HomeMy Public PortalAbout5234AGNES AVE_Building (2) 76A638A CE 0803 4/70
APPLICATION FOR BUILDI G PERM
COUNTY, OF LOS ANGELES ASSESSOR
DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL
BUILDING AND SAFETY DIVISION BUILDING
JOHN A LAMBIE COUNTY ENGINEER ADDRESS
COLEMAN W JENKINS, SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
rent or tvDe onl
BUILDING DI ICT NO GROU CONST tl TYPEP OC D
ADDRESS ll��rrJJ�� V
STATISTICAL SIFICATION S WER MAP
LOT N BLOCK CLASS NO DWELL UNITS BKPG77
TRACT USE ZONE MAP -
NO OF SLOGS NO
SIZE OF LOT NOW ON LOT SPECIAL
USE OF CONDITIONS `
EXISTING BLDG
i
T EJE
OWNE BLDG SETBACK FROM
FRONT PROP LINE OF (STREET)
ADDRESS
TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL
CITY
HIGHWAY WIDTH FROM C L
ARCHITECT OR TELa �0
ENGINEER O BLDG ETBACKFROM _
ADDRESS SIDE PROP LINEOF (STREET)
T TYPE OF EXISTING SETBACK I HIGHWAY } YARD = TOTAL
CONTRACTO HIGHWAY WIDTH FROM C L
LIC i } = O
ADDRESS p
V
LIC
CITY CLASS CORNER CUTOFF YES ❑ NO ❑
CONSTRUCTION LENDER
NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS
- to
I ADDRESS
� SQ FT NO OF NO OFNEW
SIZE
STORIES FAMILIES
USEOF ADD ❑ /� /"�1 �1�/ �/1 �f/� ` 1 'LfXif
STRUCTURE r
ALTER ❑ w ���
REPAIR❑ `
SIGNATURE OF v 144
APPLICANT DEMOL ❑ '� ��p�p. '
�P
VALUATION $ APPROVALS DATE INSPECTOR S SIGNATURE
P C PMT FOUNDATION LOCATION
FEES ` (0 FEE $ A� (!` FORMS MATERIALS
FRAME FIRE STOPS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON GAS VENT DUCTS
STRUCTION1 CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH INT
LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO
WORKMEN S COMPENSATION INSURANCE LATH EXT
SIGNATURE OFHOUSE NUMBER COR
PERMITTEETS-Z �e - RECT AND POSTED
ADDRESS 4 FINAL (J 3
JOHN F LEWIS PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION c� M o CASH _ PERMIT VALIDATION cK M o CASH
I['- 9 8 3 Sr-- APR 2 2 2 3 0 1350 ,
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