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APPLICATION FOR RELOCATION BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING 4818 Persimmon.
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY Temple City
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A. IENSEN,SUPT OF BUILDING CROSS ST. Lower Azusa
DIST.NO. 'GROUP TYPE SEWER MAP PROD SED BY
FOR APPLICANT TO FILL. IN 'y CONST. 2 G t
PROPOSED 15'-' : T 'It" I �.
BUILDING, 4818 Persimmon
ADDRESS-- WATER CERTIFICATE:: NOT:REQUIRED � _RECEIVED ❑
LOCALITY' Temple City, California MAP�I r..: HIGHWAY STATE'MAJOR SE.CON ' LOCAL
PRESENT g NO. ��r f ICIRCLE)
BUILDING
ADDRESS- 009059 Ramona Blvd° gtiy USE ZONE SPECIALFiS
.
LOCALITY
Rosemead, California T
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eal
R-3
OWNER Mrs• Yo7.arida M. Nardulll BUILDING
SETBACK ' S .t-ZdlldET `A49 ',3 gx WIDTH
,-
MAIL
ADDRESS 5352 N• Britton Ave•, FRONT y �.
CITY Temple City TENO.At -0750 P. L. «t./I a k;6; 46
SIDE
MOVIf/G TELP. L.
CONTRACTOR Jack Stever NO, 338-9629 _
ry SURETY DATE REC
7��
ADDRESS
200 1V• Sunkist Cist W. ovina BOND$` FILE.
BUILDING TEL p CASH DATE RECD M
CONTRACTOR Solar Homes NO, At 6-6400 DEPOSITS FILED• BY �l0
ADDRESS 9161 Las Tunas Dr.,. T• C. APPROVALS -D&TEe JNSPEC GNATURE
ON
USE OF FORMS., .MATERIALS
PRESENT FOUNDATION; LOCATI
BUILDING . Single family residence ;
FRAME:_FERE STOPS., 00,
PROPOSED BRACING, BOLTS
USE OF Single farm residence
BUILDIN FURNACE: LOCATION r,-
GAS VENTS, DUCTS
SO.-FT. NO. OF LATH•: INT.
SIZE 9�+1 ROOMS 3 STORIESL=� �i
WALLCOVERING stUCCO ROOFCOVERING Wood Srlin
LEGAL HOUSE NUMBER COR-
DESCRIPTION I LOT NO. 1. BLOCK "GII RECT AND POSTED pt'1
TRACT 4902 .FINAL. f�4 Zt, �J
NO.OF BLDOS. DIS CT N'GINEER
SIZE OF'LOT 50.50 NOW ON LOT 2 SURETY BOND
RELEASED ej ✓
EXISTING BLDG. demolished USE OF
FMDj S
I HERESY ACKNOWLEDGE'THAT I HAVE READ THIS APPLICATI.O
1 HEREBY STAT HAT HE INFORMATI GIVEN IS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO'COMPLY
CORRECT. WITH ALL COUNTY ORDINANCES AND STATE LAWS REOU.LATING
5lGNATURE OF y.�_ BUILDING CONSTRUCTION. I CERTIFY THAT .IN DOING THE WORK
APPLICANT fA�' AUTHORIZED HEREBY I WILL.NOT EMPLOY ANY PERSON IN VIOLA,
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT.
ADDRESS ING TO WORKMF%'COM NSATI.ON INSURANCE.
VALUATION $ SIGNATURE
j 27e.
FEE OF'
aI -, PERMITTEE
trJ FEE'� '"--ADDRESS ° -
VALIDATION M.O. CASH JOHN F. LE:WIS, PRINCIPAL ST RAL ENGINEER
PFJWT VALIDATION CK. a.0. CASH
LAL0 0. 8 4 OZS MAR29 2 5 0 2 5 t0 0 A