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7BA638A CE#80311 S7 APPLICATION FOR BUILDING PERMIT 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 GROUP I TYPE EWER MA
FOR APPLICANT TO FILL IN BK PG
CONST
BUILDING STATISTICAL SSIFICATION
ADDRESS D
CLASS N DWELL UNITS
LOT NO BLOCK MAP J STATE
NUMBER ` HWY YES O
TRACT JUSVZNE SPECIAL
NO OF BLDGS CONDITIONS
SIZE OF LOT NOW ON LOT
USE OF
EXISTING 81—DG BUILDING EXIST
� SETBACK YARD HWY S EET NAME WIDTH
OWNER ! O ♦ FRONT p
MAIL 'l P L
ADDRESS SIDE
/� P L
CITY �w.M w-A /6,-a NOLk a/ a INSPECTION RECORD
ARCHITECT OR TEL
ENGINEER NO
ADDRESS
TEL �-
CONTRACTOR NO
ADDRESS
DESCRIPTIQN OF WORK
•, v
REPAIR DEMOLISH
NO OF NO OF
SIZE STORIES FAMILIES
USED RU TURE yr¢---
y
�y 1
/ L!
SIGNATURE OF APPROVALS
APPLICANT
r ATE I bf NATURE
ADDRESS FOUNDATION LOCATION
FORMS MATERIALS
-S P C S FRAME FIRE STOPS
A� p�=Q FEE BRACING BOLTS
VALUATION $ FURNACE LOCATION
FEE GAS VENT DUCTS
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP LATH INT
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND,
AGREE TO COMPLY V4kTH ALL COUNTY,,ORDINANCES AN
STATE LAWS REG TING BUIL 1 G Co TRU TIO LATH EXT
{ SIGNATURE OF HOUSE NUMBER R /
PERMITTE 1—1 A RECT AND POSTED
µu J,
ADDRESS � ` ' / FINAL /
CLYDE N DIRLAM PRINCIPAL STRU6-r'IRA'L-EN54§QR
PLAN CHECK VALIDATION CK mo CASH PERMIT VALIDATION CK M o cash
1 2 489 Jw16 l A 8.50 N ®.
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