HomeMy Public PortalAbout5749AGNES AVE_Building (2) 76A638A CE #803 3 69 �
APPLICATION BUILDI G PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS 5749 North Agnes
BUILDING AND SAFETY DIVISION LOCALITY Temple Clt
210 JOHN A LAMBIE COUNTY ENGINEER y-
COLEMAN W JENKINS SUP T OF BUILDING NEARESTCROSS ST
FOR APPLICANT TO FILL IN DISTRICT 0 GROUP
UPP TYPE CONST ROC SSEDD'B�Y�
(PRINT OR TYPE ONLY) '57
O -L
BUILDING STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS CLASS NO -'?-/ DWELL UNITS ABK _ PG
LOT NO BLOCK USE ZONE MAP `
NO 1 i
TRACT SPECIAL
NO OF BLDGS 1 COND TIONS
SIZE OF LOT NOW ON LOT
USE OF
EXISTING BLDG BLDG SETBACK
TEL FRONT PROP LINE 0 - - (STREET)
OWNER Dale Holly NO TYPE OF EXISTING SETBACK GHWAY + YARD = TOTAL
HIGHWAY WIDTH FROM C L e
ADDRESS 5749 Worth Agnps
CITY Temple Crit
ARCHITECT OR TEL BLDG SETBACK FROM vV (STREET)
ENGINEER NO SIDE PROP LINE OF
JYPE OF EXISTING SETBACK HIGHWAY YARD = TOTAL'
ADDRESS HIGHWAY WIDTH FROM C L
CONTRACTO NOL 287-0507 +
LICc
ADDRESS600 NO 160650
CORNER CUTOFF YES E]- NO ❑
CITY San Gabriel 91776 CLASS C-39 SEE REVERSE SIDE FOR SPECIAL APPROVALS F
CONSTRUCTION LENDER C
NAME AND BRANCH LLA
V
ADDRESS 2
SO FT NO OF NO OF ❑
SIZE STORIES FAMILIES NEW
USE OF ADD ❑
STRUCTURE geroof with ❑
ALTER
Medium Shakes REPAIR
SIGNATURE OF DEMOL ❑
APPLICANT
VALUATION $ APPROVALS DATE INSPECTOR S SIGNATURE
P CPMT FOUNDATION LOCATION
FEE $ FEE $ FORMS,
ORMS MATERIALS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION FRAME FIRE STOPS
'RACING,
RACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUC GAS VENT DUCTS
TION I CERTIFYTHAT IN DOING THE WORK AUTHORIZED HEREBY I
WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE LATH INT
OF THE STATE OF CALIF NIA IN RELATINGGTATO/WORKMEN S COM
PENSATION INSURANCE LATH EXT
SIGNATURE OF vA[) HOUSE NUMBER CORRECT
PERMITTEE AND POSTED
ADDRESS FINAL /A �o
JOHN F LEWIS PRINCIPAL ST RAL ENGINEER
PLAN CHECK VALIDATION CK MO CASH - PERMIT VALIDATION CK MO CASH
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