HomeMy Public PortalAbout9330 BLACKLEY ST_Building__ 76A638ACEb8032-63, APPLICATION FOR' BUILDING PERMIT ' ,
COUNTY OF LOS ANGELES 'BUILDING- _ f
DEPARTMENT OF COUNTY-ENGINEER" ADDRESS
BUILDING AND SAFETY DIVISION, ! _LOCALITY 7
JOHN A LAMBIE COUNTY ENGINEER NEAREST
WILLIAM A JENSEN SUP T OF BUILDING, 'CROSS ST r
DIST�T N OUP ' TYPE CESSED BY
..FOR APPLICANT TO FILL IN �` CONST
BUILDING , STATISTICAL CL-ASS FICATION SgWER MAP / U
ADDRESS /�1,� 'BK G °
CLASS NO DWELL UNITS•'
LOT NO_ - BLOCK _
• CERTIFICATE` NOT REQUIRED RECEIVED
TRACT Z ,y - ,� Y MAPHIGHWAY
" NO - y, (CIRCLE) STATE MAJOR SECON ,LOCLA ,
NO,OF LLOGS
SIZE OF LOT NOW ON:LOT -
_ - USE ZONE +� SPECIAL
USE OF CONDITIONS
EX IST,I NG DG-+ - - - - ' 4 ., / "
ELOOWNER ,lSN 'y
frw 'BUILDING EXIST
SETBACK
YARD HWY STREET AM
WIDTH _
ADDRESS dZ (/JPie4 ' ` 1; FRONT
ARCHITECTe' ' _ TEL S`rp L-
ENGINEER-. '�•< < -{ NO t - SIDE
ADDRESS' O
f TEL x' til
CONTRALTO
.,f Y�,1' N O
ADDRESS
DESCRIPTION OF WORK N y W
NEW- ADD ALTER REPAIR+ MOLISH - r
SQ FT" NO OF {�{ a `
SIZE " ' STORIES FAMILIES
USE OF
STRUCTURE
SIGNATURE OF '� e,, - rb
APPLICANT==4 T
VALUATION $ -
- `APPROVAL'S ` I DATE INSPECTOR SISIGNATURE
.P C •` -- a°i PMT FOUNDATION ' LOCATION
FEE $ _ ._ `FEE $ - s _, FORMS +MATERIALS•,
FRAME .FIRE STOPS - J
�I HEREBY ACKNOWLEDGE,THAT.I'HAVE-READ THIS APPLICATION BRACING BOLTS `
"AND STATE THAT-THE,ABOVE IS CORRECT AND AGREE TO,COMPLY `FURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND"STATE LAWS REGULATING GAS VENT DUCTS
BUILDING ,CONSTRUCTION I CERTIFY.THAT IN DOING THE WORK - _ y +
:AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT
TION OF THE LABOR CODC OF THE STATE OFALIFOR -A RELAT ,
ING TO WORKMEN S COMPEN N INSURA
i ` s LATH EXT
SIGNATURE OF -
M HOUSE NUMBER
' PERITTEE r RECT AND POSTED
ADDRESS - FINAL
JOHN F LEWIS PRINCIPAL STOCK
URAL ENGINEER
PLAN CHECK VALIDATION CK M O CASH _ 7-PEIT VALIDATION M O CASHRM
LAI" ` ' , � 1 D 4;4'0' -Z,
' � G PERMIT
76A63 CE X603 2-63 APP'• ICATION,`�FOR' BU I LD I N -
COUNTY OF LOS,ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER- ADDRESS �`D`• 5
BUILDING AND SAFETY DIVISION 'LOCALI'TY !`
JOHN A L'AMBIE COUNTY ENGINEER NEAREST
' WILLIAM A JENSEN SUP T OF BUILDING CROSS ST _
DIST ICT NO GR PTYPE P O E BY_
FOR `APPLICANT TO FILL-IN coNsr J
BUILDING , A. ' STATISTICAL CLASSIFICATION- SEWER MAP
ADDRESS �jQL� d-Y I - - BK 1 G/
-'CLASS NO DWELL UNITS
(Q 't
LOT NO .'BLOCK WATER " b NOT REQUIRED RECEIVED '
Z t CERTIFICATE _
El
TRACT " it MAP A'. / HIGHWAY Y STATE,MAJOR SECOND OCAL
NO OF BLDGS NO /(p (CIRCLE)
SIZE OF LOT ` NOW ON LOT' USE ZONE I 'SPECIAL ;•' ` ,. , ,
USE OFCONDITIONS '
EXISTING BLDG •i + - _ r _% t' - . - - j
OWNER ,P�/1rAlNO BUILDING ,YARD- ,HWYYM� rSTREET NAME EXIST
/nSETBACK WIDTH ,
ADDRESS , Q el.� AZLJ',B FRONT'
ARCHITECT OR - - _ TEL ` ' P L`
ENGINEER NO - SIDE' a '
P L
ADDRESS TEL4!4
CONTRACTOR ll� gJ Y�,e NO � ' /ADDRESS lu
DESCRIPTION, OF,WORK r 1�'. .�1 �..�.rdi l � �' r�'� � Luu
NEW ADD - ALTER REPAIR DEMOLISH • ,,,�,�A
SO FT NO OF -NO OF J ,"" * �. .tom`\7 i L
SIZE STORIES 'FAMILIES '/
USE OF
STRUCTURE 6�4� �p•'`f�p, ,p_y,,y }
SIGNATURE OF
—APPLICANT
VALUATION $ / ��-� _ a { / !f ' A '
APPROVALS DATE INSPECTOR S SIGNATURE
.i c FOUNDATION LOCATION
P C L^A , - PMT - -
FEE $ FEE $, :� .{ ; FORMS MATERIALS;
'FRAME FIRE STOPS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION^'� Y' BRACING BOLTS .. p ".•+n'6�► �J` iV -
AND STATE THAT THE°ABOVE IS CORRECT AND AGREE,TO COMPLY FURNACE LOCATION
WITH ALL COUNTY, ORDINANCES AND STATE LAWS REGULATING- GAS VENT DUCTS C
BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT•EMPLOY ANY PERSON IN VIOLA y LATH INT
TION.OF THE LABOR CODE OF_THE STATE OF CALIFORNIA RELAT
' ING TO WORKMEN S COMPENSAT INSUR
LATH EXT (,q'jj•
SIGNATURE OF ° HOUSE NUMBER COR /`
PERMITTEE RECT AND POSTED. ,/
f ADDRESS �FINAL ` 2�et� y6' pts /!
JOHN F LEWIS PRINCIPAL ST RAL ENGINEER
PLAN'CHECK VALIDATION dCK M O CASH/ _ PERMIT VALIDATION MO CASH
�,Ilo T6 2 211-1-61'' hrR 14 3 D G 8.5 C�' • "
r ,
APPLICATIONIFORBUILDING PERMIT
FOR APP6�CANTTOFILL IN (Print or type only)
BUILDING COUNTY OF LOS ANGELES
ADDRESS O �L L DEPARTMENT OF COUNTY ENGINEER
CITY `�C"z� i� G l zip BUILDING AND SAFETY DIVISION
/�
NO OF BLDGS BUILDING
SIZE OF LOT CO 0 80 NOW ON LOT ADDRESS 3 3D
TRACT BLOCK LOT NO O LOCALITY
TEL NEAREST
Oy�
OWNER lC Qy &d) NO CROSS ST
O U ASSESSOR
ADDRESS L MAP BOOK PAGE PARCEL
CITY DISTRICT GROUP TYPE FIRE CESS`D Y
TL �► ZIP CONSIV.,_
ARCHITECT OR TEL V �✓ T
ENGINEER NO
STATISTICALfCLASSLF�ICAJTION EWER MAP
ADDRESS �,` CLASS NO DWELL UNITS AL BK/G 4S
CONTRACTOR '�p •`�� NO USE ZONE I MAP �v
LIC NO
ADDRESS NOSPECIAL
LIC 7-2ONDITIONS
CITY CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑
CONSTRUCTION LENDER
NAME AND BRANCH BLDG SETBACK FROM
FRONT PROP LINE OF (STREET)
ADDRE �4KZ4� CITY TOTAL SETBACK FROM TYPEOF EXISTING
SQ FT d NO OF p NO OF CHECK HIGHWAY + YARD = FRONT PROP LINE HIGHWAY WIDTH
SIZE $76 STORIES / FAMILIES ONE }
_ d
DESCRIPTION OF WORK NEW ❑ + O
V' BLDG SETBACK FROM
ADD SIDE PROP LINE OF (STREET) O
ALTER ❑ TOTAL SETBACK FROM TYPE OF EXISTING w
r�,` L REPAIR ❑ HIGHWAY + YARD = SIDE PROP LINE HIGHWAY WIDTH a-
EXISTUSE OINGBLDG Ytk% l = Z
`^K�L ,�W EMOL ❑ +
APPLICANT TEL CORNER CUTOFF YES ❑ NO ❑
(PR NT) NO
(SIGNATURE) �a� �+ IN OPEN SPACE YES ❑ NO
BY ❑
_ IN COASTAL PERMIT ZONE YES ❑ NOja
❑
VALUATION $ C� U 'P� 3
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES
AND LAWS REGULATING BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF ,7
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN S COM '�SUL�T d.�
PENSATION INSURANCE
SIGNATURE OF S`��] W 1 ]j ?25`fd21/d�//�� f��/ �rIQLUt73
PERMITTEE
ADDRESS LAJ S Z
CITY9TEL NO �OZS DA EL 77 BY
MAKE CHECKS PAYABLE TO FEE $ `n•S—v FET - C�
HARVEYT BRANDY,COUNTY ENGINEER
PLAN CHECK VALIDATIONo CASH PERMIT VALIDATION CK o CA01
9 1'9 r AtI9 27 2'-1 tj
'0 4 9.5 a s
r `�,AI}g 27 .1 0 8, 2.'5
9,2 0� 0 e-d
®s 76A638A CE p803 3 75 `, - - - --• .- -