HomeMy Public PortalAbout9178 JAYLEE DR_Building_12/15/1961_add bdr, full bath 79A656A CE#803,1-61 APPLICATION FOR BUILDING P RMIT
COUNTY OF LOS ANGELES ADDRESS —'
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY G
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST. —�
DISTRICT NO. GROUP TYPE SSED BY
FOR APPLICANT TO FILL IN l e �- I It-- CONST
.Z 115
BUILDING `.y -• \ STATISTICAL CLASSIFICATION ,I SE*(ER�/,`,R MAPF
ADDRESS ` :L
CLASS.NO._ DWELL. UNITS
LOT NO. t BLOCK WATER NOT REQUIREDRECEIVED
9} CERTIFICATE:
TRACT �V 3 ! L= MAP ,, /1., � HIGHWAY
STATE MAJOR SECOND LOCA
)
1 , NO.OF BLDGS. NO. _tf
G�
SIZE OF LOT )}y' /.�2['.' NOW ON LOT �.- USF ZONE SPECIAL
USE OFCONDITIONS
EXISTING BLDG. /jC C'" rl --
TEL.
OWNER V� C _ C' NO. BUILD NG EXIST.
�- SETBACK YARD HWY STREET NAME WIDTH
ADDRESS t, - Cs" +''- L c.1, i FRONT
ARCHITECTOR � T P.L. ,z �-
ENGINEER d _ NO, SIDE
ADDRESS ` P.L.- it CL
CONTRACTOR TEL .t e< INSPECTI N RECORD O
_•-. NO. U
ADDRESS �2_. ' ,e O
DESCRIPTION OF V ORS u
W
NEW ADD ALTER I REPAIR DEMOLISH Z
SQ.FT. NO.OF NO.OF
�IZE I-LLQ L' STORIES I FAMILIES
USE OF
STRUCTURE (;•_'�''C>!i.�.-..r y.. l" �;•aa.. a_a' - -
�- tt
SIGNATURE OF,
APPLICANT
VALUATION$ 'ia_ ( a' I
APPROVALS IYATE INSPECTOR'S SIGNATURE
P.C. PMT. FOUNDATION: LOCATION
FEE $ FEE $ FORMS, MATERIALS
FRAME: FIRE STOPS.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRAa;ING. 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,INT.
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT-
ING TO WORKMEN'S COMPENSATION INSURANCE.
/ l/ `/
LATH,EXT.
SIGNATURE Od,tea-:..l.�, (d, \yt 7�' HOUSE NUMBER
PERMITTEE
RECT AND POSTED
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ADDRESS '
FINA�_
CLYDE N. DIRLAM, PRINCIPAL STRAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION cK.�; M.o. cwsR
',r'.6 1 5 5 : DEC 15 s o 9.0 0
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