HomeMy Public PortalAbout9933 BROADWAY_Building__ A ROAD
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>••^=•r=eu•o APPLICATION FOR BUILDING PERMIT.
COUNTY OF LOS ANGELES BUILDING•
DEPARTMENT OF COUNTY ENGINEER noDREss
BUILDING AND SAFETY DIVISION: LOCALITY 2
JOHN A. LAMRIE, COUNTY ENGINEER NEAREST
'CASSATT D. GRIFFIN, SUPST.T of Bu1L�ING , CROSS (� i -
_ DISTRICT O. - GROUP TYPE P SEED 13
FOR APPLICANT TO FILL IN ' .
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BUILDING' Q STAT'
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LOT NO. /Seven/ .BLOCK MAP HWY.
_ STATE YES
NUMBER
TRACT USE ZONE SPECIAL
NO:OF BLDGS. CONDITIONS
SIZE OF'LOT NOW ON LOT
USE OF
EXISTING BLDG.' �'V�I.P p ` BUIL DING - .EXIST.
SETBACK YARD HWY STREET NAME. WIDTH
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APPLICANT
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APPROVALS
p APPROVALS DATE INSPECTOR'S SIGNATURE .
ADDRESS 3• ` FOUNDATION: CATION
FORMS. MATERIALS
VALUATION•sFRAME: FIRE STOPS,fff 4-
BRACING.BOLTS
FURNACE: LOCATION,
FEE i E_�I FEE $ I GAS VENT,DUCTS
THEREBY ACKNOWLEDGE THAT 1 HAVE R D THIS AP- LATH, INT.
PLICATION AND STATE THAT THE'ABOVE IS CORRECT AND
AGREE TO COMPLY WITH AUL COUNTY ORDINANCES AND .. -
STATE',LAWS R . LATIN/G/, BU L NG CO TRUCTION. LATH, EXT.
SIGNATURE OF /! HOUSE NUMBER RECT AND POSTED R " / �^
PERMITTE ,t"' ...'•f' - ��!?Jq,
ADDRESS FINAL
CLYDE N. DIRLAM, PRINCIPAL STRUCTURAI�EGTIQEER
PLAN CHECK VALIDATION' CK. M.O. CASH PERMLT VALIDATION- =K. m.o. CASR
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TEMPLECITY,
aACE ao3 ,.63 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY �•
JOHN A. LAMBIE: COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN. SUPT OF BUILDING CROSS ST. �.h�`
DI$ GTNTYPE S$AC9B-
FOR APPLICANT TO FILL IN CONST.
BUILDING STATISTICAL CL (CATION SEWER MAP
ADORE$$ L? 9W 'BK PG%
CLASS. NO. DWELL. UNITS G
LOT NO. BLOCK WATER (NOT REQUIRED El ❑
CERTIFICATE:
TRACT 5 MAP _HIGHWAY STATE MAJOR SECOND. LOCAL
IN OF SLOGS. NO., IIIECLEI ,
SIZE OF LOT NOW ON LOT USE ZONE SPECIAL
USE OF nJ CONDITIONS
EXISTING BLDG. j)wL:LIia � '
TEL.
OWNER �(,y yOLD"Sc�/ EIdCR. NO. BUILDING EXIST.
SETBACK YARD HWY STREET NAME WIDTH
ADDRESSppI' FRONT
ARCHITECT ORS TEL. P. L6 lJ
ENGINEER NO. - SIDE
ADDRESS O
TEL. P
CONTRACTORRwrJ�'T� �
ADDRESS ZL[ /�I/E r0 V1WV7
DESCRIPTION OF WORK a
1 I Z
E ADD ALTER REPAIR DEMOLISH
SQ, FT. / p' NO. OF NO. OF
-SIZE �/ O STORIES FAMILIES
USE L 1 YlI ^Yd'
SIGNATURE OF
APPLICANT
VALUATION $ : �00
-APPROVALS _ DATE INy�PECTOR'B SIGNATURE
P.C. . PMT. FOUNDATION: LOCATION �,�
FEE S FEE$ FORMS, MATERIALS
- FRAME: FIRE STOPS, n ��
I HEREBY qC NNOW LEpGE THAT HAVE READ THIS APPLICATION BRACING. BOLT$ 7
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE; LOCATION. ' '
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS
BU ICING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK /
'AUTHORIZED HEREBY 1 WILI.,NOT EMPLOY ANY PERSON IN VIOLA- LATH, INT.
TION OF THE LABOR COOT OF THE STATE OF CALIFORNIA RELAT-
ING TO WORKMEN'S COMPENSATION INSJFAANCE. LATH, EXT. /
SIGNATURE OFZ y� HOUSE UMBER RECT AND POSTEDR _
PERMITTEE .� fa
ADDRESS Ile7' �,(�j/�`'4' FINAL 21744
- - JOHN F. LEWIS. PRINCIPAL ST RAL..ENGINEER
PLAN CHECK VALIDATION CK N.C. CASH PERMIT VALIDATION ck.' M.O. CASH
jLO:0 5 0 2Z JUN 25 1 D 6.00- W