HomeMy Public PortalAbout5015 BALDWIN AVE_Building__ (2) 76A638A CE#803162 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY 1
JOHN A LAMBIE COUNTY ENGINEER NEAREST
WILLIAM A JENSEN SUP T OF BUILDING CROSS ST fej
DIST ICT NO GR UP TYPE P SSED BY
FOR APPLICANT TO FILL IN � corlsr
BUILDING ,�. ti STATISTICAL CLASSIFICATION SE ER MAP
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CLASS NO DWELL UNITS L .P
LOT NO CK WATER
CERTIFICATE NOT REQUIRED ❑ RECEIVED
TRACT MAPvi p HIGHWAY ff LOCAL
NO OF BLDGS NO ,Y ` (CIRCLE) STATE AJO E
SIZE OF LOT NOW ON LOT USE�ONF SPECIAL
USE OF w' !_JJ7___// CONDITIONS
EXISTING BLDG
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OWNERO UILDING EXIST
SETBACK YARD HWY STR E NAME WIDTH
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ARCHITECT OR / TEL FPOLT
ENGINEER NO SIDE
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CONTRACTOR NO -71n
ADDRESS DESCRIPTION OF WORK �_ 0�°�
NEW ADD ALTER REPAIR DEMOLISH
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SQ FT NO OF NO OF �-
SIZE STORIES FAMILIES V
USE OF
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SIGNATURE OF <�
APPLICANT r
VALUATION $ APPROVALS DATE INSPECTOR S SIGNATURE
PCM
CPMT O' FOUNDATION LOCATION 7
FEE$'� FEE $ FORMS MATERIALS I r C6�
�`�� FRAME FIRE STOPS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS n
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK n
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT C
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA ELAA
ING TO W PENSATION INSU E l
LATH EXT
SIGNATURE OF HOUSE NUMBER COR /' Q
PERMITTEE RECT AND POSTED o .d
ADDRESS FINAL "pr P? 1
JOHN F LEWIS PRINCIPAL ST URAL ENGINEER
PLAN CHECK VALIDATION G MO CASH _ PERMIT VALIDATION CK M G CASH
Uj,o3673�; AUG 3023 D 30256
X5538% OCT15 1 D 6050-
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