HomeMy Public PortalAbout5820-5820 1/2TEMPLE CITY BLVD_Building luau hos?/go APPLICATION FOR BUILDING PERMI`I" 1
COUNTY OF LOS ANGELESBUILDING • 1 t
DEPARTMENT OF COUNTY ENGlNM ADDRESS
BUILDING-AND SAFETY DIVISION- LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEE€t NEAREST
WILLIAM A.JENSEN SUPT OF BUILDING CROSS ST.-
DIST ICT N,, GROUP TYPE P SED BY
FOR APPLICANT TO FILL IN_ �; CONST.
BUILDING .✓' STATISTICAL'CLASSIFICATION. SE ER MAP'
ADDRESS "BK
�r CLASScNO. DWELL.UNITS
LOT NO. % BLOCK MAP NUMBER �i�(0 STATE YES
TRACT USE ZONE SPECIAL
NO.OF BLDGS. CONDITIONS
SIZE OF LOT I NOW ON LOT
USE OF -
EXISTING BLDG. BUILDING EXIST.
TEL. YARD HWY TR ET NAME
SETBACK WIDTH.-
OWNER O. (� -FRONT �+
P.L.
ADDRESS SIDE '
ARCHITECT OR TEL. P.L.
ENGINEER No. INSPECTION RECORD
ADDRESS
TE—Le, a
CONTRACTOR NO — /y y� } O
ADDRESS 2/ ,t `Af — .4 � 21 /_'�K,ZAP, ,0 ^U
DESCRIP ON OF WhElk ('�f // /.IV?' G14 2!t' /AI
NEW ADD ALTERREPAIR DEMOLISH
SQ.FT. OF NO.OF 'an
SIZE 6
USE OF STORIES FAMILIES ' r l 1 ��Lt/SPP �I �F L I AIL . z
STRUCTURE `G v _ p
SIGNATUREOF11-2 o-A-eiIAl n J !•' 1
APPLICA / � ) ,j F C�(�D
;; -No-
VALUATION$ ,
APPROVALS DATE INSPECTOR'S SIGNATURE
FOUNDATION:LOCATION --------- .
FEE '$ -FEE $ FORMS,MATERIALS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FRAME:FIRE STOPS, / O ✓�/t/� y�////�
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND BRACING BOLTS / /)l�� C CJ�Y
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND FURNACE:LOCATION,
STATE LAWS REGULATING BUILDING CONSTRUCTION. GAS VENT DUCTS
I CERTIFY THAT IN DOING THE WORK AUTHORIZED I LATH;INT.
WILL NOT-EMPLOY ANY PERSON IN VIOLATION OF THE
WORKMEN'S COMP TIO LAWS OF FO IA. LATH,EXT.
-SIGNATUF HOUSE NUMBER COR-
R94 -
PERMITT RECT AND POSTED
ADDRESS FINAL
CLYDE N. DIRLAM, PRINCIPAL ST CTU L ENGINEER
PLAN CHECK VALIDATION cK.- M.o. .cAsH PERMIT VALIDATION cK. m.o. cAsH
��k o 2 5 1 � JUL 29 1 D 9.(-. o