HomeMy Public PortalAbout9545 BROADWAY_Building__ )Bnb39n CE4803 8-64APPLICATION FOR 'BUILDING'PERMIT.
COUNTY OF LOS ANGELES
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LOwcDEPARTMENT OF COUNTY ENGINI3ER BUILDING AND SAFETY 1: ONJOHN A. LAMBIE. COUNTY ENGINEER RESTCOLEMAN W. JENKINS.SUP'T.OF BuaDING SS ST.
LISTRIC T'NO. - GROVP= TYPE, P OCESSE ABY
FOR APPLICANT TO FILL IN p T CONST. ylj� o
BUILDING �Y/ -- STATISTICAL CLASSIFICATION- J SEWER MAPS-_"
ADDRESS H/ NI
OWELL UMTS _r BW
'�II /�
LOT NO.`v _ CLASS NO. /
V BL- USE ZONE' MAP aa✓✓�� ��nn
TRACT' IS U f-�l�i/ �,C,lc"� SPECIAL -
NO. OF 8 gONDITIONS "
SIZE OF LOT NOW ON LOT
USE OF -
FYIqTING RL nn BLDG. SETBACK FROM _ =
FRONT PROP. LIN€ OF (STREET)
OWNER O. TYPE OF EXISTING ETBACX HIGHWAY_ } YARD = TOTAL
ADDRESS HIGHWAY WIDTH �F - - - -" -
CITY
ARCHITECT OR TEL. BLDG. SETBACK iR0 ._ - _
ENGINEER NO. SIDE PROP. LINE IB TREETI
OTAL
TYPE OF EXI INO SETB4 CK-- 'HIGHW pV" '}' YARD - - •TOTAL
ADDRESS `}� HIGHWAY W TH FROM C.I.
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CONTRA'C TO/ LIC.TE-.6p-2 } - O
ADDR ES$' 6 _/�/LyLLCAL-� NO. .LSO/6tt�/V CORNER CUTOFF YES NO O
LIC
CITY CL (2�_24- 'SEE REVERSE SIDE FOR SPECIAL APPROVALSt. u
DESCRIPTION OF WORK vWa,
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NEW - ADD . ALTER REPAIR- DEMO ,
SQ.FT. - - NO. OF N .
SIZE STORIES FAMILIES
MOP
STRUCTURE -
- it -
SIGNATURE OF A v
APPLICANT
VALUATION$ � `)M - -
APPROVALS DATE INSP EC TOR'S SIGNATURE
P.C. P,MT. ,L 'FOUNDATION, LOCATION -
FEE FEE$ FORMS,.MATERIALS
FRAME, FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT
AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION
WITH ALL COUNTY OROINANC ES AND STATE LAWS REGULATING. GAS VENT. DUCTS
GUILD NO 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 SPA E OF CALIFORNIA-RELAT-
ING TO WORKMEN'S COMPENSA N IBB RANCE. - - ._ LATH. EXT.
SIGNATURE O ..HOUSE NUMBER.COR-_
PERMITTEE .T� - RECT AND POSTE -�\
ADDRESS-76; FINAL L ��
JOHN F. LEWIS, PRINCIPAL STRUCTURAL ENG ER '
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.o. DABN
Ir' 0 7 6 Ell APR 21 1 p 8.0 rj