HomeMy Public PortalAbout4828 BALDWIN AVE_Building__ �z
TEMPLE CITY
76A638A CE #803 3 69 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING ?
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUP T OF BUILDING NEAREST
CROSS ST
FOR APPLICANT TO FILL IN
DIS TR_)yT GROU TYPE} s PRoc r
(PRINT OR TYPE ONLY) �•JC f -c
BUILDING STATISTICAL CLASSI ICATION SEWER MAP
ADDRESS CLASS NO -DWELL UNITS BKP`G'
LOT NO BLOCK USE/�ZtOONE MAP
l NO
TRACT SPECIAL
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NO OF BLDG$ CONDITIONS
SIZE OF LOT NOW ON LOT
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USE OF
EXISTING BLDG BLDG SETBACK FROM Iz
OWNER OSCa NOL FRONT,PROP LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY + YARD - TOTAL I
ADDRESS HIGHWAY WIDTH FROM C L
4828 i
CITY Temple City , Calif.
BLDG SETBAC y
ARCHITECT OR TEL SIDE PROP LINE OF (STREET)
ENGINEER NO
TYPE OF EXISTING SETBACK HIGHWAY + = TOTAL I
ADDRESS HIGHWAY WIDTH FROM C L
TEL + — _
CONTRACTOR NO -
ADDRESS NO CORNER CUTOFF YES ❑ NO ❑LIC 0
CITY CLASSC-39SEE REVERSE SIDE FOR SPECIAL APPROVALS °C
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CONSTRUCTION LENDER
NAME AND BRANCH tJJ
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NO OF NO OF
STORIES FAMILIES NEW ❑F ADDTURE
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ALTER ❑
with Cel o #1 5 REPAIR
SIGNATURE OF DEMOL
APPLICANT
VALUATION $ 600 , PQ APPROVALS DATE INSPECTOR S SIGNATURE
P C PMT FOOLOCATION i
FEE $ FEE $ 9 QQ FORMSMATERIALS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION FRAME FIRE STOPS
BRACING 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 CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I
WILL NOT EMPLOY ANY PERSON IN VI ATION OF THE LABOR CODE LATH INT
OF THE STATE OF CA41FORN A IN L TING TO WORKMEN S COM
PENSATION INSURA C LATH EXT
SIGNATURE 0 HOUSE NUMBER CORRECT
PERMITT AND POSTED
ADDRESS 529 E Valley Blvd . San - abFINAL O ��
JOHN F LEWIS PRINCIPAL ST CTURAL ENGINEER
PLAN CHECK VALIDATION CK N+ 0 CASH S PERMIT VALIDATION CK MO CASH
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76A638A CE#803 2 63APPLICATION FOR BUILDING PERMIT � 1
COUNTY OF LOS ANGELES BUILDING x
DEPARTMENT OF COUNTY ENGINEER ADDRESS !
BUILDING AND SAFETY DIVISION LOCALITY T — } y
JOHN A LAMBIE COUNTY ENGINEER NEAREST emple s ` ' t
WILLIAM A JENSEN SUP T OF BUILDING CROSS ST � , ,.
DISTRICT NO GTP TYPE ' P C ED BY
R APPLICANT TO FILL IN . 'p 6 Y/, coNsr
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BUILDING (STATISTICAL CLASSIFICATION SEWER MAP x
ADDRESS O BK =G,�
CLASS NO"-y DWELL UNITS
LOT NO , BLOCK WATER
CERTIFICATE }NOT REQUIRED I RECEIVED
TRACT r MAP ♦ HIGHWAY STATE AJOR 6ECOND LOCAL
NO OF BLDGS NO (CIRCLE)
SIZE OF LOT NOW ON LOT USE ZONE ' SPECIAL
USE OF a CONDITIONS
EXISTING BLDG T
_ TEL
OWNER O Edwards t N B ILDING EXIST
SETBACK YARDi HWY STREET NAME WIDTH
ADDRES 2 ,'p7{ Baldwin Ave FRONT I
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ARCHITECT OR TEL P L 9 ,4 i-p w ti 75 , q
ENGINEER NO } SIDE "
ADDRESS "`' ''"
� TEL F V
CONTRACTO NOW-123
ADDRESS 10920 E. Grand
DESCRIPTION OF WORK J w
to
NEW ADD X ALTER REPAIR DEMOLISH
I
SO FT t t NO OF NO OF
SIZE STORIESFAMILIES
USE OF f
STRUCTURE -install x= mmpd wall
heater,
SIGNATURE OF,
APPLICANT Y}
VALUATION $ "120,00 ..
Ja �' APPROVALS DATE INSPECTOR S SIGNATURE
PC PMT FOUNDATION LOCATION
FEE $ FEE $ FORMS MATERIALS
FRAME FIRE STOPS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS ✓/� .� .�
AND STATE THAT THE ABOVE IS CORRECT AND�AGREE TO COMPLY FURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK r
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT %
TION OF THE LABOR CODE OF THE STATE CF CALIFO IA RELAT ?
ING TO WORKMEN 5 COMPEN�ATI ON INS NC LATH EXT
1
SIGNATURE OF� I HOUSE NUMBER COR e
PERMITTEE_ --S RECT AND POSTED l H
ADDRESS FINAL
9/3 3
PLAN CHECK VALIDATION CK MO CASH I I JOHN F LEWIS PRIN�PAL STRUCTURAL ENGdNEER
J PERMIT VALIDATION 0
M O CASH
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