HomeMy Public PortalAbout5415 CLOVERLY AVE_Building__ 76A638A CE }`80316 6, APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
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DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DMSION LOCALITY
JOHN A LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A JENSEN SUP T OF BUILDING CROSS ST
FOR APPLICANT TO FILL IN DISTR�T N GROUP TYPE
CONST P E D BY,
BUILDING ,L /� �n STATIS ICAL CLASS.IJF�IrC'^ATION SEWER MAP
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CLASS NO DWELL UNITS--j/
LOT NO BLOCK WATER NOT REQUIRED RECEIVED
CERTIFICATE
TRACT � MAP HIGHWAY
p NO OFBLDGS NO Za0 (CIRCLE) STATE MAJOR SECOND LOCAL
SIZE OF LOT 8� I NOW ON LOT USE ZONE SPECIALI
USE OF CONDITIONS
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OWNER NO (p v BUILDINGTREET NAME I H
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DESCRIPTION OF WORK ��% �l1 /a
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SIGNATURE OF ` ��L" 1 (� 1'1o.I
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VALUATION$(
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IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS Y/
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
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT /
TION OF THE LABOR CODE OF THE STATE OF C LIFORNIA RELAT VV
INC TO WORKMEN S CO KATION I RAN '
LATH EXT
SIGNATURE OF HOUSE NUMBER COR- / �Q [^ ��•,`
PERMITTE RECT AND POSTED
ADDRESS FINAL tll.
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' CLYDE N DIRLAM, PRINCIPAL STR TAL ENGINEER
PLAN CHECK VALIDATION CK M o C"H PERMIT VALIDATION' CK 1m o CASH
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