HomeMy Public PortalAbout5719 GOLDEN WEST AVE_Building__ TEMPLE CITY
,..e3eACa#A). ,�I APPLICATION FOR BUILDING PER IT
cb.
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING-AND SAFETY DMSION LOCALI
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST t
WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST _
FOR APPLICANT TO FILL IN DISTR a NO GROUP TYPE PR B
Q CONST.
BUILDING �y STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS BK PG
CLASS NO DWELL UNITS
LOT NO BLOCK WATER NOT REQUIRED RECEIVED -
CERTIFICATE
TRACTMAP �O HIGH LLEI STATE MAJOR SECOND, LOCAL
f0/9111
/ - NO OF BLDGS. NO
SIZE OF LOT (I 7 L! Gt NOW ON LOT USF ZONE SPECIA -
USE OF `, CONDITI
EXISTING BLDG +S,'/ I✓L-��GL _ �-
ELg
116 p
OWNER &tj 6jjjV.S (91VNOa.9
O BUILDING EXIST
ADDRESS Q� ga_ Ig I" �L.E C�'t �/ SETBACK YARD STREET NAME WIDTH
ARCHITECT OR r TEL FPROL T q �I,
ENGINEER64 -om N�O1 SIDE
ADDRESS 7' k�7 P L r
TEL. INSPECTION_ RECORD CL
6CONTRACTOR 4 ,0 /! NO � r � � � V
ADDRESS •I
DESCRIPTION OF WORK +/ �.'`✓3i 0
NEW ADD ALTER REPAIR DEMOLISH '� �� - /C Z
SQ F NO OF NO OF' v J _
IZ STORIES FAMILIES �. I I
_ -, I��
USE •y� � �
STRUCTU F
v
G (o d
SIGNATURE OF
APPLICANT
VALUATIONS
APPROVALS DATE INSPECTOR'S SIGNATURE
P PMT. �p FOUNDATION: LOCATION
FEE $ �� Q FEE $ FORMS, MATERIALS
FRAME FIRE STOPS, /, /_/
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS 6 1;11 WWO4
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 J /�
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH, INT
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT. Y �'
ING TO WORKMEN'S COMPEN ATION INSURANCE �1 1
LATH, EXT /
SIGNATURE OF(5C_,
HOUSE NUMBER'COR-
PERMITTE RECT AND POSTED 1 9 / p yp.0
ADDRES 7/Y FINAL
CLYDE N. DIRLAM, RINCIPAL ST ' RAL ENGINEER
PLAN CHECK VALIDATION CK M.O. CASH PE MTVALIDATION CK, M.O. CASH
x. ,1984 AUU25 213, U 1a.5rit
Lko 2 4 1 0 SEP -8 1 D 4 2 .0 U
I