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76A63BA CE#803 1-67APPLICATION N F DI
. O OR BUILDING- PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER , ADDRESS "
- BUILDING AND SAFETY DMSION LOCALITY
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST i ri
COLEMAN W. JENKINS.SUP'T OF BUILDING CROSS ST 1 `�
DISTRICTNO. GROUP TYPE PROC Y �
FOR APPLICANT TO FILL IN ,00-- CONST. `
BUILDINGADDRESS J a CLASS
NO.A. DWECATION SEWER MPG
CLASS NO. DWELL UNITS
LOT NO. BLOCK USE ZONE MAP
NO.
TRACT '^ /'.J ` _ SPECIAL.
N0. OF SLOGS. �JCONDITIONS
NOW
SIZE OF•LOT ON LOT _
USE OF •
' BLDG. SETBACK FROM .
TEL (� J FRONT PROP. LINE OF (STREET)
OWNER NO. T �/� TYPE OF EXISTING SETBACK HIGHWAY YARD = .TOTAL
ADDRESS , �. Al
FROM�C./L. 7
CITY 1c '� &-- V + G49
ARCHITECT OR EL. BLDG. SETBACK FROM '
ENGINEER NO. SIDE PROP: LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C.L.
TEL. r + _
CONTRACTOR 166/O&C NO 3 -
ADDRESS W V NO 12-10 S7 LiC CORNER CUTOFF YES NO C
LIC D'
CITY CtV/ SEE REVERSE SIDE FOR SPECIAL APPROVALS a
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DESCRIPTION OF WORK 7
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NEW ADD ALTER REPAIR DEMOLISH v
SO.FT. NO. OF NO OF
SIZE STORIES FAMILIES /
USE OF
STRUCTURE —�
SIGNATURE O
APPLICANT r �j
VALUI pATION$ a,00
APPROVALS DATE IN9PECTOR'391GNATURE
P.C. 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
9UILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT.
TION OF THE LABOR COOC OF THE STATE OF C LIFORNIA RELAT-
'ING TO WORKMEN'S E SATION INSURANCE. _# LATH'. EXT.
SIGNATURE OF djd-�..0 HOUSE NUMBER COR-
PERMITTEE
RE C AND POSTED
ADDRESS "IF 0F I NAL- �?
/+vau
at JOHN F. LEWIS. PRINCIPAL STRUCTURAL EN
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O CASH
1 0 5 8 OCT 5 1 D 1 725-
7GA1538A CE#803.9-60 APPLICATION FOR BUILDING PERMLT
BUILDING
-COUNTY OF LOS ANGELES
ADDRESS
DEPARTMENT OF COUNTY ENGINEER ,
BUILDING AND''SAFETY DMSION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
'WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST.
DISTRICT NO. I GROUP TYPE _ P - SED BY
.FOR APPLICANT TO FILL IN �^" CONST.,
ADDRESS , ^�•(� G Al-L V W P L� STATISTICAL GL,ASSI ATI' SE ER MAP
BUILDING �- .r�° I• K G •
a CLASS. NO DWELL.UNITS -
LOT NO. - / - BLOCK• -MAP --"STATE--YES O
NUMBER .y/w `' HWY.
TRACT USE ZONE SPECIAL ' . '
NO.OF BLDGS. /( / CONDITIONS
SIZE OF LOT I NOW ON LOT �/��/]- '•
USE OF RAS
C�
EXISTING BLDG. RA�+ BUI,LDING 'YARD HWY ST/RMT NAME EXIST:
R / )'A l SETBACK 1' i WIDTH''
OWNER l`1LIAM �/pAil-'Aiv �l��d.�'I FRONT q n �' -•
may, P L
ADORES% ��D �L / SIDE
ARCHITE L."OR TEP,L.
ENGINEER NO INSPECTION RECORD..'
r
ADDRESS //- .- CL
CONTRACTOR W 9 �/ �(t-/'IJV L/NO - •O-
ADDRESS ` 'y 0
O
DESCRIPTION OF WORK G
W
O_
NEW ADD AL R REPAIR DEMOLISH NZ
SQ FT.- , NO OF �' NO OF
SIZE _ STORIES' FAMILIES '
USE OF _ A LL
STRUCTURE
E RL I ' 7�
SIGNATURE OF
APPLICANT '
VALUATION$ a6/� O -
APPROVALS DATE •INSPECTOR'SSIGNATURE
P C PMT*
`— FOUNDATION:,LOCATION ;
FEES . FEE $ FORMS. MATERIALS
FRAME: FIRE STOPS.
I HEREBY'ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS S' 'iCJ1I `ae.
AND STATETHAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, I -
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CONSTRUCTION I'CERTIFY THAT IN THE PERFORMANCE
OF THE WORK FOR WHICH THIS PERMIT,I5 ISSUED I SHALL NOT LATH, INT.
'•EMPLOY.ANY,PERSON IN ANY MANNER SO AS TO BECOME SUBUECT ,
TO THE WORKMEN'S COMPENSATION.LAWS OF CALIF RNIA.
LATH, EXT.
SIGNATURE-OF! HOUSE NUMBER COR-
!-FRMITTEE ayw RECT AND POSTED
ADDRESS L FINAL
CLYDE N. DIRLAM,•PRINCIPAL STRUCTURAL EN R
PLAN CHECK VALIDATION cK- M.O. CASH PERMIT,VALIDATION 'CK. M.O.• CASH
L�J04 2 3 1G ,fly 1 1 o 6:0
TEMPLE CITY
76AS30A cE#DOD Y/CO '
A�PPL-KATION POR BUILDING PERMI - . .
COUNTY OF LOS ANGELES BUILDING
ADDRESS f
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE,•COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST.
-DISTRICT NO. GROUP TYPE SED BY'
FOR APPLICANT TO FELL'IN' . CONST
fADDRE,�ING I► STATISTICAL CLASSIFICATION S WEIR MAP
(� �. - , (:. 4 BK
CLASS.NO. DWELL. UNITS'O. - IrIBLOCK MAP. STATE YES ONUMBER HWY:T [J USEZONE SPECIAL
NO:OF.BLDGS. CONDITIONSF LOT" �lJ I NOW ON LOT' - -
'USE OF
EXISTING BLDG. • BUILDING EXIST.
yy�� �{e
SETBACK YARD HWY R NAME _WIDTH
OWNER M I NV I NO. � FRONT
ADDRESS SIDE
ARCHITECT OR TEL: - P.L.
ENGINEER', NO.- INSPECTION RECORD
ADDRESS ,
CONTRACTOR Ovd-cAv-- U� l r ! i .C.- -
ADDRESS I MoXALW45J
"DESCRIPTION OF WORK �'�•� d �� ' " O
u�
NEW ADD AL"PER REPAIR DEMOLISH - •• -
SQ.FT. NO.OF NO.'OF a
SIZE STORIES FAMILIES
USE OF �j �A. n
STRUCTURE .lam / 1 {O. -
SIGNATURE OF 2
APPLICANT - - - -
VALUATION,$ . a
APPROVALS DATE, INSPECTOR'S SIGNATURE
.P.C: PMT. DO FOUNDATION: LOCATION ;
FEE $ FEE •$ �- .FORMS, MATERIALS 'J
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FRAME: FIRE STOPS, � J
BRACING,.BOLTS �y/Col'I,G.Gl.XO,f'OA�--�
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND eFURNACE: LOCATION,
AGREE TO COMPLY WITH ALL COUNTY'ORDINANCES AND GAS VENT,DUCTS '
STATE LAWS REGULATING BUILDING CONSTRUCTION.
I CERTIFY•THAT IN DOING THE WORK AUTHORIZED 1 LATH, INT.
WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
WORKMEN'S COMPENSATION LAWS OF CALIFQtZINIA. LATH,EXT.'
SIGNATURE OF HOUSE NUMBER COR-
E / RECT AND POSTED
ADDRESS 'Ot. FINAL - -
CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL EN ER
PLAN CHECK VALIDATION qr: M.o. casts -PERMIT VALIDATION cK M.O: CASH'
1 03 8 6 9.. . {iAR /_I 1 U -5 .&C