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1155 AD988 APPLICATION FOR BUILDING PERMIT ],
DIVISION OF BUILDING AND SAFETY ABUILD NG
DDRESS J.- O
Deportment of County Engineer
County of Los Angeles LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST /}
CASSATT D GRIFFIN SUP T OF BUILDING CROSS ST 0—
DISTRICT I�Q GROUP TYPE SEWER MAP
FOR APPLICANT TO FILL IN
aJL- 1J^ BK PG
CONST
BUILDING ^"
TATE
ADDRESSI- ) �� 27 NUMBER 14,0 /Q / 6 HWY YES NO
LOT NO BLOCK USE ZONE SPECIAL
,L/ G lJ_ / CONDITIONS
TRACT T() ' 0 o a
— NO OF BLDGS
SIZE OF LOT 16 0 'A I A � NOW ON LOT BUILDING EXIST
SETBACK YARD HWY STREET NAME WIDTH
USE OF
EXISTING BLDG FRONT
P L
OWNER SIDE
P L
MAIL
ADDRESS _!5*I A O TRACT DWELL I UNIT 5 INDUSTRIAL
TEL
CITY NO(C, a Cy I DWELL �j I UNIT
(Jl( 6 PUBLIC BLDG
ARCHITECT R TEL 2 DUPLEX 2 UNITS
ENGINEER NO7 ADDN ALT ETC
3 APT UNITS 8 MISCEL
ADDRESS 4 COMMERCIAL
TEL
CONTRACTOR NO INSPECTION RECORD
ADDRES
DESCRIPTIOV OF WORK
NEW ADD ALTER '/REPAIR DEMOLISH
SO FT NO OF NO OF
SIZE STORIES FAMILIES
USE OF STRUCTURE
SIGNATURE OF
APPLICANT I APPROVALS
ADDRESS DATE INSPECTOR S SIGNATURE
/l �•...� (J Cmm FOUNDATION LOCATION
P C $ FORMS MATERIALS
v V FEE FRAME FIRE STOPS
VALUATION $ r BRACING BOLTS 2 Sal
FEE FURNACE LOCATION
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS GAS VENT DUCTS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH INT
AND STATE LA REGULATING BUILp1NG-)CONSTRUC
TIONXNJI/Y/ LATH EXT
G
SIGNATURE O HOUSE NUMBER COR
PERMITTEE RECT AND POSTED n I
ADDRESS FINAL
JOHN A LAMBIE COUNTY ENGINEER V&MATjQN,, CLYDE N DIRLAM CHIEF BLDG INSPECTOR
CK MO !
ABH
LACO5 5 4 6- FEB 26 1 200 In
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