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APPLICATION FOR BUILDING PERMIT
DIVISION OF BUILDING AND SAFETY ADDRES9Asu1LDING dV�1C C.¢MFLt
Department of County Engineer
County of Los Angeles LOCALITY C
WM.J. FOX,COUNTY ENGINEER NEAREST / 7 .p I� IS
CA_SSATT D_.GRIFFIN, SUPT OF Bm_LDING CROSS ST. L. '1 L'1 V14
DISTRICT NO.
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ADDRESS CAMELLIA yG HO
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4 COMMERCIAL
CONTRACTOR MIC NAEL A(A V No•AT L D/7j INSPECTION RECORD
ADDRESS
DESCRIPTION OF WORK - -
NEW *� ADD ALTER REPAIR DEMOLISH
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SIZE
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SIGNATURE f
APPLICAN/�,p APPROVALS
ADDRESS DATE 1 SPECT//(&R%5 SIGNATURE
FOUNDATION: LOCATION
$ /0 7�o P. C. $ FORMS. MATERIALS A
�11FEE �✓ FRAME: FIRE STOPS,
¢/ BRACING. BOLTS
VALUATION $
FEE ECJ' i FURNACE: LOCATION.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS GAS VENT, DUCTS' "4 r
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH. INT. V
AND STATE LAWS REGU TING BUILDING CONSTRUC-
TION ✓ yl �t�/{�LJ(/���/L/ LATH. EXT. A
SIGNATURER HOUSE NUMBER COR-,PERMITTE c. RECTAN D POeTED
ADDRESS ` w �' "+" J FINAL
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WM.J. FOX.COUNTY ENGINEER VALIDATION C. N. DIRLAM. CHIEF BLDG. INSPECTOR
{�q1 563;v JAN .5 1 6_ 13-.001w
-.. 1241a� FEB 2 1 2600
11.55 AOB9.9
169! APPLICATION FOR BUILDING PERMIT
DIVISION OF BUILDING AND SAFETY BUILDING ADDRESS G,4/�.Jr/�;L
Department of County Engineer ADDRESS /+
County of Los Angeles LOCALITY T
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
CASSATT D. GRIFFIN, SUPT OF BURo1Ne CROSS ST. 40W�y
FOR APPLICANT TO FILL IN DISTRI/CTNO, GROUP TYPE SEWEBKR PG
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MBER - sHWY .YES O
'ADDRESS /�
LOT NO..,'"7 BLOCK USE ZOPE SPECIAL
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_ NO. OF BLDGS. BUILDING EXIST.
SIZE OF LOT NOW ON LOT SETBACK YARD HWY STREET NAME WIDTH
EXISTOG INBLDG. !Z
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P. L.
MAIL
ADDRESS O DWELL.TRACT DWELL. 1UNIUNIT T 5 INDUSTRIAL
TEL. 1
CITY NO. 6 PUBLIC BLDG.
TEL. 2 DUPLEX 2 UNITS 7 ADDN..ALT., ETC.
A==64 O. $ APT. —_UNITS -
8 MISCEL.
AD RESS 4 COMMERCIAL '
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CONTRALTO INSPECTION RECORD
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ADDRESS 5.
DESCRIPTION OF WORK
NEW ADD ALTER REPAIR DEMOLISH
SO. FT. NO. OF NO. OF
SIZE Q STORIESFA/MSI LIESUSE ,
SE t RE�TT
SIGNATURE OF
APPLICA APPROVALS
ADORES 49. 1 D TE INSP CTOR•S SIGNATURE
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_
FOUNDATION FORMS. MATERIALS / �T
P. C. $ FORMS. MATERIALS t{J t JIo
fE V FEE FRAME: FIRE STOPS. / /I
VALUATION $ BRACING. BOLTS
FEE / FURNACE: LOCATION,
1 HEREBY ACKNOWLEDGE THAT IHAVE READ THIS GAS VENT. DUCTS
If
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES - LATH. INT. J
AND STATE LAW,*_REGULATING BUILDING CONSTRUC• • f (�
TION. LATH. EXT.
SIGNATURE OF HOUSE NUMBER COR- //�� �1
PERMITT E RECT AND POSTED -L 2 i
ADDRESS FINAL M
JOHN A. AMBIE. C LINTY ENGINEER ALIDATION CLYDE N. DIRLAM. CHIEF BLDG. INSPECTOR
CK MC CASH
5664u ?4!Y 3 16• . 11 .00A III. 22 .00
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