HomeMy Public PortalAbout6339 TEMPLE CITY BLVD_Building__ APPLICATION FOR COUNTY OF LOS AN
" BUILDING PERMIT DEER
BUILDIINNG AND SAFEDrnSION
BUILDING
FOR APPLICANT TO FILL IN ADDRESS
BUILDING .-y �\
ADDRESS
:J LOCALITY
EAREST
CITY ZIP 1780 CROSS ST
ry�I- NO OF BLDGS ASSESSOR /
SIZE OF LOT 70 .(-71(1 NOW ON LOT46 MAP BOOK PAGE PARCEL
DISTRICT I GROUP TYPE V I FIRE C PROED By
TRACT I•A4 BLOCK LOT NO L_l CONST Znur
TE
OWNER �R\ NOL STATISTICAL CLASSIFICATION a
^ ' 417-
cSEW E��7R7 yMAP
ADDRESS{ q C\Z CLASS NO 0/ UNITS 4 1 - BMA' /PG
CITY
C\� ZIP 1M USE ZONE NO -2. 0
2. CO
A HPCENG SPECIAL NIT RTO N 2 NO '17-Y� �`� CONDITIONS
ADDRESS '04 ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑
CONTRACTOR TEL BLDG SETBACK FROM
NO
LIC FRONT PROP LINE OF )STREET)
PEXISTING
SS NO TOTAL 5ETBACIR FROM TWE OF E%I STING
HIGHWAY } YARD
LIC FRONT PROP LINE HIGHWAY WIDTH
CLASS
RUCTION LENDER }
AND BRANCH BLDG SETBACK FROM p
SS CITY SIDE PROP LINE OF (STREET) Cl
^ NO OF NO OF CHECKHIGHWAY } VARO = TOTAL SETBACK FROM TYO� STORIES ' FAMILIES ' ONE SIDE PROP LINE IPTION OF WORK NEW ® } _ 1~ DD CORNER CUTOFF YES ❑ NOSLTERIN OPEN SPACE YES ❑ NO ❑IN COASTAL PERMIT ZONE YES ❑ NONG BLDG \ �L� EMOL CANTV TELNT) ` NO OS-
BY (SIGNATURE) s/z' ���o�r-
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION �u �A� Nj�
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HERESY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO
WORKMEN S COMPENSATION INSURANCE �j /
SIGNATURE OF P FINAL 5 _/
Br
PERMITTEE -[ DATE /
ADDRESS % ` VO
••m^1L x.51.-7(.Q3
clTr
TEL
�4;Y�p L(, C\�v L PC Fes$ �� 3 PermR Fee
IEEUance Fee
VALUATIONS
Total Fes
PLAN CHECK VALIDATION cKc
M o CA" � PERMT VALIDATION K� .0 CAB.
0 7,31ZKO 9 2 3 - - 3.40 A
737�APR 15 1- 9 189.00AN)
7SA43SA Ca 30 ,/ _
O v�