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76A638A CE#80311 S7 APPLICATION FOR BUILDING PER IT 1
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DMSION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST
CASSATT D GRIFFIN SUP T OF BUILDING CROSS ST
DISTRICT NO I GROUP ITYPE WER MAP
FOR APPLICANT TO FILL INBK PG
BUILDING �/ /� CONST
Aq ADDRESS J�O [.�J STATISTICAL CLASSIFICATION
CLASS NO DWELL UNITS
LOT NO BLOCK MAP STATE
S� NUMBER HWY YES O
TRACT 6.9 USE ZO E SPECIA
NO OF BLDGS CONDITIONS
SIZE OF LOT. NOW ON LOT
USE OF
EXISTING BLDG BUILDING YARD HWY STREET NAME EXIST
OWNER ,�,�.,r.,rt..C:{/ „/)� c/�d� SK WIDTH
FRONT
MAILADDRESS VZ Qi s SIDE
P L
CITY�-IN,.i 2n NO INSPECTION RECORD
ARCHITECT OR TEL
ENGINEER O
ADDRESS
TEL
CONTRACTOR NO
ADDRESS
D CRIPTION OF WORK '
NEW ADD ALTER REPAIR DEMOLISH ��yy ,,
SIZE �. V NOR ES OF NO OILIES _® 1 ,v�^ _
USE OF STRUCTURE P '
cAL
a
SIGNATURE OF O_ � _ / l',/�—+ APPROVALS
APPLICANT erg-rcpt Pf'�e�"`�'�P
V�� 7 / L DATE INSPECTOR S SIGNATURE
ADDRESS i rrp[/f' FOUNDATION LOCATION
FORMS MATERIALS
P C S FRAME FIRE STOPS
U L,f FEE BRACING BOLTS =' r
VALUATION
$ W. FURNACE LOCATION
FEE GAS VENT DUCTS
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP LATH INT
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY ITH ALL COUNTY ORDINANCES AND
STATE LAWS RE TING BUIL IWNG TRUyCTr10 LATH EXT
SIGNATURE OF I * HOUSE NUMBER COR
PERMITTE RECT AND POSTED A
r ,�
ADDRESS q dt �� FINAL dd
CLYDE N DIRLAM PRINCIPALS-IRUCTURALtWr R
PIAN CHECK VALIDATION CK M o CASH PERMIT VALIDATION CK M o CAs
IAP—' 1925OR .nm 16 1 4.0 0 ®,