HomeMy Public PortalAbout5413 CLOVERLY AVE_Building__ 76A638A CE#8035 6I APPLICATION FOR BUILDIN PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADORES
BUILDING AND SAFETY DMSION LOCALITY
JOHN A LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A JENSEN SUP T OF BUILDING CROSS ST 3 r'
DISTRj.Q 'T NO GROUP TYPE CESS BY
FOR APPLICANT TO FILL IN S CONST
STATISTICAL CLASSIFICATION SEWS MAP
BUILDING BK -ypG
ADDRESS CLASS NO DWELL UNITS
LOT NO BLOCK WATER CERTIFICATE NOT REQUIRED RECEIVED
TRACT Q r O A MAP HIGHWAY
,gyp�/ q b NO OF BLDGS NO ', )CIRCLE) ,STATE MAJOR SECOND LOCAL
SIZE OF LOT i/ ^ �Q� I NOW ON LOT USE ZONE SPECIAL
USEOFCONDITIONS '
I EXISTING BLDG t'=' y
t TEL
OWNER NO - BUILDING EXI
E
1q SETBACK YARD STREET NAME WI H'
ADDRESS S ,a FRONTRCHITEC /
—ENGINEER O G = TE -69 p I ' P L Q.
r PIDE O
ADDRESS TEL 7, • /INSPECTION RECORD/ J
CONTRACTO NO - /3� o
ADDRESS ` OV �X' r v , U
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DESCRIPTION OF WORK41 S //
EW ADD ALTER ,� 'REPAIR DEMOLISH A
"NO}OF NO OF
IZE !/ STORIES FAMILIES
USE OF ce ' ,�/ / /f�f'j) li•��' ,n
STRUCTURE 'r
SIGNATURE rt Y` I(/ t•Y •]• /L�� YJ Q", /�l �+•�f` teGT�i�-
APPLICANT
VALUATION$ _ //
APPROVA ,+ �DLS TE ~-INSPEL'TORrS SIGNATUREPMT '
FOUNDATION LOCATION
FEE FEE $ '� 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', I � ,
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CONSTRUCTION-I CERTIFY THAT IN DOING THE WORK s
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA '4 LATH INT
TION OF THE LABOR CODE OF THE STATE OF C LIFORNIA RELAT t V _
ING TO WORKMEN S COM SATION IN7NC - Iv+
LATH EXT
SIGNATURE OF ` I HOUSE NUMB
ER COR-
PERMITTE r �i` RECT.ANDPOSTED
ADDRESS 7/7� FINAL
`� _ CLYDE N DIRLAM PRINCIPAL ST7RUAL ENGINEER.'
PLAN CHECK°VALIDATION cK M o CASH _PERM VALIDATION ►�o CASH
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