HomeMy Public PortalAbout5917 PRIMROSE AVE_Building__ 76A638A CE#803 12/69
APPLICATION' FOR BUILDI G PERMI fl
COUNTY OF LOS ANGELES ASSESSOR
DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE-- PARCEL
BUILDING AND SAFETY DMSION BUILDING
JOHN A. LAMBIE, COUNTY-ENGINEER ADDRESS
COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY � � J (�
FRE7
OR APPLICANT TO FILL IN NEAREST 5!�
Print ort a onl CROSS ST. ^7(
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DISTRICT NO. GR TYPE �' PFO-ES D B
SS 5917 Primrdse • Tem le Cit J . () (� P• CONST. I/' _j�CA4
STATISTICAL CLASSIFICATION J` (�E�W'ER MAP '
. < �� BLOCK I CLASS NO.. DWELL.UNITS BKPG,� USE ZONE MAP pt r�NO.OF BLDGS. NO. (/ /F LOT NOW ON •LOT ' SPECIAL
• ' CONDITIONS
NG BLD�Gt. . ResidenceI1�� 7T & M Enter rises 087-7711 ;BLDG.SETBACKFROM
SS P®De 'BOX55 FRONT PROP,LINE OF (STREET)
'f"PE QF EXISTING SETBACK HIGHWAY + YARD = TOTAL
Rosemead California :HIGHW IDTH FROM C.L.ECT OR = TEL.
ENGINEER NO. BLDG.SETBACK FROM
ADDRESS SIDE PROP.LINEOF (STREET)
CONTRACTORSan Marino Roo NOL'285-115 IGHWAYTYPEOFIEW IDFROM C.L.SETBACKHIGHWA YARD = TOTAL
ADDREss5128� Walnut Grove ' NO'• 249559 + = a
CITY San Gabriel Cal. L'C
9 CLASS C'-39 CORNER CUTOFF YES ❑ NO ❑ Ce
CONSTRUCTION.LENDER' I C
NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS c
u
ADDRESS in
SQ..FT. NO. OF NO. OF NEW [ElSIZE STORIES FAMILIES'
USE OFADD ❑
STRUCTURE Residence
ALTER
Re-roof REPAIR❑
SIGNATURE OF
PPLICANT MOL ❑
ALUATION S 2 0.bO
APPROVALS DATE INSPECTOR'S SIGNATURE
FEE S FEPMTES 'S7 oVCJ 70FORMS I MATERCAA ON
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE-15 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.,QV "
LABOR CODE OF THE STATE OF -CALIFORNIA IN RELATING TO '
WORKMEN'S COMPENSATION INSURANCE. _ LATH. EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED '
ADDRESS FINAL
JOHN F. LEWIS. PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PER-2
VALIDATION CK • M.O. CASH
-2"
SEF 24 1 D 9.00_
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