HomeMy Public PortalAbout9068 ACASO DR_Building_2/5/1963 7SA690A CE#808I eZ APPLICATION FOR 'BUILDIN/`�G PER I,T
C(1
ADDRESS `
COUNTY OF LOST ANGELES 7
DEPARTMENT OF*COUNTY ENGINEER ,
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A JENSEN,SUP T OF BUILDING CROSS ST
DISTRICT GE97 TYPE Er
BY
FOR,APPLICANT'TO FILL IN CONST FC-I--
BUILDING D STATISTICAL CIFICATION SE R MAP
ADDRESS, CLASS NO L DWELL UNITS K�
LOT NO BLOCK WATER
CERTIFICATE NOT REQUIRED RECEIVED
[�
TRACT �7 J MAP _ HIGHWAY STATE MAJOR SECO LOCAL
a NO "� (C
L/ IRCLE)
NO OF BLDGS
SIZE OF LOT' NOW ON LOT USE ZONE SPECIAL
USE OF ` CONDITIONS
G r '
" EXISTING BLD •
TEL' '141
OWNER NO aO BUILDING YARD HWY STREET NAME EXIST
SETBACK WIDTH
ADDRESS �` r a FRONT
ARCHITECT OR - TEL P L �(/ /Li+l��4;�/✓"�/.
ENGINEER • NO SIDE
P
ADDRESS ,f ' d
G
TEL- (�
CONTRACTOR NO �/��" J '
ADDRESS ' /^ ! 63 � ' �o Y , �•. O
»» ,DESCRIPTION OF WORK
a NEW`"X+ DD ALTER REPAIR DEMOLISH
SQ FT g— ,NO OF NO OF, +� "'•" `
SIZE 7/ STORIES- FAMILIES
USE+OF
STRUCTURED
SIGNATURE OF ^�
'APPLICANT
VALUATION$
APPROVALS` ID ATjE INSPECTOR S SI4fZ,N URE
PC PMT FOUNDATION LO ATIO
FEE $ 4 FEE $ a FORMS MATERI LS
FRAME FIRES TO S ` r
I HEREBY'ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION w BRACING BOLT A
AND STATE THAT THE ABOVE IS'CORRECT AND AGREE TO COMPLY FURNACE LOCATN
WITH ALL COUNTY+ORDINANCES AND STATE LAWS REGULATING 'GAS VENT DUC
BUILDING CONSTRUCTION 1' CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY WILL-NOT EMPLOY ANY,
PERSON IN VIOLA LATH INT
TION OF THE LABOR CODC OF THE STATE Of,CALIFORNIA RELAT
ING TO WORKMEN S COMPENSATION INSURANCE '
` LATH EXT
SIGNATURE OF, �/7/��/� HOUSE NUMBER COR
PERMITTEE ///-.a•� RECT AND POSTED +�+
ADDRESS , - - FINAL
. JOHN F LEWIS PRINCIPAL STRUCTURAL EN
PLAN CHECK VALIDATION CK M O' CASH _ PERMIT VALIDATION CK MO CASH
. j1'w1,'1, 5 1i ViiI+.� ID i