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7GA83EA C[:EO]}„ APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING 1_
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST -
WILLIAM A. JENBEN, SUPT OF BUILDING CROSS ST.
DISTRI d NO. GR P E ESSED BY
FOR APPLICANT TO FILL IN coNsr.
BUILDING 0, STATISTICAL CLASSIFICATION SdWER MAP
ADDRESS 7w e, S r B -K PG
CLASS. NO. DWELL UNITS
-.� LOT NO. BLOCK WATER NOT REQUIRED RECEIVED
r CERTIFICATE: f Ll
TRACT / MAP �J�-/� HIGHWAY STATE MAJOR SECOND CAL
NO.OF BLDGb. NO. OKi(J (CIRCLE)
SIZE OF LOT NOW ON LOT U9 Z NE SPECIAL
USE OF CONDITIONS
EX19TING BLDG. -
TEL
j 77
OWWER NO. U DING YARD HWY ETRE NAM EXIST.
ADA{{ L` SETBACK WIDTH
RESS - FRONT
A HITECT OR T P. L.
ENGINEER N SIDE
P. L
ADDRESS O
TEL
CONTRACTOR • NO.
ApDRE55 C e
O
DESCRIP'IION OF WORk
NEW DD ALTER REPAIR DEMOLISH
9Q. FT. NO:OF NO. OF i'+`� r•'- --
SIZE STORIES FAMILIES
USE OF `1
STRUCTURE - F' i V4+
f
SIGNATURE OF
APPLICANT
VALUATION S
APPROVALS ATE IN9"CTOR'S 2I0NA
P.C. PMT. FOUNDATION: LOCATION
FEE S FEES `"f� FORMS, MATERIALS
FRAME: FIRE STOPS,
1 HEREBY At KNOWLIDd[ THAT I HAVE READ THIS APPLICATIO - BRACING. BOLTS
AND STATE THAT THE ABOVE IB CORRECT AND AGRt[ TO COMPL FURNACE: LOCATION. �1
WITH ALL COUNTY ORDINANCES AND STAT[ LAW REGULATING GAS VENT-DUCTS r _
BUILDING CONSTRUCTION. I CiATIFY THAT IN DOING THE WORK
AUTHORIZED HER
ISY I WILL NOT EMPLOY ANY P[ ON IN VIOLA- LATH. INT.
TION OF TH[ LAD OR COD[ OF THE BTATI C FORNIA LAT-
INO TO WORKMEN'S COM ON I U [ LATH. EXT.
SIGNATURE OF OUSE NUMBER COR-
PERMITTEE • RECi'AND POSTED
ADDRESS` NAL
JOHN F. LEWIS. PFdNC
IPAL ST URAL ENGI ER
PLAN =CX VALIDATION GK. M.o. CASH _ PERMIT VALIDATION cK M.O. CAiH
a + 2 6 2..3 D. 4 0..7 5 6 r
+ - y X 8.3 0 9,2 FSB 5 i o 8 1,5 O N
7BA63M LE NT" 1Y/69
APPLICATION FOR BUILDI G PER
COUNTY OF LOS ANGELES ASSESSOR
DEPARTN= OF COUNTY ENGINEER MAP BOOK PAGE PARCEL
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS
COLEMAN W. JENKINS, SUPT OF BUIL.DIHa LOCALITY
R APPLICANT T FILL IN NEAREST
(Print or t-YD@ onlv) CROSS ST.
BUILDINGelr
DISTRI T NO. GRO TYPE P
ADDRESS l W I-L ST, 1 (9 CONST.
STATISTICAL CLASSIFICATION SEWER MAP
LOT NO. l BLOCK CLASS NO�DWELL.UNITS BK
TRACT / x.97 USE ZONE MAP
NO.OF BLDGS. / NO.
SIZE OF LOT NOW ON LOT SPECIAL
USE OF CONDITIONS
EXISTING BLDG.
OWNER IVO EA7 LL191QD NOLO -fo10 BLDG.SETBACK FROM
ADDRESS q14'y E LL, 7, FRONT PROP.LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL
CITY 6nGj0LE C /TY HIGHWAY. WIDTH FROM C.L.
ARCHITECT OR TEL, �. _
ENGINEER c) NO.
BLDG.SE OM
ADDRESS SIDE PROP.LINE (STREET)
TEL. TYPE OF EXISTING SETBACK HIGHW YARD = TOTAL
CONTRACTOR NO. HIGHWAY WIDTH FROM CA_
ADDRESS NO. + _
LIC.
CITE' CLASS CORNER CUTOFF YES ❑ NO ❑
CONSTRUCTION LENDER
NAME AND BRANCH SEE REVERSE SIDE FOR SPE L A PROVALS
1p.
DDRESS a
Q. FT. NO. OF NO. OF NEW ❑ _
IZE STORIES FAMILIES
SE OF ADD
TRUCTURE
ALTER ❑
IGNATURE OF f� REPAIR❑
PPLICANT K L�.G� ^C DEMOL ❑
ALUATION
APPROVALS DATE lNSPtCTOR'■ �I6 WA 71—.
C. PMT. FOUNDATION: LOCATION
FEE S FEES FORMS MATERIALS
FRAME: FISTOPS, I
I HERBY ACKNOWLEDGE THAT I HAVE READ THI APPLICATION BRACIRE NG BOLTS
AND STAT[ THAT THE ABOVE Il CORRECT AND AGREE TO COMPLY FURNACEI LOCATION,
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DU TS
STRUCTI ON. I CERTIFY THAT IN DOING THE WORE AUTHORIZED
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT, '
LABOR COD[ OF THE STAT[ OF •CALIFORNIA IN RELATING TO
WORKMEN'S COMPENSATION INSURANCE. LATH, EXT,
SIGNATURE OF j< HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED -
ADDRESS gj.CX.G �'� FINAL
-
JOHN F. LEWIS. PRINCIPAL STRU RAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VA.LMATIO CK. M.O. CASH
�kr, 5866� X16 1 .p. . SOON DO