HomeMy Public PortalAbout5611 CAMBURY AVE_Building__ 76A638A'6ER003 9-87
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS (OArf
BUILvING AND SAFETY*DIVISION LOCALITYOL
JOHN A. LAMBIE, COUNTY ENGINEER - NEAREST f
COLEMAN W. JENKINS, Sup T of BUILDING .CROSS ST: L /-
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP TYPE PROCESSED By
- (Pd�r o.�jrvoB opn lr) i Q CONST
BUILDING SG// CrTNU od�J STATIST) AL CLASSIFICATION SEWE ,MAP
ADDRESS CLASS NO.�DWELL,UNITS BKR PGA 7-
LOT NO. A. - _ _ _ BLOCK USE_ZON E_ MAP -'
NO
TRACT SPECIAL Q
.. . . ,
NO.OF BLDGS, CONDITIONS
SIZE OF LOT NOW ON LOT .
USE OF
EXISTING BLDG. r 4 T, C,—AX4 BLDG.SETBACK.FROM
TEL. FRONT PROP.LINEOF - (STREET)
OWNER j./L'C,♦� �j'/N�O�. TYPE EXISTING;OFz
+ YARD = TOTAL
ADDRESS •! n4 / ` .4 Ap /J V.CV HIGHWAY DTH CITY77 \ +BLDG.S ETBAARCHITECT OR TEL. SIDE'PROP.LINE (STREET) r
ENGINEER NO.
TYPE OF EXISTING SETBACK HIGHWAYYARD = TOTAL iJl
ADDRESS '• y f ,// :HIGHWAY WIDTH FROM C-L.
CONTRACTOR /���I,U 'J
ADDRESS 2. W/dA[CEj NO. I,3(o d CORNER CUTOFF YES ❑ NO ❑
CITY. . C�O.Ass C- Ltl -SEE REVERSE SIDE FOR SPECIAL APPROVALS
DESCRIPTION OF WORK �� z
NEWe!5;> ALTER REPAIR DEMOLISH )�
SQ. FT. NO. OFNO. OF �'L• W
SIZE STORIES FAMILIES
USE OFF / 2)AS G�
STRUCTURE
S
- -
l2 ca"wrlOAl Ez
SIGNATURE OF
APPLICANT ✓LQM -
1
VALUATIONS yn
/ /V� APPROVALS DATE INSPECTOR'S s IGKATURE
P.C. PMT, FOUNDATION: LOCATION .
FEE $ FEE S / F FORMS, MATERIALS
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS.APPLICATION '.BRACING, BOLTS
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY FURNACE' LOCATION,
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS
BUILDING CONSTRUCTION, I CERTIFY THAT IN DOING THE WORK _
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA-
, TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT� LATH, INT"
ING TO WORKMEN"5 COMPENSATION INSURANCE.
L�.
SIGNATURE OF LATH, EXT.
^_J- HOUSE NUMBER COR-
PERMITTEE' - RECT AND POSTED
ADDRESS + �}LL 7�L!/11a FINAL 6 -
• .A,,. JOHN F. LEWIS. PRINCIPAL STIR CTU AL ENGINEER
PLAN CHECK VALIDATION CK. 'M.O. CASH PERMIT VALIDATION GK. M.D. CASH
LAC�o5°' JU-124 1 4 1 7.25- p
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