HomeMy Public PortalAbout5803 CLOVERLY AVE_Building__ I ATION ;OeR BUILDING PERMIT
78A838A CEJ1803 8-83 APPL C
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY'ENGINEER ADDRESS V (may-C i 1
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST /
WILLIAM A JENSEN SUP T of BUILDING CROSS ST
DISTRICT NO GROUP- TYPE PR CE/S D BY
FOR APPLICANT TO FILL IN i _� coNsr G
BUILDINGSTATISTICAL CLASSIFICATION SEWER MAP/
ADDRESS S O R O �,,, r B
+/ CLASS NO DWELL UNIT.-/ J"
LOT NO ,!' J QT BLOCK WATER NOT REQUIRED RECEIVED
CERTIFICATE
TRACT MAP NO _Q O ({C HWA
IGRC E) STATE MAJOR SECOND LOCAL
NO O
SIZE OF LOT lO 0 /X- 9 0� NOW ON L TS � USE ZONE SPECIAL
USE OFEXISTING BLDG VAWA'J CONDITIONS
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OWNERR
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BUILDING EXIST
///���� SETBACK YARD HWY STREET NAME WIDTH
ADDRESS 3kkI o W. 'icd5t". JI/ � . FRONT
ARCHITECT OR TEL P L Al
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ENGINEER NO SIDE
P L /
ADDRESS d
TEL p O
CONTRACTOR NO 4- V
ADDRESS �L.LX�QU
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DESCRIPTION OF WORK G
Lua
NEW ADD ALTER REPAIR OLIS N
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NO OFN
SIIZET .3U X 4./c) STORIES FAMILIES
USE OF c i
STRUCTURE DgaM O�J4
SIGNATURE OF
APPLICANT
VALUATION $ / o f {/-= APPROVALS DATE INSPECTOR S SIGNATURE
6111111111
PC PMT FOUNDATION LOCATION
FEE $ FEE $ FORMS MATERIALS
FRAMEFIRE 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
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT
TION OF THE LABOR CODC OF THE STATE OF CALIFORNIA RELAT
ING TO WORKMEN S COMPENSATION INSURANCE
LATH EXT
SIGNATURE HOUSE NUMBER COR ,-
PERMITTEE Gf,/ RECT AND POSTED
ADDRESS �%'- 44-1-FINAL
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PLAN CHECK VALIDATION CK M O CASH JOHN F LEWIS I,NCI AL TRUCT RAL ENGINEER
PERMIT V IDATION <0 M a CASH
Ao 0 �- 1 7 Z03 hUU 2 2 _ 1 D 6,00-