HomeMy Public PortalAbout5004AGNES AVE_Building (7) 00 3 It 42 IOM _ �" APPLICATION FOR PERIVIT
DEPARTMENT OF BUILDING AND SAFETY I j? � -
COUNTY OF LOS ANGELES V gL Il�T
WM J FOX CHIEF ENGINEER
NO OF *BLDG ORD NO DISTRICT NO PLAN CK NO PERMIT NO
PLANS SETBACK LINE __ _ •�/ � '
FIRS APPROVED
ZONE 1BY DATE RECEIVED BY DATE OF ADPL DATE ISSUED
U4E APPROVED I Amb/� �x_za _<k3
ZONE BY DATE
APPLICANT FILL IN HEAVILY OUTLINEDPORTIONONLYBUILDING
n
NAME
ADDRESS
2 ADDRESS - -- LOCALITY
1- p NEAREST QL
U W CITY I CROSS ST
d STATE TEL �• ��,
LICENSE NO NO � NAME l?C
2 MAIL 1, Cl 9 ol/� pmt
NAME ADDRESS `LJ9 -.t 4
On v
ADD LESS �T />r7 fir' CITY ( � fih� TNo � (-I
H
2 CITY 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
0 i APPLICATION AND STATE THAT THE ABOVE IS CORRECT
U ESTATE TEL AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
LICENSE NO / NO �_•_.____ AND STATE LAWS REGULATING BUILDING CONSTRUCTION
O2 LOT NO ! SIZE OF LOT�J Y SIGNATUREOWNEOF ��j,p� ��p� •
6 �' NO OF BLDGS
AUTHORIZED AGT �9� , �la n alaA Ni1XAl� gi 1A
BLOCK NOW ON LOT _r_
J U TRPCT g�¢ CORREC^7TiONNSS
DI
USE
GS
ON
L
N
DESCRIPTION OF dV®ICK rjp-' k
USE OF _ r'
BUILDING
J
Q
Z
C7
f NEW r TYPE GROUP _z_ O
Y NO OF NO OF /
ALTLRATION ROOMS FAMILIES
ADDITION SIZE X
t kFPAIR __ _ _ _ STORIES —
-MOVING WALL COVERING
DEMOLISH ROOF COVERING C /a
$ P c s FINAL APPROVAL
gSd FEE
S� -7 5^ (� " L INSPECTOR S
VALVA' ION FETE DATE I NAME