HomeMy Public PortalAbout5729 TEMPLE CITY BLVD_Building__ A63"
#803(REV.11/78)
APPLICATION FOR BUILDING PERMIT.,
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUILDING
/� �q y�,f �^ y� ADDRESS e, v �,/ L
.ADLDINGDRESS / NEAREST
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CITY / C-/// �jG� ZIP '_`/ /�� CROSSST.
SIZE OF LOT y- c,! NOW ON LOT , ASSESS�2
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TRACT CtlS BLOCK/� �/ LOT NO..699<0 DISTRICT GROUP CONST. ZONE
TYPE FIRE P
EL
OWNER J'A�#C-Z-A?tl NO.?ZZ l e ! S /\i0d, {
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n .STATISTICAL CLASSIF T ONI'// •�_ � / SEWER MAP
ADDRESS f / / Y�NIyS !,/` e CLASS NO. DWELL.UNITS ` BK/°3�PG
CITY f✓1/��// j ZIP �rr�// �Upp.
E GIN ERCHITE� V k FI)J 1707V NG /2� O�`J� VALUATION
ADDRESd3&(e S.tft gft—M IWS, gel'/+,11 6'l BLDG.SETBACK FROM
TEL. �� /�J/� FRONT PROP.LINE OF (STREET)
CONTRACTOR f�e�//moi ! •�``•"�/ NO.�a -�`F 7 TOTAL SETBACK OM TYPE OF EXISTING .
ADDRESS 6//JIN�SIK� N�,71�f Z HIGHWAY + YARD = FRONT PROP.LINE HIG WAY WIDTH
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CITY /(�///�L15— GL Cy CLASS �'�/
BLDG.SETBACK FROM
CONSTRUCTION LENDER
NAME AND BRANCH SIDE PROP.LINE OF (STREET(
HIGHWAY- t YARD _ TOTAL SETBACK FROM TYPE OF EXISTING
ADDRESS CITY SIDE PROP.LINE HIGHWAY WIDTH. o'
SO.F �/C NO.OF NO.OF CHECK f =
SIZE 4J STORIES FAMILIES ONE
USE ZONE' MAP '/
DESCRIPTION OF WORK )d0.0Q � r NEW - NO o� / W
• y ADD ❑ CONDITIONS
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/f��, ❑ FINALC. BY
e—�• a REPAIR ❑ DATE' �i �' r
USE OF /2�j��//cevCC DEMOL ❑
EXISTING BLD Z '
APPLICANT �/ Ja/InO 1 TEL j:7 O1_3-/ �cC�. Q
(PRIN
BY(SIGNATURE);' _ 3 Q
IHEREBY ACKN D E THAT I H E READ THIS P (CATION AND STATE. . O YY
THAT THE ABOVE IS CORR AND AGREE TO COMPLY WITH ALL ORDINANCES Ell n
AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE S I 9 A J q 4
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF V
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM- �� (Y Zt c o 0 0'0
PENSATION INSURANCE.' g
d
SIGNATURE OF�
2 99 50
PERMITTEE c
- c oC}9f15Qv
ADDRESS
TEL ( / O 07.24•—&Q
CITY N L1
P.C.Fee$ Permit Fee
Issuance Fee
6
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Total Fee 1S