HomeMy Public PortalAbout5752TEMPLE CITY BLVD_Building (2) TEMPLE CITY_
76A638A CE 9803 3-69. APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF'COUN' Y ENGINEER ADDRESS
BUILDING AND SAFETY.DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS,,SUP'T OF BUILDING NEARESSCROSS T.
DISTRICT�1�.JQ GRO TYPE T.' PR spy..
FOR APPLICANT:.T.O FILL IN
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(PRINT OR TYPE ONLY) `! / (J
BUILDING' STATISTICAL CLASSI ICATION - . SEWER MAP
ADDRESS 5.7-52 Temple :t.-ft :. B 1 v . T.C• CLASS' N0. DWEL'L.UNITS BK' PG
LOT N0. BLOCK USE ZONE MAP.
NO. (/
TRACT• SPECIAL'
NO.-OF BLDGS. COND TIONS
SIZE OF LOT NOW;ON LOT
USE OF
EXISTING BLDG. BLDG. SETBACK FROM 771
TEL. FRONT PROP. LINE OF (STREET)
OWNER' N0. 285_471
TYPE OF EXISTING SETBACK HIGHWAY -+• YARD ' _ 'TOTAL..
ADDRESSHIGHWAY *WIDTH FROM C.L.
-9752 Temple City Rlvd - —
CITY + _ _
ARCHITECT OR f -TEL. DG.SETBA FROM
ENGINEER 'N0. SIDE PROP: LINE OF (STREET)
TYPE OF EXISTING .SETBACK HIGHWAY.•• YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM L.L.
.. _ . . - . .. .
Ran
CONTRACTOR TEL. +N0. _
40 ADDRESS529 E . Valle B1vdNo' 186086 CORNER CUTOFF YES :❑ NO E]
i
CITY . San Gabri el , Cal CLASS C-39 SEE REVERSE SIDE FOR-SPECIAL APPROVALS j
CONSTRUCTION LENDER j
NAME AND'.BRANCH I
I
ADDRESS
SQ. FT: NO. OF NO. OF ❑ .
SIZE STORIES FAMILIES NEW
USE OF ADD �.
STRUCTUREre-roof
ALTER
'mi s s i on ' ti 1 e re atr REPAIR �(
SIGNATURE OF DEMOL•
APPLICANT
VALUATION$500 . APPROVALS DATE INSPECTOR'S SIGNATURE
PMT. UNDATION:
FEE$ FEE.$ 9 .00 FO FORMS, MATERIALSN
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION FRAME: FIRE STOPS,
BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECTAND AGREE TO COMPLY FURNACE: LOCATION,
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUC- GAS VENT DUCTS
TION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I .
WILL NOT EMPLOY ANY PERSON Mx;�I!x
F THE LABOR CODE LATH, INT.
OF THE STATE OF CALI RN A, OM-
PENSATION INSURANC
LATH, EXT.
SIGNATURE HOUSE NUMBER'CORRECT
PERMITTEE AND POSTED
ADDRESS 1 ey Blv.d. SanGab FINAL
JOHN F. LEWIS, PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH - PERMIT VALIDATION CK. M.O. CASH
- 4 3 APR 1 -D �.
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