HomeMy Public PortalAbout5620 PAL MAL AVE_Building__ TEMPLE CITY'
.......�.o... :_<, APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS 8
BUILDING AND SAFETY DMSION LOCALI
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST
FOR APPLICANT TO FILL IN DISr GT GROU TYPE PR ESSED BY
_ Q CONST. /
BUILD
ING STATISTICAL��CL��//AS��SIFICATION SEWER MAP
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ADDRESS /� _ Oy DWELL.UNITS O BK PG
NO. l W ' x`76, 5 . SSS �bc9CO CLASS.N
WATER NOT REQUIRED RECEIVED Lj
� � CEflTI FICATE:
TRACT MAPHIGHWAv
NO.OF BLDGS. NO. Q (CIRCLE) STATE MAJOR SECOND, LOCAL
SIZE OF LOT jS I NOW ON LOT USE ZONE SPECIAL
USE OF ` CONDITIONS
EXISTING BLDG. 4F /
TEL.
OWNER P BUILDING YARD HWY STREET NAME EXIST.
_ SETBACK W TH
ADDRESS FRONT i�i -
TEL. P.L. t-' kct�i U
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TEL. INSPECTION RECORD p
CONTRACTOR ^I ZL`>- NO. - (J
ADDRESS /_/ K
DESCRIPTION OF WORK -'
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ADD ALTER REPAIR DEMOLISH N
S .FT. NO.OF NO.OF
IZE STORIES FAMILIES �)
USEOFQIle H �
STRUCTIUIRE
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SIGNATUREOF ��,
APPLICANT n
VALUATION S d v a o
APPROVALS DATE IN SP ECTOWS SIGNATURE
P.G. PMT. CP-(^' FOFORMS,MNUNDATMATERIA ION � -10e
FEE FEE
FRAME: FI RESTOPB,
I HEREBY THAT
THE ABOVE
THAT I HAVE READ THIS APPLICATION BRACING OCABOLT8
AND
CALL THAT THE ABOVE II GOND S AND AGREE TO REGULATING
FURNACE: LOCATION.
WITH ALL COUNTY ORD INANC[t AND STATE LAWS REGVLATINO GAS VENT DUCTS
BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH INT.
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT-
ING TO WORKMEN' COMPENSATION INSURANCE.
urH,Exr.
SIGNATURE OF HOUSE NUMISER CON.
PER M ITTE RECT AND POSTED
ADDRESSvdl FINAL
CLYDE N. DIRLAM, PRINCIPAL STR RAL ENGINEER
PLAN CHECK VALIDATION m B.o. cABR PERMIT VALIDATION M.D. CASH
2 370 SEP 70 1 p 9k "
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9°A°°°°°°°°
u-°e APPLICATION FOR BUILDING PERMIT
DIVISION OF BUILDING AND SAFETY BUILDING /
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Department of County Engine.
ADDRESS
County of Los Angeles LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN, SUPT OF BUILDING CROSS ST.
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP TYPE �- SE BK MA PG
NG y //�1 �I ),.� ♦ I It CONST.
ADDREBUILD'SS vY�p{O Pry,C MA k MAP STATE
NUMBER �00 ,9 HWY
TAT YES NO
LOT NO. `v BLOCK USEZONE SPECIAL
CONDITIONS
TRACTNO. IF
SIZE OF LOT V�1 /� /`I U NOW ON LOTS b� BUILDING EXIST.
SETBACK YARD HWY STREET NAME WIDTH
EXISTING BLDG. FROUSEOF L.
NT a f
OWNER /r/G Al A2 D // ��.C,CA/ SIDE
P. L.
MAIL � � /1
ADDRESS �7/�(///yLJ.� O TRACT DWELL. t UNIT
TEL. /� ) 5 INDUSTRIAL
CITY NO./D'Q�I i DWELL. 1 UNIT
6 PUBLIC SLOG.
ARCHITECT OR TEL. 2 DUPL 2 UNITS
ENGINEER NO. ADDN..ALT., ETC.
8 APT. -UNITS
8
8 MISCEL.
ADDRESS 4 COMMERCIAL
�� U f�
TIL. INSPECTION RECORD c'
CONTRACTOR
I
ADDRESS _/ T_� '.,�,e�
DESCRIPTION OF WORK '
I
I yy
NEW ADD ^ ALTER REPAIR DEMOLISH 7+
SQ. FT. NO. OF / NO. OF
SIZE /" STORIES ! FAMILIES
/r
USE OF STRUCTURE
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SIGNATURE O PPROVALS
APPLICANT
ADDRESS DATE INSPECTOR'S 51 GNATURE
P. C. S FOUNDATION:FORMS.MATERIALS LOCATION //
FEE U FBRA GINC. BOLTS
RAME FIRE s
VALUATION l U S
FEE `' FURNACE: LOCATION,
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS GAS VENT, DUCTS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH. INT.
AND STATE LAWS REGULATING BUILDING CONSTRUC-
TION. LATH. EXT. �/ ✓Y
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS I FINAL
JOHN A.LAMBIE. COUNTY ENGINEER VALIDA� CLYDE N. DIRLAM. CHIEF BLDG. INSPECTOR
CK MO 9
rCo1O84Z9 OCT $ 1 2.00 n
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