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DEPARTMENT COUNTY ENGINEER 19�� ' D'
DIVISION OF BUILDING AND SAFETY �
COUNTY OF LOS ANGELES P ,Q
NG
WILLIAM J. FOX, COUNTY ENGINEER APPLICATION
CASSATT D. GRIFFIN. SUPT OF BUILDING
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
BUILDING //1"� �r/ // �- DISTRICT NO. PLAN CK OR REC.No. P MIT NO
ADDRESS (U(•' G+�'IG- ;�a$f 3 �S
LOCALITY Temple City, Calif RECEIVED DA OFA PL. DAT ISSU D
CROs ST. Garabaldi F
BUILDI
OWNER Tomlee TIn RLhg
MAI LQ.,, T,. ADDRESS.' J �+
ADDRESS 9170 rte. Las ureas Dr. LOCALITY
TEL, CROSS ST.
NEAREST
CITY TemnleCffity TE AT 7-3759 FIRE NO. OF TYP GROU
ARCHITECT OR TEL. ZONE PLANS
ENGINEER NO.
BLDG. /�yy ��r►+ /r�! ,yt/, .
ADDRESS SETBACK LINE �T
Inc. o`'AT 7-3759 USE / APPROVED��CONTRACTOR Tomlee, _ ZONEBY DATE
ADDRESS 91-70 --' Las Ttlas Dr. T. C. HOUSE NUM E ING
.�
LEGALMAP NUMBER ""' �"'� NO. ASSIGNED BY�
7
DESCRIPTION I LOT NO. BLOCK - v CORRECTIONS
TRACT 19338 NO. OF B _
SIZE OF LOT 50 x 170 I _
NOW ON LOT
USE OF I NO. OF
EXISTING BLDG. FAMILIES
DESCRIPTION OF WORK D -
NEW ALTERATIONADDITION
H %
REPAIR DEMOLITION D_ I-
SIZE 1112 ROOMS STORIES 1 _
EXT. WALL StROOF
LICCO
COVERING I COVERING COMPO Shgl
USE OF STRUCTURE
Residence j
20 x 20 Dtchd parp ge _
I
APPROVALS
INSPECTOR'S SIGNATURE DATE
FOUNDATION: LOCATION
FORMS, MATERIALS
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FRAME: FIRE STOPS. j
PLICATION AND STATE THAT T INFORMATION GIVEN IS BRACING, BOLTS
CORRECT. FURNACE: LOCATION. J) -
I AGREE TO COMPLY T LL COUNTY ORDINANCES GAS VENT, DUCTS Y�
AND STATE LAWS REGU T BUILDI CON RUCTION.
LATH, INT.
SIGNATURE OF '-
PERMITTE
&- Z-
LATH. EXT.
ADDRESS x'170 E. Las Tunas Dr., T. C.
PLASTER, INT.
AUTHORIZED AGT.
PLASTER, EXT.
FEE• s ��1— HOUSE NUMBER COR-
RECT AND POSTED
VALUATION FEE s.2 FINAL
76A698A DBS S 5-82
1 � J
TE"PM
76A656A CE S603 4/72 V1J'I CFVln
APPLICATION FOR BUILDING PERMIT ]
COUNTY OF LOS ANGELES ASSESSOR
DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL
BUILDING AND SAFETY DIVISION BUILDING
MAKE CHECKS PAYABLE TO: ADDRESS i
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY
FOR APPLICANT TO F117 IN NEAREST a
CROSS ST.
BUILDIIS DISTR T NO. ROUP TYPE PR ED BY
ADDRESS 6155'N,- ]lig T.C. CONST t
LOT NO. BLOCK STATISTICAL CLASSIFICATION SEWER MAP
CLASS NO DWELL.UNITS bK PG
TRACT ,USE ZONEMAP -3
NO.OF BLDGS. NO.
SIZE OF LOT NOW ON LOT SPECIAL
USE OF ~ CONDITIONS
EXISTING BLDG.
a++ ext 8.c2-sna+ 6-6985
., BLDG.SETBACK FROM
ADDRESS 61115 N.Camllia2 bm FRONT PROP.LINE OF (STREET)
TYP OF SETBACK HIGHWAY + YARD = TOTAL
CITY Temle City Cal-if. HIGHWAY WID C.L.
ARCHITECT OR TEL. + _
ENGINEER NO BLDG.SETBACK FROM
ADDRESS SIDE PROP.LINE OF N, (STREET) o
TEL. ARS '1Q TYPE OF IDTING DETaACK H AY + YARD = TOTAL DC
CONTRACTOR ,�Yw. NO. 2b-2�1 58 HIGHWAY WIDTH FROM C.L ICD-
ADDRESS (.,a�. 91803 o.-253163
= U
282-1958 LIC. 039
CIT CLASS CORNER CUTOFF YES ❑ O ❑
CONSTRUCTION LENDER
NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS
LLI
NO. OF NO. OF NEW ❑
STORIES FAMILIES
OF ADD ❑
e
R. gr ALTER ❑
ON
OF � REPAI
DEMOL ❑
S &W.00
APPROVALS DATE INSPECTOR'* •IGNA TU R[
P.C. PMT. y�r�sy FOUNDATIONL LOCATION
FEE S FEES 22.W FORMS MATERIALS
RAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AFFLICATLON BRACING BOLTS
AND /TAT[ THAT THE ABOVE IS CORRECT AND AGREE TO COLTLY FURNACEI LOCATION,
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CDN- GAS VENT DUCTS
STRUCTIOM. I CERTIFY THAT IM DOING THE WORE AUTHORIZED
HER[BY I WILL NOT EMPLOY ANY PERBON IM VIOLATION F THE LATH, INT.
LABOR CODE OF THE STAT[ OF .CALIFOR IN R[ ING TO
WORKMEN'B CO MI'E.TION INSURA C[. LATH, EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS
00 7H S.YareWl FINAL
PLAN CHECK VALIDA'T'ION CK. M.O. CASH _ rLW111 VALIDATION CK. M.O. CAfH
L&o 9 2 7 2 ZI -OST 17 9 2,0 p a