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DEPARTMENT OF COUNTY ENGINEER t.
DIVISIONSION OF WELDING AND SAFETY
COUNTY OF LOS ANGELES
BUILDING-
WILLIAM J FOX COUNTY ENGINEER APPLICATION '
CA8SATT D GRIFFIN SUP T OF BUILDING
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
DISTRICT NO PLANCK OR REC No PERMIT NO
BUILDING ��/O I,/ 4G•'r-4 /1 vL- � ra ;
M, ADDRES 'r !v /�
LOCALITY EMPs.E CIT CA�-1 F RECEIVED BY DATE OF APPL D TE 1 SUED
NEAREST �/
CR0888T L..d 4N/Y BUILDING
N OWNER I�OLHND TzI AAADDRESS '`.J I
ADDRESS�Z O Nr AGA(as ✓E MAIL LOCALITY
/'A 1 NEAREST
CITY � CI G9 TO T 6 22 CROSS ST
ARCHITECT OR TEL FIRE NO OF —TY --f+ GR
ENGINEER ONE NO ZONE PLANS ,��{�._
ADDRESS BLDG'`' A�' SETBACK NE
CONTRACTOR ®�/ "/ NO USE
BY
( ATE
ADDRESS
i HOUSE NUMBERING
�
LEGALI I MAP NUMBER NO ASSIGNED BY �
DESCRIPTION LOT NO BLOCK
- CORRECTIONS
TRACT / 2-2.4
�] NO OF BLDGS
SIZE OF LOT I / O I NOW ON LOT t
USE OF BLDG I D C KC.�C NO OiE
DESCRIPTION OF WORK -
0
NEW ALTERATION I ADDITION y .. 'y .. D
Z
REPAIR DEMOLITION D
r
SQ FT NO OF
SIZE R OMS STORIES
EXT WALL I ROOF
COVERING COVER NG
USE OF STRUCTURE
E I . coycRCM Poiech
sL n /2." (VAA?jrs 76 I is
W -Foor.1yrriOle Fu7veE
CO U M M 4 SU PP 012 V RLr)%,ecm' APPROVAL
INSPECTOR SIGNATURE DATE
UNDATION LOCATION /f
RMS MATERIALS
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP FRAME FIRE STOPS le
PLICATION AND STATE THAT THE INFORMATION GIVEN IS BRACING BOLTS
CORRECT FURNACE LOCATION
1 AGREE TO COMPLY WITH ALL COUNTY ORDINANC GAS VENT DUCTS
AND STATE LAWS REGU TING BUILDING CONSTRUCTION
SIGNATURE OF �'/ LATH
PERMITTEE p�
ADDRESSS?-?- ll I f I 46 .•� 06 / LATH EXT
PLASTER INT rte.
AUTHORIZED AGT
PLASTER EXT
/DO i FEE
$
HOUSE NUMBER COR
/ RECT AND POSTED
VALUATION $
FEE 6 O f FINAL
79A638A Des 8 9 82
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