HomeMy Public PortalAbout5822AGNES AVE_Building ) NZo96P?C2
A C&It803 8 64� APPLICATION FOR BUILDI PERMIT
COUNTY OF LOS ANGELES BUILDING GDEPARTMENT OF COUNTY ENGINEER ADDRESSLi
BUILDING AND SAFETY DMSION LOCALITY `
JOHN A LAMBIE COUNTY ENGINEER NEAREST
COLEMAN W JENKINS SUP T OF BUILDING CROSS ST
DISTRICT NO GROUP TYPE PROCESSED BY
FOR APPLICANT TO FILL IN p = CONST
BUILDING �j STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS CLASS NO DWELL UNITS BK C PG
LOT NO �v S'(}� O BLOCK USE ZONE MAPNO
J'
TRACT �p J �'�I SPECIAL• V
d NO OF BLDGS CONDITIONS
SIZE OF LOT J�6 k /7G NOW ON LOT
USE OF
I NG B ,,�1 L� e , BLDG SETBACK FROM �\ C C
TEL C FRONT PROP LINE OF �V✓..7 (STREET)
OWNER NO S TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTHFROM C L
6th TD 3a + 2a = Sd
CITY BLDG SETBACK FROM
ARCHITECT .y TEL n ' 1
ENGINEER e / LJ NO u SIDE PROP LINE OF - (STREET)
TYPE OF EXISTING SETBACK HIGHWAY + YARD - TOTAL 1
/,�� A" HIGHWAY WIDTH FROM C L
ADDRESS ,r5� "&exs
TEL + = O
CONTRACTOR ,C[ >L NO 6 U
ADDRESS { (,ei G/) NO �6 CORNER CUTOFF YES NO O
CITY r�+ cls ` SEE REVERSE SIDE FOR SPECIAL APPROVALS W
DESCRIPTION OF WORK n �r�.,„ °'
NEW ALTER REPAIR DEMOLISH ��rt,
�' !i.
SQ FT NO OF NO OF f LI,G f� // /�
SIZE �r�0 STORIES J FAMILIES/ .•� r!'�t �
U S E O F rL iI�r /1
STRUCTURE ! t
SIGNATURE OF
APPLICANT
VALUATION$ QUv
APPROVALS DATE INSPECTOR SSIGNAT RE
FEE FEE$ FOUNDAFORMSI MATERIALSON ;;i li
FRAME FIRE '/����
I HER EBV ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTOLT4
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION C
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS r
9UILDI NG CONSTRUCTION I CERTIFY THAT IN DOING THE WORK y
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT c
TION OF THE LABOR CODC OF THE STATE OF CALIFORNIA RELAT
ING TO WORKMEN S COMPENSAToRANC INE
LATH EXT ( F7
SIGNATURE OF HOUSE NUMBER COR
PERMITTEE 7777 RECT AND POSTED
ADDRESS FINAL
JOHN F LEWIS PRINCIPAL STAL ENGINEER
PLAN CHECK VALIDATION CK M O CASH _ PERMIT VALIDATIO CK MO CASH
ulljo 9 5 9-- AU025 1 D 1500 -
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