HomeMy Public PortalAbout5353 WELLAND AVE_Building__ TEMPLE CITY
IA636A CE#803- 1-61 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING !,
DEPARTMENT OF COUNTY ENGINEER ADDRESS `J
BUILDING AND SAFETY DWISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST.
DISTRICT NO G P TYPE / PR Y01
FOR APPLICANT TO FILL IN CONST. c^
BUILDING�J� �► Welland STATISTICAL CLASSIFICATION SE KR MAP G
ADDRESS-
CLASS. NO.--/—DWELL.UNITS _
LOTNo.W 801of E 195fof 1,0427 BLOCK WATER NOT REQUIRED RECEIVED
CERTIFICATE:
TRACT 0260�7 'rf C MAPHIGHWAY STATE MAJOR SECOND, LOCAL
SIZE OF LOT /Zt�.c6J� INO.OFBLDGS. NO. C. (CR
Ey,
ON LOT 2 USE ZONE SPECIAL �}
USE OF CONDITIONS (/
EXISTING BLDG.Dw®King and attached garap, -
OWNERWilliam J. SCOtt TNI GI45271 BUILDING EXIST.
SETBACK YARD I HWY STREET NAME WIDTH
ADDRESS 4545 Halifax FRONT /F O
ARCHITECT OR TEL. P. L.
ENGINEER none NO. SIDE
ADDRESS �
CONTRACTOFYanta Anita COnstr@No AT79744 INSPECTION RECORD. 0
V
ADDRESS8717 Lag Tunas Dre, San Gabriel ` . ,'� o
DESCRIPTION OF WORK 0
W
CL
NEW ADD ALTER REPAIR DEMOLISH Z
SQ.F } e NO.OF NO.OF _
$IZE�8 r r STORIES 1 FAMILIESUSE OF
1
STRUCTURE Dwelling and attached
Garage
SIGNATURE O
APPLICANT
VALUATION S
APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. (' .5 PMT. - FOUNDATION: LOCATION
FEE $ t' FEE $ FORMS,MATERIALS
FRAME: FIRE STOPS,
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING,BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION,
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH, INT.
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT-
ING TO WORKMEN'S COMPENSATION INSURANCE.
LATH,EXT.
SIGNATUR oe HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS FINAL - -
CLYDE N. DIRLAM, PRINCIPAL S C RAL ENGINEER
PLAN CHECK VALIDATION CK M.O. CASH PERNIIT VALIDATION CK. M.O. CASH
5 Fi 2: DEC._ 1 2 3 D -19.5 0 4
5857: DEC 7 3 D 3 9.0 0 r