HomeMy Public PortalAbout4938AGNES AVE_Building (10) MENT OF BUILDING AND
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COUNTY OF LOS ANGE ESAFETY ® � I L I) I lklm G
WM J FOX, CHIEF ENGINEER ® APPLICATION _
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
� DIST NO. PLAN CK OR REC INO^ PERMIT NO
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BUILDING
ADDRESS L
RE EIVED BY DATE OF PL DATE I SUED
LOCALITY �rffK17N 49Z r2en? .31 " S�
NEAREST / A
CROSS ST !r/7 BUILDING
S D ADDRESS Al
OWNER Q
MAIL 9U L= LOCALITY
ADDRESS NEAREST
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_ f CROSS BT 1
CITY NOL 2.61 FIRE + NO OF . I O UP
ARCHITECT OR TEL ZONE �� PLANS ^
ENGINEER NO BLDG
ADDRESS
.�-�(�! SETBACK LINE
�`- USE I APPROVED
TEL ZONE BY I DATE
CONTRACTOR NO HOUSE NUMBERING
ADDRESS MAP NUMBER A-0 & NO ASSIGNED BY
LEGAL I CORRECTIONS ,
DESCRIPTION LOT NO BL CK
TRACTwoVl&6-.Di
NO F BLD38
SIZE OF LOT r O NOW ON LOT
USE OF NO OF r '-
EXISTIN BLDG FAM'L.E.
DESCRIPTION OF WORK
XZNEW ALTERATION ADDITION Z
D
REPAIR DEMOLITION r
SQ FTNO OF
SIZE 3 ROOMS STORIES i
EXT WALL ROOF �
COVERINGt��E�s 1 /d-`�e'
COVERINgS.;g M p
USE OF STRUCTURET
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INSPECTION FOR APPROVALS
OCCUPANCY AS INSPECTOR 5 SIGNATURE DATE
FOUNDATION LOCATION
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP FORMS MATERIALSa-
PLICATION AND STATE THAT THE INFORMATION GIVEN IS FRAME FIRE STOPS
CORRECT BRACING BOLTS
I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES ACE LOCATION
FURNACE /3
AND STATE LAWS REGULATING BUILDING CONSTRUCTION GRN VENT DUCTS
SIGNATURE OF G.A . ` LATH INT
PERMITTEE O
ADDRESS A�v�,r( a m 7 TQ, _ LATH EXT
PLASTER INT
AUTHORIZED AOT
PLASTER EXT
FEE HOUSE NUMBER COR
RECT AND POSTED
VALUATIONJ&16�
FEE ?� FINAL
76A638A DBS 3 751