HomeMy Public PortalAbout5611TEMPLE CITY BLVD_Building 76ASSBA CEM603 3-68 ,
APPLICATION FOR BUILD( G PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVLSION LOCALITY
JOHN A LAMBIE, COUNTY ENGINEER NEAREST
COLEMAN W JENKINS, SUP T CF BUILDING CROSS ST
DIST CT NO G P- TYPE P OC
FOR APPLICANT T FILL IN O coNST
(Print ort . only)
BUILDING IST.TISTICAL CLA (FICA TION S ER MAP
ADDRESS ' CLASS NO DWELL UNITS_ BK PG
LOT NO BLOCK USE ZONE MAP O JI
NO (/
TRACT JfI SPECIAL
NO OF SLOGS CONDITIONS
SIZE OF LOT NOW IN LOT
USE O
EXISTING BLD TZ-3
TBACK FROM
EL — ROP LINE OF —(STREET)
OWNER NOISTIHG SETBAOK HIGHWAY + YARD ^ — TOTAL
A DOR E59 WIDTH FROMGL
TBACK FROM
ARCHITECT TELP LINEOF (STREET)
ENGINEER NO (STING SETB.CK HIGHWAY RO = TOTAL
ADDRESSWIDTHFROMTELNTRALTO NO +LADDRESS NO(� CORNER CUTOFF YES ❑ NOCITU cLCA,ssEVERSE SIDE FOR SPECIAL APPROVALS
DESCRIPTION OF WORK a
z
NEW ADD ALTER REPAIR DEMOLISH
SO FT NO OF NO OF
SIZE STORIES F MILIES
USE OF
STRUCTURE
SIGNATURE OF
APPLICANT
VALUATION 5
APPROVALS DATE Ixeru Ton•..I6xw TU R[
P C PMTFOUNDATION LOCATION
FEE S - A FEE S FORMS MATERIALS
FRAME FIRE STOPS
1 HERESY ACNNOWL[DO[ THAT I HAVE HEAD THF{ ATLICATIOH BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AHD 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
AUTHORISED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA
LATH INT
TION OF THE "no" CODE OF THE STATE OF CALIFOIINIA RELAT
ING TO WORK M[N S MPENSATION I RANCE
LATH EXT
SIGNATURE 10 HOUSE NUMBER CDR
-
PERMITTEERECT AND POSTED
ADDRESS FINAL / C>
PLAN CHECK VALIDATION CK yp cABN JOHN F LEWIS P NCIPAL ST URAL ENGINEER
PERMIT VALIDATION CK No CASH
- r
4 0 5 042 I I'Ia 12 1 0 9.0 0'