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76A638A CE 9803263 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING ef
' DEPARTMENT OF COUNTY ENGINEER ADDRESS Q
BUILDING AND SAFETY,DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST /1 ( •
WILLIAM A JENSEN SUP T OF BUILDING CROSS ST
DISTRICT NO GROG. TYPE PROCESSED BY
FOR APPLICANT TO FILL IN J CONST
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G STATISTI AL CLASSIFICATION SEWER MAP
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BLOCK ) WASTER
CERTIFICATE NOT REQUIREDEl
RECEIVED
TRACT MAP, HIGHWAY
NO OF BLDGS NO (CIRCLE) STATE MAJOR SECOND LOCAL
SIZE OF LOT ; NOW ON LOT USE ZONE SPECIAL I o
USE OF r s -> CONDITIONS
EXISTING BLDG CG
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OWNER �� 91-VAI NO BUI ING EXIST
SETBACK YARD HWY STREET NAME WIDTH
ADDRESS /P t FRONT �1i1 .� A//^t, /D l
ARCHITECT OR TEL P - ✓l! �JGC�' (q
ENGINEER NO SIDE
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APPLICANT,
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,. VALUATION $�
fl APPROVALS DATE INSPECTOR S SIGNATURE
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FRAME FIRE STOPS F I'
I I HEREBY ACKNOWLEDGE THAT I HAVE READ THISAPPLICATIONBRACING BOLTS
I AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY FURNACE LOCATION
1 WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS .w+
BUILDING CONSTRUCTION I CERTIFY THAT SIN DOING THE WORK
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AUTHORIZED
HEREBY'I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT
TION OF THLABOR+CODC OF THE STA OF CALIFORNIA RELAT / _ 910 ^ ,.a
ING,TO WORKMEN 5 COMP NSATIONJIN ANCE LATH EXT
SIGNATURE OF „ HOUSE NUMBER COR * M
' PERMITTEE RECT AND POSTED
I ADDRESS FINAL o /
a + 'JOHN F LEWIS
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RINCIPAL STR RAL ENGINE
ER
M PERMIT CKPLAN,CHECK VALIDATION, CKoCASH M O CASH
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