HomeMy Public PortalAbout5833 AGNES AVE_Building_5/14/1965_foundation, frame, stucco ^ � L
76A638A,CE#8038+64 APPLICAI'1C N FOR BUILDING ERMIT
COUNTY OF LOS ANGELES BUILDING ✓
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST
COLEMAN W JENKINS SUP T OF BUILDING CROSS ST r
DISTRICT NO GROUP TYPE _ PRO• E SED BY
PRE
APPLICANT TO FILL IN CONS
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STATISTICAL CLASSIFICATION SEW R MAP
CLASS NO _J DWELL UNITS —' BK/.SPG �
�S BLOCK USE ZONE MAP L
NO
SPECIAL
�� 9 NO OF BLDG9 111 CONDITIONS
� L/ NOW ON LOT I
EXISTIBLDG SETBACK FROMrYr T 3 NOL FRONT PROP LINE OF AI e — (STREET)
TYPE OF EXISTING SETBACK HIGHWAY YARD — TOTAL
ADDRESS /� IGHWAY M C
CITY /Yt 1&�^ L 1 /
ABLDG SETBACK FROM
ARCHITECT OR TEL
ENGINEER NO SIDE PROP LINE OF (STREET)
TYPE OFEXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C L CL
O
CON TRA CTO /" ,/ 40
F
TEL
+ V
LIC
ADDRESS 6GNO L� CORNER CUTOFF YES NO O
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cl Y Llc SEE REVERSE SIDE FOR SPECIAL APPROVALS w
DESCRIPTION OF WORK (�{v
NEW ADD ALTER REPAIR DEMOLISH va
SQ FT NO OF NO OF
SIZE p STORIES / FAMILIEe
USE4J s
STRUCTURE /T
SIGNATURE OF
APPLICANT �f7
VALUATION$ �B- V APPROVALS ATE INSPECTOR991GNAT RE
FEE$ FEE$ FOUNDAON FORMS 1 MATERcIALSON
FRAME FIRE STOPS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT9 A�I t
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS !
9UILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK ) fl�^—
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH-INT A� d /I�y,/ � V
TION OF THE LABOR CODC OF THE STATE OF CALIFORNIA RELAT
ING TO WORKMEN S COMPENSATION INSURANCE I��A �s► ✓ `{�
LATH EXT u 4l_
SIGNATURE OF HOUSE NUMBER COR
PERMITTEE RE AND POSTE
ADDRESS L FINAL
JOHN
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PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION CK M O CASH
L,jo 1 6 2 6:a MAY 14 1 D 15 00-
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