HomeMy Public PortalAbout4938AGNES AVE_Building (9) I 7 �
9WARTNIENT OF BUILDING AND SAFETY APPLICATION FOR PERNIIT
-� COUNTY OF LOS ANGELES U I L D O G
WM J FOX CHIEF ENGINEER
,
FOR APPLICANT To"
FILL IN FOR OFFICE USE ONLY
DISTRI O PLAN CK NO ERMIT NO
G Ii'� � /:6 - r —
fV (�,(�
Y / � � _ RECEIVED BY DATEOFAPPL DATEISSUED
/l(� BUILDING
ADDRESSC`?.,A c�xLl /�, f �eLOCALITY� � � � NEAREST,I /� TEL CROSSST �'.1--,--aS,9 ,, AAA NO FIRE NO OF --I TYN I GR!Lr
ARCHITECT OR TEL ZONE — PLANS �V/
ENGINEER NO BLDG
vSETBACK LINE
ADDRESS APPROVED
TEL BY DATE
CONTRACTOR NO USE APPROVED
ZONE BY DATE
ADDRESS HOUSE NUMBERING
LEGAL
DESCRIPTION LOT NO � BLOCK MAP NUMBER FIELD CHECK BY
1 '
TRACT NO ASSIGNED BY ATE
p NO OF BLDGSCORRECTIONS
SIZE OF LOT �) x /�6! NOW ON LOT /( �b IVQ 40 ,!O / 0 7" /
USE OF NOOF
EXISTING BLDG Q�11, FAM IuHs -
9 L� s"L iicsG 5�-•c�TdrlJ
DESCRIPTION OF WORK
NEW I'4 I ALTERATION I I ADDITION
REPAIR I I DEMOLITION
SQ FT NO OF
SIZE �, ROOMS STORIES Z
EXT WALL ROOF r
COVERING COVERING
6-01�4-
USE OF STRUCTURE
APPROVALS
INSPECTOR SIGNATURE DATE
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP FOUNDATION LOCATION' -may
PLICATION AND STATE THAT THE INFORMATION GIVEN IS FORMS MATERIALS �r
CORRECT
I AGREE TO COMPLY WITH THE CORRECTIONS LISTED FRAME FIRE STOW
HEREON AND WITH ALL COUNTY ORDINANCES AND STATE BRACING BOLTS
LAWS REGULATING BUILDING CONSTRUCTIO FURNACE LOCATION
SIGNATURE OF �[J`/ GAS VENT DUCTS
PERMITTEE
ADDRESS LATH INT
I/
AUTHORIZED AGT LATH EXT
PLASTER INT
7aAaSSA 0882 1050 P C >$
p-� FEE PLASTER EXT
_ f
msamsc�
VALUATION OO FEE $ FINAL 'S
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