HomeMy Public PortalAbout5025 KAUFFMAN AVE_Building__ ?7-1gg APPLICATION FOR *BUILDING PERMIT��
FOR , PPLIC%NT„^TO FILL IN (Print or type only')' L11�
BUILDING _ - - ' ... COUNTY OF LOS ANGELn'S” "���-/�
ADDRESS SO25Kauffman i!e- - DEPARTMENT OF COUNTY ENGINEER
CITY Temple City, Califaip BUILDING AND SAFETY DIVISION
NO.OF BLDGS. BUILDING
SIZE-OF
��LOT' NOW ON LOT - ADDRESS Q �J
TRACT'/'yt,! 33 BLOCK LOT NAO,f Y LOCALITY -
OWNER John Franklin ST
NO 445-9'706 GROSSNEAREST. CC
ASSESSOR
ADDRESS 5025- Kauffman MAP-BOOK PAGE PARCEL
DISTRICT_ GROUP TYPE " FIRE PROCE ED BY
.
.CITY'Temple City, Calif.ZIP - �. Q RO CONS'T./ ZO
ARCHITECT OR TEL.
ENGINEER NO.
- -
STATISTICAL-CLASSI IC-ATION EWER MAP
.ADDRESS - ._ CLASSS NC. _DWELL;UNITS - GBK'-2G
CONTRACTOR Rigid deli C.O. NO.G63-5181 uE,ZONE MAP ^'� (v/ /_
LIC. /`C,� NO' OO
ADDRESS fti--6782 - NO.. 159.996 ONDIIT ONS
CITY LorS An eles Calif.- CLASS C-39 -
g i _ ROA_D DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑ .
CONSTRUCTION LENDER
NAME AND-BRANCH BLDG.SETBACK FROM
FRONT PROP.LINE OF _ (STREET) c:)
ADDRESS CITYC.7
HIGHWAY } YARD TOTAL SETBACK FROM TYPE OF EXISTING =
SQ. FT. NO. OF NO. .OF, CHECK FRONT PROP: LINE HIGHWAY WIDTH CD
SIZE STORIES FAMILIES ONE - V
DESCRIPTION OF WORK' NEW ❑ + N
BLDG.SETBACK FROM Z
re-roof
With Rigid pkepared. ADD ❑ SIDEPROP. LINEOF (STREET)
ALTER ❑ _ T L BACK FROM TYPE OF EXISTING
FI tf HIGHWAY -}-- YARD - HIGHWAY WIDTH
Class C material PROP. LINE
- -
REPAIR -
USE OF + , _..-. ..
EXISTING BLDG, residence _ DEMOL ❑
APPLICANT - - TEL - CORNER CUTOFF YES ❑ NO ❑
(PRINT) NO.
BY (SIGNATURE) IN'OREN SPACE YES ❑I - NO ❑ -
. Q'. IN'COAS TA ZONE YES ❑ NOVALUATION ❑
-. ✓ '/ o. � CATEGORICAL EX E_MPTION "YES❑ NO ❑
I HEREBY ACKNOWLEDGE THAT I HAVE READ THI S'AP.PLICATION ENVIRONMENT
AND STAT.E T,HAT'T.HE-ABOVE.-I.S CORRECT AND.AGREE TO-COMPLY IMPACT. EXEMPTION DECLARATION SIGNED (DATE)
WITH ALL ORDINANCES AND LAWS -REGULATING BUILDING CON-
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT-REPORT PROCESSED (DATE)
HEREBY I WILL NOT .EMPLOY ANY .PERSON :IN.-WOLA,TION.OF•T.H E.,
LABOR CODE OF THE 5 'll. Of .CALIFORNIA IN RELATING TO 3 rZ!/� �A�v ,�• _ �Gv�sy,,,, Q_
WORKMEN'S CO MPE NBAIIOtiINS U�/R¢gNC E.
SI GN,ATURE OF 9 9. Company .. �.
PERMITTEE � � Aj
ADDRESS pp0 BOX 67 . . 72)
Calif. 9002..2263518 FINAL BY
TEL - DATE
CITY NO.
-- MA'KE.LHECKS'l'AYABLE TO: p E E
$ FET. 12'00-
HARVEY T. BRANDT. COUNTY ENGINEER
PLAN.CHECK VALIDATION.. CK. M.O. CASH PERMIT VALIDA I N CK. M.O. CASH
9:4 5 crura 9' 1 `0_ 1 2-.0.0
76A638ACE#803 7/73 _- - - •� w. _„
-. Jf_
76A638A CE #803 12/69
APPLICATION FOR BUILDING PERMUT
COUNTY OF LOS ANGELES ASSESSOR
DEPARTMENT.OF COUNTY ENGINEER MAP BOOK „PAGE PARCEL
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS
COLEMAN W. JENKINS, SUPT OF BUILDINGL
OCALITY -
FOR APPLICANT TO FILL IN NEAREST J
' CROSS ST.
Print ort a only)
DISTRICT NO. GR1� TYPE .�C �SS, ED BY
BUILDING -1rj0�/_
ADDRESSKauman CONST,
STATISTICAL CLASSIFICATION SEWER MAP
LOT NO. BLOCK
/ � v .CLASS NO. Cl OWELL•UNITS K PG
TRACT Z USE ZONE MAP
NO. OOF BLDGS. NO.
SIZE OF LOT NOW N LOT SPECIAL
USE OF I CONDITIONS
EXISTING BLDG. Rem dence -
TEL.
OWNER
,john V. Franklin NO. - BLDG.SETBACK FROM
ADDRESS 5025 Kauffman
FRONT PROP.LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
CITY Temple Cit California HIGHWAY WIDTH FROM C.L.
t
ARCHITECT OR TEL. `\ + _
ENGINEER - NO. BDG.SETBACK FROM
ADDRESS - BLDG.
PROP.LINE OF `� (STREET)
TEL p TYPE OF EXISTING SETBACK HIGHWAY +BARD = TOTAL
CONTRACTOR Oj'n O. 26 1S1 HIGHWAY WIDTH FROM C.L.
LIC. }
ADDRESS NO. 1 +
- LIC. �
CITCalifornia CLASS C- CORNER CUTOFF YES ❑ NO ❑ U
CONSTRUCTION LENDER
NAME,AND,BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS
W
ADDRESS CL
V7
SQ. FT. NO. OF NO. OF NEW ® Z
SIZE STORIES FAMILIES
USE
F.
OSTRUCTURE // ALTER ❑
❑
SIGNATURE OF REPAIR
APPLICANT DEMOL ❑
VALUATION $ VVO.00 APPROVALS DATE INSPECTOR'S SIGNATURE
F E $ FEE S 12.00 FOUNDATION:
MATERIALSION
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 ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT.
LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO
WORKMEN'S CO PE NSATION INS RA*N�O,�
Rigid LICK. Company LATH, EXT,
SIGNATURE F HOUSE NUMBER COR-
PERMITTEE _ RECT AND POSTED
ADDRESS FINAL
7—
JOHN
JOHN F. LEWIS. PRI IPAL ST
IRL LNGINEER
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATIONCASH
iLo 5 6'k-_ DEC 6 1 0 1. 2.v 0