HomeMy Public PortalAbout5743 CLOVERLY AVE_Building__ ii I IQY PL CITY
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76AG33A CE 9603,1-61 APPLICATION TOR BUILDING PERMIT �
COUNTY, OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS Q. <Q_
` BUILDING AND SAFETY DIVISION
JOHN A LAMBIE, COUNTY ENGINEER NEARES
WILLIAM A JENSEN SUP T OF BUILDING CROSS ST
D ICT NOGROUP TYPE PROC SSED BY
FOR APPLICANT TO FILL:IN CONST
BUILDING �" 7 1, STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS ✓ ..7 C �l CLASS NO. DWELL UNITS 0 BK, `PG
LOT NO _ BLOCK WATER NOT REQUIRED RECEIVED
TRACT, �� l r
CERTIFICATE
r''/�','
SIZE OF LOT - NO OF BLDGS NOP vrL-� (J e /(CIRCLE)
IGHWAY STATE MAJOR SECOND LOCAL
NOW ON LOT USF ZONE SPECIAL
USE OF 0 ELi CONDITIONS
EXISTING BLDG e S / v
OWNER C C1' h NO, /BUILDINGEXIST
SEI BACK YARD HWY STREET NAME WIDTH
ADDRESS' -'C FRONT
ARCHITECT OR - TEL P L co
ENGINEER NO SIDE
'• P L �
ADDRESS, TEL,,// INSPECTION RECORD O
CONTRACTOR6,S hr t- r p 6 ,z z { V
ADDRESS Z k V p'►✓�b� r `
DESCRIPTION OF WORK 0
6 a
NEW ADD ALTERIA R DEMOLISH h
SQ FT NO OF NO OF i z
IZE STORIES FAMILIES
USE OF
STRUCTURE
l
r � ,
SIGNATURE OF '
APPLICANT
VALUATION$
APPROVALS DATE° INSPECTOR S SIGNATURE
P C PMT FOUNDATION LOCATION .-
FEE $ FEE $ FORMS MATERIALS
i FRAMEFIRE STOPS
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS
• AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO_ COMPLY FURNACE LOCATION . 5
WITH ALL COUNTY ORDINANCES ASND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CONSTRUCTION I CERTIFY,THAT IN DOING THE WORK _I
AUTHORIZED HEREBY I WILL NOT EMPLOY A Y PERSON IN VIOLA LATH INT
TION OF THE LABOR CODE OF THE STATE CAL ORNIA ELAT
ING TO WORKMEN 5 C SATION INSU ANC
LATH EXT
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RF_CT AND POSTED '
ADDRESS I
FINAL
CLYDE N DIRLAM PRINCIPAL STR RAL ENGINEER
PLAN CHECK VALIDATION CK. M O -CASH PERMIT-VALIDATION CK MO CASH
78A638A DBS 9 9 BS
APPLICATION FOR BUI'L®IIVC PERMIT �.
IVI$IOFi OF BUILDING AND SAFETY BUILDING
Department of County Engmeer ADDRESS
County of LOB Angeles LOCALITY
WM J FOX,COUNTY ENGINEER NEAREST
F
T �,}�`T
CASSATT D GRIFFIN BUP T,OF BUILDING CROSS ST f'V 1'
DISTRICT NO GROUP TYPE I SEWER MAP
-FOR APPLICANT TO FILL IN I CONST
BUILDING MAP . STATE NO
ADDRESS / f D NUMBER HWY
LOT NO Q BLOCK USE ZONE SPECIAL `
CONDITIONS
TRACTNO OF/y`
SIZE OF LOT (fV o4 / NOW ON LOTS B61LDING YARD HWY STREET NAME `EXIST
WIDTH
USE ^ FPL T y ` O ,
EXISTING
FRONT
NG BLDG �-� i1 L
�5 e _ �
OWNER (/ SIDE t'
�j r�
ADDRMAILESS � ! P L
'�/9K !1 _ d.t ✓'lo+ •' Y
r r O TRACT DWELL 1 UNIT
,ry � 5 INDUSTRIAL _
CITY Y, TEL ,DWELL I UNIT
.� NO "" 6 PUBLIC BLDG
2 DUPLEX 1 UNIT
ARCHITECT ORr � � TEL 7 ADDN ALT _ETC
ENGINEER NO 3 APT UNITS
8 MISCEL
ADDRESS 4 COMMERCIAL
TEL
CONTRACTOR NO INSPECTION RECORD
ADDRESS -lib.}Y �,
DESCRIPTION OF WORK
NEW ADD ---ALTER REPAIR DEMOLISH
SO FT / ('��j NO OF J NO OF
SIZE �/ R Lf STORIES / FAM IL.
E3
USE OF STRUCTURE
SIGNATURE OF �. , .,, ° `„spy�fr °
APPLICANT APPROVALS
ADDRESS DATE INSP SIGNATURE
FOUNDATION LOCATION
$ P C $ FORMS MATERIALS r r
3 1/00,
I FEE FRAME FIRE STOPS r
VALUATION BRACING, BOLTS
FEE f • FURNACE LOCATION, _ -
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GAS VENT DUCTS -
APPLICATION AND STATE THAT THE ABOVE IS CORRECT _ 1
AND AGREE TO COMP WITH ALL COUNTY ORDINANCES LATH INT
AND STATE, LAWS ULATING BUILDING ,CONSTRU - s
TION ��/
LATH. EXT
SIGNATURE OF ROUSE NUMBER COR-
PERMIT TE RECT AND POSTED
ADDRESS FINAL
WM J FOX.COUNTY ENGINEER VALIDATION C. N DIRLAM, CHIEF BLDG INSPECTOR
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