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11.55 APP :1GATION FOR 'BUILDING PERMIT ],
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DIVISION OF BUILDING AND SAFETY ILDI
ADDRESNG S �w
Deportment of County Engineer
County of Los Angeles LOCALITY 7�* G
JOHN A.LAMBIE,COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN,SUP'T OF BUILDING CROSS ST.
DISTRICT NO. ' GROUP TYPE SEWER MAPPG
FOR APPLICANT TO FILL IN J CONST. / .
BUILDING 46!V MAP STATE. y�
ADDRESS !/ �-e NUMBER 0 HWY YES O
LOT NO. BLOCK USE ZONE SPECIAL
// / a? CONDITIONS-CONDITIONS
TRACT CO..�J � � GI.e L`
SIZE OF LOT Gal X [� I NOW ON LOTNO.OF S��On�. BUILDING EXIST.
USE OF
SETBACK YARD HWY STREET NAME WIDTH
EXISTING BLDG. FPOL T
OWNER L�(�'N L7/^ SIDE
MAIL
P. L.
! e J r
ADDRESS /�(�(_1J_r/Q�U / ��- O �TRACTDWELL. 1 UNIT 5 INDUSTRIAL
t
TEL I DWELL. I UNIT
CITY .1, � � NO. 6 PUBLIC BLDG.
ARCHITECT OR TEL. 2 DUPLEX 2 UNITS ADDN.,ALT., ETC.
ENGINEER NO. 3 APT. UNITS
8 MISCEL.
ADDRESS � h . 4 COMMERCIAL
I�
CONTRACTOR i 01j , !d1) p-ROO. AO6•39I
NY.SS..YPiElCTION CORD
ADDRESS '✓fQ7 f
lJrl� � /�"jfi✓�� /
r
DESCRIPTION OF WORK
NEW ADD ALTER REPAIR DEMOLISH C
SQ.FT. NO.OF NO OF
SIZE h�0 STORIES �Z'e. FAM IL1E5 HY•
USEOF STRUCTURE S,J
SIGNATURE OF
APPLICANT / J APPROVALS
ADDRESS /0,1 ,E GLL /C0 a � %~_ DATE PECT%'S. IGNATURE
FOUNDATION:LOCATION r
7 C—A FFEE*
CS FORMS.MATERIALS
✓�/ FRAME: FIRE STOPS.
VALUATION $ / BRACING. BOLTS
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B FURNACE: N.
GAS VENT.DUCTS
1 'HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT �.
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH, INT.
AND STATE LAWS REGULATING BUILDING CONSTRUC-
TION. LATH. EXT. l �'
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE^ RECT AND POSTED
v �1 M f1
ADDRES FINAL
JOHN A.LAMBIE.COUNTY ENGINEER VALIDATION CLYDE N.DIRLAM. CHIEF BLDG. INSPECTOR
CK MO CASH
3 3 0. 4. 2 JUL �1_ 1 G 8 r, 1) L in' n
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