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BUILDING I ADDRESSG 4-Izi zc-, vi A
APPLICATION LOCALITY C
DIVISION OF BUILDING AND SAFETY NEARESTCROB13 BT t"' I
Department of aunty Engineer DISTRICT NO RECEIPT NO PERMIT NO
county of Lom Angeles Z� S 3 4C( B
WM J FOX, COUNTY ENGINEER OROUP DATE RECEIVED DATE ISSUED
CASSATT D GRIFFIN SUPT or BUILMIN ' t
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FOR APPLICANT TO ILLTYPECONBT RECEIVED BY 1�8UED BY
OWNERMAP Q�Q
MAIL NUMBER 1 sHWY ADDREBB L�" �� QE ZONE SPECIAL
CITY / NOLCONDITIONS
ARCHITECT OR TEL5cc_l_O
ENGINEER NO
BUILDING YARD HWY STREET NAME EXIST
ADDRESS �j� 1 SETBACK WIDTH
TEL. PL FRONT
CONTRACTOR NO
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BUILDING DATE CORRECTIONS INSPECTOR
ADDRESS S cam- !llrJ
n 3 a � ,CiST
LOT NO 7 BLOCK t
TRACT `p / / A NO OF SLDOB. I (�f�'1,
SIZE OF LOT C/ NOW ON LOT '
USE OF
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DESCRIPTION OF WORK A
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SIZE ` ORIEH FAMILIES t'
USE O RUCT RErc
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1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP
PLICATION AND STATE THAT THE IN
GIVEN 18 APPROVALS INSPECT 'B 13IONATURE DATE
CORRECT
1AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION: LOCATION /
AND STATE LAWS REGU TING B ILDINO CONSTRUC DN FORMS MATERIALS i/ e� 7/s
FRAME FIRE STOPS, r
SIGNATURE O BRACING BOLTS
PERMITTE FURNACE LOCATION,
ADORES OAS VENT,DUCTS
LATH INT {�
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LATH, EXT
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RECT AND POSTED
VALUATION G- FINAL
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