HomeMy Public PortalAbout4840 AGNES AVE_Building_9/17/1968 v
76AMBA CE#9089W APPLICATION FOR BUILDING PERMIT ', �.
COUNTY OF LOS ANGELES ADD EISS ®
DEPARTMENT OF COUNTY ENGIIVEER
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST / h
CASSATT D GRIFFIN $UP T OF BUILDING CROSS ST
DISTRICT NO GROU`p TYPE PROCESSED BY
FOR APPLICANT TO FILL IN T S' �J CONST A �-+
r �� STATISTICAL CLASSIFICATION
BUILDING L/b �; GC — I SEWER MAP
ADDRESS 77
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`.DWELL UNITS— Z4
LOT NO r BLOCK MAPNUMBER yc: / L► STATE
YES NO I `
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( U Z NE SPECIAL '
NO OF BLDGS CONDITIONS ,
IL
MAIL
F LOT d��1 I NOW ON LOT r I o
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G BLDG -a BU7 DING EXIST
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SETBACK YARD HWY S EET NAME WIDTH
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TEL P L`
CITY �- NO INSPECTION RECORD
ARCHITECT OR EL
ENGINEER
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ADDRESS
r TEL
CONTRACTOR NO r�
ADDRESS
DESCRIPTION OF WORK v
NEW ADD ALTER REPAIR DEMOLISH
SQ FT NO OF NO OF
SIZEUSE OF STORIES /� FAMILIES
STRUCTURE F) ``-.0 Vtfn,
SIGNATURE OF
APPLICANT
APPROVALS DATE INSPECTOR S SIGNATURE
ADDRESS ` FOUNDATION LOCATION
�` FORMS MATERIALS
VALUATION $ / C \� FRAME FIRE STOPS
BRACING BOLTS
PC SPMT FURNACE LOCATION
FEE $ FEE ��I GAS VENT DUCTS
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP LATH INT ~
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WIT ALL COUNT O DINANCES AND"
STATE LA St REGULA ING UILD ONSTRUCTION LATH EXT `
SIGNATURE OF r HOUSE NUMBER COR
PERMITTE , RECT AND POSTED ,
ADDRESS yb �c►f f FINAL
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i I CK la o CASH CLYDE N DIRLAM PRINCIPAL STRUCTURAL L E cwsN R
PLAN CHECK VALIDATION PERMIT VALIDATION
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