HomeMy Public PortalAbout9527 BROADWAY_Building__ APPLICATION FOR COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING PERMIT BUILDINGANDSAFETY DIVISION
FOR APPLICANT TO FILL IN ADDRESS
BUILDING
ADDRESS E r Q LOCALITY -
n NEAREST
�iA.
CITY 4 G/ , ZIP CROSS ST. SAL
Q� O.OF BLDGS. ASSESSOR
SIZEOFLOT GoK O NOWONLOT MAPBOOK PAGE PARCEL
DISTRICT GROUP TYPE FLLRE P -SSEWY
TRACT BLOCK I LOT NO. �r CONST
TEL. ♦OJ
OWNER N01251-11.1 LALCLA
O STATISTICALCLA IFICATION SEWER MAP
ADDRESS inr CLASS NO. "IN' DWELL.UNITS O SK I PG
CITY ZIP USE ZONE MAP 4
ARCHITECT OR TEL, T?-�' NO.
ENGINEER. NO. 11_- SPCI AL
'+ CANDITIONS
ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ N ❑
,� rr << � EL.
CONTRACTOR�(!- UR. ., I'trlAjNO. yyC9 BLDG.SETBACK FROM
_ LIC FRONT PROP.LINE OF ISTREETI
ADDRESS IS - Y NO. HIGHWAY + YARD = TOTAL SETBACK FRO TYPE OF EXISTING
LIC. FRONT PROP. HIGHWAY WIDTH
CITY @ Q CLASS _G _
CONSTRUCTION LENDER + i
NAME AND BRANCH J
BLDG.SETBACK FROM V
ADDRESS CITY SIDE PROP.LINE OF ISTREETI 0
SO.FT.gI NO.OF NO.OF CHECK HIGHWAY + YARD — TOTAL SETBACK FROM TYPE OF EXISTING w
SIZE STORIES FAMILIES ONE SIDE PROP.LINE HIGHWAY1 WIDTH ti
+ = Z
DESCRIPTION OF WORK NEW
ADD ❑ COR CUTOFF YES ❑ NO ,❑
r ALTER ❑ IN OPE ACE YES ❑ NO ❑
USE OF REPAIR ElOASTAL PERMIT ZONE YES NO
❑ ❑
EXISTING BLDG. C DEMOL ❑
APPLICANT TEL
(PRINT) NO.
BY ISIGNATUREI
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES
AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM.
PENSATION INSURANCE.
SIGNATUREOF / DATE B
PERMITTUEESIGNATUR DATE
ADDRESS
TEL. P.C.Fee$ 3 Permit Fee L
CITY NO.
Issuance Fee CDQ
VAWATION� 97
/ Total Fee ��V
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
8 6 2L=JLIL 24 •2 3 U 3 6.0 D e s 8 6 3�JIJL 24 1 U cj 2.0 0 AO-8
Qf 76AG36ACE9603A6/77
76A638A,D%#803 D%#----- APPLICATION FOR BUILDING PERMIT �.
BUILDING AND SAFETY DIVISION BUILDING
Department of County Engineer ADDRESS
gis7 �—
County of Los Angeles LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN, SUPT of BUILDING CROSS ST.
- DIS��NO. GDISTR NO. GROUP (TYPE SEWER MAP
FOR APPLICANT TO FILL IN BK PG .
CONST.
BUILDING
ADDRESS 1--7 STATISTICAL CLASSIFICATION
'� I CLASS. NO. DWELL. UNITS�I
LOT NO. j OCK MAP STATE
NUMBER -• HWY YES O�
TRAC7 SE ZONE SPECIAL
USE OF NOW ON LOTS -6 CONDITION — 3014/
SIZE OF LOT
EXISTING BLDG. BUILDING EXIST.
YARD HWY STREET NAME
SETBACK WIDTH
OWNER Jam/ �V / c. FRONT
MAIL -� P. L.
ADOR S S 37 SIDE
TEL P. L.
clTv NO 51dINSPECTION RECORD
ARCHITECTUR TEL.
ENGINEER NO.
2Q 5? GQo wt � c.wu
ADDRESS
TEL. / �� ..1�Y b0.La ��tl.Cn adtt CY
CONTRACTOR - NO -4 O
ESCRIPTION OF WORK
NEW ADCD ALTER REPAIR DEMOLISH
SIZE FT.//
S O STORIES FAMILIES
/
_
USE OF STRUCTUR
APPROVALS
SIGNATURE
APPLICANT DATE INS ECTOR'S SIGNATURE
41
ADDRESS FOUNDATION: LOCATION ten
FORMS. MATERIALS C� SSV IzT ems` w-`C •
5 S p C, $ FRAME: FIRESTOPS. 1 /�
/y aQO FEE �.__. BRACING. BOLTS
VALUATIONFEE S FURNACE: LOCATION.
GAS VENT. DUCTS r AA
1 HEREBY ACKNOWLE`GE THAT I HAVE READ THIS AP- LATH. INT.
PLICATION AND STATEAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WI ALL COUNTY O DINANCES AND 'l
LATH. EXT.
STATE LAWS R N BUIL-GING ONSTRUCTION.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS FINAL /J k�
JOHN A. LAMBIE. COUNTY ENGINEER, CLYDE N. DIRLAM, PRINCIPAL STRU RAL ENGWY :iR
V
PLAN CHECK ALIDATION L(� m.o, DASH PERMIT VALIDATION4fCK.,j M.O. CASH
w00 9/ 6� AUG 5 16 1 6.7 S a n
/ I: 10 1 5 1 2S�; AUG23 1 3 3.50 M