HomeMy Public PortalAbout4958AGNES AVE_Building _SE#6Q3 3 68
APPLICATION FOR BUILDING, ERMIT
COUNTY OF LOS ANGELES BUILDING /
DEPARTMENT OF COUNTY ENGINEER ADDRESS 6 /
BUILDING AND SAFETY DIVISION LOCALITY " �� ��7-
JOHN A LAMBIE, COUNTY ENGINEER NEAREST
COLEMAN W JENKINS SUP T OF BUILDING CROSS ST s/¢
DISTRICT NO GROUP TYPE PROCESSED BY
FOR APPLICANT TO FILL IN / CONST
Print ort J a only) t , D(Y
BUILDING STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS CLASS NO DWELL UNITS , BKE PG
LOT NO Q � BLOCK USE ZONE NOP l
TRACT / SPEC AL
T ONS r
NO OF BLDGS
SIZE OF LOT�ONOW ON LOT
USE OF
EXISTING BLDG ro BLDG SETBACK FROM (STREET)
TEL / FRONT PROP LI NE OF -
OWNERf 7, O (9' TYPE OF EXISTING SETBACK HIGHWAY + YARD - TOTAL
ADDRESS
HIGHWAY WIDTH FROM C L
Q (jC£
CITY G L C L 6V^C} 3 0 +
ARCHITECT OR TELA" BLDG SETBACK FROM - (STREET)
ENGINEER NO SIDE PROP LINE OF
TYPE OF EXISTING1 SETBACK HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C L
CONTRACTOR is NO TEL + d
LIC O
ADDRESS NO CORNER CUTOFF YES ❑ NOLeiv
CITY CLASS SEE REVERSE SIDE FORSPECJAL&PPROVALS
DESCRIPTION OF WORK i �� t + '"
z
E ADD ALTER REPAIR DEMOLISH
SQ FT NO OF NO OF
SIZE �a�®
USE OF STORIES FAMILIES
STRUCTURE
SIGNATURE OF
APPLICANT
VALUATION $ � / / SQ D APPROVALS DATE IN CTOR s sl NATURE
PMT
F E $ c// 3461 g., f I FEE $ 110.2-6 FOUNDATIONFORMS MATERIIALSON
FRAME FIRE STOPS
I 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 1 CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT
ING TO WORKMEN S CO PENSATION INSURANCE
_� LATH EXT r
SIGNATURE OF � HOUSE NUMBER COR /
PERMITTEE RECT AND POSTED "� -
ADDRESS ' FINAL42,1
JOHN F LEWIS PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATIONrIDM O CASH PERMIT VALIDATION CK 110 CASH
LAjr , 8 4 9 7'0 FEB 6 23 D 5 1 3 Q o
8363:0 FEB11 23 D - �' � 5kr
-
- ►Ar 8 J 6 4' FEB1 1 1 D 1 1 0 7 0"' q