMOL
EXISTING BLLLDG TEL
Z ,
APP ICAT
IPRINTLy. L . ndol NOL n
BY ISIGNATUR ,
>
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLKATION AND STATE uyY -
THAT THE ABOVE I5 CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES W ]• j
AND LAWS REGULATING BUILDING CONSTRUCTKMI I CERTIFY THAT IN DOING THE S o(S {r
WORK AUTHORIZED HEREBY WILL NOT EMPLOY ANY PERSON IN VIOLATION OF V ^
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN SCOM
PENSATION INSURANCE
SIGNATUREOF _
PERMITTEE \ "
ADDRESS �, •` o 0
[N7N
TY San GaHrlel , Ca . `
TEL 288.•40.4 _ n ' `a4 '
�D,p " > //- 6 -7Y'
S B� ���0 f}