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7GA689A CE#8039 SG APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
S6 I
BUILDING AND SAFETY DMSION LOCALIT
JOHN A LAMBIE COUNTY ENGINEER NEAREST `
CASSATT D GRIFFIN SUP T OF BUILDING CROSS ST
DISTRICT NO GROUP TypE PRO ESSED BY .
FOR APPLICANT TO FILL IN - �'' CONST
BUILDING STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS 020 A e$ St
Temple Cityt PG
/'7�r CLASS NO DWELL UNITS Y
LOT NO S I.ZO BLOCK MAP STATE yE5 NO
NUMBER HWY
TRACT / USE ZONE SPECIAL
NO OF BLOGS CONDITIONS
SIZE OF LOT O F I NOW ON LOT
USE OF
EXISTING BLDG BU LDING YARD HWY STREET NAME EXIST
SETBACK WI TH
OWNER Franz A von Ruf FRONT
MAIL P L -
ADDRESS 5020 Agms, TEmple citv SIDE -
TEL P L
CITY No At,, 7-92 INSPECTION RECORD
ARCHITECT OR TEL
ENGINEER NO
ADDRESS
CONTRACTOR TEL
d No
ADDREss2524 W Main P 0 Box8 Alhambr "
DESCRIPTION OF WORK
NEW ADD- ALTER REPAIR x DEMOLISH
SQ FT NO OF NO OF
SIZE STORIES FAMILIES
USE OF
STRUCTURE residence ,
4
l
SIGNATURE
APPLICANT
_ APPROVALS DATE INSPECTOR SSIGNATURE
ADDRESS P.O. FOUNDATION LOCATION
FORMS MATERIALS
VALUATION $540°00 FRAME FIRE STOPS s
BRACING BOLTS '� T
PC PMT FURNACE LOCATION
FEE S FEE S OO GAS VENT DUCTS
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP t�
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND LATH INT
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND '
STATE LAWS REqVLATING BUILDING CONSTRUCTION LATH EXT
SIGNATURE OF HOUSE NUMBER COR
PERMITTEE- RECT AND POSTED
ADDRESS FINAL
CLYDE N DIRLAM PRINCIPAL ST UCT RAL ENGINEER
PLAN CHECK VALIDATION CK M o CASH PERMIT-VALIDATION CK M o CASH
903S FEB 25 -' I A yh
5 0 0 Y'
y S