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7BAS38A CE#909,059 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 O GRIFFIN SUP T OF BUILDING CROSS ST
DISTRIC NO r GROUP I TYPE P ESSED BY
FOR APPLICANT TO FILL IN `- CONST'
BUILDING SE ER MAP
AD ES 3 STATISTICAL CLASSIFICATION, BK P6
(� J r CLASS NO DWELL UNITS
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LOT NO BLOCK MAP STATE
NUMBER HWY YES O
TRA / USE ZONE SPECIAL
NO OF BLDGS � CONDITIONS s
SIZE OF LOT NOW ON LOT
USE OF �y
EXISTING BBLDG .L jjt �y7�` � BUILDING YARD HWY S REET NAME EXIST
OWNER CLAY/d'�Jf�G7�f/Q /'l G.��/� SETBACK WIDTH
FRONT
ADDRESS O SCG( o�D 'C�s SIDE
CITY >G �/ / TE P L
ARCHITECT OR INSPECTION RECORD
ENGINEER " NO
ADDRESS
TEL
CONTRACTOR NO
ADDRESS
DESCRIPTION OF WORK
NEW ADD ALTER REPAIR DEMOLISH
SO FT NO OF NO OF
SIZE STORIES FAMILIES �.
USE OF STRUCTURE
SIGNATURE OF APPROVALS
APPLICANT
DATE INSPECTOR S SIGNATURE
ADDRESS FOUNDATION LOCATION
FORMS MATERIALS
$
�� - P C $ FRAME FI S
BOLTS
� FEE � BRACING BOLTS
VALUATION $ B FURNACE LOCATION
FEE GAS VENT DUCTS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP LATH INT
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATE LAWS REGULATING BUILDING CONSTRUCTION LATH EXT
SIGNATURE OAF A/ _ - D HOUSE NUMBER COR
PERM ITTE CLQ �/ RECT AND POSTED
ADDRESS e— FINAL "II^--�--
CLYDE N DIRLAM PRINCIPAL STRUCTURAL ENG R
PLAN CHECK VALIDATION CK mo CASH PERMIT VALIDATION CK M O ASH
F Irlo5 ,862 APP g 1 A ' 300
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