HomeMy Public PortalAbout9434 BROADWAY_Building__ 76AS30A CE 9808-6-67 APPLICATION FOR BUILDING PEWIT �.
COUNTY OF LOS ANGELES BUILo1NG
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCAuTY7Y1 121 L G" .
JOHN A.L.AMBIE,COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN,SUVT OF BUILDING CROSS ST. C
DISTRI(I_rja I GR O SEWER MAP
FOR APPLICANT TO FILL IN TYPE _ G
CONST.
BUILDING ,/ STATISTICAL CLASSIFICATION
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ADORE V O
/ �OT CLASS.NO. yDWEL NITS
LOTNO tP BLOCK MAP �/� STATE YES NO
NUMBER / HWY.
TRACT iSJ/P /Ect! C 4E ONE SPECIAL /J
NO.OFBLDGS. CONDITIONS
SIZE OF LOT NOW ON LOT 1
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ARCHITECTOR TEL. INSPECTION RECORD
ENGINEER NO.
ADDRESS
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CONTRACTOR OW �/�is NO.
ADDRESS
DESCRIPTION OF WORK
NEW/ ADD ALTER REPAIR DEMOLISH
SO. FT. NO.OF NO.OF JL p L—
SIZErr1STORIES FAMILIES
USEOFSTRUCTURE
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SIGNATURE OF APPROVALS
APPLICANT
9„ y� DATE INSPECTOR' G NATURE
ADDRESS �+`CJ FOUNDATION: LOCATION
_ - 91 FORMS.MATERIALS Q-Sr
$ P f F FIRE STOPS
BRACJ
CrC/OD FEE
VALUATION /V/ S Q FURNACE: LOCATION.
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_ FEE FEE f GAS VENT. DUCTS
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH, INT.
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND49�4
• AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND �j
STATE LAWS REGU/L�gTING UIL CONSTRUCTION. LATH. EXT. LJ�
SIGNATURE OF C / HOUSE NUMBER COR- .
PERMIRE �I �"��VV REST NUMBER
ADDRES FINAL. S/-5-9
JOHN A. LAMBIE.COUNTY ENGINEER. CLYDE N. DIRLAM, PRINCIPAL STRU RAL ER
PLAN CHECK VALIDATION M.O. CASH PERMIT VALIDATION w M.o. teem
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