HomeMy Public PortalAbout5929-5929 3/4 PRIMROSE AVE_Building__ � ' ® ' BUILDING"} '- -N- lTjM 80-5E
ADDRESS - -
APPLICATION; LOCALITY � /I�I��� C/7
NEAREST 11/y 1
DIVISION OF BUILDING AND SAFETY CROSS ST. �J`✓ `�
Department of County Engineer DISTRICT N RECEIPT NO. PERMIT NO.
County of Los Angeles r. t-3 ' 71 66 $'
WM. J. FOX, COUNTY ENGINEER GROUP - DATE RECEIVED DATE ISSUED
CA99ATT D. GRIFFIN, SUPT OF BUILDING /! 4 -5,
' �9
12
FOR APPLICANT TO FILL IN TYPIf CDNST. RECEIVED By,
Y S ED BY' a
3'l.
OWNER ��7
ADDRESS �,�!/JNI/y��MAILNUMBER V O sHWYE O
USE ZONE SPECIAL'
CITY NEL' TvS�o r CONDITIONS
ARCHITECT OR/QU� A-7-�-%�R `
ENGINEECT I � /N O;
ADDRESBU!/v N �/��Y{/ �I,; �j/T r 13AV-� B 6 DING YARD HWY STREET NAME EXIST.
SETBACK t WIDTH
c� FRONT Y'/ TEL. Ps
CONTRACTOR NO. SIDE
ADDRESS P.L.
BUILDING 31 /A1� DATE CORRECTIONS INSPECTOR
ADDRE89V l!��J�J L�
LOT NO. L� / BLOCK i
ZIt S-s. 6417w Ae? :a t r tyls�6
TRACT , _
J D y NO.OF BLDG9.
L ;
SIZE OF OR6� �) NOW ON I[� ./
4w
USE OF ��,/ 1 A - } ��U cIT1D/Y '�S Tb .UT/7�l"•.I
EXISTING BLDG. /4 61., 4- ✓�C/V '
DESCRIPTION OF WORK Ry C< A-W-r. //✓fJ%� I D O
21W.C5 Lo-M-1/hr/7, 'h le
NEW
ADD ALTER REPAIR DEMOLILS.�H
34.FT.9 Jl' ( STOR E9 FAQ IOLIE9 / l�Ff� M r
SIZE i'
USE or STRUCTURE
OF It
NO.OF
EMPLOYEES I+ '
, I
HER ACKNOWLEDGE THAT I HAVE READ THIS AP-"'
PLICATION AND STATE THAT THE INFORMATION GIVEN 19
CORRECT. APPROVALS INSPECTOR'S SIGNATURE DATE
1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
FOUNDATION: LOCATION
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FORMS,MATERIALS
FRAME: FIRE STOPS,
SIGNATURE OF -/Y— � BRACING,BOLTS ( , /.�;�G�4LJ�U� 7+b
PERMITTE �V
�J � FURNAC LOCATION.
ADDRESSII ,3/ GAS VENT,D� S'rP
U/CTS , !/d EG / 6-7�13tS
AUTHORIZED ADT. !/
LATH, INT. jl -
LATH, EXT.
$ - P.C.S HOUSE NUMBER CDR--
-FEE: RECT AND POSTED C hav&b -V
VALUATION * J��fe//VV FEE &tFINAL
76A638A DBS 3 Ob 5-54
APPLICATION FOR BUILDING- PERMIT,
FOR
FOR APPLICANT TO FILL IN (Print or type only) ��"/6'
FSI
ING COUNTY OF LOS ANGELES
ESS 5929 Primrose DEPARTMENT OF COUNTY ENGINEER
Tem le Cit ZIP BUILDING AND SAFETY DIVISION
J NO.OF BLDGS. BUILDING
OF LOT �Qx NOW ON LOT ADDRESS �Mq zo�&,
TRACT 46,571.711BLOCK L'OT NO.2& LOCALITYTE . NEAREST
�� s
OWNER E. W. Mushinskie NOL CROSS ST. Lv
ASSESSOR
7
ADDRESS 5937 Primrose MAP,BOOK PAGE PARCEL
DISTRICT jr.ROUP ITYPE FIRE PRO SSED BY
CITY Temple City ZIP �/� CONST. ZON r22?r
ARCHITECT OR TEL. ,," r �/ 1
ENGINEER NO.
STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS CLASS No.-- .,?.r DWELL•UNITS r BK PG
CONTRACTOR Rigid a NOL 261-51glUSE ZONE MAP
LIC. NO.
ADDRESS 337 S. WoodNO. SPECIAL
LIC. CONDITIONS
CITY Los Angeles CLASS C-19 ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑
CONSTRUCTION LENDER
NAME AND BRANCH BLDG,SETBACK FROM o
FRONT PROP.LINE OF (STREET)
ADDRESS CITY HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING C
SQ, FT. NO. OF NO. OF CHECK FRONT PROP, LINE HIGHWAY WIDTH Q
SIZE I STORIES FAMILIES ONE I.C1...
DESCRIPTION OF WORK NEW ® G
ADD ❑ BLDG.SETBACK FROM co
Re- ri' SIDE PROP.LINE OF (STREET)
LTER ❑ HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING
REPAIR❑ SIDE PROP. LINE HIGHWAY WIDTH
USE OF DEMOL E] +
EXISTING BLDG.
APPLICANT TEL CORNER CUTOFF YES ❑ NO ❑
(PRINT) NO.
BY (SIGNATURE) IN OPEN SPACE YES ❑ NO ❑
IN COASTAL ZONE YES ❑ NO ❑
VALUATION$ 896.50 CATEGORICAL EXEMPTION YES❑ NO ❑
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY IMPACT EXEMPTION DECLARATION 51GNED (DATEI
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION. 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE)
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO
WORKMEN'S COMPENSigf6MU CES COMPANY
SIGNATURE OF aa��LLllaallLL lY r
PERMITTEE
ADDRESS 337 S. 410
FINAL BY
Los Angeles TEL. DATE �j
CITY g NO. - �• C—
MAKE KE C HE C KS PAYABLE '/'O: FEE $ FEEPMT $ 15.00
HARVEY T. BRANDT. COUNTY ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDAbiON C M.O. CASH
I-Alf
e'—v 1 u i —5.0ua
76A638A CE#803 12/72