HomeMy Public PortalAbout9582BISBY ST_Building (4) {7eAdaei.'ci+rao3 5-65APPLICATION FOR BUIL NG PERM
Y COUNTY OF LOS ANGELES
BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY K
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS,6UP'T OF EUILDINO CROSS ST.
DI ICbNO T(PEP SD Y_
FOR APPLICANT TO FILL. IN CONST.
DUILDINO STATISTICAL C�k6RI FICATION DE MAF .
ADDRESS I -Lr
"DW CL'A93 NO. DWELL UNITS B PO
LOT NO. BLOCK USE ZONE MAP _ _
N2.
TRACTECIA
O [. CONDITIONS
SIZE OF LOT MOW ON LOT N LOT
MO
UDE OF
[LD[. SETBACK FROM
L. FRONT PROP. LINK OF + WREST)
OWNER hrOF [)SISTINE S[T[ACK HIGHWAY YARD TOTAL
r 1 TYF[
ADDRESS d E 7 T M C L. '
2:
- CITY zol
ARCHITECT OR TEL. BLDG.1ACK FROM _
ENOINEVPt NO. EIDE PROP. LIN[ OF- ETR[[T
TYPE OF [ZW-INE S[TB-ArK 1i1[HWAY + -'YARD = TOTAL
ADDRHDS HIGIWAY WIDTH FROM C.L.
TEL.
CONTRACTOR NO
LIC CORNER CUTOFF YES NO
ADDR EII - NO
CITY C LASSLIC SEE RSE SIDE FOR SPECEAD APPROVALS
DESCRIPTION OF WORK
NEW ADD X ALTER REPAIR DEMOLISH '
SQ,FT. I NO. OF NO. OF 1
SIZE STORIES FAMILIES
USE OF
9TRUCTURE IfiL
SIONA URE OF -EQ.'
APPLICANT ` T
a
VALUATION0`0 APPROVALS DAT I E OR'ED
RE
P.C. PMT. �} FOUN-0ATION, LOCATION
FEE FEE$ r(l L/ FORMB MATERIALS
FRAME, FIRE STO-PS,
I HIRIDY ACKNOWLEDGI THAT 1 HAVE READ THIS APPLICATION DRACINO BOLT r '
AND BTATF THAT THE A*OYK 1E CORRECT AND AOR[[ TO COMPLY FURNACES LOCATION ,
WFrH ALL COUNTY ORDINANCE[ ANb STATE LAWS REGULATING OAS VENT. DUC l '
bUILD1 NG NS
COTRUCTION. I CERTIFY THAT. IN bOING THE WORK
AUTHORIZED HIIaEY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT.
TI9N OF TH[ LAECALIFORNIAOR COD[ OF THE I TATO OF RILAT-
ING TO WORKMEN'[COMPENSATION INSURANCE. LATH. EXT. 1
SIGNATUREAF� � /�J HOU9E NUMBER COR- r/
r PERMITTEE ���JJJ _,I� /lam- R N POTEDn
ADDRESS Fl N A L
JOHN F. LEWES, PRINCIPAL ST RAL E GINEER
PLAN CI�CK VALIDATION CK_ M.O. CARH _ PERMIT VALIDATION M.O CASH
�0276� cK MAR 8 1 D 15.00^' V