HomeMy Public PortalAbout5228 KAUFFMAN AVE_Building__ Ct'/803,REV.6/781 ,
APPLICATION FOR BUILDING PERMIT-
COUNTY OF LOS ANGELES BUILDING AND SAFET
BUILDING
FOR APPL'ICANT,TO FILL IN' ADDRESS Z
BUILDING
ADDRESS LOCALITY
- NEAREST
CITY Temple City- ZIP CROSS ST -
c� C� V F NO OF BLDGS ASSESSOR "
SIZE OF LOT� 2` 1 •^ 05 NOW ON"LOT YZ� MAP BOOK P E PARCEL-
DISTRICT G UP TYPE• 'FIRE'( PR ESSEDBY�
TRACT f3 BLOCK LOT NO �C CONST ZONE"
TEL U 3
OWNER N0287 823�
STATISTICAL CLASSIFICATION SEWER M
ADDRESS -N KAICLASS NO DWELL UNITS. Z.PG
CITY Temple-.Cit_ ZIP
ARCHITECT OR TEL VALUATION
ENGINEER .'•,• NO
ADDRESS BLDG'SETBACK FROM
TEL " FRONT PROP LINE OF (STREET)
CONTRACTOR TOTAL SETBACK FROM TYPE OF EXISTING
IGHWAY + YARD = FRONT PROP.LINE HIGHWAY WIDTH
Ab�32' E. San' Bern.", RI 316141
LIC + _
CITY C Ovi$a :CLASS " B-1
BLDG SETBACK FROM
CONSTRUCTION LENDER
NAME AND BRANCH SIDE PROP LINE OF (STREET(
TOTAL SETBACK FROM TYPE OF EXISTING
ADDRESS CITY HIGHWAY + YARD = SIDE,PROP LINE HIGHWAYI WIDTH 0
SO FT NO OF NO OF CHECK + _ U
SIZE STORIES FAMILIES ONE 0
DESCRIPTION OF WORK Enlarge bedroo $IEW E3P C Fee S Permit Fee 0
ADD O Issuance Fee
ALTER
REPAIR ❑ Total Fee Z —
USE OF ❑ 1
EXISTING BLDG DEMOL l Z
APPLICANT EL G[C 0/iC� 2
(PRINT) NO Q
y
BY(SIGNATURE( >Q ,
IHEREBY ACKNOWLEDGE THAT I HAVE REA T IS APPLICATION AND STATE Y F L 9 n n A '
THAT THE ABOVE IS CORRECT AND AGREE TO C LY WITH ALL ORDINANCES t W 456 U
AND LAWS REGULATING BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE V
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF - # o o �o 0 0 1
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN S COM Z
"PENSATION INSURANCE'
2'- 1 4 2 0'0 •SIGN •.r -
TPERMTEEEOF. _ 001YUR
4 2 0 0 5
ADDRESS7 -NT • ' ZO p 5.2 4i-7 9
TEL
CITY QQV121A NO Q
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COND TIONS
FINAL BY
DATE Iv 7 !
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