HomeMy Public PortalAbout5420 CLOVERLY AVE_Building__ 76AG38A CE#80911-57 'APPLICATION FOR-BUILDING PERMIT-.
COUNTY OF LOS ANGELES Apo E'ss
DEPARTMENT OF COUNTY ENGINEER -
BUILDING AND SAFETY DMSION LOCALITY '
JOHN A'LAMBIE,COUNTY ENGINEER NEAREST I
CASSATT D GRIFFIN SUP T OF BUILDING CROSS ST
DISTRICT NOIGRrOUP .I.�,PE - SEWER MAP G
FOR APPLICANT TO FILL IN CONST
BUILDING ✓ STATISTICAL CLASSIFICATION
ADDRESS / - -
CLASS NO DWELL UNITS
LOT NO BLOCK MAP STATE YES O -
NUMBER HWY
TRACT USEZONE SPECIAL,
t NO OF BLDGS �j CONDITIONS
SIZE OF LOT NOW ON LOT ,r
USE OF, w
EXISTING BLDG BUILDING EXIST
SETBACK YARD H WY STREET NAME - WIDTH
OWNER FRONT
MAIL a P L 7 s
ADDRESS wu
y SIDE
TEL
CITY INSPECTION RECORD
ARCHITECT OR TEL
ENGINEER NO / /A r
ADDRESS I r
TEL
CONTRACTOR L NO - `
ADDRESS 9939 iflao,- 'elk
DESCRIPTION OF WORK -
NEW / ADD ALTER REPAIR DEMOLISHSO -
ET J S ORES FA G9 O
SZOF NO
ILIEST ` ��� 1A � �� •��r �;f µ~ r
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USE OF TURE r �J 4(;! ,n-,
SIGNATURE OF - I' APPROVALS
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APPLICANT _ ! I 1
_ DATE � INSPECTORS SIGTIATURE i
ADDRESS ,FOUNDATION LOCATION 7;
FORMS MATERIALS !
5 / O D D P C $ Q FRAME FIRE STOPS
/ '
J FEE O BRACING BOLTS Y
VALUATION SFURNACE LOCATION
-FEE GAS VENT DUCTS i
I G
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ HIS AP LATH INT
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND y�f•'�
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATE LAWS RE_G LATING Br�7y�LDI Q CONST CTION LATH EXT '
SIGNATUREOF
Y ��>0/ /`f HOUSE NUMBER COR
PERMITTEERECTAN D POSTED s
t �
ADD sS FINAL f `\
6v r 4 f•• CLYDE N DIRLAM PRINCIPAL`-STii C EER
PLAN CHECK VALIDATION c M o CASH PERMIT VALIDATION x mo CASH
� 1 5 4 1 OR JUN 51 64'- 2 0.5,0 d A
1 8 4 6S -JuNll'3 1 A ,J: 4�1,p0 ®.
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