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APPLICATION FOR BUILDING PERMIT �•
DIVISION OF BUILDING AND SAFETY BUILDING � �Q
Deportment of County Engineer ADDRESS
Al
County of Los Angeles LOCALITY 5,yw
WM J FOX COUNTY ENGINEER NEAREST � '
CASSATT D GRIFFIN SUP T OF BUILDING CROSS ST ,ogy ����I
DISTRICT NOGROUP TYPE SEWER MAP F
FOR APPLICANT TO FILL IN r I
CONST
BUILDING (1 NMAP D O TAT
ADDRESS ih`l. .ir-� UMBER IV NO
LOT NO cz. BLOCK USE ZONE CON D TI OAL NS I GVEIV
TRACT45 S�41.00
d R_A #1
NO OF.�y�_. 1.00 fJ L NOW ON LOTS Z- BUILDING YARD HWY STREET NAME EXIST
SIZE OF LOT
�/�� y SETBACK WIDTH
USE EXISTING BLDG /!t'-o"u`-^' "`t"R f-�r�- FRONTPOLT
7 r e l.0/✓hL.� I SIDE
OWNER - '7L-yt! `�'J-x'' - P L
MAIL
ADDRESS O TRACT DWELL I UNIT
5 INDUSTRIAL
TEL �f `f 1 DWELL 1 UNIT
CITY U- P� NO / 6 PUBLIC BLDG
21 DUPLEX I UNIT
ARCHITECT OR (( y l / TEL V 7 ADDN ALT ETC
ENGINEER/t,`X�Nw+""p`/�( 1���,> /NO y G 7f 3 APT UNITS 8 MISCEL
ADDRESS/ 7 -L- .� lb-y-'+''��1� G`�a_ 4 COMMERCIAL
CONTRACTOR J��V- 01 �'►• TNo 5y��7q/ / y��IINSPECTI/OWN RECORD
ADDRESS/i 4/ e/i;' a---
DESCRIPTION
P-DESCRIPTION OF WORK �c
NEW L ADD ALTER REPAIR DEMOLISH
So ^
FT NO OF NO OF
SIZE �(/ STORIES FAMILIES
USE OF STRUCTURE V
4
SIGNATURE OF Q L f t�
APPLICANT APPROVALS
ADDRESS
(��Y'JQ LC ),1�j.!�.,i[�a �i��(.IJ .L DATE INSPECTOR S SIGNATURE
FOUNDATION LOCATION
//PPqq O P C 1 0 FORMS MATERIALS
FEE FRAME FIRE STOPS
VALUATION !62 c90 BRACING BOLTS b
FEE "0- FURNACE LOCATION
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GAS VENT DUCTS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH INT
AND STATE LAWS REGULATING BUILDING CONSTRUC '
0
TION LATH EXT I
SIGNATURE OF //j tw HOUSE NUMBER COR-
PERMITTEE--,KK I RECT AND POSTED 6 i
ADDRESS , FINAL
WM J FOX COUNTY ENGINEER VALIDATION C N DIRLAM CHIEF BLDG INSPECTOR
��Co 3 5 1 1 L rEB 2 7 1 6 1 0 0 0 to 1 '2000 0 0 0 >�
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