HomeMy Public PortalAbout5426TEMPLE CITY BLVD_Building (2) T6weaBAu#eo I BZ A�CATION FOR BUILDING PE MIT
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 OF BUILDING ;ROSS ST
DISTRICT NO GROUP E P SEED BY
FOR APPLICANT TO FILL IN :5 CONST
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BUILDIN�G��• STATISTICAL CLASSIFICATION SE ER MAP
ADORES
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CLASS NO DWELL UNITS �—
LOTNO CB OC WATER NOT REQUIRED RECEIVED
CERTIFICATE 11
TRACT y�p�— MAP HIGHwwv
SIZE OF LOT p/� NNO OEL OW ON LOTS NO ,CIRCLET STATE MAJOR CON LOCAL
USE ZO E SPECIAL
USE OF / iJ'T CONDITIONS
EXISTING BLDG /�/��JY //Q� 1/LJI�' ��iX /✓,(7./
OWNE XQ / Q/Y TNIyJ BUILDING YARD HWY STREET NAME EXIST
SETBACK WIDTH I
ADDRESS e FRONT
ARCHITECT OR TEL P Lzgdzbog
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ENGINEER NO SIDE
P L Y
ADDRESS
CONTRACTO O
ADDR ^ f��fl BL
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DESCRIPTION OF WORK , >> l V)
NEW ✓ADD ,O ALTER REPAIR DEMOLISH ` y
50 FT NO OF NO OF /.� ,
SIZE �1 STORIES FAMILIES
USE
C STRUCTURE ZO
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SIGNATURE OF
APPLICANT-
VALUATION
PPLICANT �p
VALUATION
APPROVALS /(DATE. INxEGToR as`%NATURE
PC PIVIT FEE $ FEE $ / _ FOUNDATION LOCATION
FORMS ATE ALS O
FRAME PS
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATIO BRAC B ,
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITH ALL COUNTY ORDINANCE6 AND STATE LAWS REGULATING GAS VENT DUCTS /
BUILDING CONBTRUCTION I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT
ING TO WORKMEN 6 COM TION IN6URA CE
LATH EXT •/,)
SIGNATURE OF %9HOUSE NUMBER COR //
PERMITTEE REGI AND POSTED I
ADDRE FINAL I
PLAN CHECK VALIDATION CK Mo CASHJOHN F LEWIS RI CIP L STR RAL ENGINEER L
PERMIT VA XiAT16N CN M O CASH
L,f,o 9 7 1 3 JAN 16 1 D 1 1 .5 0~ v