HomeMy Public PortalAbout5918 TEMPLE 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
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