HomeMy Public PortalAbout5138 TEMPLE CITY BLVD_Building__ �cMPLt QTY
70AE3BA CE0803 sea APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGST FS BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDR Ess
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEARESTbDC.PV
WILLIAM JENSEN SUP T OF BUILDING CROSS ST L-AL. =
DISTRICT NO GROUP TYPE OCESSED BY
--FOR APPLICANT-TO FILL-IN-=- coNsr
BUILDING STATISTICAL CLASSIFICATION ER MAP
ADDRESS SK PG
hh CLASS NO DWELL UNITS
LOT NO V BLOCK WATER NOT REQUIRED RECEIVED
CERTIFICATE
TRACT MAP o / �cGRCLEI
NO OF BLDGS NO o'�VSTATE MAJ SECOND OCA
S� L
SIZE OF LOTS (oO NOW ON LOT U�$ONE SPECIAL
USE OF / CONDITIONS
EXISTING BLDG
TEL
OWNER NO BUILDING EXIST
SETBACK YARD MWY STREET NAME WIDTH
ADDRESS FRONT
ARCHITECT OR TEL P L 120
ENGINEER NO SIDE
P L
ADDRESS
TEL - O
CONTRACTOR NO U
ADDRESS
DESCRIPTION OF WORK N'w
NEW ADD ALTER REPAIR DEMOLISH Z
SQ FT NO OF NO OF
SIZE STORIES FAMILIES
USE OF
_STRUCTURE tZ
SIGNATURE O
APPLICANT
VALUATION S ILZ
APPROVALS DATE INSPECT011 8SIGNAT
PC PMTFOUNDATION LOCATION
FEE S FEES t-c-) FORMS MATERIALS
FRAME FIRE STOPS
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY FURNACE LOCATION 6
WITH ALL COUMY ORDINANC[8 AND STATE LAWS REGULATING"' 'GAS VENT DUCTS
BUILDING CONSTRUCTION 1 CERTIFY THAT IN OOING THE WORK \
AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT
TION OF THE LABOR COOK OF THE STATE OF CALIPORN IA RELAT
ING TO WORKMEN S COMPENSATION INSURANCE 1
LATH EXT
SIGNATURE O6P 13 ��7 HOUSE NUMBER COR
PERMITTEE RECT AND POSTED
ADDRESS FINAL
PLAN CETF.0 VALID 'cA CK M o GASH JOHN F LEWIS PRINCIPAL ST RAL ENGINEER
PERMIT VALIDATION CK mo CASH
L,uo 6 9 7:D OEC 1- 7 1 D
6.00 -
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