HomeMy Public PortalAbout5822TEMPLE CITY BLVD_Building 7GA636A CE#B033-66 UL ,FeAPPLICATION FOR B I DI . PERMI' 1
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING-AND SAFETY •DIVISION LOCALITY
JOHN A.LAMBIE'. COUNTY ENGINEER NEAREST
COLEMAN W. JENKINSAUP•T OF BUILDING CROSS ST.
DISTRICT O. . •= OUP TYPE BY
FOR APPLICANT TO FILL IN CONST.
BUILDING STATISTICAL CLASS( (CATION SEWER MAP
ADDRESS g-2 Z C�!/'OLe. G� L.✓� CLASS NO. DWELL UNITS BK PG
LOT NO. BLOCK- US•E"ZONE AP • ' '
TRACT NOS. V
12 jZ6 SPECIAL
N0. OF LOSS.
SIZE CONDITIONS
SIZE OF LOT
USE OF y1
EXISTI �" G L'&_ .W 0'0-S
- BLDG. SETBACK FROM'
TE PRONT PROP. LINE'OF (STREET)
OWN- NO- ?Z23TYPE OF EXISTINOt ---BACK HIGHWAY:' YARD - TOTAL
ADDRESS R4�c^ (-w D HIGHWAY W 'F M C.L. -
CITY. 7,anhllwaL _ L /Q BLDG:,SETBACK.FpOM
ENGINEER
NO.EOR TEL. SIDE PROP. LINE OF (STREET)
ENGINE
TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL.
ADDRESS - HIGHWAY WIDTH PROWC.L.
CONTRACTOR/ . L ( lV ,,,, NO {
AD'DRES$/ /-Ccf ex- 2140 �D p - CORNER CUTOFF• YES NO C
CITY&L LIC SEE REVERSE SIDE FOR SPECIAL APPROVALS c
DESCRIPTION OF WORK t
f- f-14 is EL J-- '�S6 3b
cr
EWADD ALTER REPAIR DEMOLISH �) , !
.FT. _ NO. OF NO. OF 6'VITIGA/ rd
SIZE STORIES FAMILIES
USE OF I ` >
STRUCTURE
SIGNATURE
APPLI:CAN
VALUATION i •1 I I.,DI O I �QQ
'APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. PMT, FOUNDATION, LOCATION
FEE$ FEE$ FORMS,MATERIALS -
FRAME, FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT
AND STATE THAT THE ABOVE IS CORRECT'AND AGREE TO COMPLY FURNACE: LOCATION -
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS,
SUILDI NO CONSTRUCTION. 1 CERTIFY THAT. IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. '
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT-
ING TO WORKMEN'54fllftENSATION'INSURANCE. LATH. _EXT. '
SIGNATURE HOUSE NUMBER COR-
PEIRMITTEE RECT AND POSTED
ADDRESS FINAL
JOHN F.�L�E�WIS. PRINCIPAL STIR RAL ENGINEER
PLAN C lECK VALIDATION CK. M.O. CASH PEIMii• VAMATION CK. M.O' CASH
7 5 0 4 1�. MAR 8 1- D 6.0 Q '
• -