HomeMy Public PortalAbout5921 TEMPLE CITY BLVD_Building (2) 76AG38A CE0803 9-67 P4-PL6 C e \� ,
APPLICATION FOR BUILDING PERMIT LJ
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' C.OUNTY OF LOS ANGELES BUILDING ---'—
DEPARTMENT OF_ COUNTY ENGINEER ADDRESS 612, r
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER
'COLEMAN W. JENKINS, SUPT OF BUILDING NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN DIST.P,QT NO. GROUP TYPE /PRO(ZESSED BY
(Print or type only)
BUILDING
ADDRESS ). / fxA J x,E STATISTICAL CLASSIFICATION SEWER MAP
CLASS NO. DWELL,UNITS BK PG
LOT NO. Z BLOCK USE ZONE MAP
l - 7 - NO.
TRACT CONDITIONS
r
SPECIAL
NO.OF BLDGS.
SIZE OF LOT N ON LOT
USE OF �+
EXISTING BLDG. I T�g� BLDG.-SETBACK FROM
OWNER J0 ySxfr� /�I L._:go rj FRONT PROP.LINEOF -(STREET).
a7 TYPEDF EXISTING SETBACK HIGHWA } YARD - TOTAL
HIGHWAY WIDTH FROM C.L.
ADDRESS f c i P \ -
CITY BLDG.SETBACK FROM
ARCHITECT OR PrEL. SIDE PROP.LINE OF (STREET)
ENGINEER NO. TYPE OF EXISTING SET CK HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTH. FR C.L.
n �/ STEL. �y-G � + _ >•-
CONTRACT jF r /`Ory sem. ANO. Ash/ 7 �D - ' CD
ADDRESS 6+4./� °l[ NO. ✓ 0 3 ,- CORNER CUTOFF YES ❑ NO ❑ w
CITY L HAM R/� c�Ass 1 SEE REVERSE SIDE FOR SPECIAL APPROVALS 15
DESCRIPTION OF WORK a
NEW ADD ALTER REPAIR DEMOLISH L
SQ. FT.. NO. OF NO. OF • �
SIZE STORIES FAMILIES G
USE,OF O
STRUCTURE /
S AGL. 680 PLO QP
SIGNATURE O ° p r1l `!+ /��
APPLICANT ./`�/ /y/ . .-
VALUATION S 0 0
APPRO LS DATE INSPECTOR'S SIGNATURE
P.C. PMT.. FOUNDATION: LOCATION
FEES FEES t FORMS, MATERIALS
FRAME: FIRE STOPS,
I
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS r
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION,
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS
BUILDING CONSTRUCTION. I CERTIFY THAT .IN DOING THE WORK
AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA-
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT• ,
ING TO WORKMEN'S MPE T N INSU NCE.
LATH, EXT. 1,
SIGNATURE �a�17_ HOUSE NUMBER COR-
PERMITTE RECT AND POSTED zj
ADDRESS �- FINAL
JOHN F. LEWIS. PRINCIPAL STRUCTURAL ENGINE
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. MOAS
�o5-8 .2 6N AUG 9 1 D :. 913.0