HomeMy Public PortalAbout5853 TEMPLE CITY BLVD_Building MAMA CIE#8032/60 APPLICATION FOR BUILDING PERMIT_ 1
COUNTY OF LOS ANGELES BUILDING ;
DEPARTNIENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN SUPT OF'BUILDING CROSS ST.
FOR APPLICANT TO FILL IN DIS�CT NO GR I TYPE ES'g5p BY
1 O CONST. L
BUILDING C� Q p�1���/'`jam, cp v� STATISTICAL CLASSIFICATION S BK' MAP
ADDRESS S S , 1V 1. l 7 4� BK'
CLASS.NO. yA�WELL.UNITS
LOT NO. Cs` BLOCK- MAP NUMBER V STATE YE NO
TRACT USE ZONE SPECIAL
NO.OF SLDGS. n CONDITIONS
SIZE OF LOT I NOW ON LOT
USE OF
EXISTINGBLDG. BUILDING YARD HWY STREET NAME' EXIST.
TEL. SETBACK WIDTH
OWNER - Sc_• V�c NO. FRONT O
ADDRESS ? SIDE
ARCHITECT OR TEL. P.L.
ENGINEER NO.
ADDRESS 1AiSPECTION RECORD
1 TEL. r _�
CONTRACTOR (RFL-O • / C _NO. /� �(/��n/ .,�f�./�' W
r0
ADDRESS 130
DESCRIPTION OF WORK 0
• H
NEW ADD ALTER REPAIR DEMOLISH
SQ.FT. NO.OF NO.OF Qt
SIZE STORIES I FAMILIES
USE OF
STRUCTURE �w N I 16( g.
SIGNATURE OF
APPLICANT
VALUATION$ 60
APPROVALS DATE INSPECTOR'S SIGNATURE
FOUNDATION:LOCATION
F E $ '� FEE $ _ FORMS,MATERIALS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FRAME:FIRE STOPS,
BRACING BOLTS
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND FURNACE:LOCATION,
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND GAS VENT,DUCTS
STATE LAWS REGULATING BUILDING CONSTRUCTION.
1 CERTIFY THAT IN DOING THE WORK AUTHORIZED 1 LATH,INT.
WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
WORKMEN'S COMPENSATION LAWS OF iFORNIA. LATH,EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTE RECT AND POSTED
ADDRES 1 '3j 6 /Z INAL J �" /V t r/�'Z'oY t'7
N. DIRLAM, PRINCIPAL STRUCTURAL EN EER
PLAN CHECK VALIDATION ' , CLYDE PERMIT VALIDATION cK, m.o.
cnsR
Lr 602903%-03 APR LI. 4 4 U ,C1 0�
AW 4 _7..1. I AY 2 1 D 4.t'�:�'� ®F