HomeMy Public PortalAbout5738-5738 1/2-5740TEMPLE CITY BLVD_Building (2) APPLICATION FOR
BUILDING PERMIT
FOR APPLICANT i BUILDING �y /
pz�+J F C( ADDRESS / ,
BUILD I �- OF
ADDRESS /G 3 r LOCALITY
5 NEAREST IF
CITY
G ` 7` ZIP CROSS ST.
NO.OF BLDGS. ASSESSOR
SIZE OF LOT / / NOW ON LOT F/I MAP BOOK PAGE PARCEL
TRACT 6 S G I BLOCK LOT TEL. �^/ DISTRICT Q GROUP CONST.v TYPE FIRE VM-717
OWNER" �1d/t 1'itvJL� NO. (� -Sr v �-
j STATISTICAL CLASSIFICATION.. SEWER MAP
ADDRESS /Ut Clr�v�/f �1'1i£ CLASS NO.��� JDWELL.UNITS BK//(O
G
CITY �rL� G/r6%( ZIP USE ZONE MAP
ARCHITECT OR TEL. 4e -3 -No. -100-7
ENGINEER NO. / .� SPECIAL
CONDITIONS
ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO E]CONTRACTOR V*^ ,/ T&flQ T O. e 325 BLDG.SETBACK FROM
7 �+ / �j Q FRONT PROP.LINE OF (STREET)
ADDRESS �} Y u/ /J¢ d 01 NO. J % S� _ TOTAL SETBACK FROM TYPE OF EXISTING
LIC HIGHWAY' + YARD - FRONT PROP.LINE _HIGHWAYJ WIDTH
CITY VAI AJ NV. S CLASS O 11toftf
CONSTRUCTION LENDER + = a
NAME AND BRANCH BLDG.SETBACK FROM CL
ADDRESSCITY SIDE PROP.LINE OF (STREETI
SQ.FT. N0.0F NO.OF 'CHECK HIGHWAY + YARD OTAL S CK FROM TYPE OF EXISTING �j
SIZE STORIES FAMILIES ONE SI ROP.LINE HIGHWAY WIDTH a
+ = Z
DESCRIPTION OF WORK NEW ❑
ADD ❑ CORNER CUTOFF YES ❑ NO ❑
ALTER EIIN OPEN SPACE YES ❑ NO ❑
USE OF REPAIR IN COASTAL PERMIT ZO YES ❑ NO ❑
EXISTING BLDG. DEMOL ❑
APPLICANT TEL
(PRINT) NO. .�+
BY(SIGNATURE) o-V14
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPCItAYION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES
AND LAWS REGULATING BUILDING CONSTRUCTION:I CERTIFY THAT IN DOING THE '
RK_AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF-
WO '
THE LABOR CODE OFTHE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM•
PENSATION INSURANCE.
SIGNATURE 0 � FINAL 7 -7'7 BY
PERMITTEE DATE
ADDRESS ?`33 S
CITI^REv a.* C,#, NO. 3 z r P.C.Fee$ Permit Fee J
Issuance Fee.
VALUATION$ ��'D - • 'c; • _n
Total Fee
PLAIN CHECK VALIDATION CK M.O. CASH " PERMIT VALIDATION CK. M.O. CASH
� m
3 4 5
M4 30 .1 01 1 2_0 0
BS 76A638B CE/8038 6/76