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HomeMy Public PortalAbout5849TEMPLE CITY BLVD_Building (2) TEMPLE CITY vi L MANNA CE#9G9-.1-61 APPLICATION FOR BUILDING PE MIT -COUNTY OF LOS ANGELES BUILDING L DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST WILLIAM A.JENSEN SUPT OF BUILDING CROSS ST. DISTRICT NO. %1P TYPE SSED BY FOR APPLICANT TO FILL IN ;' J4 �r CONST. 2 r BUILDING 4 ��fI� STATISTICAL CLASS !CATION SEWER MAP ADDRESS V BK PG --CLAS.NO. DWELL.UNITS "� / `L LOT NO. BLOCK WATER NOT REQUIRED RECEIVED CERTIFICATE: TRACT r MAP HIGHWAY STATE MAJOR(SEI LOCAL NO.OF BLDGS. NO. (CIRCLE) SIZE OF LOT. I NOW ON LOT USE ZONE SPECIAL USE OF /I y CONDITIONS _EXISTING BLDG. / L OWNER/I fj� SlI0_FNO. 4A CV, SETBACK WIDTH ADDRESS '!, YARD HWY ST E T NAM FRONT ARCHITECT OR TEL. P.L. J ENGINEER NO.. SIDE ADDRESS INSPECTION RECORD °'O TEL. CONTRACTOR NO. V ADDRESS O DESCRIPTION OF WORK 0 W ' a NEW ADD ALTER REPAIR DEMOLISH h SQ.FT. NO.OF NO.OF ? SIZE STORIES FAMILIES USE OF ST CTURE i GNATUR OF APPLICANT VALUATION�� I APPROVALS DATE INSPECTOR'S SIGNATURE P,C. PMT. ,q� FOUNDATION:LOCATION FEE $ FEE v I/ FORMS,MATERIALS FRAME:FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS ' AND STATE'THAT THE-ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE:LOCATION. WITH•ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK , AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- LAThI,-INT. TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- ING TO WORKMEN'S CObJEENSATION IN RANCE. LATH,EXT. - / SIGNATURE OF HOUSE NUMBER COR' 1 /' / j� PERMITTE RECT AND.POSTED (l /n sT�jf� ADDRESS FINAL CLYDE N. DIRLAM. ERINCIPAL'STRU URAL ENGINEER PLAN CHECK VALIDATION cK. m.o. cAsil PERM VALIDATION 'A.". M.O. CASH L,n.! 0 4 9 5 0 APR 4 1 *1� 3.0 0 • r