HomeMy Public PortalAbout9653 BROADWAY_Building__ TEMPLE CITY
TBASBBA CE xFBOB I-GZ APPLICATION FOR BUILDING PERMIT
- COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS /7lcrG
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST /
WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST.
DISTR CT O. GROUP VPE ESSED BY
FOR APPLICANT TO FILL IN /� � CONST. 7 Ff-C
BUILDING STATISTICAL CLASSIFICATION S WER MAP
ADDRESS' /� L, BK
CLASS. NO.ALL DWELL. IT
UNS`
_ ®Z .�4 f ,B / WATER NOT REQUIRED RECEIVED
.{/ ?-4` MAP II FICATE: HIGHWAY
O NO.OF BLDGS. / NO. ' Q (CIRCLE) S ATE MAJOR SECOND. LOCAL
SIZE OF LOT r('�L Ka NOW ON LOT / USE ZONE SPECIAL
USE OF - CONDITIONS
EXISTING BLDAj
T
BUILD NG. EXIST.
YARD HWY STREET NAME
SETBACK WIDTH
A FRONT
ARCHITECT R TEL. P. L.
ENGINEER
NO. SIDE }
P. LADF
. / //1 / y
CO DR +� /G� ditre/1 ?.cG'UF /tzvZ/�f(/ 1�0 V
7 ac
ADDRESS_ y�G(�' O
11-
i)ESdRfPTION OP WORK w
a
NEW ADO ALTER REPAIR EMOLISH Z
SO. FT. NO. OF
SIZE / STOft I ES FAMILIES
USE OF
STRUCTUR /
SIGNATURE OF
APPLICANT
VALUATION $ d a
FOUNDATION(/r. APPROVALS DATE INSPECT/OR'�GNATURE
FEE $ FEE $ . - FORMMATERIALS ON
FRAME: FIRE STOPS,
1 HER ACKNOWLEDGE THAT HAVE READ THIS APPLICATION BRACING BOLTS
ANO STATE TO COMPLY FURNACE: LOCATION.
WITH ALL COUTHAT THEABOVE IS CORRECT ANO AGREE /
NTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS ! `
BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WO
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN v LATH, INT.
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA AT-
IN.TO WORKMEN'S COMPENSATIO /RANCF. LATH. EXT.
SIGNATURE F HOUSE NUMBER COR- 1 T t�
PERMITTEE - REIT AND POSTED
ADDRESS FINAL IJ 6� ,/�✓��
JOHN F. LEWIS, PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION ER. M o. GASH _ PERMIT VALIDATION GK. .... CASH
LACo 9 1 4 40 JUl 7 1 D 4.0 G-
DIVISION BUILDING AND SAFETY. (� �j �J ® � ({���
Depa ent of County Engin ODU i� 1=1
County of Los Angeles �"` � � �LJf
WMJ . FO1, CGuw'rY trTGINEER +1I-V 195 APPLICATION
.1
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
(� �r / DISTRICTNO. PLAN CK. OR RICO.
RICO..No. PERMIT NO.
BUILDINGQ
ADDRESS /��'� /L /r IC��/�T/.11?G' .) S 1 / O �� 44�4 I�
T RECEIVED BY \ DATE OF APPL. DATE IBSUED
LOCALITY %rIs/./• /J
NEAREST ��
CROSS ST. BUILDING /J/ (-� IF If _ /
ADDRESS `/1A �1 C J LCl�/..Gyc
OWNER a . - K � � q
MAIL LOCALITY
ADDREBB - ) NEAREST
TEL - CROSS ST.
CITY ,/i NO. FIRE NO.OF TYPE I GROUP(,
ARCHITECT OR TEL ZONE PLANS (\
ENGINEER NO. BEDS. ,( D /�0 Dy NO.
BETSACK LINEY-
ADDRESS
USE:? ,C'(j /QG'`) ry'/J4 LSC TEL ) / ZONE APPROVED
�e NTRAC OR•• � [ NO. {/ /, i - BY HOUSE NUMBERING
DATE
ADDRESS • MAP NUMBER NO. ASSIGNED BY
LEGAL
DESCRIPTION I LOT NO.' BLOCK1/ t 7 CORRECTIONS �p
TRACT.N,'ij//I//per,e/a' Qf/,c,i
N . OF BLDGB. S /"-`fi`-'b'!�. I l �I / �S •(�., N
SIZE OF LOT O 3 OW
i/ NOON LOT IV lJ
UBE OF I NO. DF
EXISTING BLDG. FAWL190 1 .+G�•� /A � / In I
DESCRIPTION OF WORK lX o
NEW ALTERATION ADDITION
z
REPAIR DEMOLITION
Sq.FT. ]/ �Z� �
SIZE ROOMF M �pn.vT H4
STORIES t
EXT.WALL /((ta 'Y ROOF fn/Q
COVERING I COVERING ll�i GCIY/
USE OF
STRUCTURE'. % ,r '
. V
INSPECTION
R
OCCUPANCYAHT'' 9rE 'y-Q� APPROVLS
INSPECTORAI891GNATUR E DATE
FOUNDATION: LOCATION
FORMS, MATERIALS JL
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP•,
PLICATION AND STATE THAT THE INFORMATION GIVEN, IS. FRAMEI FIREBTOPS,
CORRECT. BRACING, BOLTS
1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION. L/
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. GAS VENT, DUCTS
SIGNATURE OF LATH, INT.
��
PERMITTEE ���•Y/�Y
1 LATH. EXT.
ADDRESS
.
AUTHORIZED AST PLASTER, INT.
PLASTER. EXT.
3'1- P 4 FEE 6 —' HOUSE �
RECT AND POSTED
VALUATION q ME FINAL
-
19W638A 0693 1-59 /