HomeMy Public PortalAbout9429 BLACKLEY ST_Building__ �-y0111,
78A08A�q'803 9-67APPLICATION FOR4§uILDI G PE
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCA
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUP T OF BUILDING NEAREST
CROSS ST _
FOR APPLICANT TO FILL IN Dls�l� N,p GIU corPisT PR s eY
Print or t only
BUILDINGSTATISTICAL CL SS ]CATION SEWER
ADDRESS
ADDRESS CLASS NO DWELL UNITS BK
LOT NO B OCK USE ZONE MAP -z 0
�J
NO
TRACT SPECIAL
NO OFBLDGS / / I CONDITIONS
SIZE OF LOT NOW ON LOT
USE OF
EXISTING BLDG SETBACK FROM
.v TEL FRONT PROP LINE OF (STREET)
OWNE NO TYPE OF EXISTING SETBACK HIGHWAY } ARD = TOTAL
ADORES HIGFJWAY WIDTH FROM C L
�• 6 d + v =
ARCHITECT4R TEL BLDG SETBACK FROM (STREET)
ENGINEER NO SIDE PROP LINE OF _
TYPE OF EXISTING SETBACK HIGHWAY } YARD — TOTAL
AD ESS HIGHWAY WIDTH FROM C L
TEL O } a
NT O
ADDk �� NIC CORNER CUTOFF YES ❑ NO U
cl c�Ass (2--tO SEE REVERSE SIDE FOR SPECIAL APP O ALS c
DESCRIPT ON OF WORK411
a
N
z
NEW D ALTER REPAIR DEMOLISH
SQ FT NO OF NO OF
SIZE TORIES FAMILIES
U
SIE
SIGNATURE OF
APPLICANT
VALUATION ��
APPROVALS DATE INSPECTOR'S SIGNATURE
P C PMT od FOUNDATION LOCATION
FEES FEE $ FORMS MATERIALS
FRAME FIRE STOPS
I HEREBY ACKNOWLEDGE THAT 1 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 DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY ERSON IN VIOLA
TION OF THE LABOR CODE OF THE STA OF C LIFORNIA RELAT LATH INT
ING TO WORKMEN S COMPE ION I ANCE
LATH EXT
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS FINAL
JOHN F LEWIS PRINCIPAL STRURAL ENGINEER
PLAN CHECK VALIDATION CK M O CASH _ PERMIT VALIDATION CK TM O CASH
4 9 3�8 rn15 1 0 6.0-4
�6 38ACEB032631APPLICATIDN FOR BUILDING PERMIT
+
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY '
JOHN A LAMBIE, COUNTY ENGINEER NEAREST /
WILLIAM,A JENSEN SUP T OF BUILDING CROSS ST
DISTRICT NO GR P TYPE PIltlIZESS5pBY
FOR -APPLICANT TO FILL IN 0
Co
04—
BUILDING ' STATISTICAL CLASSIFICATION S ER MAP
ADDRESS 1e7� Lr .
CLASS NO �-DWELL UNITS �'�r '�C/
LOT-NO (�' OCK- �� WATER `
CERTIFICATE NOT REQUIRED ❑ RECEIVED
3.
TRACT MAP /A, HIGHWAY 'STATE MAJOR SECOND OCAL,
q 1 NO OF BLDGS NO �/ (CIRCLE)
SIZE OF LOT I96 NOW ON LOT USE ZONE SPECIAL
USE OF CONDITIONS
EXISTING BLDG - ") y ^`r 'BAR 1 rQ0
- '
�. ,TEL �� -
OWNER NO BOLDING `EXIST.
1 SETBACK YARD WY STREET NAME' WIDTH
ADDRESS, 4 3,j `' O
FRNT
ARCHITECT OR TEL P_
ENGINEER N NO SIDE
L
ADDRESS ) _ XL
L TEL C..J� ,� ��Q�I �1� 0
CONTRACTOR S I �NO 3'7 +n+5,,�
ADDRESS W CL 0 AA �(�� S O
mm
DESCRIPTION_OF WORK ,�, < <S' w
q�y '. cj-
NEW' ADD - ALTERY REPAIR Y� �DEMOLISH,,Ih,
SQ'FT NO OF,,.,'" 1 NO OF
SIZE} STORIES FAMILIE
U5E,OF
STRUCTURE _ r 4,,,, +>•
SIGNATURE OFArG/�L.F�/Pa����Y
VALUATION $ _ ter,6 -r . y�. '
J 5 - APPROVALS �Q�' �?) DATE INR OR S SIGNATURE ,
PC PMT FOUNDATION ,LOCAT-ION J/'/
FEE $ F FEE $ 'FORMS MATERIALS ('` ,
FRAME FIRE STOPS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS ,jI �q�,� /.A Bi„V
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITH ALL COUNTY ORDINANCES'AND STATE LAWS REGULATING GAS VENT DUCTS I `
BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY'ANY'PERSON IN VIOLA LATH INT
TION OF THE BOR CODC OF THE STATE OF CALIFORNIA RELAT
ING TO W K N S MP SA NS U RANCE
LATH EXT
SIGNATU E' HOUSE NUMBER COR-
PERMITTE ��GJJfff RECT AND POSTED f
ADDRES tt FINAL' 1
PLAN CHECK VALIDATION cK M O CASH ' b
JOHN,F LEWIS' PR NCIPAL SORAL ENGINEER^
PERMIT VALIDATION M O I CASH
Lrjc�0'3 6 6 6t2 DEC 2 3 D 2 8.5,0b
�j L�L/J-