HomeMy Public PortalAbout6240-6242 ROSEMEAD BLVD_Building__ 7GA638A CE#803 3-66 APPLICATION, FOR 'BU 1 .I NG PERIVIVr
COUNTY OF LOS ANGELESBUILDING
DEPARTMENT OF COUNTY ENGINEER pDDR.ESS
BUILDING AND SAFETY DIVISION LOCALITY.
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS.SUP'T OF BUILDING CROSS ST.
DISTRI. T NO GROUP.. TYPE PR Cj,S B.
FOR APPLICANT-TO FILL IN r- coNST.
BUILDING STATISTICAL LASSIFICATION SEWER MAP
ADDRESS •CLASS NO. .DWELL UNITS BK41 PG
LOT NOS. Q / BLOCKUSE ZONE MAP -
p
NO.TRACT C - 'SPECIAL
0. OF SLDGS. CONDITIONS
SIZE OF LOT ["NOW ON T
USE OF
EXI BLDG. SETBACK FROM' ,
S p TEL. -FRONT PROP. LINE OR. (STREET)
OWNER G NO. TYPE OF EXISTING SETS HIGHWAY 'I' YARD - "?TOTAL
ADDRESS HIGH.WAY D F C.L.
CITY. BLOO. SETBACK. OM
J%RCHITECT OR 'TEL.
ENGINEER No. SIDE PROP. LI OF (STREET)
TYPE OP ISTI,NO SETBACK XIOHW.AY_ ;+'_ _
TOTAL -
ADDRESS H10XWAY IDTH FROM C.L.
TEL. +
CONTRACTOR NO b
LIC
ADDRESS NO CORNER CUTOFF YES NO
C.
CITYcls c— W;6— REVERSE SIDE FOR SPECIAL APPROVALS c
DESCRIPTION OF.WORK `�
NEW ADD ALTER REPAIR e EMOLISH
SO.FT. -NO. OF 140. OF
SIZE STORIES FAMILIES
USE CF
STRUCTURE
SIGNATURE OF
APPLICANT
VALUATION$ �• i .,QD
' 1 APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. PMT. FOUNDATION,_LO.CATION
FE FEE$ FORMS,MATERIALS _
FRAME; FIRE STOPS.,
I HEREBY ACKNOWLEDGE'THAT 1 HAVE READ THIS APPLICATION BRACING BOLT '
AND 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. I CERTIFY THAT. IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY'ANY PERSON IN VIOLA- LATH. INT: '
TION.OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT.
INGTO WORKMEN'S cnmPENSATION INSURANCE. LATH. EXT. - '
• ,
SIGNATURE OF HOUSE NUMBER COR-
PE,RMITTEE ' RE AND POSTED �y "
ADDRESS--,j I NAL l/)
JOHN F.
LE�WIS. PRINCIPAL STR CTURAL EN
PLAN CHECK VALIDATION CK. M.O. CASH — PERMVALIDATION CK. M.O CABX
L&.-5'4,6-SV' -OCT?5 1. D 4.0 Q-,, V .