HomeMy Public PortalAbout5738AGNES AVE_Building (3) 76A638A CE 0803 4/70 r ��
�"�. '... _APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES ASSESSOR
DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LA MBI E, COUNTY ENGINEER
ADDRESS
COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
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DISTRICT NO, GROUP TYPE P BY
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OWNER NO. BLDG.SETBACK FROM
ADDRESS r FRONT PROP.LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL
CITY - HIGHWAY WIDTH FROM C.L.
ARCHITECT yy TEL. } _
ENGINEER t NO.
BLDG.SETBA ROM .
ADDRESS SIDE PROP.LINE (STREET)
' TEL. TYPE OF EXISTING SETBACK Y } YARD = TOTAL
CONTRACTOR V� NO. HIGHWAY WIDTH FROM C.L.
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ADDRESS NO.
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SIGNATURE OF
APPLICANT /�r� DEMOL
VALUATIONS /(.T V - APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. PMT, FOUNDATION: LOCATION
FEE $ FEE $ t 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
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 ORNIA IN RELATING TO
WORKMEN'S COMP S 71 NSUR, CE. LATH, EXT,
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE
RECT AND POSTED
ADDRESS �' ' FINAL
JOHN F. LEWIS. PRI IPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION "CK. M.O. CASH
I n 0 3 6 8-1 1141AY 21 6.00-
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