HomeMy Public PortalAbout5827-5827 1/2-5729TEMPLE CITY BLVD_Building (2) 78A538A CE#8031.82 APPLICATION FOR BUILDING IJ
L INC PERMIT
COUNTY OF LOS ANGELES -TUILADD Els"se+� � pL� ?T
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY e---h)oi L r Ar '
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A.JENSEN,SUPT OF BUILDING CROSS ST. /J9S
As �riil '
FOR APPLICANT TO FILL IN DTRISCT N G�t//OUP COONN
o �' '� ST.
BUILDING c� STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS /�i+PL� G p /
CLASS. NO. DWELL.UNITS
LOT.NO. D BLOCK WATER NOT REQUIRED RECEIVED ❑
CERT I F I CATS:
TRACT MAP H 1 GH WAY
NO.OF BLDGS. ( NO. (�Q (CIRCLE) STATE MAJOR SECON ,LOCAL
SIZE OF LOT NOW ON LOT USE-ZONE SPECIAL.
EXISTING BLDG A- G USE OF
CONDITIONS
c �
OWNER A.7 ESTI /i /l,E�* BUILDINGEXIST
ADDRESS S 6 E/J/I�LLi (� f SETBACK YARD HWY STREET NAME If WIDTH
FRONT /
ARCHITECT OR TEL. P. L. I fo
ENGINEER NO. SIDE _
ADDRESS P L.
4
c
s�0p
CONTRACTOR ,I'"/�//r/I�v
ADDRESSljlq /V E c
F
DESCRIPTION OF WORK G
a
v
NEW ADD / ALTER REPAIR DEMOLISH z
SQ.FT. NO.OF NO.OF
SIZE ® STORIES FAMILIES
USEOF
STRUCTURE `.
SIGNATURE OF
APPLICANT �y
VALUATION $
APPROVALS DATE 1 SP€CTOR S SI G((ATURE
P.C. PMT FOUNDATION: LOCATION 7
FEE FEE $ (p c V V FORMS, MATERIALS ty':
FRAME: FIRE STOPS, {
1 HERE ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING, BOLTS p
AND STAT THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, "
WITH'ALL. COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS VIA
BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH, INT.
TION OF THE LABOR C OF THE STATE OF C IFORNIA RELA' p
ING TO WORKMEN'S C P SATION INSURANCE LATH,EXT. hog",
rw't A�}j", ,'r IF IAI
�-
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED G low/1 d l
ADDRESS i ° p� Av w q.
FINAL //. '' s ./'J 0 a•7
/�/J JOHN F. LEWIS. PRINCIPAL` TRS URALWENGINEER
PLAN CHECK VALIDATION 10.0}7 ( _ .PERMIT VALIDATION CK. M.O. CASH
LH[► 5 2 8 3 OCT 8 4 4 D. . .00 -•a
L& 5284% OCT 8 1 D 6.00cv
-
. �����