HomeMy Public PortalAbout4906AGNES AVE_Building (3) L -
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76A A 13561k�PLICATION FOR BUILDING PERMIT
OUNTYOF LOS ANGELES BUILDINGD TMENT OF COUNTY ENGII�= ADDRESS
BUILDING AND SAFETY DMSION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST
WILLIAM A JENSEN SUP T OF BUILDING CROSS ST
DISTRI T NO GROUP+ TYPE P CES BY
FOR APPLICANT TO FILL IN � CONST
BU DI G' v STATISTICAL CLASSIFICATION - SEWER MAP
AD S CLASS NO DWELL UNITS PG
O i L BLOCK WATER NOT REQUIRED RECEIVED
CERTIFICATE
TRACT MAP_ HIGHWAY
1)41k nn NO OF BLDGS NO Q (CIRCLE) STATE MAJOR SECOND OCAL
SIZE OF LOT G/O I NOW ON LOT USE ZONE ECIAL
USE OF CONDITIONS
EXISTING BLDG L - a
OWNE r BUILDING yAgD STREET NAME EXIST
_ SETBACK WIDTH
ADDRESS ,
ARCHITE T TEL FPROLNT
ENGINEER 1, NO SIDE
ADDRESS/ ` ` P L V
CONTRACTO
F
ADDRESS
DESCRIPTIO OF'WORg �: i� N
E ADDALTER' REPAIR DEMOLISH
FT NO OF NO OF
IZE STOIW ES YAMILIISS
USE O -5+ ten/ J�'. -
STRUCTUR .7 v-
l mo
SIGNATURE OF
APPLICANT s v
VALUATION$ .9Ownl;-_ , p ,/7I�1If
' r APPROVALS /DAME !'//�1I�SPECTOR S SIGNATUREPC PMT
r
FEE $ FEE $ FOON FORMSIMATER ALSON
FRAME FIRE STOPS
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING 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 1 WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT 1 '
TION OF THE LABOR CO E OF THE STATE OF LIFORNIA RELAT
ING TO WORKMEN OM EN ION 1 R CE '
J) LATH EXT
SIGNATURE HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS FINAL ?
CLYDE N DIRLAM RINCIPAL STRU URAL ENGINEER
PLAN TION c el o CASH PERMIT VALIDATION c MO, CASH
LAC,08 1 0 4 -0 FEB 8 2'3 D' " ',2 2 5 i! M
o"8943 % rEs28 1 D 4500 '�