HomeMy Public PortalAbout9828 BROADWAY_Building__ IA630.P CER003 9-68
APPLICATION -FOR BUILDING PERMIT`
CpUNTY•OF LOS ANGELESBUILDING ��
DEPARTMENT OF COUNTY ENGINEER ADDREss HPOA bY 4 .V
—
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS, SUP T GF BUILDING CROSS ST.
FOR APPLICANT TO FILL IN DIST C N G P TYPE
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CONST.
(Print or type only)
BUILDING Qrn n STATISTICAL CLA SI FICA TION S WER MAP
ADDRESS J fT J CLASS NO. OV--- L.UNITS_ BK PG
LOT NO. 130 BLOCK USE ZONEI
NMA
OP V D
TRACT /15 SPECIAL
NO.OF BLOGS. CONDITIONS
SIZE OF LOT Q NOW ON LOT
USE OF /
EXISTING BLDG. _C BLDG.SETBACK FROM
'µ TEL. FRONTPROP.LINEOF (STREET).
OWNER y�� /� No.
t�j� TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL
ADDRESS LT Gd 45 R/) Gi 0#-.I HIGHWAY WIDTH FROMC.1- � /�
CITY / e:r / D + . �d =
BLDG.SETBACK FROM
ARCHITECT OR TEL. SIDE PROP.LINE OF (STREET)
ENGINEER NO. TYPE OF EXISTING SETBACK I HIGHWAY } YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C,L.
T
- C
CONTRACTOR TEL. }
® NO. C
LIC.
ADDRESS NO, CORNER CUTOFF YES ❑ NO ❑ C
LIC. H'
CITY CLASS SEE'REVERSE SIDE FOR SPECIAL APPROVALS,
CONSTRUCTION LENDER
NAME AND BRANCH �� /4
ADDRESS
SO. FT. NO. OFNO. OF /
SIZE 5D® STORIES N14J7 FAMILIES C,,,W NEW
RUC URE ❑
USE OF ADD L iL[{j
ST
ALTER ❑
IGNATU OF AIR❑ Alf e�
APPLIC T ",& DEMOL ❑ F
3
azfj Mc,
VALUATION 5 ✓r6 O. p FD4zff9
APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. PMT. FOUNDATION: LOCATION nn tt
FEE S FEES , FORMS, MATERIALS U 1
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLYFURNACE: LOCATION, v
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS STRUC TION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT.
LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO
WORKMEN'S COMPENBATIO NSURANCE. LATH, EXT. /
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE - Q�"'
0'a
/7 RECT AND POSTED
ADDRESS (u 0'a0 LaZa 0,�_ FINAL - 70
JOHN F. LEWIS. PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. GASH _ PERMIT VALIDATION CK. M.O. o BH
i Ar 2 s -9 ;� GOT 24 1 D 2 7.75- a