HomeMy Public PortalAbout4912 CAMELLIA AVE_Building__ ..fes n
, TEMPLE OTLL ,.
1M61.cF 401, 1-61 APPLICATION FOR BUILDLNG PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVSION LOCALITY
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
WILLIAM A. JENBEN SUPT of BUILDING CROSSST.
DISTRICT NO, G P TYPE P SSED BY
FOR APPLICANT TO FILVIN CONST
BUILDING `�,� _ - f' - F STATISTICAL CLASSIFICATION - SE RMAP
ADDRESS �(iQ
Al
CLASS. NO. WELL. UNITS
LOT NO. BLOCK WATER NOT REQUIRED RECEIVED
/
TRAC} CERTIFICATE;
- MAP HIGHL Y STATE MAJOR SECOND, LOCAL
C NO,OF BLDGS. N ICIRCLEI
S/ZE OF LOT.-✓ INOW ON LOT USE ZONE SPECIAL
60
00NDITIONS
EXISTING BLDG. �
OWNER11,4x INr- 7,4yeAla p-r NO`.Sr72 747 BUILDING EXIST.
`7' yy�� � //jJ_ �� I ,.- 'T-^ SETBACK YARD HWY STREET NA WIDTH'
'ADDRESS "L/9I.2 )to l.avka-&-' /- '' FRONT
ARCHITECTOR TEL.I P. L.
ENGINEER NO. SIDE �-lf-
- - P. L.
ADDRESS / 7EL.Gl INSPECTION RECORD a
CONTRACTORA-Z-44<-us:� e'G''u-"m°'NO. - 0
ADDRESS /q--'57 /)I0-.,Q
DESCRIPTION OF WORK /ti '41 'KA.11�1'411zl�
,// M �r
/L)-1 4�,r41 LAI
NEW ADD ALTE REPAIR DEMOLISH
SO. FT. .if q �( NO.OF - NO.OF w F 4' S2.m .F'd M`�6Ri•.R ®�iA /12'w ,I-ZC�
SIZE pC�!</(/ STORIES FAMILIES -
USE of /djc I d.t /e�.asRRVNe a
STRUCTURE (� ✓L�d- &.
SIGNATURE OF //� /-�" ��.d / tLI.,.,o �•7r L�
APPLICANT_/ - -
VALUATIONS `'r-0. /A. ! .f
I 1r Nlj .w/{Rl.0 n. All Levo /l�L
�� I APPROVALS DATE_INSPECTOR
y'S SIGNATURE
FEE Ste- FEE S �> FO FORMS. MATERIALS LOCATION
FRAMIR STO '
PS,
I HEREBY ACKNOWLEDGE THAT HAVE READ THIS APPLICATION BRACCINGNG, BY Iy<I / d✓d
AND STATE THAT THE ABOVE IS CORRECT NO AGREE TO COMPLY FURNACE: LOCATION.
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING 'GAS VENT DUCTS
SO
LDING CONSTRUCTION, I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA, LATH, INT.
TION OF-THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT.
INC TO WORKMEN'S COMPENSATION INSURANCE,
LATH,EXT.
SIGNATUREO HOUSE NUMBER COR-
PERMITTEE }�'/d�i,G/L1LrILL•C,,-' /d RECT AND.POSTED
FINAL
CLYDE N. DIRLAM. PRINCIPAL STRUCTURAL EN
PLAN CHECK VALIDATION CK. M.O. CASH PERM VALIDATION cK M.G. CASH
(l �ip97b 16 f 1D 3 .G 0,
c / Ty of rrjnPIC c, ) 7- y
76A638A CEH803 3-60
`►`..APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS - qql -2 CAM C- 1, A-
BUILDING AND SAFETY DIVISION LOCAL ITY T
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPT Dd BUILDING NEAREST l• - -
CROSS ST.
DISTRICT NO. GROUP TYPE PROCESSED BY
FOR'APPLICANT TO FILL IN 1
(Print or.typ. only) S `, ! CONST. 'i •V �L •-�
BUILDING
l STATISTICAL CLASSIFICATION- SEWER MAP'
ADDRESS QQ ` CLASS NO. DW ELL,UNITS LBKS PG�Z�'•
LOT NO. gJ JJ - ` BLOCK" - USE ZONE NAO P'
I TRACT •� C 7. SPECIAL _
NO.OF SLOGS. CONDITIONS
SIZE OF LOT NOW ON LOT
USE OF ''`` ;
EXISTING SLOG, L Gllt BLDG.SETBACK FROM
TEL.//�� q FRONT PROP,LINED t -�T A"'� )/' �^ - (STREET).
OWNER NO. OLSS 2OS Z TYPE OF EXISTING SETBACK I HIGHWAY } YARD' TOTAL
ADDRESS
C ell;,q
HIGHWAY WIDTH FROM C.L.
V-7
CITY
ARCH ITECTOR', TEL. fo BLDG.SETBACK FROM ,-' - ' ��•
IC , SIDE PROP.LINE OF (STREET)
AlENGINEER// ND' TYPE OF EXISTINGSETBACK 'HIGHWAY' -' .YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C.L.
CONTRACTOR / - III 1 325ClI LIC.
ADDRESS I. Y tq "I NO. -7,1)-711 f CORNER CUTOFF YES ❑ NO ❑ 'U'
LIC. m
CITY L: A ' ti Z CLASS I SEE REVERSE SIDE FOR SPECIAL APPROVALS
U
DESCRIPTION OF WORK
z
NEW DD ALTER REPAIR DEMOLISH —
SO. FT. / NO. OF NO. OF
SIZE y STORIES FAMILIES '
USE OF
STRUCTURE A7- , C`
SIGNATURE OF
APPLICANT
VALUATION S �fs'O 49
'APPROVALS, - DATE INSPECTOR'S Sill cNATURE
P.C. PMT. FOFORMS FOUNDAT
ION:
SION -
FEE S FEE S /�, �) r7
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS �4
ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FLIRNAC E:'LOCATION,
WITH ALL COUNTY ORDINANCES AND STATE LAW. REGULATING GAS VENT, DUCTS
BUILDING CONSTRUCTION. I CERTIFY THAT IN OOING"TME WORK _
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA. '
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT. LATH', INT.
I NG TO WORKMEN'S COMPENSATION INSURANCE. _
LATH, EXT. _
SIGNATURE OFA HOUSE NUMBER COR-
PEFtMITTEE c}Lf,�y1 /7 G•T1:�//-� A,. /!.'='-/�•a RECT AND POSTED
ADDRESS et t�I Y-".[,AAYIT!/ �CTl�• 22- FINAL
JOHN F. LEWIS. PRINCIPAL STRUCTURAL ENGI ER
PLAN CHECK VALIDATION CK. M.O.' CASH _ PERMIT VALIDATION «. M.D. u.„
Lid 0 6 3' 5 7 SEPI. 1 L D 1 2.0-0 v-
7GA638A CE#8038-63APPLICATION FOR BUILDING PERMI
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.
DISTRICT N OU TYPE ED BY
FOR APPLICANT TO FILL IN G�: ' CONST.
BUILDING /� J� ' /� N STATISTICAL CL SS FICATION WER MAP r
ADDRESS �V _( BK PG
CLASS. NO. DWELL. UNITS
LOT NO. BLOCK WATER NOT REQUIRED ❑ RECEIVED ❑
CERTIFICATE:
TRACT MAP HIGHWAY
NO.OF BLDGS. yJ NO. r G� 3 (CIRCLE) STATE MAJOR SECOND LOCAL
SIZE OF LOT NOW ON LOT C+ USE,,,ZONE SPECIAL
USE
BLDG. n_� I CONDITIONS
EX
OWNER Or�j/r N/f(a(_f NO ^ yf1 —BUILDING EXIST.
S�4M FRONT
YARD HWY STREET NAME WIDiH
ADDRESS .
ARCHITECT O T L. P. L_ .�
ENGINEER G SIDE '
P. I
ADDRESS CURB, GUTTER, DRIVEWAY APPROACH, ' ' O
CONTRACTOR / l—' r � �./,�N�O.�JCP� I '� v
ADDRESS4W -li[/T� m
III Prrmlts fe- curb, gutter, sidewalk, andrivew.,f - - 1T.Q
DESCRIPTION OF WORK Stalial {IOC e e tekOS OUT aT 111-_ .. U
f len or 7. C. CG. ERcineer's Of'ce immedialc!y i. - w
OL
NEW ADD ALTER REPAIR DEMOLISH a len9:ny delay. Survey & Design work takes tilde ai °- - N
. FT. NO. OF NO. OF {.?
SIZE STORIES FAMILIES •, has oA
USE OF p�l S`yr/ ,..rl /_. cit Ha"I
STRUCTURE Y ./ /r
SIGNATURE OF L /�/p-�✓
APPLICANT
VALUATION$ q
----++"�`vv�0m✓? APPROVALS DATE INSPECT SIGNATURE
P.C. Z PMT. S� FOUNDATION: LOCATION
FEE $_ FEE $ FORMS. MATERIALS
FRAME: FIRE STOPS. '
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING. BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. <
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS
BUILDING CONSTRUC ON. CERTIFY THAT IN DOING THE WORK
AUTHORIZED MERE WILL NOT EMPLOY Y PERSON IN VIOLA LATH. INT.
TION OF THE LAB R OE OF THE TAT CALIFORNIA RELAT-
ING TO WORKME MPENSgTIO U CE LATH. EXT.
SIGNATURE F 'L fff HOUSE NUMBER COR.
PERMITTEE �"� RECT AND POSTED
ADDRESS A6075 FINAL
JOHN F. LEWIS. PRINCIPAL STIR RAL ENGINEER
PLAN CHECK VALIDATION GK. D. GASH PERMIT VALIDATIO CK, M.D. GASH
Ltko--0 � ;. stP g' 1 D 5.63
6
Jil0535'm SEP 8 1 D 22.50~ cr
I
tl LinMPL` E."AM LL .
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DMSION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN SuwT or BUILDING CROSS SL.
FOR APPLICANT TO FILL.IN DISTRjCT y0. G UP TYPE SSED BY
77y///, (D/' CONST.
BUILDING /J/q M STATISTICAL CLASSIFICATION MAPS
ADDRESS //7 oL/'/.O CLASS.NOlf_ XDWELL. UNITS ��
LOT NO. �6 /3'�`y BLOCK WATER NOT REQUIRED RECEIVED
TRACT � 7 (O / CERTIFICATE:
b // r ,, / MNO.AP��/`'� HIGHWAY STATE MAJOR SECOND LOCAL
SIZE'OF LOT. �� ^ IIZ�p I NOW ON LOTS Y USE ZONE SPECIAL
(CIRCLEI
USEOF �///o"" _� '� / CONDITIONS
EXISTING BLDG. •y -u� .
rr��II A. -3EL.
OWNER TT/� C VE CJNO. BUILDING YARD HWY STREET NAME EXIST.
ADDRESS � �` SETBACK WIDTH
FRONT
ARCHITECTOR TEL P. L.
ENGINEER NO ' SIDE
P.L.
ADDRESS �
nn ,^� / TEL. INSPECTION RECORD ,rJ
'
CONTRACTOR, Y''(.A / s O. ' O
ADDRESS / Osl-CL O
DESCRIPTI F WORK -
W
d
NEW ADD ALTER' REPAIR DEMOLISH ♦ . N
SQ.FT. NO.OF NO.OF �// .�%I /In AZ As %A-M IQ A-
nK ?
IZE STORIES} FAMILIESUSE OF
STRUCTURE LLa T
alu-4. Q
SIGNATURI
OF !'A.do' t;� +�/f AFt�FA
IF
VALUATION$ 50 I ' 1 '/
APPROVALS DATE INSPECTOR'S SIGNATURE JJJJ77
P.C. `� PMT. ? ` FOUNDATION: LOCATION
FEE $ FEE $ V FORMS, MATERIALS
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS
AND STATE THAT THE ABOVE IS 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
AUTHOR IZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH,INT.
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT.
ING TO WORKMEN'S COMPENSATION INSURANCE. - LATH, EXT.. J ,I. • �!'
SIGNATURE OF
HOUSE NUMBER COR- V i
I'1 •' �i/J
RECT AND POSTED
ADDRESS ��/�- //MA/ IJw 1
FINAL
` CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL ENCW14ER
PLAN CHECK VALIDATION cK M.o. CARR PERMIT VALIDATION cN. M.o. (9—
3 .0
LC�•o 1 0 9 a U QrU 4 1 p R
c � I I
76A63BACEn6D3B-aa•APPLICATION F R BUILD.
G PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDREss
I
BUILDING AND SAFETY DIVISION LOCALITY \
JOHN A. LAMBIE-. COUNTY ENGINEER NEAREST
COLEMAN W. JENKINSAUP'T.OF BUILDING CROSS ST.
DIS 1 T O. OUP TYPE P SED BY
FOR APPLICANT TO FILL IN CONST. '
BUILDING STATISTICAL CLASSIFICATION SE R AP
ADD CLASS NO, DWELL UNITS E PG
��
LOT NO. BLOCK USE ZONEAP
\
MO.
T ACT 114q SPECIAL
/ xO. OF SLOGS. CONDITIONS
,`iZE OF LOT 6,J NOW ON LOT
E OF
[ST,
NG RLDGI / BLDG. SETBACK FROM
TEL. !� �Q`7 FRONT PROP. LINE OF (STREET)
OWNER /O. J •7 TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS � / ai HIGH AY WIDTH Imo, C.L.
) + _ 17
CIT �' BLDG. SETBACK FROM
ARCHI ECT TEL.
ENGINEER ( \ ,NO. I Q SIDE PROP. LINE OF (STREET)
(yam ,�/�• TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS✓J }' XIGXWAY WIDTH fROM C.L.
d
E + = 0
CONTRACTOR U
LIC
ADDRESS O ' CORNER CUTOFF YES NO O
CITY` i CL s SEE REVER b'ffT I+ ISRE1ilA ,,Z&OVALS G
`bESGRIP1rION OF WORK N
Z_
NEW ADD ALTER REPAIR DEMOLISH stella}ions sbDuld be u,�^LJutfer, sidewalk, and drivewa a
SO.FT. NO. OF NO. OF
SIZE STORIES FA MILIE ICG, or T. C, CO. En ineeri `"O' Read DDPf., Alfadera
a len O}{ice immG ; I.
USE C � „ ) a avo
STR Uei URE K� aafa Permit bas' eslgn wD:k fakes time and is no}
boon issued. ster}a
SIGNATURE OF C
APPLICANT 4 r • • G Ie iI
VALUATIONS �. OoQ APPROVALS DATE INSPECT, SSIGNATURE +
P.C. a PMT.L+ FOUNDATION,
iMATERIALSON
FEES FEES,?-
FRAME, FIRE STOPS,
1 HEREBY AC NNOWL °GE THAT I HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION c,_�
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS T
9UILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK 4
AUTHORIZE° HEREBY WILL NOT EMPLOY ANY PERSON IN VIOLA. LATH. INT.
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT.
ING TO W ORKMENS COMPENSATI NINSURANCE.
/q q LATH. EXT. 9 � o •..(/DyFA
SIGNATURE OF*111- L4 2^✓r�^// HOUSE NUMBER COR- P
PERMITTEE—''// ���w `LlICAiG ��(L C/✓ RECT AND POSTED
AODRESs ` /f/-!9 / FI NAL
JOHN F. LEWIS, PRINC PALEST URAL ENGINEER
PLAN CHECK VALIDATION DK. M,0. uBH PERMIT VALIDATION OK. M.O. CASH
LACO 4002)JUL 26 23D 14.50 A 5 2 9D' ' 19i 1 1. D 2 9.00
' 76A638A CE#803 B-64 APPLICATION F012t BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
. DEPARTMENT OF COUNTY ENGINEER ADDRESS '
BUILDING AND SAFETY DIVISION LOCALITY q J
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST R
COLEMAN W. JENKINS,SUPT.OE BUILDING CROSS ST. `>, "
FOR APPLICANT TO FILL IN DlsjrsLi �P I TYPECONST. PROGE0_J,j r ,
BUILDING STATISTICAL CLASSIFICATION SEW MAP rl
ADDRESS V Al • CLASS NO. ' DWELL UNITS B -Ak
LOT NO. BLOCK USE ZONE MAP
_ N .
TRACT / SPECIAL -
N0. OI BLDG9. •] CONDITIONS
SIZE OF LOT r NOW ON LOT �C
USE OF
EXISTING BLDG. SETBACK FROM -
TEL. c FRONT PROP. LIN, OF -� (STREET)
OWNER GV NO, o �.I TYPE OF STING SETBACK HIGHWAY + YARD - TOTAL
ADDRESS HIGHW Y WIDTH 'FROM C.L.
CITY X •C':�^ �-/ + - �
ARCHITECT OR TEL. BLDG. SETBACK FROM 'F -
ENGINEER NO. SIDE PROP. LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY +. YARD TOTAL
ADDRESS XIGXW AY WIDTX FROM C.L.
(� T ' �-
CONTRACTO AS=S OL. O
ADDRESS / / NO. CORNER CUTOFF YES El NO C
O
CITY cls SEE REVERSE SIDE FOR SPECIAL. APPROVALS u
UU
DESCRIPTION OF WORK3 ` 5 ` a
2_77Z_ Z
NEW ADD ALTER REPAIR DEMOLISH _
SOFT. - NO. OF .NO. OF �� �Cl��['A A•�'J
SIZE STORIES / FAMILIES
USE OF �' ac,
STRUCTURE
O v /�o
SIGNATURE OF
APPLICANT
VALUATIONS • �� OO
APPROVALS GATE INSPECTOR'S SIGNATURE
P.C. PMT. C'(J FOUNDATION, LOCATION
FEE'S FEESFORMS, MATERIALS
' FRAME, FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE IS 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 WORN
-
AUTHORIZED HEREBY I WILL-NOT EMPLOY ANY PERSON-IN VIOLA-- LATH. INT.
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT. /y
LNG TO WORKMEN',CO //
MPENSATION INBURANCE. LATH.EXT. dA
/ LiII
SIGNATURE OF L/. HOUSE NUMBER COR- n
PERMITTEE ��LU6 RECT ANO POSTED //
ADDRESS / PSL ol/� FINAL
JOHN F. LEW[S. PRINCIPAL,ST TURAL'ENG]NEER
PLAN CHECK VALIDATION DK. M.D. CASH PERMIT VALIDATION CK. Wo. CASH
:�_ [aT5.731� MAR14 1 D 6,00" .1
76A638 CE#803663 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESSi�
BUILDING AND SAFETY DIVISION LOCALITY ✓`/
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. _ i
DISTRICT N O TYPE / P E D
FOR APPLICANT TO FILL IN 5_ CONST. / ,
BUILDING ((jf )} STATISTICAL CLCATION SEWER MAP
ADDRESS /J�,Z /!J. „� BK PG
.� CLASS. NO. DWELL. UNITS
LOT NO. BLOCK WATER I
NOT REQUIRED ❑ RECEIVED ❑
I/ CERTIFICATE:
TRACT 7 MAP "1 HIGHWAY
ry N .OF SLOGS. �7 NO. / (CIRCLE) STATE MAJOR SECONO -LOCAL
SIZE OF LOT J^ S .NOW ON LOT USE ZO E SPECIAL
USE OF CONDITIONS
EXISTING BLDG. "
TEL
OWNER 6U . p
NO. O �'I " BUILDING EXIST.
/ SETBACK YARD HWY STREET NAME WIDTH
ADDRESS N ' C/'/AJ`//, , lr FRONT �}
ARCHITECT OR TEL. e. L.
ENGINEER NO. SIDE
ADDRESS TEL. 'l
CONTRACTOR NO.
ADDRESS i
�. O
DESCRIPTION OF WORK
NE ADD ALTER REPAIR DEMOLISH /
SQ. FT, NO. OF NO. OF
G P V Ci' Ic r'7J• Z
SIZE STORIES FAMILIES
USE OF ^:,./ _ � ,.•' f�/'bt�
STRUCTURE G '
v.yi ,moo
SIGNATUREICOF' kco" s `,' �___
APPLANT ee > ,r
VALUATION $ (9-"� J kG"On ••
_ / %l PATE N.FECTqp 7.1iGGUU.E
PC. PFOUNDAT!o a CATION /31
F E $ FEE $ C V (./ FORMS. ATE RIALS
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I 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= LATH. INT.
TION OF'THE LABOR CODE OF THE STATE OF CALIFORNIA-RELAT. _
ING TO WORKMEN'5 COMPENSATION INSURANCE,
LATH. EXT.
SIGNATUREHOUSE NUMBER COR-
PERMITTEEy RECT AND POSTED
'ADDRESS 91 - G.,� Mw-/I/.S� Cs FINAL
JOHN F. LEWIS. PRINCIPAL•STRUCTURAL EN
PLAN CHECK VALIDATION CK. M.D. GASH PERMIT VALIDATION EK. M.G. =ASH
LLti 0 0 3 6 3 ;:uc 2 9 1 D 6.0'0