HomeMy Public PortalAbout5525 TEMPLE CITY BLVD_Building__ TaASSpA CEREOS 8-64APPLICATION FOR BUILD PERMIT,
COUNTY OF LOS ANGELES BUILDING �L,
DEPARTMENT OF COUNTY ENGINEER ADDRESS �1�! ✓ / 1
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMSIE COUNTY ENGINEER NEAREST
COLEMAN W JENKINS VUP T OF BUILDING CROSS ST
DIST CT O OROP BY
FOR APPLICANT TO FILL IN U CONST TYPE
BUILDING STATISTICAL AS FICATION SEOR MAP
ADORE ge S l (� BK Pa 00
�y CLASS NO "--YY��oo��OV ELL UNITS
LOT NO A BLOCK USE ZONE _MAP
NO
/
TRACT S l+ 0l' Y.w AG E'S pP ECIAL
NO 01 BLOBS
SIZE OF LOT
i � 4 NOW ON LOT
USE OF
ElIlTIlG BLDG, BLDG SETBACK FROM
L -'f FRONT PROP LIN[O ' (STREET)
OWNER .'m"40, J TYPE OF I EXISTING E[TpACR IBNWAY Y = TOTAL
ADDRESS WI-TMC L
CITY 1.1 } 0 - O
ARCHITECT OR TEL BLDG SETBACK FROM
EN OINEER NO BIDE PROP LIN[ OF $"BIT
TYPE OF EXIBTINO SETBACK HIGHWAY } YARD = TOTAL
ADDRESS HIGHWAY WIDTH IR OM C L a
TEL } = 0
CONTRACTOR NO I I V
LIC CORNERCUTOFF YES NO O
ADDRESS NO
CL
LIC SEE REVERSE SIDE FOR SPECIAL APPROVALS
DESCRIPTION OF WORK 'Al
Z_
NE ADD ALTER REPAIR DEMOLISH
SO FTNO OF NO OF
SIZE 7/ STORIES IAMILIFS
USEC
STRUCTURE S o I'C
SIGNATURE OF
APPLICANT
VALUATION 445to" APPROVALS GATE INSPECTOR'S SIGNATURE
P C PMIT I' << FEES FO FORMS,ON LOCA T,MATERIAL,FEE$ V� FRAME FIRE STOPS,
I HERESY ACKNOWLEDOC THAT 1 HAVE READ THIP APPLICATION BRACING BOLT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REOUunnO GA] VENT DUC
•UILDINO CONSTRUCTION 1 CERTIFY THAT IN 001 [ WORK
AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY N VIOLA LATH INT 3/GJ
TION OF THE LABOR CO OF TN[ STATE 01 AL11 IA RELAY
ING TO WORKMEN S NBATION INSURA 51PIA1 '
EXT JAY T
B IGNATTEE O HOUSE NUMBER COR-
PERMITTEE q
ADDRESS FINAL
JOHN F LEWIS PRINCIPAL STAL ENGIN ER
PLAN CHECK VALIDATION _ o CASH PERM VALIDATIO cN o CAR"
LACE 3 1 7 A Ju,'J29 2 3 7S0- Q
LA�o3 1 7 5-� X'i29 1 D 155,00-
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