HomeMy Public PortalAbout9431 BLACKLEY ST_Building__ DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR-PERMIT
COUNTY OF LOS ANGELES i V s2
WM. J. FOX, CHIEF ENGINEER U i L D I. G
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
1 ��� .,D18TRICT NO. PLAN CK.NO PERMIT NO
BUILDING � A
ADDRESS f /..� ■
.. LOCALITY r` a 7 �L�f ' .RECEIVED BY DATE OF APPL. DATE ISSUED
NEAREST " - 1 .•. �/ 1
CROSS 8T. ,y
pt BUILDING
` OWNER ADDRESS
• MAIL Jr� y c LOCALITY ■
" ADDRESS
' NEAREST
CITY �.•'GrC,A "t NO f i, CROSS ST
FIRE NO OF TYP GROUP
ARCHITECT ORc TEL ZONE PLANE
.'ENGINEER
ENGINEER t NO.
/ 'BLDG r O D.NO
ADDRESS �E � �CA�' f i' HETBACKLINE _ ■ _ _� .
- TELL APPROVED_,
CONTRACTOR lrG/�-7�°ii ./E.�t NO. BY t DATE _.
+ ��:-W"'�- l USE APPROVED
ADDRESS
ZON y" BY DATE
` LEGAL
DESCRIPTION I u T HrB.e`+ BLOCK _Ft-% -CORRECTIONS'
l _ t - r� f
TRACT $'i A;':.x ;L D
NO OF BLDOiL
SIZE OF LOT ry NOW ON LOT r • aT I� M
USE OF NO OF NO OF
• EXISTING BLD FAMILI[a ROOMS
DE�jSCRIPTION OF WORK
NEW •/� ,ALTERATION ADDITION
- Q
REPAIR +.,. MOVING DEMOLISH `�� - U
Sp FT No OF,
SIZE ROOMB - STORIES _ CL
WALL I{ ROOP o
COVERING S�t c2 C 1 COVERING- }�[j h
,
USE OF NEW _ r
BUILDING ,.'d, i" -
r
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS ' •,`APPROVALS._l ^
APPLICATION AND BTATEr,THAT THE ABOVE'IS CORRECT 'FOUNDATION: LOCATION -?' =INSPECTOR` DATE
AND AGREE TO COMPLY,WITH ALL`COUNTY•ORDINANCES FORMS,MATERIALS "a_,_qp� - 4r`'^ Z.
AND STATE LAWS REGULATING-BUILDING CONSTRUCTION - - - `}
w �✓ - s,f�j�,'` � f; FRAME: lIREST.P8,
BRACING,BOLTSHIGNATURE OF,,-
PERM
FA`
PERMIT7EFf
/e
,LATH,INT.:
AUTHORIZED AGT9
EXT..
DBS-3 SDMBET9 1-4e +.$ fes.,,s°L -p -s.4�� , PLASTER,INT.
w ,�S>+A1/�f�L• FEES PLASTER,EXT. _
-VALUATION
FEEFINAL
S' ' `
76A 638A CE ,jl)3 I/YIPPLICAWO ORB LDING P MIT
COUNTY OF LOS ANGELES ASSESSOR
DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL
BUILDING AND SAFETY DIVISION BUILDING
ADDRESS
COLEMAN W JENKINS, SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
Print or type only)
DISTRI� NOl/ Gl O1 TYPE PR S D BY
BUILDING CONST y
ADDRESS Y'-
STATISTICAL CLAS IFICATION SEWER MAP
BL/Cl NO BL K
CLASS NO �� DWELL UNITS K PG
TRACT USE ZONE MAP /}/
OF BLDGS NO (/
SIZE OF LOT NOW ON OT - SPECIAL
USE OF CONDITIONS
EXISTING BLDG100
TELA S
OWNER N BLDG SETBACK FROM
ADDRE FRONT PROP LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
C _ HIGHWAY WIDTH FROM C L
ARC ITE T TEL + _
ENGINEER NO BLDG SETBACK FROM
ADDR SIDE PROP LINE OF (STREET)
TE TYPE OF EXISTING SETBACK HIGHWA + YARD = TOTAL d
CO NO HIGHWAY WIDTH FROM C L U
LI + O
AD RE ' N
LIC
1 LLj
U
`CITY iC CLASS CORNER CUTOFF YES ❑ NO ❑
CON TRUC ON LENDER a
NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS Z
[ADDRESS
SO FT NO OF NO OF NEW ❑
SIZE STORIES FAMILIES
USE OFADD ❑
STRUCTUR ✓ll
_ ALTER
SIGNATURE REPAIR❑
APPLICANT DEMOL ❑
VALUATION S APPROVALS DATE INSPECTOR'S SIGNATURE
P C PMT FOUNDATION LOCATION
FEE S ( -Z.> 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,
WITHALL 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 COMEe
N INS N E
��'�� LATH EXT
SIGNATURE(O�rJHOUSE NUMBER COR- v
PERMITTEE RECT ANDPOSTED
ADDRESS FINAL
JOHN F LEWIS PRINC PCK
L ENGINEER
PLAN CHECK VALIDATION CK M O CASH _ PERMIT VALIDA O CASH
�LLAGo 6 0 6 .E MAY15 1D