HomeMy Public PortalAbout5834TEMPLE CITY BLVD_Building 76A63�A CE#803 5-65 APPLICATION F
OR BUILDING PERMIT
COUNTY OF LOS ANGELES- BUILD)NG�-
DEPARTMENT OF COUNTY ENGINEER A D D R E 99�+' ;
BUILDING AND SAFETY DIVISION LO C A LI T / I
JOHN A. LAMBIE. COUNTY ENGINEER _ NEAREST
COLEMAN W. JENKINS.SUP'T OF BUILDING CROSS ST ge
-
DIS ICT N GR TYPE, P O S
FOR APPLICANT TO FILL IN y CONST.
BUILDING ns STATISTICAL CLAS IFICATION SEWER"MAP-
ADDRESS 3 El"� Lk� �/� B{t PG ;;.
CLASS NO.- Z22 WELL UNITS
LOT NO. - BLOCKUSE ZONE NMA
OP Q -
TRACT SCPECIAL
NBLDOS.�e n ONDITIONS
SIZE OF LOT fir/ --"1-011 LOT
USE OF •'
EXIS NG BLDG. SAN*4ILKI 104 BLDG. SETBACK FROM - --
`�/`�,` FRONT PROP. LINE OF
OWNER ` d& TYPE OF EXIST IN SETBACK HI W91Y YARD = I-TOTAL
ADDRESS HIGHWAY WI DT 'ROM C.L.
CITY BLDG. 9E ACK FROM,
ARCHITECT OR TEL.
NGINEER NO. SIDE PR LINE OF _ (STREET).
E _
TYPE' EXISTING SETBACK HIGHWAY •}• -.YAAU' TOTAL
ADDRESS _- HIGH AY WIDTH FROM C.L. ••
CONTRACTO �ppL�AO. NO �OS +
Ass Lp• `�ICr7� � CORNER CUTOFF YES 1:1NO' E] - 0
ADDRESS
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CITY LIC LASS.4. SEE REVERSE SIDE FOR SPECIAL APPROVALS -FO
DESCRIPTION OF WORK ti
H
NEW ADD ALTER RE.PAI DE OLISH Z
SQ,FT. NO
...OF NO. OF `
SIZE �' STORIES FAMILIES - - -
USE OF
STRUCTURE
SIGNATURE OF
APPLICANT
VALUATION$ APPROVALS DATE INSPECTOR'S SIGNATURE'
P.C. PMT. FOUNDATION, LOCATIONS
FEE$ FEE$ FORMS, MATERIALS -
FRAME, FIRE STOPS,
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION -
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS -
13UILDING CONSTRUCTION. I CERTIFY THAT. IN DOING THE WORK
AUTHORIZED HEREBY'1 WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT.
TION.OF THE LABOR COOL'OF THE STATE OF CALIFORNI RE _
ING TO WORK PENS `ATION NSURA�NCE. LATH. EXT. -
SIGNATURE \ �l HOUSE NUMBER COR-
PERMITTE V RECT•AND POSTED.
ADORES SF I NAL f
l.i
JOHN F. LEWIS. PRINC'IPAL_ST UC RAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH _ - -PERMIT VALIDATION CK. M.O CASH
Ul��so 4 2371.0 AUG! 9 1 -D :: .4,0 0-
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