HomeMy Public PortalAbout9574 BLACKLEY ST_Building__ 76A638A CEu803 5-65 APPLICATION FOR BUILDI G PERM1;4'�_ -
COUNTY OF LOS ANGELES BUILDING S
DEPARTMENT-OF COUNTY ENGINEER ADDRESS tJ /
BUILDING AND SAFETY DIVISION LOCALITY Q�
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
COLEMAN W JENKINS,SUP'T OF.BUILDING' CROSS ST
F DICT NO(�i GRR TYPE PR YFOR APPLICANT TO FILL IN - CJ-� coNST.G /�r wry STATISTICAL C SIFICATION SEWERMAP
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APPLICANT Y ,
VALUATION$ -
APPROVALS DATE � INSPECTOR'S SIGNATURE
FOUNDATION, LOCATION ����✓�
FEE$ FEE$ FORMS-MATERIALS
FRAME, FIRE STOPS, /
THEREBY 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
9UILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH INT
TION OF THE LABACIOE
THE STATE OF CALIFORNIA RELAT-
ING TO WORKMEN' TION URA E LATH EXT
SIGNATURE OF � HOUSE NUMBER COR-PERMITTEE RECT AND POSTED
ADDRESS FINAL Z"
JOHN F. LEWIS. PRINCIPAL STRUCTURAL E
CASH
PLAN CHECK VALIDATION CK M o CAST/ _ PERMIT VALIDATION CK. M O
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76A638A CE X78032-63 APPLICATION -FOR BUILDING PER /MIT _
COUNTY--.OF LOS ANGELES BUILDING N
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY `
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN, SUP T'OF BUILDING •CROSS ST -
DIST CT N GROUP TYPESb y
FOR APPLICANT TO FILL IN CONST„ '
BUILDING STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS CLASS-NO DWELL?UNITS I BK PG
LOT NO '7 BLOCK, : WATER
_ CERTIFICATE: NOT REQUIRED ,� RECEIVED El
TRACT -47
RACT '7��-+Z MAP, HIGHWAY STATE MAJOR SECOND, CAL
SIZE OF LOT:/yJ A/ oS NOW ON LOTS_
OTS USOE ZONE ^ECIIq LCLE) `
USE OF. DITIONS -
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DESCRIPTION OF:WO K " >• _ i V
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NEW ADD ALTER .REPAIR -DEMOLISH '.a e Z
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SIGNATURE
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VALUATIO
�7 APPROVALS JDATE, INSPECTOR'S SIGNATURE,/
UNDATION
FEE $ � '���� FEE $ ¢P-'D' FO FORMS. MATERIALSON f'1/ �Q•� �i
+ FRAME FIRE STOPS.
HDBRACING.-BOLTS
I HEREBY ACKNOWLEGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION //) ``
WITH ALL COUNTY ORDINANCES' AND STATE LAWS REGULATING GAS VENT, DUCTS !� kv
BUILDING CONSTRUCTION ,I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSONI VIOLA- LATH. INT
TION OF THE LABOR CODE.OF THE STATE OF CALIF N RELAT-
" ING TO WORKMEN COMP ION SURANC
LATH, EXT.
• SIGNATURE OF ' /. HOUSE NUMBER COR; J n
PERMITTEE RECT AND POSTED
ADDRESS'� 2'� L� lF' o/ & FINAL
PLAN CHECK •VALIDATION CK MO. CASH ' _ JOHN F LEWIS. PRINCIPAL sT " ALENGINEER, ,
PERMIT. VALIDATIO mo CASH
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