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7eweaewce$e030tn APPLICATION FOR BUILDING PERM[
` COUNTY OF LOS ANGELES N BUILDING 1 ti
DEPARTMENT_OF COUNTY ENGINEElf ADDRESS 2 a
BUILDING AND SAFETY DIVISION I!OCALITY a'
r JOHN A LAMBIE COUNTY ENGINEER NEAREST
CASSATT D GRIFFIN SUP T OF BUILDING CROSS ST
DISTRICT NO GROUP TYPE P 0 SSE HY
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BUILDING 1> STATIST KCAL CLASSIFICATION r SEWER MAP to
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LOT NO B MAP + '=k STATE s
6 a t w ,}NUMBER I` HWY YES NO
TRACT In 11 USE ZONE SPECIAL v r v ! n
II It" OF BLDGS -t '9 CONDITIONS "
SIZE OF LOT MZ I NOW ON LOT
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EXISTING BLDG + A BUILSETBACKsONG kAR"DHWY STREET NAME EXISTOWNER a `v WIDTH
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CITY SA a NO o ,' d,d INSPECTION 'RECORD /g
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DESCRIPTION OF WORK
ADD ALTER REPAIR DEMOLISH
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SIZE STORIES �� FAMILIES
STRUCTURE WG Ai-USE OF `A( r
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SIGNATURE OF �s 11-9- ts� '�'�y o i
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+ F4 APPROVALS DATE INSPECTOR S SIGNATURE
ADDRESS,o (�K j FOLNDATION LOCATION
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VALUATION FRAME FIRE STOPS
BRACING BOLTS 1.J/�.IIAt
P C. LI O PMT L1 I FURNACE LOCATION 4
FEE, $ FEE t �1 �1 GAS
1 HEREBY ACKNOWLEDISE THAT It HAVE READ THIS AP
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND LATH INT # 22/C�® •
AGREE TO COMPLY WITH ALL COUNTY ORDIN NCES AND & 4
STATE LAWS REGULA BUILDING TRUCTION LATH EXT fl ' K
SIGNATURE OE— < < HOLSE NUMBER COR } o J t
PERMITTE RECT AND POSTED
ADDRESS # r FINAL
s v I CLYDE N DIRLAM PRINCIPAL ST T AL ENGINEER
r' PLAN CHECK VALIDATION M O CASH 'PERMIT,VALIDATION Ckc > M o CASH
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