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SIGN OF BUILDING AND SAFETY AP 14
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` i,• COUNTY OF LOS ANGELES -
WILLIAM J. FOX. COUNTY ENGINEER APPLICATION
CASSATT D. GRIFFIN, SUPT OF BUILDING
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
BUILDING •'13 L DISTRICT NO. PLAN CK.OR Rae.No. PERMIT NO.
ADDRE88 L.Y 5 F"I�, �.n ^.1•'' 3Z E7 /
LOCALITY TC RECEIVED BY (DATE OF APDL. DAT/E ISSUED
NEAREST
CROSS ST
ADDREISSG,
OWNER e 1
MAIL LOCALITY
ADDRESS - NEAREST 1 I
TEL. CROSS ST. CF.V'vN p ` I N '\ V
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ARCHITECTOR TEL. FIRE NO. OF TYPE I GROUP
ENGINEER � NO. ZONE PLANS
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ADDRESS -�'-•� SETBACK LINE V 1 \iA- L IO41'(01f`�
TEL USE APPROVED �/
CONTRACTOR O. Z ZONE - BY �d��... DATE 'T-
ADDRESS T (I„ �`�OU HOUSE NUMBERING 1
LEGAL MAP NUMBER-��Q n NO. ASSIGNED BY
DESCRIPTION I LQTNO. BLOCKt I CORRECTIONS v
TRACTOFO�•''='C' A�-��Gl, ,I -I/�
SIZE OF LOT ('00 I NOW ON LOTS
C1 �A.Uct+ V- .v'7"
USE OF NO. OF
EXISTING BLDG. FAMILIES
DESCRIPTION OF W �, _ _ D -
a
NEW ALTERATION ADDITION I 6 7 S'/ R T**� �T6 1 N ^^ �w 3
IH.II !�J-L..-•---... j
REPAIR +� DEMOLITION 1,
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E T /L L i/L ROOMS STORIES ,
EXT. WALL 11 ROOF p
COVERING 7M.CC d COVERING L O
USE OF STRUCTUR
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ND GSA APPROVAL'S
J INSPECTO/&S SIGNATURE DATE
FOUNDATION:FORMS, MAT IAL9�O
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FRAME: FIRESTOPS, v
PLICATION AND STATE THAT THE INFORMATION GIVEN IS BRACING, BOLTS
CORRECT. /
I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION. Jr all
SJAND STATE LAWS RE LATING BUILDING CONSTRUCT N. GAS VENT, DUCTS
SIGNATUPE OF LATH, INT. -
PERMITTIJ
.77 LATH. EXT. /
ADDRE68
PLASTER. INT.
AUTHORIZEDAG
O0 P. C. 8PLASTER, EXT.
FEE -\ HOUSENUMBERCOR-
RECT AND POSTED
VALUATION S [� O:=O
FEE ' � FINAL
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DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES 11 9 ® �
WM. J. FOX, CHIEF ENGINEER U
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
[�L{ DISTRICT NO. PLAN CK.NO. PERMIT NO.
ADDRESBS V 11 g 1-0
LOCALITY RECEIVED B—Y,- DATE SF APP" rDATEISBUED
NEAREST [/)p
CROSS STBUILDINCV.
ADDRESS �� � VO/O�X10
OWNER MAIL
ADDRESS Z!/f ��V(J LOCALITY
NEAREST
TEL CROSS ST.
TY NO.
FIRE NO.OF TYPE DROOP
ARCHITECT OR TEL ZONE PLAN ;
ENUIX[Ep NO.
ADDRESS SETBACK LIN[
.(J APPROVED
CONTRACTOR _ NO, BY DATE
// / UE
// APPROVED
ADDRESS .�9r / ZONEK BY DATE
LEGAL /� CORRECTIONS
DESCRIPTION LOT"4f// .i� BLOCK \ -`
TRACT/ _� �1 _/- Ir.6 C 4 / lj�f 7"G X j-O U
/) .,[ ( NO.OF SLDGa.. /
SIZE OF LOTy , /� Q�DO , NOW ON LOT r
USE OF NO.OF I ND.OF
EXISTING BLDG. aNI LIE. ROOMS
r f ,. 7
DESCRIPTION OF WORK
NEW ALTERATION ADDITIONQ[.��.c �
O
REPAIR MOVING DEMOLISH f 4 S hold `a 4 « O
Sq. FT. y-I !D� NO.OF t =
SIZE { f ROOMS STORIES ,�v;-WALL ROOF
COVERING %�y"E/ (. COVERING F
USE Ora
F NEW
BUILO a
/yK
1 HEREBY ACKNOWLEDSE THAT 1 HAVE READ THIS APPROVALS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION INSPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS. MATERIALS ��RA6 S-�G --Y7
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. /� y)
FRAME: FIRE BTOP9.
SIGNATURE OF BRACING. S
BOLT
OWNER LATH,INT.:
AUTHORIZED'AGT. - LATH.EXT.:
V
oes-z zsN sere I-av IS P C ® pLABTER..INT.
FEE PLANTER. KT.
VALUATION
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FEE `� FINAL