HomeMy Public PortalAbout9543 BLACKLEY ST_Building__ `l lel F'�► £,
76A636A CE 48031.62 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING = L
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY C "
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN. SUPT OF BUILDING CROSS ST. u
DISTR T NO GROUP TYPE P O ED BY
FOR APPLICANT TO FILL IN z -.r— yT' coNs �_ �/'` I
BUILDING STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS /`1 La' "-� Y�L7`' /-'` W -BG?
CLASS. NO. DELL. UNITS
LOT N .�f' BLOCK WATER NOT REQUIRED F7 RECEIVED ❑
/ CERTIFICATE:
TRACT _"IlejAl ,(L f MAP HIGHWAY STATE MAJOR SECOND, CA
NO. OF BLOGS. NO. (CIRCLE)
SIZE OF LOTS x NOW ON LOT -- USE ZONE SPECIAL -
USE OF CONDITIONS
EXISTING)BLDG. TELp}
OWNER/ _r ✓ ' NO -IYd BUILDING EXIST.
YARD HWY STREET NAME
SETBACK WIDTH
ADDRESS ��' ,E�/ QS�.n�r�L� FRONT
ARCHITECT OR TEL. P. L.
ENGINEER NO. SIDE
P. L,
ADDRESS d
TEL. V
CONTRACTOR NO.
OC
ADDRESS Q
0
DESCRIPTION OF WORK
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AL
EW_--� HADD ALTER REPAIR DEMOLISH H
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SIZE T til PvZ STORIES FAMILIES J
USE OF s
STRUCTURE
SIGNATURE
APPLICANTO
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VALUATIONS / — -
ALUATION $ - (�Z�
APPROVALS •DATE INSPECTOR'S SIGNATURE
PPMT. "� FOUNDATION: LOCATION
EE $ �. �,f FEE $ \5d FORMS, MATERIALS
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING. BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND THIS
TO COMPLY FURNACE: LOCATION,
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS '.j
BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK -
AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT.
TION OF THE LABOR CO OF THE STATE OF CALIFORNIA RELAT-
ING TO WORKMEN' C P SATION INSURANCE.
J LATH, EXT.
SIGNATURE t / HOUSE NUMBER COR-
PERMITTEE L RE
CT AND POSTED 3 J''�-
ADDRESS L /� d� FINAL ^ '
JOHN F. LEWIS. PRINCIPAL STOUIURAL ENGINEER
PLAN CHECK VALIDATION CK. M.o. CASH _ PERMIT VALIDATION M.G. CASH
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