HomeMy Public PortalAbout5211AGNES AVE_Building 74A498A CE p009 9 60 APPLICATION FOR BUIL t NG PERMIT
COUNTY OF LOS ANGELES BUILDING 5211' Agnes St.s, /
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY TOTr3p1e Citi /
JOHN A LAMBIE COUNTY ENGINEER NEAREST
WILLIAM A JENSEN SUP T OF BUILDING CROSS ST
DIST IGT O OUP TYPE PRO SSED BY
FOR APPLICANT TO FILL IN �0I1 11 coNsr i r,�.
ADDRESS 5211 Agnes 1.7t♦ , =TATISTICALCLASSIFICATION rj 'W ER MAP
BUILDING 1 BK PG
CLASS NO;)'--[ //DWELL UNITS
LOT NO BLOCK MAPNUMBER 4 �V STATE
Lp HWY YES y '
TRACT 12268 USE ZONE SPECIAL
NO OFBLDGS1 '4/ CONDITIONS
SIZE OF LOT I NOW ON LOT r ' '
USE OF 1sej garage and guest ro UILDING
EXISTING �i -_
YARD HWY STREET NAME EXIST
/� DaviTEL-9 � SETBACK WIDTH
OWNER E, GD
ean -9 NO r FRONT
A gne s t. , Temple City ` PIL
+ SIDE
ARCHITECT OR TEL P L
ENGINEER PLANNO INSPECTION RECORD }.
ADDRESSy Ay � Pools Inc• NW-3221
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DESCRIPTION 0
OF WORK v
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NEW X ADD ALTER REPAIR DEMOLISH r I Z
SQ FTn NO OF - NO OF t , #A,* 1412110"04eSIZE G STORIES FAMILIESUSE OF
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YSTRUCTURE Private sw3,m OPT
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SIGNATURE O I�
APPLICANT M
VALUATION 320 0 000 I 1
APPROVALS DATE INSPECTOR SSIGNATURE
PC PMT I FOUNDATION LOCATION S�'i� tl
FEE _ FEE $ ,r FORMS MATERIALS
FRAME FIRE STOPS
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION} BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY, rFURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CONSTRUCTION I CERTIFY THAT IN THE PERFORMANCE
OF THE WORK FOR WHICH THIS PERMIT IS ISSU I SHALL NOT LATH INT
EMPLOY ANY YEINNY MANNER SO TO ECOME SUBUECTTO THE WORENSATION LA F IpRNIA ' LATH EXT
SIGNATOR HOUSE NUMBER COR 1
AT AND POSTED S
BhLg(3�R' a to B vd So a 1+' FINAL e
CLYDE N DIRLAM' PRINCIPAL STR)JC RAL ENGINEER
PLAN CHECK+VALIDATION cK , mo CASH PERMIT VALIDATION., cic. M o CASH
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