HomeMy Public PortalAbout5703AGNES AVE_Building (7) 76A838A CE#803 3 eBAPPLICATION FOR BUILDINrG PERMff
COUNTY OF LOS ANGELES BUILDING /J
DEPARTMENT OF COUNTY ENGINEER ADDRESS..
BUILDING AND SAFETY DMSIONLOCALITY IeA
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUP T OF BUILDING NEAREST
CROSS ST
FOR APPLICANT TO FILL IN DISTRICT NO GROUP TYPE PRO ESSED BY
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CONST
BUILDING STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS 5703 North Agneg E-3659 CLASS NO DWELL UNITS ` ePl—�P6—
LOT NO BLOCK USEZONE MA
NOP
TRACT '—/
I SPECIAL
NO OF BLDGS CONDITIONS r
SIZE OF LOT NOW ON LOT I
USE OF
EXISTING BLDG BLDG SETBACK FROM
TEL FRONT PROP LINE OF (STREET)
OWNER eTOSe h Policy NO TYPE OF EXIS G SETBACK HIGHWAY } YARD = -TOTAL
ADDRESS 5703 N. Agnes
HIGHWAY WIDTH ROM C L
CITY } I
ARCHITECT OR TEL BLDG SETBACK FROM (STREET)
ARCHITECT OR ;tL
ENGINEER NO SIDE PROP LINE OF
TYPE OF EXISTING1 SETBACK HIGHWAY } YAR = TOTAL
ADDRESS HIGHWAY WIDTH FROM C L
CONTRACTOR Monarch Roof TEL SY 6-6191 } D�
LICC:)ADDRESS 175 VistaNO '' CORNER CUTOFF YES ElNO U
CITY Pasadena 110 CL SS C-39 SEE REVERSE SIDE FOR SPECIAL APPROVALS o
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DESCRIPTION OF WORK
e le Cit License z
NEW ADD ALTER REPAIR X DEMOLISH �
SQ FT NO OF NO OF
SIZE 2500 STORIES FAMILIES
USE OF
STRUCTURE eroof with meds.wn shakes x
e
SIGNATURE OF
APPLICANT
nes- q1000•
VALUATION $ Oc
1 200.00 Gar- 200.00 APPROVALS DATE INSPECTOR S SIGNATURE
P C PMT 18 O FOUNDATION LOCATION
FEE$ FEE $ • FORMS MATERIALS
FRAME FIRE STOPS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THI;APPLICATION BRACINGBOLTS
ANSTATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITH ALL COUNTY &DINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT LATH INT
ING TO WORKMEN S COMPENSATION INSURANCE
LATH EXT
SIGNATURE OF /, HOUSE NUMBER COR
PERMITTEE RECT AND POSTED
ADDRESS FINAL
JOHN F LEWIS PRINCIPAL STRU T RAL ENGINEER
PLAN CHECK VALIDATION CK M o CASH
_ PERMIT VALIDATION CK MO CASH
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