HomeMy Public PortalAbout9564BISBY ST_Building (3) APPLICATION FOR CITY OF TEMPLE CITY
BUILDING PERMIT 5908 Kauffman , Temple City
91780
BUILDING
FOR APPLICANT TO FILL IN ADDRESS
BUILDING
ADDRESS LOCALITY
oTY T e!D 1 e C t t - zip 91780.
NEARESToST.
NO.OF BLDGS. ASSESSOR
SIZE OF LOT G NOW ON LOT 2 MAP BOOK PAGE PARCEL
TRACT / d,7 / BLOCK LOT NO. `�' v a GROU CCONN.ST. o1 E TYPE F1 RE D BY
TEL
OWNER NO.
STATISTICAL CLPSSIRCATION SEW MAP
ADDRESS9564 B1s4 St. CLASS NO.�DWELL.UNITS
BK�
CITY ZIPQ17AQ
USE ZONE MAP
ARCH FFECT OR TEL /,/�) NO.
ENGINEER NO. �/ ��
CON FTIONS
ADDRESS ROAD DEPARTMENT APPROVAL REGUIRED YES❑ NO ❑
coNTRAcTob<0 a r d L NO,288,404a BLDG.SETBACK FROM
UG FRONT PROP.LINE OF )STREET)
ADDRESS NO. TOTAL SETBACK FROM TYPE OF EXISTING
0C HIGHWAY + YARD FRONT PROP.UNE HIGHWAY WIDTH
QCLASS C-39
c I +
NAME AND BRANCH. BLDG.SETBACK FROM OU
SIDE PROP.UNE OF (STREET)
ADDRESS CITY
O
SG.FT. NO.OF NO.OF CH E{]C HIGHWAY + YARD T SETBACK FROM TYPE OF EXISTING r
SIZE STORIES 1 FAMILIES ONE SIDE PROP.LINE HIGHWAY WIDTH a
vi
+ Z
DESCRIPTION OF WORKR NEW
ADD CORNER CUTOFF YES ❑ NO ❑
ALTER IN OPEN SPACE YES ❑ NO ❑
REPAI R�
USE OF DEMOL IN COASTAL PERM) E YES ❑ NO ElEXISTING BLDG.
APPLICANT Ta w C�M✓p �-
IPRINTI No.
BY ISIGNATURQ
1 HERBY ACKNOWLEDGE THAT I HAVE READ THIS APPUCATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH All ORDINANCESAND LAWS K-GULATING
.I CERTIFY THAT LN DOqr4G THE
WORK AUTHORIZED HEREBY II WILL NO EMDqNG PLOY ANY PERSON W VFOLADON OF
THE LABOR CODE OF THE STATE OF CALIFORNIA W RELATING TO WORKMEN-5COM-,
PENSATION INSLFPAI`�
SIGNATU9' HNAB
PERMITTEE DATE
119' 1
ADDRESS
o. P.C. Fee$ Permit Fee 27 . 00
c,�, San Gabriel
7 . 00
Issuance Fee
VALUATKJN$ 2QQQ . QQ T I 4 . 00
PLAN CHECK VALIDATION CK Y.O. CASH T PERM1T VALIDAP? CK M.O. CASH
(1% 76"ZSe Cc f&Me erre 1MAY 1fQ 1 0 3 4.0 O '&M
a