HomeMy Public PortalAbout5218AGNES AVE_Building (7) ` 6
76A4A CE A03 3 69
_L APPLICATION FOR B NG PERMIT
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COUNTY OF LOS /ANGELES BUILDING�—� /�/ j V
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUP T OF BUILDING NEAREST
CROSS ST
DISTRICT NO IGROUP TYPEZT PROCESSED, BY-
FADDRESS
OR APPLICANT TO FILL IN �- 1
(PRINT OR TYPE ONLY) O
G /+ /` STATISTICAL CLASSIFICATION w SEWER MAP
. _� CLASS NO �.LOWELL UNITS BK PG '
BLOCK USE ZONE r NO
' SPECIAL w
Cl CONDITIONS 1
NO OF BLDGS / - -
LOT NOW ON LOT p
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G BLDG LuL°�//.0 BLDG SETBACK FROM
TEL FRONT-PROP LINE OF �ry /fiG�LS �iIJ� (STREET)
�j(f� 0 `NO TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
"� GES s HIGHWAY WIDTH FROM C L� I de60
M ^ +
ABLDG SETBACK FROM
ARCHITECT OR TEL (STREET)
ENGINEER � NO SIDE PROP LINE OF _
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C L
TEL +
CONTRACTOR NO y
ADDRESS LIC NO CORNER CUTOFF -YES ❑ NO L
CITY CLASS SEE REVERSE SIDEOR SPECIA PPR ALS
CONSTRUCTION LENDER �'y�
NAME AND BRANCH
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ADDRESS u
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SIIZEF2 �/`STOR IES FAMILIES NEW ❑
USE OF
STRUCTURE l ADDER Q
REPAIR ❑
SIGNATURE 0 /a DEMOL ❑
APPLICANT ( �f
VALUATION V 0 APPROVALS DATE INSPECTOR S SIGNATURE
P C PMT FO S
FORM ,MATERIA SN Y� -3 70
FEE $ FEE $ �
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION FRAME FIRE STOPS
BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUC GAS VENT DUCTS
TION I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I
WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE LATH INT
OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN S COM
PENSATION INSURANCE LATH EXT
SIGNATURE OF Ll HOUSE NUMBER CORRECT
PERMITTEE O"e— AND POSTED {
ADDRES 5�2 ' FINAL
JOHN F LEWIS PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION CK M 0 CASH - PERMIT VALIDATION CK M O CASH
I � 4 2 8 D 1725-