HomeMy Public PortalAbout5122 PAL MAL AVE_Building__ 76A638A CEN803 9-68
APPLICATION FOR BUIL®1N PERMIT
COUNTY OF LOS ANGELES ABUILMING
DDRESS 5122 No. Pal Mal
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION LOCALITY Temple City
6889 JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS, SUPT OF BUILDING CROSS ST.
DISTRICT NO G TYPE �- RR ES BY
FOR APPLICANT TO FILL IN �' CONST.
(Print or type only)
BUILDING ADDRESS P STATISTICAL C W
SIFICATION S ER MAP
122 NO al 1 CLASS NO. DWELL.UNITS BK PG
LOT NO, p� BLOCK USE ZONE MAP
NO.
TRACT SPECIAL
NO.OF BLDGS. CONDITIONS
SIZE OF LOT NOW ON LOT I
USE OF
EXISTING BLDG. BLDG.SETBACK FROM
L. FRONT PROP.LINE OF (STREET)
OWNER R. G. Gain NO
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS 5122 NO. Pal Mal HIGHWAY WIDTH FROM C.L.
CITY Temple Cit. BLDG.SETB ROM
ARCHITECT OR TEL, SIDE PROP.LINE (STREET)
ENGINEER NO. TYPE OF EXISTING SETBACKHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C.L.
CONTRACTOR Virgin Roof Go. NOL 2 — + `
ADDRESS00 Son el NIOC360650
CORNER CUTOFF YES ❑ NO
CITY San Gabriel
—LIC. S C-39 SEE REVERSE SIDE FOR SPECIAL APPROVALS
CONSTRUCTION LENDER
NAME AND BRANCH
ADDRESS
SQ. FT. NO. OF NO. OF NEW ❑
SIZE STORIES I FAMILIES
USE OF ADD ❑
STRUCTUREReroof with 235#
ALTER ❑
Comp. shingles
SIGNATURE OF REPAIR®
' APPLICANT DEMOL ❑
VALUATION$343,00 1 APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. PMT. FOUNDATION: LOCATION
FEE S FEE$ 9.00 FORMS, MATERIALS
FRAME: .FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT 1 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. 1 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 COMPENSATIOl�SURANCE. LATH, EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE �� RECT AND POSTED
ADDRESS f 5
FINAL .[
JOHN F. LEWIS. PRIN'CIP4Z STRUJ= RAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH
E fir;3:_G,}Q 6� 8 1 0 9.0 0� ��
DEPARTMENT'.OF BUILDING AND SAFETY. rVrs•rcaunal
ij COUNTY OF LOS ANGELES
k WM. J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
UILDING DISTRICT NO. 09AN CK.NO. PERMIT I�fl
ADDRESS �f l ..,F•" C ,�
LOCALITY _/]'//43 �.���_ .J}7/ "J �� t'af n REC VED BY DATE OFAPPL. DAT,/IIBBBUED a
CROSSBST.r4"x? (51
BUILDING
OWNER T�/h,.,?�/ / f. • �/tr�ss ADDREBB
MAIL y� LOCALITY
ADORESNEAREST
• TEL 4 / CROSS ST.
CITY! NO. . �`f'00
FIRE NO.OF TYPE GROUP
ARCHITEM OR TEL. ZONE PLANS T
ENGINEER NO.
BLDG. ORD.NO.
'ADDRESS SETBACK LINE , w
TEL- APPROVED7�
CONTRACTOR (/—� Z*�{" NO. /J[OOBY _x/—Z-v',-- "_/-L—_ /4%5 DATE
USEAPPROVED
ADDRESS r•,n ! .( 1 / /( P__ r ZONE ' BY DATE
LEGAL CORRECTIONS
DESCRIPTION LOTNO. J BLOCK `—
TRACT /,� `'a 6—
v S�a X / 7 o I NOW ON LOTS
SIZE OF LOT
USE OF i/"J ,& I NO.OF , I NO.OF 4:-
EXISTING BLD r etl.. • FAMILIES ROOMS r
DESCRIPTION OF WORK
NEW ALTERATION ADDITION O
REPAIR MOVING DEMOLISH p
SQ.FT. '/ NO.OF Z
SIZE �•T ROOMS STORIES D
WALL ROOF I'
COVERING I COVERING
USE OF NEW
BUILDING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS
APPLICATION AND STATE THAT THE ABOVE IB CORRECT FOUNDATION:LOCATION INSPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMB,MATERIALS
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
FRAME: FIRE
SIGNATURE ORS " f /� �a� ► BRACING.BOLTS
PERMITTEE � ''_-, L
ATH,INT.:
AUTHORIZED ABT ( LATH,EXT.:
DSS-3 SOM SETS 1-40 $ P.C.BPLASTER,INT.
FEESTER,EXT.
® /.
VALUATION FEE � AL ,ir" :•: �j i c7 Ab
' DIVISION OF BUILDING AND SAFETY U I LD I lei
Deip I ent of County Engineer
�. County of Los Angeles
WM. J. FOX, COUNTY ENGINEER APPLICATION
UILFOR APPLICANT TO FILL IN ADD EISS
ADDRESS Z LOCALITY.ST.
/J�y E
LOCALITY��ir/ a4 E �y CROSS ST.
_ DISTRICT NO. PLAN CK.OR REO.No. PERMIT NO.
NEARESTCROSS ST. CC
OWNER ,41 RECEIVED BY DATE OF APPL. PATE,*SD
MAIL /� /� _mom
ADDRESS� � ��t. , ^`p dl— USE ZOi/� NO. OF TY GRO/ IRE Z NE
®�� NO.Jgio x 0 0 f ��/ PLANS / I
ARCHITECT OR TEL. ��../J"` Q ZONING
ENGINEER NO. �7°°'i�' APPROVED BY
BUILDING ,7 , O O.
ADDRESS SETBACK LINE:
CN���E�.. TEL.. APPROVED _
DAY
CONTRACTOR NO. BY:
HO NUMBERING
ADDRESS
LEGALMAP NUMBER NO. ASSIGNED BY
DESCRIPTION LOT NO. I BLOCK
DATE I CORRECTIONS I INSPECTOR V
TRACT 4.:�_ C> -)v
NO. OF
SIZE OF LOT p I NOW ON LOT SLOGS. I-
USE OF O. OF /
EXISTING BLDG. ���1AMiL1E8 / p
DESCRIPTION OF WORK
z
NEW ALTERATION ADDITION r
REPAIR DEMOLITION
SQ. FT. 9 NO. OF
SIZE ROOMS STORIES
COVERINGA L (�J/9 d I ROOF
COVERING .Y
USE OF STRUCTURE
_ GJ C7 GC'c
� r _ i�c�l't � I ..
APPROVALS
INSPECTOR/SIGNATURE DATE
FOUNDATION: LOCATION
FORMS, MATERIALS
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- e p
PLICATION AND STATE THAT THE INFORMATION GIVEN IS FRAME: FIRE STOPS, /
CORRECT. BRACING, BOLTS 'ff?.�.�
I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION,
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. GAS VENT, DUCTS
SIGNATURE OF LATH, INT.
PERMITTE dopy
ADDRESS•,,
�. LATH. EXT.
AUTHORIZED AGT. PLASTER, INT.
V O PLASTER, EXT.
O FEE 6 ® HOUSE NUMBER COR-
RECT AND POSTED
S OQ
VALUATION FEE FINAL
78A838A DBH 8 2-88
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