HomeMy Public PortalAbout9580 BLACKLEY ST_Building__ 76A6364 GE+8032-63 APPLICATION FOR BUILDING PERMIT -
COUNTY OF LOS ANGELES BUILDING
_DEPARTMENT -OF COUNTY ENGINEER ADDRESS
-BUILDING AND SAFETY DIVISION LOCALIT
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN. SUPT OF BUILDING - CROSS ST
DISTRI N GROUP TYPE S£D BY '
FOR APPLICANT TO FILL IN coNsr
[ADDRESSIN B/Q��/Lo �� STATISTICAL CLASSIFICATION SEWER MAP
BK PG
CLASS NO DWELL UNITS NO (O BLOCK WATERCERTIFICATE NOT REQUIRED -RECEIVED
CT MAP IGHWSTATE MAJOR SECOND, OCANO.OF BLDGS. NO. Q (CIRLE)•E OF LOT � NOW ON LOT Oq� USE ZONE SPECIAL
E OF. ONDITIONSSTING BLDG
�N �^ TEL.' p
OWNER (JBL UcV Dei NO. zt! BU LeDI 6 G EXIST.
s92�-�/ry/ !� e// •y$f SETBACK YARD HWY STREET NAME WIDTH
ADDRESS
FRONT
ARCHITECT OR TEL P L
ENGINEER NO SIDE - - I >
P Ll A CLO
ADDRESS /� / / y� '
CONTRACTOR NO 4Z?J •J /� �- .� 'G'" �� �,
ADDRESS Y2rp^7ey.,
DESCRIPTION OF' WORK a
NEW J—ADD ALTER REPAIR DEMOLISH
•SO. FT'. JJ// NO OF NO OF
SIZE /(O STORIES Z FAMILIES
USE OF
STRUCTURE
SIGNATURE OF• -
APPLICANT r� '
VALUATION'S 1 1
9 .L- APPROVALS D,�A[T�E INSPECTOR'S SIGNATE
y�UR
PC PMT //!{J� 'FOUNDATION FORMS, MATER ALSON 1'r?O 144 � :f
FEE-S -� FEE.S (O(� _ -
FRAME FIRE STOPS. ,r �
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS Ain 1�i:� A/
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY - FURNACE LOCATION
WITH ALL- COUNTY ORDINANCES AND• STATE LAWS REGULATING GAS VENT, DUCTS g •�j'�'_ J
' BUILDING- CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH, INT.
TION-OF THE ,LABOR CODE OF THE STATE OF CALIF NIA RELAT- II (ry
ING TO WORKMEN'S COMPENSATION INSURANCE LATH. EXT.SIGNATUF
P RMITTEE OF / - HOUSE NUMBER RECT AND POSTED
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ADDRESS FINAL G,J
rlINCIPAL
CK M O, CASH
JOHN PERMIT VALIDATION STP-7,1
cK U M G' c SH ER
Oi' PLAN CHECK VALIDATION � _ ,
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Lrio 384 9 s�P 16 i D 6 0.50-
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