HomeMy Public PortalAbout5827-5827 1/2-5729TEMPLE CITY BLVD_Building IGAS88A CE#808._8_67 APPLICATION FOR BUILDING PERM IT ],
COUNTY OF'LOS ANGELES BUIILMIIIN .S�"g-Z 7 ",
ADDRESS
DEPARTNIENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A.LAMBIE,COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN,Sup T Op BUILDING CROSS ST.
DISTRICT NO. GROUPSEWER MAP '
FOR APPLICANT TO FILL IN TYPE BK PG
BUILDING q,
CONST.
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ADDRESS o STATISTICAL CLASSI KATION
3 CLASS.NO. 'DWELL.UNITS
LOT NO. BLOCK MAP J7STATE YES
jAO
NUMBER � HWY.
TRACT USE ZONE SPECIAL
NO.OF BLDGS. CONDITIONS
SIZE OF LOT NOW ON LOT
USE OF
EXISTING BLDG. BUILDINGEXIST.
�/ SETBACK YARD HWY STREET NAME WIDTH
OWNER �C!{�., / �' -c�. FRONT
MAILADDRESS 6 Zl 7T ,ems /w_ SIDE
�J TEL. P.L.
CITY70'w" f� 0, NO.
ARCHITECT OR olool TEL. INSPECTION RECORD
ENGINEER NO.
ADDRESS
CONTRALTO W r TEL
S - + t4g' .A ` ~
Lo
ADDRESS /
DESCRIPTION OF WORN a' \ F-,N �hR•- 0.\o �.a C? 1,.��►�2 6��.e..-
NEW ADD ALTER REPAIR DEMOLISH ..
SQ.FT. NO.OF NO.OF �� L �hx, V twi .
SIZE STORIES FAMILIES
USE OF STRUCTURE 4.� Qo�., C A.WC V,
SIGNATURE O APPROVALS v
APPLICAN/T� DATE INSPECTOR'S SIGNATURE
ADDRESS �� �� �'�� OUNDATION: LOCATION
FORMS,MATERIALS
P.C. $ FRAME: FIRE STOPS.
�v FEE /�"/�V BRACING,BOLTS
VALUATION $ �"C FURNACE: LOCATION.
FEE GAS VENT.DUCTS
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH.INT..
PLICATION AND TE THAT THEA O IS CO T AND
AGREE TO CO LY 1 ALL CO OR A ES AND
STATE LAW R NG B RU%C LATH.EXT.
SIGNATURE.OF r�! - HOUSE NUMBER COR-
PERMITRECTAND POSTED 11 11
ADDRE FINAL
JOHN A.LAMBIE•COUNTY ENGINEER. CLYDE N.DIRLAM,PRINCIPAL STR URAL ENGINEER
PLAN CHECK VALIDATION. CIC, da.O. ' CASH PERMIT rALIDATION(5,d m.o. CASH
LAC04 0-1 2 09 AUG 19 1 A 4.0 0 ko