HomeMy Public PortalAbout5472TEMPLE CITY BLVD_Building (2) Y f
l�
TeeeeeA¢aemxo APPLICATION FOR BUILDING P MIT
COUNTY OF LOS ANGELES BUILDING l
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST
WILLIAM A JENSEN SUP T OF BUILDING CROSS ST /
DIST;r p GROUP TYPE SSED BY
FOR APPLICANT TO FILL. IN !/ CC/ CONST
BUILDING / i STATISTICAL CLASSIFICATION S ER MAP
ADORES �T O� -� K P
CLASS N DWELL UNITS
LOT NO BLOCK WATER
CERTIFICATE NOT REQUIRED ❑ RECEIVED
TRACT Z MAP q'�� HCCRHcwe1 STATE MAJOR ON LOCAL
Q O �[ [�/ NO OF SLOGS NO Off'(/
SIZE OF LOT /- V ( NOW ON LOT USE ZONE SPECIAL
USE TI CONDITIONS
EXISTING BLDG
TEL
OWNER O NO BUILDING EXIST
!, - } r SETBACK YARD HWY STREET N E WIDTH
ADDRESS i7 / C� FRONT
ARCHITECT OR TEL P L
ENGINEER NO SIDE
P L",
ADDRESS / /� O
TE
CONT RACTO NO 4 - / � _-- /J � w
ADDRESS S / '/f —0
DESCRIPTION OF WORD
NEW ADD ALTER REPAIR DEMOLISH
FT NO I NO OF' I, -
SIZE ORIES AMILIE6
USE OF
STRUCTURE _
SIGNATURE OF {
APPLICANT
VALUATION S ��'� '�'
APPROVALS DATE INSPECTOR SIGNATURE
PC PMT FOUNDATION OCATIO ,(
FEE S P— `FEE S FORMS IA S /
.FRAME FI i
- 1 HEREIY ACKNOWLEDGE,THAT 1,HAVE READ THIS APPLICATION BRACIN /
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LIOCSTION
WITH ALL COUNTY ORDINANCES ANO 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 COOC OF THE STATE OF CALIFORNIA RELAY
INC TO WORKMEN S COMPENSATIONINSURAI E LATH EXT
SIGNATU � HOUSENUMBER COR
PERMITTI RE CT
AND POSTED
ADDRESS" �Q `1/ �n Q /� FINAL
JOHN F LEWIS PffNCIPAI 5TRLICTURAL E
PLAN CI-IECR VALIDATION CK MO CASH _ PERMIT VAIRATIOff cK mo cASH
L,10829 '9: AliG 1 . 1 D 5.0 0Ev
-