HomeMy Public PortalAbout5210AGNES AVE_Building (17) k_W1'_,_ TMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT o a
COUNTY OF LOS ANGELES Temple City Off*BUILDING (' �
" WM J FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
DISTRICT NO PLANCK NO PERMIT NO
a u1LDN
ADD EISB 634 S. Agnea
LOCALITY Temple City, Calif RECEIVED BY DATE OF APPL DATE ISSUED
NEAREST
CROSS ST Howland Drive
BUILDING
OWNER Rantial R Tully ADDRESS
MAIL LOCALITY T
ADDREBB 2)$81 W Valley Blvd, C
NEAREST
TEL. CROSS ST oz..' rt Iti-� ✓ ,
CITY Alhambra, Calif, NO CU: 332115 FIRE NO OF TYPE OROUPsr-
ARCHITECT OR TEL. ZONE �—_No
ENGINEER ' ,!� g.g Yi'a� W T A
BLDG ORD NO
ADDRESS HEATING & AIR SETBACK LINE
CONDITIO ?iLING CO APPROVED
CONTRACTOR NO BY DATE
USE APPROVED
ADDRESS I"IOA OOd .38Calif ZONE BY DATE
LEGAL CORRECTIONS
DESCRIPTION LOT NO BLOCK
TRACT
NO OF BLDGB
SIZE OF LOT NOW ON LOT
USE OF NO OFNO OF
EXISTING BLDG FAMILI[B ROOMS
DESCRIPTION OF WORK
NEW ALTERATION X ADDITION Y
O
REPAIR MOVING DEMOLISH p
SO FT NO OF Z
SIZE ROOMS STORIES D
WALL ROOF r
COVERING I COVERING
USE OF NEW
BUILDING Residence
1-•551Ui Royal .T Pt. Flow
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION LOCATION INSPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS MATERIALS
AND STATE LAWS REGULATING BUILDING CONSTRUCTION
FRAME FIRE STOPS,
SIGNATURE OF BRACING BOLTS
PERMITTEE LATH INT
AUTHORIZED AGT - LATH EXT
DBS 3 BUM BETS 1 48 $ P C 0 PLASTER,INT
15®.00 FEE
PLASTER,EXT
VALUATION FEE * 2400 FINAL