HomeMy Public PortalAbout9318 1/2 BROADWAY_Building__ TES PLE CITY
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]5A5n9n.DB IRBE9 ,APPLICATION .FOR BUILDING PERM.IT , ,,.
COUNTY OF LOS-ANGELES BUILDING
-DEPARTMENT OF=COUNTY ENGINEER ADDREss, Ila
BUILDING AND 'SAFETY DIVISION LOCAL TY ' c
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST - -
_ - WILLIAM A. JENSEN, SDP'i OF BUILDING CROSS ST:
., DISTRICT NQ GROUP TYPE ESSED BY
FOR APPLICANT. TO FILL'IN CONST.
BUILDING. _ a`,-�� �y-' STATISTICAL CLASSIFICATION 5 WER MAP •
ADDRESS 3,2 O !K /.Leri K P
y CLASS. NO. -"DWELL. UNITS
LOT-NO. y�P^ .- BLOCK _ .WATER NOT_REQUIRE D:T RECEIVED ❑
'CERTIFICATE: _
TRACT MAP �HIGHWAv STATEMAJORSECON . LOCAL
NO. OF BLDGS. NO. - CIRCLE)
SIZE OF LOT NOW ON LOT
USE ZONE C SPECIAL A
USE OF - A CONDITIONS
EXISTING BLDG.
TEL. /\'
OWNER'Al"t"NLi NO. BUILDING "` EXIST.
SETBACK ' YARD' HWK STREET NAME WIDTH
ADDRESS P LM" l< FRONT
ARCHITECT OR TEL. P. L.
ENGINEER NO. ,SIDE I • ./ x�
-. P.
ADDRESS - O
TEL 7777
7 0
CONTRACTOR NO. - "
ce
ADDRESS : O
DESCRIPTION OF'WORK. W:
a
. t y
EW ADD ALTER REPAIR. DEMOLISH • � Z.
50FT. NO, OF' NO. OF
SIZE y STORIES ` FAMILIESUSE -
STRUCTURE Q /G-*
SIGNATUREb '
APPLICANT -
VALUATION $ �� (� • �,
APPROVALS DATE •INSPECTOFSSIGNATURE
P.C. PMT. pO- FOUNDATION: LOCATION r�'J
FEE- FEE $ ,� FORMS, MATERIALS
FRAME: FIRE STOPS. '
1 HEREBY ACKNOWL OGE THAT I HAVE READ THIS APPLICATION. BRACING. BOLTS / / n
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 LABOR CODE OF THE STATE OF CALIFORNIA'RELAT- _
INO TO WORKMEN'S COMPENSATIOIINSURANCE. _ / G
LAT H. EXT. -
SIGNATURE OF HOUSE NUMBER CORN
PERMITTEE RECT AND POSTED
ADDRESS _ 4/.(n iJUF. AFINAL f
' JOHN F. LEWIS. PRINCIPAL SOURAL ENGINEER
PLAN CHECK VALIDATION DR. M D. CASH' _ PERMIT VALIDATION CK. M.D. GASH
L&o'q�,,8:8`0t2 :.&9l42 3-^D 2 8 510A .Q
57.00-
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o 9'"0.9 9 Aug 20 1 D '