HomeMy Public PortalAbout5014AGNES AVE_Building � J
76A838A CE#803 8 63APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
ADDRESSG %
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY y
JOHN A LAMBIE COUNTY ENGINEER NEAREST /
WILLIAM A JENSEN SUP T OF BUILDING CROSS ST
DIST CT NO GROUP TYPE PROCESSED BY
FOR APPLICANT TO FILL IN y CONST _
BUILDI NG
� h STATISTICAL CLAS IFICATION S WER MAP
ADDRESS BK PG/7/
�i CLASS NO DWELL UNITS �� L
LOT NO J 3 / BLOCK WATER ❑
CERTIFICATE NOT REQUIRED RECEIVED
TRACT ( MAP HIGHWAY
NO OF BLDGS NO (CIRCLE) STATE MAJOR SECOND OCAL
SIZE OF LOT NOW ON LOT USE ZONE SPECIAL
USE OF CONDITIONS
EXISTING BLDG q-),
TEL
OWNER NO BUIL ING EXIST
SETBACK YARD HWY STREET NAME WIDTH
ADDRES FRONT I /
ARCHITECT OR TEL P L _
ENGINEER NO SIDE
tn
P L
ADDRESS d
r TEL 0
CONTRACTO NO l 1 u
ADDRES 19
0
DESCRIPTION6F W RK u
W
t d
NEW ADD ALTER R PAR DE LI H I Z
SO FT NO OF
SIZE STORIES FAMILIES I
USE OF °
STRUCTURE
SIGNATURE OF
APPLICANT #
VALUATION S
APPROVALS DATE, INSPECTOR SIGNATURE
PC PMT Q FOUNDATION LOCATION A '
FEE S FEE S s FORMS MATERIALS f
FRAME FIRE STOPS
B
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION RACING BOLTS J I
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 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
ING TO WORKMEN S CO PENSATION INSURANCE y
LATH EXT
SIGNATURE OF HOUSE NUMBER COR
PERMITTEE t RECT AND POSTED
ADDRESS FINAL (�
JOHN F LEWIS P INCIPALSTDCKK
RAt ENGINEER
PLAN CHECK VALIDATION CK M O CASH F PERMIT VALIDATIO M O CASH
LA 0 �'-5 y L,40 MAY 5 1 D 600-