HomeMy Public PortalAbout5823 CLOVERLY AVE_Building__ 7,7Mp/-,r-- Clio-/
76AG38A CE#803 8 63APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING ���� (�/ uR�L
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST )D� /y
WILLIAM A JENSEN SUP T OF BUILDING CROSS ST (/
DISTRICT OGROUP TYPE P OC SED BY
FOR APPLICANT TO FILL IN S7 o8I _1T^ coNsr
BUILD' / ' p /STATISTICAL CLASSIFICATION EWER MAP/
�y li'[,tiL L CLASS NO O DWELL UNITS LBK PG j
LOT NO •/ / BLOCK WATER
CERTIFICATE NOT REQUIRED l./I RECEIVED ❑
TRACT �p MAPHIGHWAY STATE MAJOR SECON LOC
NO OF BLDGS NO da '7 (CIRCLE)
SIZE OF LOT 4J7-
V1 NOW ON LOT USE ZONE SPECIAL
USE OF
EXISTING BLDG VAI��,vT p[(� CONDITIONS
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OWNER s� r �YJO BUILDING YARD HWY STREET NAME EXIST
�4JO WJ st, L -j^ FRONT
, SETBACK WIDTH
ARCHITECT OR V TEL � PL CA-,) v��L/ O
ENGINEER NO SIDE
P L
ADDRESS
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CONTRACTOR /T /NO -k�/ V
ADDRESS / Im
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DESCRIPTION OF WORK ri
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NEW ADD �` ALTER REPAIR MOLISH Z
SIZE SQ T 3C� �C.. '7't..J STORIENO S NO 07
FAMILIES
USEjet:-M /sH
STRUCTURE i-�
SIGNATURE OF
APPLICANT
VALUATION
APPROVALS DATE INSPECTOR SSIGNATURE
PC PMT A 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
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 C MPENS N INSURANCE LATH EXT
SIGNATURE HOUSE NUMBER COR
PERMITTE - / ECT AND POSTED
ADDRESS '�-� _ f , AL `
JOHN F LEWIS PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION CK M D CASH PERMIT VALIDATION CK M D CASH
LALO 0 2 2 1-0 AU022 1 D 6.00-