HomeMy Public PortalAbout4845 BALDWIN AVE_Building__ (2) APPLICATION FOR
BUILDING PERMIT
D DING
FOR APPLICANT TO FILL IN ADIDRESS J
LDING
-ADDRESS / I LOCALITY �G
NEAREST
CITY �? p J ZIP �� O CROSS STNO 0 BLDGS ASSESSOR
SIZE OF LOT Q X ,, NOW ON LOT MAP BOOK PAGE PARCEL
DISTRICT GROU TYPE FIRE PROC SSEIi BY
TRACT BLOCK T F7� 17 ONS +
TEL „U O ,S
OWNER /7 NO ��
STATISTICAL CLASSIFI�CAT'I,ON SEWER P
ADDRESS `Y6a u I` � allyl) CLASS NODWELL UNITS B�G
CITY ZIP X�OYE No G
ARCHITECT OR TEL ' SPECIAL
ENGINEER NO
"Z JJ CONDITIONS
ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO❑
TEL _
CONTRACTO N BLDG SETBACK FROM
LIC FRONT PROP LINE OF (STREET)
ADDRESS NO TOTAL SETBACK FROM TYPE OF EXISTING
LIC HIGHWAY + YARD = FRONT PROP LINE
HIGHWAYI WIDTH
CITY CLASS _
+
CONSTRUCTION LENDER _ }
NAME AND BRANCH BLDG SETBACK FROM OU
ADDRESS CITY SIDE PROP LINE OF (STREET)
O
SQ FT NO OF NO OF CHECK HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING
SIZE STORIES FAMILIES ONE SIDE PROP LINE IHIGHWAV WIDTH
N
DESCRIPTION OF WORK NEW
qt7M=LL_- 610p
ADD ❑ CORNER CUTOFF YES ❑ NO ❑
ALTER ❑ IN OPEN SPACE YES ❑ NO ❑
REPAIR ❑
USE OF , DEMOL ❑ IN COASTAL PERMIT ZONE YES ❑ NO ❑
EXISTING BLDG
APPLICANT TEL ��C TD �7--
(PRINT) NO
BY(SIGNATURE)
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECTAND AGREE TO COMPLY WITH ALL ORDINANCES
AND LAWS REGULATING BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN S COM
PENSATION INSURANCE
SIGNATURE OFFINAL _7? BY
PERMITTEE (Fa�" a DATE 46�
ADDRESS ��
TEL PC Fee$ Permit Fee
LV'TA'
NO
QIssuance Fee
LUATION G
..... Total Fee 0 J
PLAWCHECK VALIDATION CK M o CASH _ PERMIT VALIDATIONCK M o CASH
8 6 9,ZOGT S1 1 D 9
7
CIS 76A638B CE 180313 6/76
78A838 CE#8033 BI APPLICATION FOR BUILDING PERMIT u
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY L
JOHN A LAMSIE COUNTY ENGINEER NEAREST ol
WILLIAM A JENSEN SUP T OF BUILDING CROSS ST
DISTRICT NO GROUP -ryPE P SED BY I
FOR APPLICANT TO FILL IN CONST
BUILDING � STAIISIICALCLASSIFICATION - SE ER MAP
ADDRESS I V{ V 'vC -
CLASS NO DWELL UNITS
IJ _ E-5p"
LOT NO 7 BLOCK WATER
CERTIFICATE NOT REQUIRED WIT RECEIVED
LIN Li
TRACT MAP HIGHWAY STATE MAJOR SECOND LOCAL
i �� NOW)F BLDGS / NO (CIRCLE)
SIZE OF LOT a( NOON LOT / USS ZONE SPECIAL
USE OF /I ,/ CONDITIONS
EXISTING BLDG /,(�/�/(/
OWNER 'L.l NO 07' BUILDING EXIST
Y SETBACK YARD HWY ST E NAME WIDTH
ADDRESS S T+ / Ci FRONT
ARCHITECT OR TEL P L G>.
ENGINEER NO SIDE O
P L
ADDRESS '`C
CONTRACTOR L)A h N L I NO I-1'(.S INSPECTION RECORD
ADDRESS - L uS 1¢ rC �U
ILU
DESCRIPTION OF WORK �i c` N
NEW ADD ALTER REPAIR DEMOLISH �r /
SO FT NO OF NO OF / J t1rN" Y/�✓L ;�ilfi/ D�
IZE l STORIES FAMILIE ^r
USE OF p ,�t � � ao y
STRUCTURE
SIGNATUREOF
APPLICANT
VALUATIONS f 04)-b
APPROVALS DATE INSPECTOR S SIGNATURE
P C o-Q $ FOUNDATION
LOCATION
FEE FORMSMATERIA
FEE $ FRAME FIRE STOPS 7 =yam
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS j
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 Lr'
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT
ING TO WORKMEN S COMPENSATI N INSURANCE
LATH EXT
SIGNATURE OF J HOUSE NUMBER COR
PERMITTEE 472-
' f 7 RECT AND POSTED
ADDRESS 0`' 2- h � J.e FINAL
CLYDE
PLAN CHECK VALIDATION cK o cwaH P RERMIT VALIDATION T REN
cK. L o CASH
LACO1683112 11PR 5 2 5 D 2500
U,L,o2 0 6 11-23) 1IhR1 4 1 D 5 C 00M ;