HomeMy Public PortalAbout5411TEMPLE CITY BLVD_Building r
TENKS-.CITY
7eA6MA CE bem=„ APPLICATION FOR BUILDING' PERM T
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS —
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST
WILLIAM A JENSEN SUP T Or BUILDING CROSS 5T
OISTRT F P TY P ESSED BY
FOR APPLICANT TO FILL IN CONST
BUILDING STATISTICAL CLASSIFICATION EWER MAP
ADDRESS .4'1
C �r0 ` CLAS$ NO DWELL UNITS K
LOT NO BLOCK WATER NOT REQUIRED RECEIVED
CERTIFICATE
TRACT MAP q. IGHWAY STATE MAJOR CO D LOCAL,
NO OF BLOG6 N01�ci O ICIRELEI
SIZE OF LOT NOW ON LOT USE ZONE SPECIAL
USE OF CONDITIONS
E%ISTING BLDG J G
TEL
OWNER NO BUILDING YARD HWY EET NAME EXIST
SETBACK WIDTH
ADDRESS � //Qi(E C V � FRONT
ARCHITECT OR TEL P L
ENGINEER NO SIDE }
P L d
ADDRESS
TEL LC//i1.!♦ O
CONTRACTOR NO
ADDRESS / W
DESCRIPTION OF WORK
3 "
NEW ADD ALTER REPAIR DEMOLISH t) C Z
No
5SO 2ET .2YA STORIES FAMIOLIES �+ ` V J A OLY w.VRY� _
USE OF
STRUCTURE / buH /� - eel
SIGNATURE OF ` v
APPLICANT /
VALUATION S B ^
APPROVALS DATE ry R S SIGNATURE
PCPMT n FOUNDATION LOCATION
F E S �— FEE S Z FORMS MATE IALS
FRAME FIRE STOPS Q
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLT$ O
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT
TION OF THE LABOR CODC OF THE STATE OF CALIFORNIA RELAT
ING TO WORKMEN S COMP SATION INSURANCE
LATH EXT Ell vt
SIGNATURE OF HOUSE NUMBER COR
PERMITTEE / �irYl RECT AND POSTED
ADDRESS T4// yQ BLVD 7�MHECJN FINAL M�
JOHN F LEWIS PR NCI AL STRUCTURAL ENG
PLAN CHECK VALIDATION CK MO CASH _ PERMIT VALIDATION CK NO CASK
LF& 4 1 8 7� JAN 8 1 D 2 2.0 0'