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HomeMy Public PortalAbout5460 TEMPLE CITY BLVD_Building__ APPLICATION FOR BUILDING PERMIT BUILDING FOR APPLICANT TO FILL IN ADDRESS C41cx :c iLNG , AUDDRE55 —' LOCALITY AM NEAREST CITY y ZIPNO OF CROSS ST DGS SIZEOFLOT y�1 Q NOW ONLOTr MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE P ED BY TRACT BLOCK LOT NO v p ? CONST L / E TEL V d V OWNER �� NO��� 4 STATISTICAL CLASSIFICATION SEWER MAP ADDRESS �` _ CLASS NO DWELL UNITS b BK/aPr2 CITY ZIP LRE ZONE MAP ARCHITECT0 TEL on NO ENGINEER '� 1 N Y„ /c... / SPECIAL CONDITIONS ADDRESS Z_ . T L ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO❑ EL 1 CONTRACTOR NOZx \ BLDG SETBACK FROM q FRONT PROP LINE OF (STREET) ADDRESS NO '.L�I TOTAL SETBACKFROM TYPE OF E%(STING HIGHWAY + YARD FRONT PROP LINE HIGHWAY WIDTH CITY l `C'L`ASS G—� S CONSTRUCTION LENDER + i NAME AND BRANCH 7 CI BLDG SETBACK FROM V ADDRESS CITY /�� SIDE PROP LINE OF (STREET) �0j SIIZZE� STORIOES FAMIF NO OIIES "C% QryEK HIGHWAY + YARD TPKL SETBACK SIDE PROP LINE HIGHWAY EXISTING 6 ❑ + Z DESC I TION OF WORK NEW ^�"7 ADD CORNERCUTOFF YES ❑ NO ❑ ALTER INOPEN SPACE YES ❑ NO ❑ REPAIR USE OF IN COASTAL PERMIT ZONE YES ❑ NO ❑ EXISTING BLDG L, DEMOL APPLICANT TEL C I WRINTI f"LQ NO -r 1 O �T e� BY(SIGNATU C/ THA I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS WITH AND STATE LACES AND THE ABOVE IS CG BUIL AND AGREE 1TI COMPLY CERTIFY T ALL ORDINANCES L AND LAWS ORIIHAbNG BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL EMPLOYVIOLATIONOY ANY PERSON IN VIOLATION OF THE LABOR CODEOF THE STATE OF CALIFORNIAIF IN RELATING TO BCOM FFNSAl1ON INSURANCE y� ND SIGNATU �PERMITTERE OF �L]J �` DAffL /J f_ BY ADDRESS TEL PC Fee E Permit Fee CITY NO Issuance Fee VALUATION$ oL,IJO Total Fee PLAN CHECK VALIDATI c mo CASH PERMIT VALID,17Q cL ;0 C"H 6250AY, 25 21_ n6_ 0 • es 76""m ca M28 6/ 8 tlp �-� p - ra--7 62 60-RAY ,25 •1 0 - -3-4.00 " APPLICATION FOR BUILDING PERMIT "OR APPLICANT TO FILL IN (P,,.t or tvPR only) BUILDING .r!C T - COUNTY OF LOS ANGELES ADDR DEPARTMENT OF COUNTY ENGINEER CITY ZIP ING AND SAFETY DIVISI O OF BL BUILDING SIZE OF LOT NCM' ON L ADDRESS TRACT BLOCK LO LOCALITY "J TEL NEAREST OWNER �� / r NO CROSS ST ASSESSOR _ ADDRESS Remy MAP BOOK PAGE - CEL DISTRICT GROUP T FIRE ESSED By CITY ZIP CONS ARCHITECT OR TEL ENGINEER NO STATISTICAL IFICATION SEW MAP ADDRESS CLASS NO DWELL UNITS B P CONTRACTOR Ap NEL E ONE MAP A DORESS .CF Sr LIC NO NO S SPECIAL I LIC CONDITIONS CITY CLASS ROAD DEPARTMENT APPROVAL REQUIRED ES❑ NO CONS RUCTION LENDER NAME AND BRANCH BLDG SETBACKFROM FRONT PROP LINE OF (STREET) ADDRESS CITY HIGHWAY } YARD TOTAL 5 TBACK PROM TYPE OF EXISTING SI FT�` NO OF NO OF CHECK FRONT ROP LINE HI HWAV WIDTH SIZE (�IdO STORIES I FAMILIES I ONE > } - Itno C DESCRIPTION OF WORK NEW o OD mBLDG ' Ct SIDE PROPROP LI LINEEOF OF -(STREET) � ALTER HIGHWAY _ } YARD - TOTAL SETBACK FROM TYPE OF EXISTING / REPAIR SIDE PROP LINE HIGHWAY WIDTHUSOF y� _ D EXISTING BLDG ��Q.� �'/� EMOL } Z APPLICANT TEL.y�LOt(� CORNER CUTOFF YES NO C] RINT) NiBdoGG O BY (516NA TUR EI IN OPEN SPACE Y NO Cl IN COASTAL PERMIT ZONE ES NO C] VALUATION$ 1 HEREBY ACKNOWLE04E THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 13 CORRECT AND AGREE TO COMPLY WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON ST RUC TIONCERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY 1 WILL NOT EMPL Y ANY PERSON IN VIOLATI OF THE LABOR CODE OF THE E OF CALIFORNIA IN TING TO WORKMEN 3 COMPEHSAT INSURANCE SIGNATURE OP PERMITTEE _ _ � ADDRESSZOE LS ` /r4 FINAL BY CITY Npl�G6,J / DATE 11AIAT 4t AE CHECAS Y.ISAHLE 70 FEE $ FEE W �� 1 HARVEY"T BRANDT. COUNTY ENOINEER PLAN CHECK VALIDATION CK M o CASH PERM VALIDATION cN o CASH " 36NY 1 1 On 21.75A9' 71AG30A CS*BUE E/71 /�