HomeMy Public PortalAbout5017 TEMPLE CITY BLVD_Building__ .� TEMPLE-CITY
TE.GJ9,CE HBO] ]!, APPLICATION FOR BUILDING PERMJT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST
WILLIAM A JENSEN SUP T OF BUILDING CROSS ST cp
DIST�JCT GROUP TY ESSED BY
FOgAPPIlC
L IN �� coNsr
BUILDING STATISTICAL CLASSIFICATION S ER MAP
ADDRESS CLASS NO DWELL UNITSJJ K
LOT NO BLOC WATER NOT REQUIRED RECEIVED
CERTIFICATE
TRACT / MAP HIGHWAY SLOGS NO .,RCLEI STATE MAJOR ECO LOCAL
SIZE OF LOT N LOTIII USETONE SPECIAL
USE OF CONDITIONS
EXISTING 8 DEL
OWNER � NO BUILDING E%IST
SETBACK RD HWY STRE AME WIDTH
ADDRESSFRROLT C}�I `ARCHITECT ORTEL I&ENGINEERNO SI }
P R
ADDRESS O
TE V
CONTRACTOR N Ed
ADDRESS � �� �� W
DESCRIPTION OF WOR%
/ a
_ w
EW ADD ALTER REPAIR DEMOLISH
SO FT NO OF NO OF -
SIZE STORIES FAMILIES/
USE OF
STRUCTURE
IRA
0.
SIGNATURE OF
APPLICANT
VALUATION 5 V /
APPROVALS D4TE/ INS E aflaMAruRe
PVTQ FOUNDATION LOCATION /
FEE $ ` FEE $ FORMS MATERIALS
FRAME FIRE STOPS
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE M 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 �L
AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT �j+� ,� r
TION OF THE LABOR CODC OF THE eFATE OF CALIFORNIA RELb
MPEA_ N INSURANCE TO WORKMEN S
LATH
SIGNATURE OF HOUSE ENUMBER
PERMITTEE COR
RECT AND POSTED
ADDRESS -FINAL
PLAN CHECK VALIDATION 0 o CASH' _ JOHN F LEWIS PRINCIPAL STRUCTURAL ENGINEER
PERNIIT VALIDATION CK M O CASH
GL 4559G JAW 1723 D ' 3025A 5
I Udo 4 8 8 5G JAW 2 7 1 D 6 0.5 0-