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HomeMy Public PortalAbout5918TEMPLE CITY BLVD_Building -'00- COUNTY OF LOS ANGELES APPLICATION FORPARTMENT OF COUNTY ENGINEER BUILDING PE R M I T UILDING AND SAFETY DIVISION BUILDING i( ' FOR APPLICANT TO FILL IN ADDRESS / BUILDING Q! r ADDRESS —! e LOCALITY CITY Cz ZIP' NEAREST CROSS ST. �7 NO.OF BLDGS.' ASSESSOR SIZE OF LOT !�,S NOW ON LOT MAP BOOK -. UPAGE PARCEL J DISTRICT GROP TYPE FIRE PRO SED BY TRACTS_&/ BLOCK LOT NO .0 /_ CONST/ Z.2E OW NE 11 lWA,Gkom� 410. STATISTICAL CLASSIFICATION, SEWER MA ``P ADDRESS 4 'fp CLASS NO-7-2— DWELL.UNITS ICCL-- 8K'3 iQ CITY P!31 C�� USE ZONE MAP No. SOU ARCHITECT OA EL C SPECIAL ENGINEER s ` NO. CONDITIONS ADDRESS ROAD)DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ CONTRACTOR No.TEL. BLDG.SETBACK FROM LIC. FRONT PROP.LINE OF (STREET) L ADDRESS NO. HIGHWAY + YARD TOTAL SETBACK FROM HTYPE OF IGHWAY EXISTING H LIC. FRONT PROP. LINE DT CITY CLASS _ CONSTRUCTION LENDER + a NAME AND BRANCH BLDG.SETBACK FROM C7 ADDRESS L CITY SIDE PROP.LINE OF (STREET) v SQ. FT NO. OF NO. OF CHECK HIGHWAY + YARD = TOTAL' TB K FROM TYPE OF EXISTING C SIZE STORIES FAMILIES ONE SIDE PJ16P. LINE I HIGHWAY WIDTH DESCRIPTION OF WORK NEW ❑ + y ADD- ❑ CORNER CUTO YES ❑ NO ❑ i ice/ DMM LTER ❑ REPAIR[] IN OPEN SPAC YES ❑ NO ❑ USE OF IN COASTAL PERMIT ZONE YES ❑ NO ❑ EXISTING BLDGqq 'j% ,��� [��JD�•E�MOL ❑ APIPRINT) L�N y,(•, K JOA/ NOI. Gq L+i& BY (SIGNAT RE I HEREBY ACKNOWLEDGE THAT 1 HAVE RE THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT ANWAGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S C ATION INSURANCE. SIGNATURE F FINAL 7-?7 BY PERMITTE DATE / / ADDRESS CIT TEL P.C. Fee$ Permit Fee Q Issuance Fee VALUATION$ � Total Fee rJ � PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. 4.2 1tiPSAR 30 # 9.0 0-AS8 7GA63BA CE'WS0313 12/75 ��yf 1 I If / V IJ�-