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APPLICATION FOR BUILDING PERMIT 1
DIVISION OF BUILDING AND SAFETY ADD EING L4
�U 7 ' V/
Department of County Engineer —
County of LOS Angeles LOCALITY
WM.J. FOX. COUNTY ENGINEER NEAREST
CASSATT D. GRIFFIN, SUPT OF BUILDING CROSS ST.
DISTRICT N . GROUP TYPE �' SEWER MAP
FOR APPLICANT TO FILL IN / (/ BI( P
.J' C.N.T. _Z �' Y
BUILDING h `� w/'_ ,�j,_ a,n y _ MAP �G ` b `STAT YES NO
ADDRESS / / 7y� /� "«-W'WL NUMBERHWY
LOT NO. y' BLOCK USE ZONE SPECIAL
CONDITIONS 1
TRACT 140
ve
SIZE OF LOT , I NOW ON LOTS, BUILD_SET AICK NG YARD HWY ST ET NAME WIDTH
USE FRONT '/
EXISTITI D
NG BLDG. _ P L ✓ IJ
OWNER L Zj� SIDE I v )
MAIL L
ADDRESS O TRACT DWELL. I UNIT
5 INDUSTRIAL
TEL. -- 'I DWELL. I UNIT
CITY NO. 6 PUBLIC BLDG.
ARCHITECT OR TEL. 2 DUPLEX I UNIT
ENGINEER NO. 7 ADDN., ALT., ETC.
3 APT. UNITS
8 MISCEL.
ADDRESS t{ COMMERCIAL
TELNO.. / 731
INSPECTION RECORD
CONTRACTOR !� `p D
ADDRESS - •. -'Wa`-I/ I e
DESCRIPTION OF WORKT ,. Lam!s
NEW ADDA T REPAIR DEMOLISH
SQ. FT. Q/ . OF NO. OF / y - �.�j fi
SIZE a (ro STORIES / FAMILIES / X
USE OF STRUCTURE /y
SIGNATURE OF
APPLICANT APPROVALS
ADDRESS DATE INSPECTOR'S SIGNATURE
FOUNDATION: LOCATION
$ P. C. $ / pCI FORMS, MATERIALS .v
_ CO FEE FRAME: FIRE STOPS, 4/
YALUATION , O / 8 /JOQ BRACING,BOLTS
FEE .�i[G FURNACE: LOCATION,
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GAS VENT,DUCTS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH, INT.
AND STATE LAW EGULATING BUILDING CONSTRUC-
TION.
LATH, EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS FINAL
WM.J. FOX,COU NGINEER VALIDATION C. N. DIRLAM, CHIEF BLDG. INSPECTOR
�L�3 9 1 &4c, MAR 9 1 6 1 1 .0 0 1 o'Co 5 9 1 9 Vn MAR 9 1 2 2.0 0 '�'