HomeMy Public PortalAbout5136AGNES AVE_Building (6) TEMPLE CITY
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76A638A CE q803263 APPLICATION FOR BUILDING-PERMIT
COUNTY OF LOS ANGELES BUILDING J /
DEPARTMENT, OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST
WILLIAM A JENSEN SUP T OF BUILDING CROSS ST
DISTRICT NQ _ GROUP TYPE t CESSED BY
FORI,APPLICANT TO FILL IN w L`/' (U� CONST
BUILDING STATISTICAL CLASSIFICATION J EWER MAP
ADDRESS e K t G
CLASS NO _ __DWELL UNITS `'�� I +
LOT NO + BLOCK WATER µ
CERTIFICATE NOT REQUIRED RECEIVEDYI
TRACT MAP HIGHWAY I
d ,� .f,�f NO OF BLDGS NO (CIRCLE) `STATE MAJOR SECOND OCAL
SIZE OF LOT /c/f NOW ON LOT USE ZONE SPECIAL
USE OF CONDITIONS +
EXISTING BLDG F �f
TEL /
OWNER C// NO BUILDING YARD HWIY STREET NAME EXIST
+ SETBACK WIDTH
ADDRESS /VO, C, ,F C/7 FRONT /J
ARCHITECT OR I TEL P L �f
ENGINEER NO _ Q SIDEt Y I a
P LZ-441 O
ADDRESS O 4aVof1
TEL I F
CONTRACTOR NO
ADDRESS A.QoJE b t
DESCRIPTION OF WORK a
NEW ADD ALTER REPAIR DEMOLISH ,,�.._ �-P 'µ •// I�'""� � �
SQ FT 1 NO OF N �,.��1"�'
SIZE STORIES FAMILIES
USE OF
STRUCTURE
AiV-P 041/40
SIGNATURE OF ;
APPLICANT r{
VALUATION $ t/
DATE S' INSPECTOR S SIGNATURE
PC PMT FOUNDATION LOCATION a
FEE $ FEE FORMS MATERIALS
FRAME FIRE STOPS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS C
AND STATEiTHAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS j
BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANYt PERSON IN VIOLA LATH INT
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT i
ING TO WORKMEN S COMPENSATION INSURANCE LATH EXT
SIGNATUREOF ' •'//�� HOUSE NUMBER COR r ,
P E R M I TT E E X [fd..z ` /y1 ly,Q e6���L RECT AND POSTED .. r
ADDRESS S/5!Z AM Ar-.V FINAL 19A. /
JOHN F LEWIS PRINCIPAL(STRUCTURAL EN R
PLAN CHECK VALIDATION CK M O CASH _ PERMIT VALIDATION CK M O CASH
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