HomeMy Public PortalAbout5131 BALDWIN AVE_Building__ (2) 76AG38A CE9803 8 G3 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCAL Y e
JOHN A LAMBIE COUNTY ENGINEER NEAREST (//✓
WILLIAM A JENSEN SUP T OF BUILDING CROSS ST
D S RICT W TYPE P ED BY
FOR APPLICANT TO FILL CONST
BUILDING oo STATISTICAL CL-ASSIFIdATION S ER MAP `
ADDRESS A U4 B�
CLASS NO DWELL UNITS^^��
LOT NO ZZ. BLOCK WATER NOT REQUIRED LJ- RECEIVED ❑
CERTIFICATE LLLLJJJJ
TRACT MAP HIGHWAY
NO OF BLDGS NO ' (CIRCLE) STATE MAJOR ECOND LOCAL
SIZE OF LOT NOW ON LOT USE$ON S ECIAL
USE OF / CONDITIONS
EXISTING BLDG Q �-
OWNERQ UI DING EXIST
11.� SETBACK YARD HWY I STREET NAME WIDTH
ADDRESS UL FRONT
ARCHITECT OR TEL P L
ENGINEER 'i / NO SIpE
ADDRESS T€8 S / / a
CONTRACTO / % ��// (� O
ADDRESS
DESCRIPTION OF WORK ' �''� �� " "' '� O
W
CL
NEW ADD ALTER REPAIR DEMOLISH
SQ FT 2 NO OF OZP OF / -�'��✓_���`
SIZE STOR ILIES
USE OF t ` �—
STRUCTURE I / I_� ( _
9 7
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SIGNATURE OF
APPLICANT-
VALUATION
PPLICANT VALUATION $
APPROVALS DATE I SP TOR S SIGNATURE
J' \ PMT
FOUNDATION LOCATION �_ e
FEE $ / J FEE $ �� FORMS MATERIALS 4�
FRAME FIRE STOPS Q
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 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 IN
TION OF THE LABO CDC OF THE STATE OF CALIFORNIA RELAT
ING TO WORKMEN C MPENSATION SURAI�CE
LATH EXT
SIGNATURE OF HOUSE NUMBER COR
PERMITTEE RECT AND POSTED
ADDRESS FINAL
PLAN C CR VALIDN CK M o CASH JOHN F LEWIS PRINCIPAL ST C URAL"ENGINEER
PERMIT VALIDATION cK M O CASH
' 9335G MAY 27-23 D 9255 "C,
L&9336-%'07 MAY27 1 0 1850- a