HomeMy Public PortalAbout4910AGNES AVE_Building (4) 76AB38A CE*803 5 6S APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS -
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T BUILDING AND SAFETY DIVISION LOC A LI T Y - / I
JOHN A LAMBIE COUNTY ENGINEER NEAREST - /H��/r;rZ t 4
COLEMAN W JENKINS SUP T OF BUILDING CROSS ST �iV�Vf/cam /�/
DIS RICT O TYPE PROCESSED BY
FOR APPLICANT TO FILL IN , 6 GR CONST
BUILDING �� STATISTICAL � ,ASSIFICAT10N SEWER MAP`
ADDRESS y CLASS NO OY DWELL UNITS BK/`_�FG
LOT NO BLOCK USE ZONE MAP C:•
TRACT donp
z9r of
SP `� O
SPECIALL
NO OF BLDGS CONDITIONS
SIZE OF LOT NOW ON LOT t
USE OF
ISTINGG B6DG BLDG SETBACK FROM
OWNER (r�p E TOEL ✓ FRONT PROP LINE OF ��J (STREET)
TYPE OF EXISTING SETBACKHIGHWAY
_ + YARD =„ TOTAL
ADDRESS D sr• HIGHWAY WIDT FROM C L 's
CITY a All" 'le C'17
/l i�O _a
ARCHITECT OR TEL BLDG SETBACK FROM
ENGINEER NO SIDE PROP LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS ..7 q HIGHWAY WIDTH FROM C L
CONTRACTOR �,�5'(Ji+c�tO L D-,2,� + — 0
ADDRESS Np 1 7-1-1 CORNER CUTOFF YES NO V
dx
CITY /9/E /0 CLLSEE REVERSE SIDE FOR SPECIALr PPROVALS 0
DESCRIPTION OF WORK f, Y,7`
d
NEW ADD Y ALTER REPAIR DEMOLISH r "// N
SQ FT � O OF NO OF b e
SIZE STORIES FAMILIFS _
USE OF �
STRUCTURE
SIGNATURE OF
APPLICANT - 4
VALUATION$ DDD �— '
APPROVALS DATE INXJ4ZOR SSIGNATURE
P C ' PMT u FOUNDATION LOCATION
FEE$ FEE$ FORMS MATERIALS
FRAME FIRE STOPS
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
9UILDI NG CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT
TION OF THE LABOR CODC OF THE STATE OF CALIFORNIA RELAT
INC TO WORKMEN S Cn I� NSATION INSU� LATH EXT
SIGNATURE OF (N HOUSE NUMBER COR
PERMITTEE RECT AND POSTED
ADDRES Fl NAL _
PLAN CHECK VALIDATION CK MO CASH _ JOFi PERMIT VALIDATION T�Tt� AL
F LEWIS PRINCIPAL RC EN C CASH
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