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76A638A CE9803 8 63 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES ADDRESS
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST
WILLIAM-A JENSEN SUP T OF BUILDING CROSS ST
DISTRICT GROUf> CTYPE ONST PROCESSED BY
FOR APPLICANT TO FILL IN S—,d :3,-
BUILDING
BUILDING [� 7�� q r�/� STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS 118 N. A nes Ave• ll� BKL� PG
CLASS NO �DW ELL UNITS ` w
LOT NO BLOCK WATER
CERTIFICATE NOT REQUIRED RECEIVED
TRACT 94,91
MAP NO c /dlc ({CI
NHWAY
O OFRCLE( STATE MAJOR SECOND LOCAL
„
SIZE OF LOT NOW ONBLDGS LOT USE ZONE SPECIAL
USE OF CONDITIONS N
EXISTING BLDG Sheda
TEL
OWNER 'NO BUILDING EXIST
177q6 SETBACK YARD HWY STREET NAME WIDTH
ADDRESS 814 Primroae Ave• TFRONT
ARCHITECT OR TEL P L
ENGINEER NO SIDE '
P
ADDRESS ' { d
TEL41116 7 /y V
CONTRACTOR NO
ti
OC
ADDRESS224 PRast Valley. S .G. O
DESCRIPTION OF WORK ° c
b
E H
NEW ADD ALTER REPAIR DEMOLISHZ
SCI FT NO OF NO OF
SIZE2,98 STORIES 1 FAMILIES
USE OF
STRUCTURE Shed
SIGNATURE OF ~
APPLICANT
VALUATION $ ( Rd '
vAPPROVALS DATE INSPECTOR S SIGNATURE
PC PMT FOUNDATION LOCATION
FEE $ I ' FEE FORMS MATERIALS
FRAME FIRE STOPS
I HEREBY ACKNOWLEDGE THAT 17HAVE 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 IN
TION OF THE LABOR CO OF THE F CALIFORNIA RELAT
ING TO WORKMEN C P SAT( INSURAN E
LATH EXT
SIGNATUR HOUSE NUMBER COR
PERMITT ol RECT AND POSTED
ADDRESS Awl FINAL
JOHN F LEWIS PRIN IPAL ST URAL ENGINEER
PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION CK M o CASH
b 7 FEB � Q 0