HomeMy Public PortalAbout5855 TEMPLE CITY BLVD_Building W696A dIi4o92/66 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING GG r r
DEPARTMENT OF COUNTY ENGDIEER ADDRESS
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BUILDING AND SAFETY DMSION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A.JENSEN SUPT of BUILDING CROSS ST: .� -
DfSTRI NO GROUP TYPE PROCES BY
FOR APPLICANT TO FILL IN Imo' CONST.
BUILDING ` STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS 6 BK PG
CLASS.NO. DWELL.UNITS-]
LOT NO. BLOCK MAPS
YES O'
NUMBER X00. HWY.
TRACTUSE ZONE SPECIA
NO.OF BLDGS. CONDITIONS
SIZE OF LOT IN ON LOT "9_
USE OF 6�
EXISTING BLDG. BUILDING YARD STREET NAME EXIST.
TEL. SETBACK WIDTH.
OWNER O, FRONT I'
�� �- PL.
ADDRESS. SIDE � '
ARCHITECT ORTEL./.. P.L.
ENGINEER I -- No. ` ANS CTION RECORD
ADDRESS
TEL.
CONTRACTOR NO. O
ADDRESS
- V
DESCRIPTION F WORK
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EW D ADD ALTER REPAIR DEMOLISH
SQ.FT. NO.OF ' NO.OF
SIZE STORIES FAMILIES N
USE OF
STRUCTURE
SIGNATURE OF f
APPLICANT
VALUATION
APPROVALS DATE INSPECTOR'S SIGNATURE
FE $ FPMT
EE $ .� � FOUNDATION:LOCATION
E
FORMS,MATERIALS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FRAME:FGRE STOPS,
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND BRACING,BOLTS
FURNACE:LOCATION,
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATE LAWS REGULATING BUILDING CONSTRUCTION. GAS VENT DUCTS
I CERTIFY THAT IN DOING THE WORK AUTHORIZED I LATH,INT.
WILL NOT EMPLOY ANY.PERSO IN VIOLATION OF,THE
WORKMEN'S COMP 7NSA. Q LA OF�FORNIA. LATH,EXT.
SIGNATURE OFr. HOUSE NUMBER COR-
PERMITTE RECT AND POSTED
ADDRESSFINAL
CLYDE N. DIRLAM, PRINCIPAL sTRjJCTbkRAL ENGINEER
PLAN CHECK VALIDATION cr. M.O. CASH PERMIT VALIDATION cm m.o. CASH
1 3 .0 0 . ' ®.