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78A 638A CE#8D38_63 APPLICATION FOR BUILDING PERMIT
ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST.
DISTRICT O. GROUP YPE SS BY
FOR APPLICANT TO FILL IN �! C1 r - CONST. -tl
BUILDING STATISTICAL CLASSIFICATION SE ER MAP
ADDRESS - BK���PG
CLASS. NO. DWELL. UNITS
LOT NO. §LOCK WATER NOT REQUIRED RECEIVED ❑
CERTIFICATE:
TRAC 4�wGL MAP HIGHWAY
NO.OF DGS. NO.: (CIRCLE) STATE MAJOR SECOND, OCA
SIZE OA LOT NOW O LOT USE ZONE SPECIAL
USE OF CONDITIONS
EXISTI LD . +]
TEL. G►�
OWNER NO. BUILDING EXIST.
s * SETBACK YARD HWY S11 EE AME WIDTH
ADDRESS FRONT
ARCHITECT OR TE P. L.
ENGINEER NO SIDE
P. L.
ADDRESS L - • a
��"" �.. TEL.
CONTRACTOR -�V NO. V
ADDRESS OIm
DESCRIPTION OF WORK go
ral
W
NEW ADD ALTER REPAIR DEMOLISH Z
SQ. FT. NO. OF NO. OF
SIZE STORIES FAMILIES
USE OF /
STRUCTURE.
SIGNATURE OF
APPLICANT
VALUATION $ ®o
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.
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS
BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK '
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA. LATH, INT. f'
TION OF THE LABOR COD- F E STATE OF CALIFORNIA RELAT-
ING TO WORKMEN'S CO E1.f6A CE. LATH. EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS ? � ;��FINAL
JOHN F: LEWIS. PRINCIPAL STRUCTURAL ED7"
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O.
(�iuo 4 9 2 1�L OCT 15 1 0 4.%r_'j 0•-
TEMPLE CITY
76A638A CE 19032-63 APPLICATION FOR BUILDING PERM IITI..41111�
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS [/ X
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST T
WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST.
DISTFJ.ICT NO. GROUP YPE SSED BY
FOR APPLICANT TO FILL IN r cONST.
BUILDING STATISTICAL CLASSIFICATION SE ER MAP
ADDRESS —
CLASS. NO. DWELL. UNITS BK P ,
LOT NO. '~ BLOCK WATER NOT REQUIRED RECEIVED ❑
CERTIFICATE: 654
TRACT M1YAP J HIGHWAY STATE MAJOR SECOND, L CA
NO. OF BLID NO.: / c IRCLE>
SIZE OF LOT '�,� NOW ON LOT USE ZONE SPECIAL
USE OF CONDITIONS
EXISTING BLDG. •�F,�
TEL. y
OWNER NO. [7 BUILDING YARD HWY T EET pllE EXIST.
SETBACK WIDTH
ADDRESS - e FRONT
ARCHITECT OR YEL. P. L. !/
ENGINEER NO. SIDE >a
P. L. O-
ADDRESS O
TEL, A V
CONTRACTOR NO. ce
ADDRESSF-
DESCRIPTION OF WORK �" `� a
W DD ALTER REPAIR DEMOLISH
Stf. FT. NO. OF NO. OF
SIZE STORIES FAMILIES
USE OF
STRUCTURE
SIGNATURE OF
APPLICANT �C
VALUATION
APPROVALS DATE INSPECTOR'S SIGNATURE
FOUNDATION: LOCATION
FEE
P C �� FEE S +�� FORMS. MATERIALS
�
FRAME: FIRE STOPS.
HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING. BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY Iz `�'�1�, LOCATION, 2
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS V
BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY 1 WILL N T EMPLOY ANY PERSON IN VIOLA- LATH. INT.
TION OF THE LABOR COD- HE STATE OF CALIFORNIA RELAT-
ING TO WORKMEN'S COM N ON INS RANO
LATH. EXT.
SIGNATURE OFA HOUSE NUMBER COR- `\
PERMITTEE - RECT AND POSTED
ADDRESS FINAL
JOHN F. LEWIS. XONCIPAL STRUCTURAL EONPLAN CHECK VALIDATIO CK. M O. CASH PERMIT VALIDATION CK. M.O.
L 6 3 6 213 MiAR 9 1 D 1i J
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76A638A CE#803 8.63 APPLICATION FOR BUILDING P RMIT
COUNTY OF LOS ANGELES BUILDING �•
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST.
DISTRICT NO. UP TYPE �, ESSED BY
FOR APPLICANT TO FILL IN S70 I
CONST. J '
BUILDING < STATISTICAL CLASSIFICATION 5 VER MAP
ADDRESS BK G
CLASS. NO. DWELL. UNITS
LOT NO. BL CK WATER NOT REQUIRED RECEIVED ❑
CERTIFICATE:
TRAC MAP HIGHWAY
NO.OF LDGS. NO. (CIRCLE) STATE MAJOR SECOND, LOCAL
SIZE OF LOT NOW LOT USE ZONE SPECIAL
USE OF CONDITIONS
EXISTING B G `I
TEL. ,-{ �/
OWNER NO. BUILDING EXIST.
SETBACK YARD HWY T EET AME WIDTH
ADDRESS FRONT
ARCHITECT OR TEL. P. L
ENGINEER NO. SIDE
P. L.
ADDRESS
d
TEL. 0
CONTRACTOR NO. p u
ADDRESS OC
0
ESCRIPTION OF WORK
W
a
NEW ADD ALTER REPAIR DEMOLISH Z
SQ. FT. NO. OF NO. OF
SIZE STORIES FAMILIES
USE OF
STRUCTURE
SIGNATURE OF
APPLICANT rryye.))
VALUATION $f
_• APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. PMT. O FOUNDATION: LOCATION ,4
FEE $ FEE $ �� FORMS. MATERIALS
FRAME: FIRE STOPS, ;1
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION.
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS
BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH, INT.
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT-
ING TO WORKMEN'S CO INSURANCE. LATH. EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS FINAL
JOHN F. LEWIS, PRINCIPAL STRUCTURAL ENGI IR
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH /
Lr-�c3 5 3 8 5 OCT 2 9 1 D 4.0 0