HomeMy Public PortalAbout9416 BLACKLEY ST_Building__ 76A638A CE03 5-65 APPLICATION FOR BUILD G PERMIT
COUNTY OF LOS ANGELES BUILDING
G•)EPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION Loc A LI T Y
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JOHN A LAMBIE COUNTY ENGINEER NEAREST _
COLEMAN W JENKINS SUP T OF BUILDING CROSS ST r�
DISTR CT NO GROI p --TYPE PRO ES Y t
FOR APPLICANT TO FILL IN
CONST
BUILDING / STATISTICAL SSI FICA TION SEWERMAP, • f
ADDRESS CLASS NO DWELL UNITS BKPG
LOT NO LOCK USE ZONE MAP �Q// Y �• ' "
N O ri
TRACT , SPECIAL
'r ` NO OF BLDGS CONDITIONS '
SIZE OF LOT : 7 Y NOW ON LOT
USE OF -
(STING BLDG SETBACK FROM /� - _-
TELATS FRONT PROP LINE OF (STREET)'
OWNER4dL NO TYPE OF EXISTING SETBACK HIGHWAY _+ YARD_ TOTAL -
ADDRESS H HWAY WIDTH FROM C L -�
CITY J
ARCHITECTPR TEL BLDG S TBACK FROM
ENGINEER NO SIDE PROP LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY- +`-_ YARD = -TOTAL _
ADDRESS HIGHWAY WIDTH- FROM C LTEL .:y + - - _
CONTRACTOR NO O
LIC CORNER CUTOFF YES ❑ NO V
ADDRESS NO
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DESCRIPTION OF WORK au
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APPLICANT
VALUATION$ 0 APPROVALS DATE INSP T R'-9-B_ATURE
P C PMT S7 FOUNDATION, LOCATION
FEE FEE$ FORMS, MATERIALS _
FRAME, FIRE STOPS,
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
9UILD I NG'C ONSTRU CTION I CERTIFY THAT IN DOING THE WORK
AUTH O RIZED•HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH IN-T-'
TION OF THE LABOR CODC OF THE STATE OF CALIFORNIA RELAT
ING TO WORKMEN 5 Cn MPENSATION INSURANCE LATH EXT
SIGNATURE OF
4HOUSE NUMBER COR-
PERMITTEE ,_ RECT AND POSTED
ADDRESS _ Fl NAL ��� �G� L-otA
JOHN F LEWIS PRINCIPAL STPRUICTURAI ENGINEER
PLAN CHECK VALIDATION CK M o CASH . _ PERMIT VALIDATIONCK M o CASH
LN,l,O 3 4 3 11° JUL 11 1 D. 1 1 .5 0-
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76A638A CE 9803 12/69
APPLICATION FOR BUILDIN PERMIT/* ,
COUNTY OF LOS ANGELES ASSESSOR
DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE P RCEL
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBI E,,COUNTY ENGINEER ADDRESStl
COLEMAN W. JENKINS, SUP T OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
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BUILDING
DISTRICT NO GR TYPE O
ADDRESS 9S B
)� _ CONST416 E. Blackley R
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LOT NO BLOCK 'STATISTICAL CLASSIFICATION SEWER MAP
-
CLASS NO DWELL UNITS BK G
TRACT . ��
USE ONE MAP �} !
NO OF BLDGS NO V
SIZE OF LOT NOW ON LOT / SPECIAL
USE OF f CONDITIONS
EXISTING BLDG residence
OW ER Phil Dunlop
TEL
BLDG SETBACK FROM
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ADDRESS- Blackley. _ FRONTPROP LINEOF (STREET)
TYPE OF EXISTINGSETBACK HIGHWAY + YARD = TOTAL
CITY Temple City HIGHWAY WIDTH FROM C L
ARCHITECT OR TEL + _
ENGINEER NO
j8LOG SETBACK FROM ,
ADDRESS SIDE PROP LINEOF (STREET)
TEL TYPE OF EXISTING SETBACK HIGHWAY YARD = TOTAL
CONTRACTOR Rigid Mfg. Compan3,0 263-5181 HIGHWAY WIDTH FROM C L
ADDRESS 337 S. Woods Ave. NO 15 + _ a
LIC CD
CITY Los Angeles 22 .. CLASS C-39 CORNER CUTOFF YES ❑ NOS❑
CONSTRUCTION LENDER
NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS
W
ADDRESS d.
to
SO FT NO OF NO OFde,
SIZE STORIES FAMILIE
USE OF -STRUCTURE Reroof entire houwith composlt On SIGNATURE OF APPLICANT - (�iy(VALUATION S - APPROVALS DATE INSPECTOR'S SIGNATURE
P C PMT FOUNDATION LOCATION
FEE S FEE S 9'00 FORMS MATERIALS
FRAME FIRE STOPS
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 ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS
STRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH INT
LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO
WORKMEN'S COMPEIy�^TIO �N�yI .NCE ompany LATH EXT
tj1 /1TVjI .
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS P.O. Box 6782. L.A. 22
FINAL
JOHN F LEWIS PRINCIPAL STR URAL ENGINEER
PLAN CHECK VALIDATION CK M 0 CASH _ PERMIT VALIDATION ,%cK M 0 CASH
t 9 6 8 1' APR 1 D 9.��
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