HomeMy Public PortalAbout9412 BROADWAY_Building__ ,........R... ...D APPLICATION. FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING _
DEPARTMENT OF COUNTY ENGINEER ADDRESS.
BUILDING AND SAFETY DMSION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER_ . . NEAREST _
WILLIAM A. JENSEN. SUPT OF BUILDING CROSS ST.
DISTRICT N GRO TYPE P BY
FOR APPLICANT TO FILL IN �S Q i I coNsr. c�
BUILDING c ��JJ/,M, � M��^ I STATISTICAL CLAS IFICATION 5 ER MAP
ADDRESS / 7 7 C, BK . PG` ,
--T—� CLASS.NO. !�!11 D/WELL UNITS
STAT
-LOT NO. �. BLOCK NUMBER V O HWYE YES NO
TRACT / t/S [p/ 1,-/ USE ZONE SPECIAL
- G J X Z U NO.0 I NOW ON LOTS �' ^ CONDITIONS Lei (CJ
SIZE OF LOT µ
' USE OF �/� /� ' 1
EXISTING'BLOG. )DAn, Ojj tuILDING EXIST,
YARD HWY -STREET NAME
J a.../I SETBACK WIDTH
OWNER w/!� �% D / /Y NO. FRONT �10 �
p /� In.� /� ` P. L. OC _
ADDRESS / Y L' C ,/'(G 6I L/ �A'/ SIDE
ARCHITECTOR TEL. P.L. -
ENGINEER NO. _ - _INSPECTION RECORD _
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ADDRESS. -
- / TELJ /J,/ p- ip �11n T� 0,
CONTRACTOR C /I I.51pAAJ
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ADDRESS ( Ji 0 /K �[ /I S b i O
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-DESCRIPTION OF WORKcmc/ 0' Q� --�+ u
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NEW ADO. ALTER REPAIR DEMOLISH Z
SD. FT.pJ NO.OF NO.OF ^
SIZE All) o STORIES FAMILIES
USE OF -
STRUCTURE _ a
SIGNATURE OF
APPLICANT _ .
VALUATION 5 / 00
APPROVALS .J DATE . .INSPECTOR'S SIGNATURE
` /y/] FOUNDATION FORMS.MATERIALS Na/. ly /.�/!n�A�..��J
P.C. �. PMT: (/ (1
FEE $ FEE S
E:.FIR ESTOPS. -
I HEREBY ACKNOWLEDGE'THAT I HAVE READ THIS APPLICATION BRACING. BOLTS '
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY UR ACE: LOCATION. -
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CONSTRUCTION. I CERTIFY THAT IN THE PERFORMANCE
OF THE WORK FOR WHICH THIS PERMIT IS ISSUED I SHALL NOT LATH. INT,
EMPLOY ANY PERSON IN ANY MANNER 50 AS TO BECOME BUSJECT
TO THE WORKMEN'S COMPENSATION LAWS OF CALIFORNIA. LATH,'EXT.
SIGNATURE.OF HOUSE NUMBER COR-
PERM]
OR- !! V U' //• I .
PERMITTE _ RECT AND POSTED
ADDRESS FINAL
CLYDE DIRLAM. PRINCIPAL
PLAN-CHECK VALIDATION CK. M.O. GASH PERMIT VALIDATION T CK: Rm.o.ENER.
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