HomeMy Public PortalAbout5728AGNES AVE_Building (3) 76A638A CE #803 4/72
APPLICATION FOR BUILDING PERMIT-,,,,
COUNTY OF LOS ANGELES ASSESSOR
DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL
BUILDING AND SAFETY DIVISION BUILDING
MAKE CHECKS PAYABLE TO: ADDRESS
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY
FOR APPLICANT TO FILL IN NEAREST / CnAy,
Print ort a onl CROSS ST. (...!
DISTRICT NO. GROUP TYPE CESSED BY
ADDREBUILDSS _ C (S CONST
LOT NO. BLOCK
STATISTICAL CL.�SSIFICATION SEWER MAP
CLASS NO. —f DWELL,UNITS BK PG
TRACT USE ZONE MAP r� y. -7NO.OF BLDGS. NO, Zae,
SIZE OF LOT NOW ON LOT SPECIAL
USE OF CONDITIONS
EXISTING BLDG. CC=
TEL.
OWNER
//✓J me NO. 7 BLDG.SETBACK FROM
ADDRESS17 A/ G,t/FS FRONT PROP,LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL
CITY L c r HIGHWAY WIDTH FROM C.L.
ARCHITECT OR ,.y�, TEL. }
ENGINEER (�j /Cs+t NO. �3a22
BLDG.SETBACK FROM 0.
ADDRESS ' G'l !4.0 SIDE PROP.LINE OF (STREET)
n TEL TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL
CONTRACTOR ��r�(j (��'4( , �/-U!j'j HIGHWAY WIDTH FROM C.L.
ADDRESS �7iS/c*,f, NO. 3-1I�� + = a
LIC. V!
CITY [� (-��//� CLASS L- CORNER CUTOFF YES ❑ NO Z
CONSTRUCTION LENDER
NAME AND BRANCH dell G-- SEE REVERSE SIDE FOR SP CIAL APPROVALS
ADDRESS c.
SIQZE T STOR/IES FAMINO. OLFES NEW El
USE OD
CTURE /(;�� p cocoAlez
STRUCTURE
7X/ _ ALTE
REP AIR❑
SIGNATURE OF
APPLICANTr-. o DEMOL ❑
VALUATION S 2,7—
,
APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. PMT. / FOUNDATION: LOCATION
FEE $ FEE $ 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 ALLORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS
STRUCTION. I 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 SURANCE.
e / LATH, EXT,
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS FINAL
PLAN CHECK VALIDATION cK. M.o. CASH^ _ c. PERMIT VALIDATION CK. .... CASH
L, or 7 r ,6 wAN26 2- 1 D 7.20N
1 D 12.00-
i' 727 JAN r
tot o _._ _