HomeMy Public PortalAbout6149 ROSEMEAD BLVD_Building__ 78AB38A CE#808 8-88 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS 6149 N. Rosemead Blvd..
BUILDING AND SAFETY DIVISION LOCALITY Temple City
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A.JENSEN, SUP'T OF BUILDING CROSS ST.
DISTRICT NO. I GROUP TYPE PROCESSED BY
FOR APPLICANT TO FILL IN __7 coNsr
BUILDING STATISTICAL C SSIFICATION SEWER MAP
ADDRESS6149 m- 'Rosemead 'R 3rd BK,,;�, PG
y �+ CLASS. NO. DWELL.UNITS
If
LOT NO. Q/� `� BLOCK WATER NOT REQUIRED ❑
CERTIFICATE:
TRACT MAP HIGHWAY S E MAJOR SECOND CAL
NO.OF BLDGS. NO. (CIRCLE)
SIZE OF LOT NOW ON LOT USE ZONE SPECIAL
USE OF ,e CONDITIONS
EXISTING BLDG.
TEL. '
OWNER To. j. WagnerNO. ram BUILDING YARD H Y STREET AME EXIST.
SETBACK WIDTH
ADDRESS 61,49 N R TEL. FRONT
ARCHITECT OR P. L.
ENGINEER NO. SIpE
P. L.
ADDRESS
TEL.
CONTRACTOR o
NO. 0
ADDRESS 600 SO. Sall Gabriel Blvd., S C
DESCRIPTION OF WORK
Lu
o.
NEW ADD ALTER EP roWPOLISH in
SQ.FT. NO.OF NO. OF Z
SIZE STORIES FAMILIES
USE OF
STRUCTURE
compo. shingles.
SIGNATURE OF
APPLICANT
VALUATION $
APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. PMT. FOUNDATION: LOCATION
FEE $ FEE $ 6.W FORMS, MATERIALS
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS
ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION.
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS
BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT.
TION OF THE LABOR ODE OF THE STATE OF CALIFORNIA RELAT-
ING TO WORKIEN'S C M Ij.�,A�QfVNIN^�l�i�(•L . /
111{{ 11 �t((((�� ��jj'' H.EXT.
SIGNATURE LG HOUSE NUMBER COR-
PERMITTEE cr RECT AND POSTED
ADDRESS 6 O O. San Gabriel Blvd FINAL
JOHN F. LEWIS. PRINCIPAL ST URAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
A'
I_i-W 4'5 5 5 SEP 12 1 D 6.0 0 N
APPLICATION FOR � C
BUILDING PERMIT
FOR APPLICANT TO FILL IN ADIDRESS !o4 C ��• %`I �G'
BUILDING
ADDRESS � LOCALITY `r
NEAREST
CITf2 � ZIP CROSS ST.
No.OF BLDGS. ASSESSOR
SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL
DISTRICT GROUP TYPE FIRE PROCESSED BY
TRACT BLOCK LOT NO. , CONST. ZONE �
OWNER T L-NEOr _S� 7 J9- •T`�
STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS CLASS NO. Z DWELL.UNITS B" PG
CITY ZIP USE ZONE MAP
ARCHITECT OR TEL.' NO,
2C C�
ENGINEER NO. SPECIAL
CONDITIONS
ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NOL.
❑
CONTRACTOR /LL O. BLDG.SETBACK FROM _
LIC FRONT PROP.LINE OF (STREET)
ADDRESS e NO .f TOTAL SETBACK FROM TYPE OF EXISTING
HIGHWAY + YARD = FRONT PROP.LINE HIGHWAY WIDTH
LIC.
CITY ZA CLASS -
CON RUCTION LENDER + _ CL
}
NAME AND BRANCH BLDG.SETBACK FROM OU
ADDRESS CITY SIDE PROP.LINE OF (STREET) 0
SQ.FT. NO.OFNO.OF CHECK HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING u
SIZE STORIES FAMILIES ONE SIDE PROP.LINE HIGHWAY WIDTH ai
En
+ = Z
DESCRIPTIO41 OF WORK 1 NEW ❑
ADD CORNER CUTOFF YES ❑ NO ❑
ALTER ❑ IN OPEN SPACE YES ❑ NO ❑
REPAIR ElUSE OF BLDG. DEMOL ❑ IN COASTAL PERMIT ZONE YES ❑ NOEXI ❑
APPLICANT TEL
(PRINT) NO. 9 G14-7,1 &!ar /C-e—7/0 A/$ A10 T" WA/C-
BY(SIGNATURE)
• I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES
AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S-COM.
PENSATION INSURANCE.
� �
SIGNATURE OF �� FINAL �7 BY f'
~
PERMITTEE a ' DATE
ADDRESS
r
TEL. P.C.Fee$ Permit Fee
CITY ����u�®�- NO.
��� - Issuance Fee
Q
VALUATION p a O. U
t Total Fee S
PLAN CHECKVALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH
� —• .- 6 CT 12 •1 0 7 5.7 5 ®id
®s 76AS388 CE 18038 6/76