HomeMy Public PortalAbout5118AGNES AVE_Building 78A638A CE#803 8 83 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DMSION LOCALITY j
JOHN A LAMBIE COUNTY ENGINEER NEAREST
WILLIAM A JENSEN SUP T OF BUILDING CROSS ST
DISTRICT GROUP TYPE PROCESSED BY
FOR APPLICANT TO FILL IN CONST
BUILDING STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS 5118 North Agnes Ave. ,,Tf—
BKe- PG 74
CLASS NO —/—DWELL UNITS (�
LOT NO BLOCK31 WATER
CERTIFICATE NOT REQUIRED 1:1 1:1❑
TRACT 94R1 MAPJ HIGHWAY
NO OF BLDGS NO Q/ � (CIRCLE) STATE MAJOR SECOND LOCAL
SIZE OF LOT NOW ON LOT USE ZONE SPECIAL
USE OF CONDITIONS
EXISTING BLDG _ Q
TEL
OWNER NO B ILDING EXIST
SETBACK YARD HWY STREET NAME WIDTH
FRONTADDRESS 5814 PrimeroseAve. ,TC
ARCHITECT OR TEL PL
ENGINEER NO SIDE
P
ADDRESS / CLO
TE
CONTRACTOR SHANNON T40MICTS NO
09
ADDRESS 4- S Valley, S .G. G
DESCRIPTION OF WORK uj
a
NEW X ADD ALT R REPAIR DEMOLISH 4 SAS`+�� � Z
SO FT NO OF NO OF
SIZE t�fOO STORIES FAMILIES
USE O F1# �� �"• 4a� -0Y d.F+1
STRUCTURE
'00
SIGNATURE OF
APPLICANT pg � 0
VALUATION $ eog
APPROVALS 4DATE INVECTOR WIWqATURE
FOUNDATION LOCATION
FE PMT FORMS MATERIALS
FEE $ 41,f16 9
i0 FEE $
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 I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT
TION OF THE LABOR CODCOF THE ST CALIFORNIA RELAT
ING TO WORKMEN S COM OF
6 ION I SURANC
LATH EXT
SIGNATURE OF HOUSE NUMBER COR e p �
PERMITTEE RECT AND POSTED �p6 S
CY J�
ADDRESS � FINAL
PLAN CHECK VALIDATION cK M o CASH JOHN F LEWIS P NCIPAL STIRDCK
URAL ENGINEER
PERMIT VALIDATION M o CASH
a s s ,FEn 2 5°2,3 D 67051
7 7 2w fai- 2 2 3 D 1 2 60 -
tr', 8773' Halt 1 D l32.75-