HomeMy Public PortalAbout4836 TEMPLE CITY BLVD_Building__ 76A638A CES8035 65 APPLICATION FOR BUILD) PERMIT � LJ
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALIT f
JOHN A LAMBIE COUNTY ENGINEER NEAREST
COLEMAN W JENKINSAUP T OF BUILDING CROSS 3
DI9TR1 T N ORO TYPE PR C AY
FOR APPLICANT TO FILL IN CONS
BUILDING STATISTICAL SSIPICATION SEWER MAP
ADDRESSLgMOaL CLASS NO �OWELL UNITS B P
LOT NO BLOCK USE ZONE I
NOP L O
TRACT / SPECIAL `
MO 01 GLOSS CONDITIONS
S1ZE OF LOT NOW ON LOT
U5E OF
NO BLDG, SLOG ETSACK FROM • ,
p ` EL/I(1/ CI IRONY LIME 01 (ETRE[})
OWNER C O OLEO J }y1[ 01 [% 0 DI TRACK HIGHWAY YARD = TOTAL
ADDRESS HIGHWAY
MCL - -
} _
CITY T P �� [LSO SETBACK FROM
ARCHITECT OR TEL
ENGINEER NO SIDE PROP LINE OF (STREET)
TYPE OI [EIDTIXO pETpACN XIEXWAY YARD) TOY"
ADDRESS HIGHWAY WIDTH IR OM C L
TEL - - } -
CONTRACTOR NO _ O
LIC CORNER CUTOFF YES EJ NO 1:1V
AGGRESS NO
CIT ^ CL
LIE SEE REVERSE SIDE FOR SPECIAL APPROVALS O
DESCRIPTION OF WORK
NEW ADD ALTER REPAIR DEMOLISH N
Z
SO FT N OF NO OP
SIZE STORIES FAMILIFS ,
USE OF
STRUCTURE
SIGNATURE
APPLICANT
VALUATIONS
APPROVALS DATE INSPECTOR IS SIGNATURE
PC PMTFOUNDATION LOCATION
FCtS"�� FEES FORMS MATERIALS
FRAMEBRACING FIRE STOPS
I HEREBY AC HNOWLEDGE THAT I HAVE READ THIS APPLICATION BOLT
AND STATE THAT THE ABOVE 18 CORRECT ANO AOR![ TO COMPLY FURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING OAS 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 STAT! OF CALIFORNIA RELAY
ING TO WORKMEN S COMPENSATION INSURANCE LATH EXT
SIGNATURE O V HOUSE NUMBER COR-
PERMITTEE RECT AND_POSTED
ADDRESS conFINAL
JOHN F LEWIS PRINCIPAL STRUCTURAL EN R
PLAN CHECK VALIDATION CK M D CASH _ PERMIT VALIDATION cH No QCAD-
�9 6 7 3� F�B14 1 D 6.00~