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` ' F-APPLICATION FOR' BUILD•ING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY -
FOR APPLICANT TO FILL IN
BUILDING
BUILDING
ADDRESS U LOCALITY
NEAREST
CliZ-RQ Ie ZIP CROSSST.
NO.OF FLOGS.•y ASSESSOR
SIZE OF LOT .[ I�-V NOW ON LOT MAPBOOK'- - PAGE . PARCEL
DISTRICT UP T E FIRE EBBED BY
TRAC� - BLOCK LOT N(4/ 0, NST. Z
OWNER \1Ci1 N - O a t-y�
ADDRESS I � ' .�J/pp` ,� �. ST CLASSNOATISTICAL ClA551i —DWELL.UNITS ' K,/) ?PGS
ARCS �� ,'� Il..' ZIP
ARCHITECT OR TEL. VALUATION $•�—IO�
ENGINEER NO. ..
ADDRESS _n - BLDG.SETBACK FROM-
1{t{_ GFRONT PROP.LINE OF - - (STREET(
CONTRACTOR0 `{1 I LJ IN TOTAL SETBACK FROM TYPE OF EXISTING
HIGHWAY + .YARD FRONT PROP.LINE HIGHWAY,WIDTH
'LIC
ADDRESS 'O Uv ' , I\„\ O-
CRV�(.'� .LIC. _ +
y j I CLASS BLDG.SETBACK FROM '
CONSTRUCTION LENDER SIDE PROP.LINE OF - (STREET)
NAME AND BRANCH-
HIGHWAY + YARD TOTAL SETBACK FROM TYPEOF EXISTING Y .
ADDRESS CITY SIDE PROP.LINE HIGHWAY WIDTH O
SQ.FT NO,OF NO.OF CHECK + _ U
SIZE- STORIES FAMILIES ONE , / W
DESCRIPTI O TT NEW P.C. Fee$ �• Z Permit Fee �.% Crz_
ADDALTER ❑ / • / `q
.Issuance Fee sa
\ 4r as •
yG.9�•
XI REPAIR❑ Total Fee
E0y DEMOL READ CAREFULLY
EXISTING BLDG. 1 Z
APPLICANTTEl THIS APPLICATION IS A BUILDING PER O - 'AT4!�•6A'
(PRINT) t� . N � MITI WHEN PROPERLY FILLED OUT ft
SIGNED, AND MACHINE VALIDATEDp p -
� FOR THE CORRECT PERMIT FEE IN THE O `goocoto o 2.V
BY(SIGNATURE) ,/ VALIDATION' SPACE. PERMISSION 15
THEREFOREGRANTEDTONDO'SUCH.> ll�o•e13Q2.4
I HEREBY ACKNOWLEDGE THA S HAVE READ THIS APPLICATION AND STATE WORK AINDICATED IN THIS APPLI-uuY -
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES CATION', IN ACCORDANCE WITH,AND IY q
AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE SUBIECI-TO ALL OF THE PROVISIONS.= IOROI e'W Q 2'4 4=i'
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF OF THE BUILDING CODE, ORDINANCE U
THE LABOR CODE OF THE STATEOF CALIFORNIA IN RELATING TO WORKMEN'S COM. 92225 OF THE COUNTY OF LOS ( -
' SATIONINSt)teANCE ANGELES,AND RELATED LAWS'
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SIGNATURE OF\ THIS PERMIT BECOMES'NULL AND VOID TWl,Tf1 "
PERMITTEE IF WORK 15 NOT COMMENCED WITH
IN 120 DAYS FROM'THE DATE OFIS 141e'Y a,e*T
ADDRESS' SUANCE OR IF WORK IS SUSPENDED a
AT ANY TIME DURING CONSTRUCTION Z '6
TEL FOR MORE THAN'120 DAYS,OR,IF ANY (I's�e,'fj'��.Q.Q
CITY NO. WORK IS DONE ON THE SAID BUILDING Q '
USE ZONE NADP, �O/' COUNTYCORDINANCEE VIOLATION
STATE LAW < lege Lo;6���.�,�v
.y1 V RELATING THERETO. 7
SPECIAL � I'1;2'0'=T -
CONDITIONS A ROAD .DEPT. PERMIT'IS REQUIRED F -
FOR ANY MATERIAL STORAGE OR n _C q
FINAL BY 'WORK DONE IN THE ROAD RIGHTOF ZI e
DATE' ItR• WAY.
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CE 08031NEV,6/781 J'SI
APPLICATION FOR. BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN ADDRESS - - {
BUILDING - s
ADDRESS _ LOCALITY
NEAREST i A 1 '
CIT , ZIP CROSS ST.
(� NO.OF BLDGS. ASSESSOR
SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL
�J _ �s DISTRICT G UP T E FIRE EBBED BY
TRACT, O BLOCK LOT NO. " NST. ZO T
TE
OWNER N 4 -A AL CLASSIFICATION EW ER ER MA
ADDRESS CLASSLASS NO.�DWELL.UNITS BK 2�G
orCS) Y ZIP p
ARCHI T ECT OR TEL VALUATION S �
ENGINEER NO.
ADDRESS BLDG.SETBACK FROM
TEL FRONT PROP.LINE OF ISTREETI
CONTRACT l N TOTAL SETBAC KFROM TYPE OF EXISTING
�\ •LIC. ''\\ HIGHWAY + YARD = FRONT PROP.LINE HIGHWAY WIDTH
ADDRESS U O. t.)
LIC. + _
CIi`C ' CLASS - BLDG.SETBACK FROM
CONSTRUCTION LENDER SIDE PROP.LINE OF ISTREED
NAME AND BRANCH
TOTAL SETBACK FROM TYPE OF EXISTING �
HIGHWAY + YARD . = SIDE PROP.LINE HIGHWAY WIDTH G
ADDRESS CITY O
SO.Fi NO.OF No.OF CHECK + = V
SIZE STORIES FAMILIES ONE 09
DESCRIPTigR O NEW P.C. Fee$ c �--� Permit Fee 7
` 1 ADD Iz Issuance Fee / N
`\ ALTER
REPAIR T tal Fee
USE OF �` �� DEMOL ,1
EXISTING BLDG. /`�1��, /A , (/(/ •A��
APPLICANTY1 !No O( � ✓ n /Dy Q 14.1.21:.
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BY ISIGNATUREI
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HEREBY ACKNOWLEDGE THA HAVE READ THIS APPLICATION AND STATE {� Y 1 0 0 3 Q 2 4
THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES O — 30245
AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN WING THE V
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. Z
PENSATION INS NOCE. \1 1 1 5 •I 1.2 0— / V
SIGNATURE OF e. 9 1 4 1.7A
PERMITTEE
DU 1
ADDRESS 2 # a e e o 6
TEL. ° lee 6 1.0 0
CITY NO. .
USE ZONE MAP e e e 6 1.0 Q c=
/y .r1 SPECIAL �_ 11,20-78
1/\ CONDITIONS F
O
FINAL BY a s
DATE'
...... APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES ADDR we
DEPARTMENT OF COUNTY ENGINEER ooREss
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN. SUPT OF BUILDING CROSS ST.
DISTRICT NO. I GRfWPB
FOR APPLICANT TO FILL IN j TYPE u
BUILDING / ��JJwg STATISTICAL CLAS IFICATION 15 R MAP
ADDRESS 131Z O93`04) B1 G
6
CLASS. NO. DWELL. UNITS
LOT NO. /O BLOCK MAP STATE YES NO
NUMBER HWV.
TRACT (�D USEZONE SPECIAL
SIZE OF LOT 5D ,k 1 Zp I NOW ONO N LOTS CONDITIONS
USE OF
EXISTING BLDG. �O /nJ BLhLDFINGYARD HWY STREET NAME
.TE SETBACK lWIDTH
NO FRONTOWNER C CEI1 tJ7, L y /
ADDRESS ilP0`(fes
SIDE
ARCHITECT OR TEL. P.L.
ENGINEER NO. INSPECTION RECORD
Y
ADDRESS I - L
TEL.! O
CONTRACTOR 54M C NE ,_]ATC U
ADDRESS J A`-M L{ C
Q
DESCRIPTION OF WORK v
UJ
D_
NE ADD ALTER REPAIR DEMOLISH +n
Z
FT.
SIZE �� v 2 STORIES FAMILIES
I`
USE OF
I STRUCTURE /
SIGNATURE. ,I
APPLICANT •-�
VALUATION
v V I APPROVALS DATE INSP CTOR'5 SIGNATURE
PMT+ AQ./T FOUNDATION: LOCATION
FEE S I FEE S i 6 (� FORMS,MAT ERIALS —I ' 1
FRAME: F IP.E STOP S. <<
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS ' .J
AND $TATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION,
WITH
ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
UILD I NO CONSTRUCTION. I CERTIFY THAT IN THE PERFORMANCE
F THE WORK FOR WHICH THIS PERMIT IS ISSUE. 1 SHALL NOT LATH. INT. /
M PLOY ANY PEHSO IN NY MANNER 50 AS TO BECOME SUBUECT
L` i0 THE WOgKME CO ENSAT ION LA 5 OF CALIFORNIA. LATH.EXT. 1 A-
IGNATU RE HOUSE NUMBER COR-
TUR
OR- /�L
RMITTE RECT AND P057ED n
DRESS ,Z •k' FINAL
1 CLYDE N. DIRLAM. PRINCIPAL STR RAL ENGINEER
CB VALIDATION CK. M.O. CASH PERINUT VALIDATION (OKj M.O. ' CASH
Lt'.LO 4 7 6 2 0 APR. 3 1 A 6 .0 0 `,