HomeMy Public PortalAbout5822TEMPLE CITY BLVD_Building (2) 76A638ACE08098-64 APPLICATION FOR BUIL ING PER �J
COUNTY OF LOS ANGELES BUILDING �y
DEPARTMENT OF COUNTY ENGINEER . _ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY f
JOHN A. LAMBIE-. COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS¢UP•T.OF BUILDJNG CROSS ST.
DISTRICT N GROUP TYPE. PR BY
FOR APPLICANT T-0 FILL IN , 09. CONST.
BUILDING /J,,,,yq STATISTICAL C A SIFICA "ON SE ER MAP
ADDRESS /� V�J��� CLASS NO. DWELL
/UNITS PK PG
•LOT NO. BLOCK USE
ZONE NO. �V V
TRACT to S (/�� SPECIAL
N0. OF BLDG$. l! CON I IONS
SIZE OF LOT N0W-ON LOT
USE OF
XI'TING
BLDG. SETBACK FROM
TEL. may/ PRON T PROP. LINE OF (STREET)
OWNER `YwY�I O. d V TYPE OF EXISTING -SETBACKHIGHWAY YARD = TOTAL
HIGH Y WIDTH 'FROM C,j
r BLDG. SETBACK FROM
.ARCHJTECT OR TEL.
•E'IQGINEER NO. SIDE PROP. LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY- •I- YARD = TOTAL
HIGHWAY WIDTH FROM C.L. O.
AbDRESS. pC
•CONTRA'CTO7RA / NOL G..4� + L,
G%J
ADDR.ESS `Cr/-�✓ L C ` 13i CORNER CUTOFF YES E] NO C
cl .ir ao3 LIC / SEE REVERSE SIDE FOR SPECIAL APPROVALS w
DESCRIPTION OF WORK o
NEW ADD ALTER EPAI DEMOLISH � !! a// /.5 Aoly
SQ.FT. NO. OR NO. OF
SIZE STORir FAMILIES.
USE OF �
G. �GI GGA/ c/ ! e° r •F
STRUCTURE ` r
SIGNATURE OF �j�,
APPLICANT /17
VALUATION$ ``o-�lf APPROVALS DATE INSP ECTORISSI8NATURE
PIAT ,per FOUNDATION, LOCATION
FEE$ 'FEE•$ FORMS,-MATERIALS
FRAME, FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT (Y/
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS
9UILDINa CONSTRUCTION. I 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.W.ORKMEN'S CnMPENSATION INSURANCE. -LATH. EXT.
SIGNATURE OF HOUSE NUMBER COR-.
PERMITTEE R AND POSTED
ADDRESS FI NAL
JOHN F. LEWIS. PRINCIPALS URAL ENGINEER
PLAN CHECK VALIDATION . CK.. M.O. CASH _ PERMIT VALIDATION CK. M.O.. --CASH
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