HomeMy Public PortalAbout4958 AGNES AVE_Building_0 18AC39A'CE#903 9 BB
I APPLICATION FOR BUILD NG PER
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COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST
COLEMAN W JENKINS SUP T OF BUILDING CROSS ST
FOR APPLICANT TO FILL IN DISTR CT NO GR TYPE D B
(Print ort pe only) CONST
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BUILDING STATISTICAL CLA�,SSIFICATION SEWER MAP
ADDRESS 72ft CLASS NO�—DWELL UNITS BK PG
LOT NO BLOCK USE ZONE MAP
INVNO
TRACT 77® Lv 7— 2 SPECIAL
NO OF BLDGS CONDITIONS
SIZE OF LOT NOW ON LOT
USE OF
EXISTING BLDG BLDG SETBACK FROM
OWNER
�f No `� FRONT PROP LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS
HIGHWAY WIDTH FROM C L
CITY * +
BLDG BACK FROM
ARCHITECT OR TEL SIDE PRO EOF (STREET)
ENGINEER NO TYPE OF EXISTING CK HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C
_ C
CONTRACTOR TEL C
NO - c
ADDRESS NO CORNER CUTOFF _ YES ❑ ❑ c
CITY CL SS SEE RE RS FOR SPECIAL APPROVA i
CONSTRUCTION LENDER
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NAME AND BRANCH P-
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ADDRESS 04 �
SO FT NO OF NO OF NEW ❑
SIZE STORIES FAMILI S
USE OF ADD ❑
STRUC URE
ALTER ❑
SIGNATURE OF REPAIR❑
APPLICANT DEMOL
VALUATION $ a Iola APPROVALS DATE INSPECTOR S SIGNATURE
P C PMT FOUNDATION LOCATION
FEE $ FEE $ �!/ FORMS MATERIALS
FRAME FIRE STOPS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON GAS VENT DUCTS
STRUC TION I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH INT
LABOR CODE OF TH STATE OF CALIFORNIA IN RELATING TO
WORKMEN 5 COMP ION INSURANCE LATH EXT
SIGNATURE OF G
PERMITTEE HOUSE NUMBER COR
� RECT AND POSTED
ADDRESS I N AL
PLAN CHECK VALIDATION CK Mo CASH JOHN F LEWIS PRINCIPAL ST TURAL ENGINEER
PERMIT VALIDATION CK M o CASH
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3 3-0 0AR 1 7 I o 6.00— ',
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