HomeMy Public PortalAbout4840AGNES AVE_Building (4) 78A888A CE#80810 Be APPLICATION FOR BOILDING° PERMIT 1
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS TO /ye'G.�'
BUILDING AND SAFETY DIVISION LOCALITY / C I ~t
JOHN A LAMBIE COUNTY ENGINEER NEAREST ZNJC� �I
CASSATT D GRIFFIN SUPT OF BUILDING CROSS ST •� V Z%jr4.
DISTRICT No
GROWW TYPE PROCC ED BY
FOR APPLICANT-TO FILL IN T.L CONS4.-)o
[OWNER
UILDING STATISTICALCLASSIFICATION SEWER MAP
DDRESS ' PG
y CLASS NO DWELL UNITS �r
OT NO �^ �� Jii BLOCK ` MAP / / TATE le
NUMBER �' L7 YES O
RACT US ZONE 1�SPECIAL ,
NO OF BLDGS CONDITIONS
IZE OF LOT I NOW ON LOT s r
SE OF
XISTING BLDG a ,��s/ �� BUILDING YARD HWY STREET NAME'v- EXIST
SETBACK WIDTH
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MAIL ' P L A
ADDRESS S b SIDE
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CITY NO ` INSPECTION RECORD
ARCHITECT OR
ENGINEER O
ADDRESS 1 _
TEL
CONTRACTOR NO
ADDRESS DESCRIPTION'OF WORK
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NEW ADD ` ALTER REPAIR DEMOLISH `
SQ FT NO OF NO OF Iv
SIZE sicpc� STORIES FAMILIES t e 1
USE OFZ2 G N G" F V*VeO
STRUCTURE
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SIGNATURE
APPLIC APPROVALS 'DATE INSPECTOR S SIGNATURE ,
ADDRESS p» t Ls FOUNDATION LOCATION _ S
FORMS MATERIALS �?•d/ A�/ 7, s
VALUATION$ 5Q0� ,t FRAME FIRE STOPS
v BRACING BOLTS ��
FEE" a JPMT
FEE 8/y
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I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP " ` '
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND LATH INT - '' l
` AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND -
STATE LAWS REG LAT 4G BU DI CONSTRUCTION LATH EXT I J �►' ,�.,s*
SIGNATURE OF HOUSE NUMBER COR-
PERMITTE E� W.00RECT AND POSTED
ADDRES o r FINAL ��-`��� l �`-� r�� _
1 y CLYDE N DIRLAM PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION CK mo awswr PERMIT VALIDATION `CK M D CASH I
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