HomeMy Public PortalAbout5752AGNES AVE_Building 5-3 . .3 APPLICATION FOR BUILDING PERWT
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COUNTY OF LOS ANGELES BUILDING
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DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY i e
JOHNA. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST.
DIST ICT NO. GR TY E R CESSED BY
FOR APPLICANT TO FILL IN S' � � coNsrt_t�
BUILDING STATISTICAL CLASSIFICATION EWER MAP
ADDRESS sp� 6` toC'S �:aa: BK G
'u sO ti f, CLASS. NO. DWELL. UNITS L
LOT NO. '� f BLOCK WATER ❑
CERTIFICATE: NOT REQUIRED TX RECEIVED
TRACT A (iCGRCLE) STATE MAJOR SECOND, (OCAL
NO.OF BLDGS.
SIZE OF LOT NOW ON LOT ,U �E SPECIAL
USE OF CONDITIONS
EXISTING BLDG. Mere-
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OWNER �� J L�jty2�(.�'�c{ NO f�-•r�j"S�1S� ILDING YARD HWY STREET NAME EXIST.
_ _ SETBACK WIDTH
ADDRESS `j ,� - QS A V e— FRONT / �)
ARCHITECT OR TEL. P•
ENGINEER NO. SIpE
O..
ADDRESS
TEL. V
CONTRACTOR 1, It NO. ..
^44 cke�
ADDRESS
DESCRIPTION OF WORK w
a
H
NEW ADD ALTER REPAIR DEMOLISH Z
SQ. FT. NO.OF NO. OF -
SIZE �g STORIES FAMILIES
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- APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. PMT. tee' 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 ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS ••
BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. r N ?� J✓
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT-
ING TO WORKMEN'S COMPENSATION INSURANCE. LATH, EXT. e.
SIGNATURE OF HOUSE NUMBER COR- _�_,•,.•�4_�".,�,�_.
PERMITTEE ` Lllaa. RECT AND POSTED
ADDRESS FINAL
JOHN F. LEWIS. PRINCIPAL STRUCTURAL E INE
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK, M.U. CASH