HomeMy Public PortalAbout5002AGNES AVE_Building 78A638A CE x$803182 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING �f
DEPARTMENT OF COUNTY ENGINEER ADDRESS �[y
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST '
WILLIAM A JENSEN SUP T OF BUILDING CROSS ST ,
DISTRICT NO GROUP TY E CESSED BY-'
FOR APPLICANT TO FILL IN �� CONST
BUILDING — STATISTICAL CLASSIFICATION EWER MAP
ADDRESS fg IVC- 5 r5 + CLASS NO DWELL UNITS-/-- 'MBK G
LOT NO bi/ 5T ER1 /-T Or BLOC ' WATER
CERTIFICATE NOT REQUIRED ❑ RECEIVED
TRACT MAP / HIGHWAY
jrNO OF BLDGS NO (CIRCLE) STATE MAJOR SECOND OCAL
SIZE OF LOT NOW ON LOT USE ZONE SPECIAL
USE OF CONDITIONS
EXISTING BLDG
OWNER �, 0 % [ANO i'3-y V BUILDING EXIST
SETBACK YARD HWY STREET NAME WIDTH
ADDRESS`/�/> � /� I L®P FRONT �241 �
ARCHITECT OR ,// TEL P L
ENGINEER �� NO SIDE
ADDRESS i O
TEL
CONTRACTOR � NO
ADDRESS r✓/ /�. �r r• O
DESCRIPTION OF WORK � � � ®� ;�F�•'� 4Lu
A
NE ADD ALTER REPAIR DEMOLISH ^fNO OF NO
.P�C
SIZE T a STORIES FA IILFES
USE OF " 11e 3/ �J iinv1 �9"✓( r
STRUCTUR 5. v Q'✓
SIGNATURE
APPLICAN v r ✓
VALUATION
w�) APPROVALS DANE INSPECTOR,SS IIIGNATURE
PC "' C4 PME $T v FOUNDATFORMSION MATERIAL SION�
FEE $ FE
FRAME FIRE STOPS I
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS \
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLYr r
FURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK /
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT
TION OF THE LABOR CODC OF THE STATE OF CALIFORNIA RELAT _ \ P
ING TO WORKMEN S COMPENSATION INSURANCE
SIGNATURE LATH EXT (J A.04'PERMITTEE OF HRECT AND POSTE DR
ADDRESS -� FINAL
JOHN F LEWIS PRINCIPAL ST R RAL ENGINEER
PLAN CHECK VALIDATION mo cysH _ PERMIT VALIDATION CK M O CASH
LI&O6U52N kOu 7 �2- # 2850A
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