HomeMy Public PortalAbout5430TEMPLE CITY BLVD_Building 76A638A CE9803565 APPLICATION FOR BUILD) G FERMI
COUNTY OF LOS ANGELES BUILDING S- O
DEPARTMENT OF COUNTY ENGINEER ADDRESS A
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST c
COLEMAN W JENKINS SUP T OF BuILOING CROSS ST
OIS CT O O TYPE P B
FOR APPLICANT TO FILL IN CONST
BUILDING�• STATISTICAL SSIFICATION SE MAP
ApDRESSy 10 T� CLASS NO DWELL UNITS BK pG �/
LOT NO BLOCK USE ZONE MAP O -
I ^/ NO
ae� ,I�`/ SPECIAL
NO OF SLOGS CONDITION
SIZE OF L O NOW ON LOT
USE OF
EXISTING BLDG. BLDG SETBACK FROM
FRONT PROP LINE OF (STREET)
TYPE OP EX12TINO SETBACK HIGHWAY YARD = TOTAL
S _ HIGHWAY FROM C L
+ _
C
BLDG SETBACK FROM
RCHITEC R TESIDE PROP LIKE GF (STREET)
ENGINEE NOTYPE OF EXISTING 5[TOACK XIGX WAY + YARD = TOTAL
ADDRESS / HYPE
WIDTH FROM C L
TE +
T NO
LICCORNER CUTOFF YES ❑ NO ❑
ADDRESS NO
LICSEE REVERSE SIDE FOR SPECIAL APPROVALS
DESCRIPTION OF WOi
NEW ADD ALTER REPZ
91 F T�O + O F
SI 2 E _
USE OF
STRUCT,Ojpp 76
Is a
SIGNATURE OF
APPLICANT
VALUATION$__;, � E
APPROVALS DATE INSPECTOR'S SIGKATURE
FOUNDATION LOCATION
FEE$ FEE$ 0`0 FORMS MATERIALS
FRAME, FIRE STOPS
I HEREBY ACKNOWLCOG[ THAT I HAVE READ THIS APPLICATION BRACING BOLT
AND STATE THAT TH[ ABOVE 18 CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
9U LOI NG CONSTRUCT)ON I CERTIFY THAT IN DOING THE WORK
AUTHORIZED H[REpY WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT
TION OF THE LABOR COOC OF THE STAT[ OF CALIFORNIA RELAT
ING TO WORK M�EEN/B COMPENiATIO SUR ANCE LATH _EXT
SIGNATIi!¢l HOUSE NUMBER COR-
PERKU'TTEEEEEE RE AN POST
A114 ' FINAL
JOHN
�+Fp�LEWIS
� PRR/I�NCIPAL ST RAL ENGINEER
PLAN CHECK VALIDATION CK MO CASH _ PERMIT •AIIDATIO CK MO CASH
LACp 8 5 4 3 Z8 JAN 5 ID 6.0 0 a