HomeMy Public PortalAbout9458 BROADWAY_Building__ DIVISION OF BUILDING AND SAFETY +j
Department of County Engineer I� F�uJ fel l�
County of Los Angeles
WM. J. FOX, COUNTY ENGINEER APPLICATION
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
DISTRICT O.O. PUN CK. ON REC.NO. PERMIT NO.
BUILDING _ n A C� �+
ADDRESS ( j ®j-ili_�.c.J' B
RECEIVED
BY DATE OF APPL DATE ISSUED
LOCALITY
NEAREST
CRO99 BT. i.�l,;.X i mei ,i _ BUILDING �'+ /
�..�w.� ADDRESS % ��45 t i�I_'!l Tii,.✓.OY
OWNER� �, LOCALITY T�t�
�9%/ . .�I NEAREST
cn—
CITY �..� A NO. /L� J �J- FIRE�BT• NIGOF •/E�6P I GROUP
ARCHITECT OR TEL ZONE PLANE .n
ENGINEER NO. BLDG. ORD. NO.
SETBACK LINE
ADDRESS
UBCAPPROVED
ZONE BY DATE
T[L
CONTRACTOR ✓ y / NO. HOUSE NUMBERING
ADDRESS / MAP NUMBER 200 8 NO. ASSIGNED BY
LEGAL y /j1- CORRECTIONS
DESCRIPTION LOT NO. L CK
TRACT �
No. OF BLDGS.
SIZE OF LOT tl D X I NOW ON LOT
USE OFNO.OF
EXISTING BLOB. I FAMI LIKE
DESCRIPTION OF WORK
NEW ALTERATION ADDITION n
D
REPAIR I DEMOLITION: I m
SD•FT. I 7 NO.OF r
SIZE /' ROOMS STORIES
EXT.WALLI ROOF - -
COVERING COVERING
USE OF STRUCTURE
A
INSPECTION FOR APPROVALS
OCCUPANCYAS INSPECTOR'S SIGNATURE DATE
FOUNDATION: LOCATION
FORMS, MATERIALS
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP-
PLICATION AND STATE THAT THE INFORMATION GIVEN IS FRAME: FIRESTOPS,
COR AGREE TO COMPLY WITH ALL COUNTY ORDINANCES BRACING. BOLTS
I
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FURNACE: LOCATION,
GAS VENT, DUCTS
SIGNATURE OFLATHr INT.
PERMITTEE—
ADDRESS f LATH, EXT.
PLASTER, INT.
AUTHORIZED ADT.
PLASTER. EXT.
P.c.
FEE HOUSE NUMBER COR-
RECT AND POSTED
VALUATION FEE ✓ FINAL _ �' p❑❑ ""
7"A 39A*DBS 3 1-152 '7 y
/ G