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1159 APPLICATION FOR BUILDING PERMIT ],
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DMSION OF BUILDING AND SAFETY ADD Elss✓ A33 C"S tie-
Deportment of County Engmeer
County of Los Angeles LOCALITY T n f� 6, S4/
JOHN A LAMBIE COUNTY ENGINEER NEAREST
CASSATT D GRIFFIN SUP T OF BUILDING CROSS ST v/1,4 59
FOR APPLICANT TO`FILL IN
DISTRICT GROUP TYPE SEWER MAP
BK PG
CONST
BUILDING/9 �JMAP
ADDRESS�J oC �p�/ES' �j'1J e NUMBER Q HWY STATE YES
LOT NO j3 T BLOCK USE ZONE SPECIAL
CONDITIONS
TRACT J Z,Z._
NO OFBLDGS
SIZE OF LOT fJ(/�S� I NOW ON LOT ON BUILDING EXIST
USE OF
SETBACK YARD HWY STREET NAME WIDTH
EXISTING BLDG FPROL p,r ^
OWNER,4&,j. �G'& f//14G / &f . SIDE �J V
MAIL A
ADDRESS Jp ^� ITRACT DWELL 1 UNITTEL ) 5 INDUSTRIAL
CITY 7 2 �>J�/ NO WELL 1 UNIT
6 PUBLIC BLDG
ARCHITECT 6R TEL 2 DUPLEX 2 UNITS
ENGINEER NO 7 ADDN ALT ETC
3 APT UNITS
8 MISCEL
ADDRESS // 4 COMMERCIAL
CONTRACTOR)�>114r 130.4. NO ,Q-{ E,*7/11 INSPECTION RECORD
ADDRESS 19 �AS Tt/�1A5 �JP t
DESCRIPTION OF WORK
NEW X ADD ALTER REPAIR DEMOLISH r^�"
SQ FT NO OF j NO OF
SIZE STORIES / FAMILIES
U,$€J OF STRUCT E
JJ�� l A I.CI 7
SIGNATURE O
APPLICANT APPROVALS
ADDRESS DATE INSPEFTOR S SIGNATURE
5 mG �p v -� FOUNDATION LOCATION
yT SIf/ P C $ FORMS MATERIALS CL.,�.
f /�ro® FEE FRAME FIRE STOPS �pp�
VAL ATION V $p. BRACING BOLTS
FEE O( FURNACE LOCATION II
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS GAS VENT DUCTS /
APPLICATION AND STATE THAT THE ABOVE IS CORRECT I
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH INT I -Ip
AND STATE LAWS REGULATING BUILDING CONSTRUC '
TION LATH EXT
SIGNATURE OF /1l' HOUSE NUMBER COR
PERMITTEE RECT AND POSTED
ADDRESS-_,FJ ad Q� '�^ FINAL u
JOHN A LAMBIE COUNTY ENGINEER VALIDATION CLYDE N DIRLAM CHIEF BLDG INSPECTOR
CK MO CASH
6409ZR 11AY25 16 1300Am
i .6 4 4 �>� t�pY 2� 1 2800 r�
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