HomeMy Public PortalAbout5128AGNES AVE_Building 76A638A CEI4803263 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY /J /
JOHN A LAMBIE COUNTY ENGINEER NEAREST /
WILLIAM A JENSEN SUP T OF BUILDING CROSS ST
DI/5J}T NO GROUP TYPE '�� ESSED BY
FOR APPLICANT TO FILL IN CONST
BUILDINGSTATISTICAL CLASSIFICATION SE ER MAP
ADDRESS / 12, K
CLASS NO DWELL UNITS
_/_j
LOT NO t BLOCK WATER I
CERTIFICATE NOT REQUIRED RECEIVED
TRACT 42 2 MAP HIGHWAY STATE MAJOR SECOND OCA
NO OF BLDGS NO (CIRCLE)
SIZE OF LOT NOW ON LOT USE ZONE SPECIAL
USE OF 1 CONDITIONS
EXISTING BLDG
t TEL
OWNER NO BUILDING YARD HWY STREET NAME EXIST
`'ETBACK WIDTH
ADDRESS t FRONT
ARCHITECT OR / TEL P L X
ENGINEER / NO �� SIDE 1 I d
\ P L
ADDRESS O
� I V
TEL. `\ vI ' u
CONTRACTOR I NO 1 ,/
ADDRESS (I Zre, O
u �1 [/Gd /p/ W
DESCRIPTION OF WORE 3 � 5 � i �
/nDf Av r !v Z
NEW ADD ALTER REPAIR DEMOLISH �`A� G r _. / �+-A�
Q FT NO OF NO OF �P- "�1
SIZE STORIES FAMILIES / t I / _kf
USE OF 0 A
STRUCTURE _ fy g n
SIGNATURE OF
APPLICANT_
PPLICANT d0 1
I .r;!t I ...-
VALUATION $
APPROVALS " DATE INSPECTOR S SIGNAILLRE
PC ' �}' PMT ,y'/ C FOUNDATION LOCA ION fj tpy
x
FEE $ ' FEE $ / FORMS MATERIALS' PA/'4
FRAME FIRE STOPS P )1
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS (l U
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION + Y"
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT
TION OF THE LABOR CODC OF THE STATE OF CALIFORNIA RELAT {p
ING TO WORKMEN S COMPENSATIO INSURANCE If
`! 1 F
LATH EXT f1,
SIGNATURE OF HOUSE NUMBER COR wicu_PERMITTEE RECT AND POSTED ADDRESSFINAL
PLAN CHECK VALIDATION CK M o cnsH _ JOHN F LEWIS PRINCIPAL STRUCTURAL EN
PERMIT VALIDATION CK MO CASH
t
U1�Jo 4 V7 9 16:� JAN 2.5 2 3 D 3 2 0 0 A
4 9 7 5,z JA1112 9 1 fD 6400-
4 r .. 5 a•