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76AG30A Cit#8032160 APPLICATION FOR BUILDING PERMIT 1
COUNTY OF LOS ANGELES BUILDING r /J /7I�/ �
� �n WD 40-0
DEPARTMENT OF COUNTY ENGINEER ADDRESS J /'/
BUILDING AND SAFETY DMSION LOCALITY `!�E t4 PL Lr C'1 7
JOHN A LAMBIE COUNTY ENGINEER NEAREST ,A /n
WILLIAM A JENSEN SUP T OF BUILDING CROSS ST �� &
I V
DISTRICT N I G O P TYPE P C Y
FOR APPLICANT TO FILL IN ,0 CONST
ABUILDING DDRESS L���� STATISTICAL CLASSIFICATION SEWER MAP
7
CLASS NO JDWELL UNITS
LOT NO BLOCK MAP_ NUMBER ()� STATE
_/` nrf� HWY YES O
TRACT 6&-61 f aOdk 72 P�&-S 3� 3� USE ZONE SPECIAL
NO OF BLDGSj� CONDITIONS
SIZE OF LOT ) NOW ON LOT Y /f 3
USE OF ,t
EXISTING BLDG L C GJ BUILDING EXIST
OWNER SA L YARD HWY STREET NAME
/1` ` `' TEL a SETBACK WIDTH
STV���6 �p NO ?T� FRONT
ADDRESS ALC�SA�i/ij,r?� SIDE /7
ARCHITECT OR TEL P L
ENGINEER NO i INSPECTION RECORD
ADDRESS
TEL �
CONTRACTOR L� )eV� NO O
ADDRESS ,U
DESCRIPTION OF WORK 94
E
EW dA,D/DL, ALTER REPAIR DEMOLISHSO FT W
S / TT NO
ZE OF NO OF
STORIES� FAMILIESUSEOF
yy
ST UCTUREPA-Ft Co]�Ll) / i�rG.
/ Lo" 2ovF
SIGNATURE OF
APPLICANT
VALUATION$ /,30- C --o
APPROVALS DATE INSPECTOR S SIGNATURE
PC PMT FOUNDATION LOCATION l!Of
FEE FEE $ o FORMS MATERIALS ` ®
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP FRAME FIRE STOPS
BRACING BOLTS
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND FURNACE LOCATION
STATE LAWS REGULATING BUILDING CONSTRUCTION GAS VENT DUCTS
I CERTIFY THAT IN DOING THE WORK AUTHORIZED 1 LATH INT
WILL NOT EMPLOY ANY RSON INVIOLATION OF THE
WORKMEN S CoMPENSA O p LAWS 1 CALIFORNIA LATH EXT
SIGNATURE OF� HOUSE NUMBER COR
PERMITTEE
,/ ,,,, RECT AND POSTED �y �}
ADDRESS T N, Lcss�+ FINAL '�b ' /dL(�-V
CLYDE
PLAN CHECK VALIDATION CK. M O CASH p REM VALIDATIONTR STRUCTURAL SNCasH R
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