HomeMy Public PortalAbout5853 TEMPLE CITY BLVD_Building (2) 16A688A CE AW 10-38 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING !
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST.
DISTRICT NO. GROUP �pE P ESSED:HY
FOR APPLICANT TO FILL IN I CONST.
I STATISTICAL.CLASSIFICATION S ER MAP
BUILDING dj — I BK P _
ADDRESS .�77 C 'CLAS NO. WELL.UNITS�1
7f MAP
LOT NO.' BLOCK NUMBER '� H ATE YES NO 4 §1
SPECIAL"
' TRACT USE ZONE -
NO OF BLDGS CONDITIONS
SIZE OF LOT I NOW ON LOT (�
USE OF
EXISTING ''� �' UILDING YARD HWY STREET NAM EXIST.
SETBACK WIDTH
V OWN I FRONT
MAIL [j77' P.L.
ADDRESS J(p pLL+' SIDE
TEL. P.L.
CITY No. INSPECTION RECORD.
ARCHITECT OR TEL.
ENGINEER- NO.
ADDRESS I
TF
CONTRACTOR
ADDRESSS r '
DESCHIPTIOTJ OF WORK
NEW ADD ALTER . REPAIR DEMOLISH
N SQ.FT. NO.OF NO.OF
SIZE STORIES FAMILIES
USE OF
ST CTURE: / C
SIGNATURE OF
APPLICANT
r- � APPROVALS DATE INSPECTOR'S SIGNATURE
ADDRESS S a J 2 iC FOUNDATION:LOCATION
FORMS,MATERIALS
VALUATION-S i ' FRAME:FIRE STOPS.
BRACING,BOLTS
P.C. MTFURNACE:LOCATION:
FEE $ I FEE I GAS VENT.DUCTS
I HEREBY ACKNOWLEDGE THAT I AVE'READ THIS AP- LATH.INT.
PLICATION AND STATE THAT THAT IS CORRECT AND
AGREE TO COMPLY WITH ALL COUljTV ORDINANCES AND
STATE LAWS REG LA ING BUIL CONSTRLICTIO LATH.EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTE t RECT AND POSTED
ADDRESS' af=4 FINAL
CLYDE N.DIRLAM.9RINCIPAL *1RUCTURAL E SER
PLAN CHECK VALIDATION CK. M.O. CASH 'PERMIT VALIDATION CK M.O. CASH