HomeMy Public PortalAbout10525 1/2 DAINES DR_Building__ 7eeeeeec¢#eo3960 APPLICATION FOR BUILDING PERMJT
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COUNTY OF LOS ANGELESaBUILDI ADDRESS/0,5 �
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST
DISTRI T NO GROUP YPE OCES, BY
FOR APPLICANT TO FILL IN ' ,� CONST
BUILDIN
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�OS� / STATISTICAL CLASSIFICATION SEWER MAP
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ADDRESS CLASS NO,�DWELL UNITS-��''F,J1�
LOT NO MAP ODHWYE ' YES' b
-�� NUMBER
TRACT - Q USE ZONE SPECIAL
J / NO OF BLDGS CONDITION /� 9
SIZE OF LOTS, ;C100_ I NOW ON LOT ,f/.��i
USE OF Ai 'I
EXISTING BLDG BUILDING - EXIST
SETBACK YARD STREET NAME WIDTH
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ARCHITECT OR ^� TEL P L
ENGINEER 7. .t'I.(J!(i NO INSPECTION RECORD
ADDRESS /�,� � /PQ �oex'�
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NEW ADD ALTER REPAIR DEMOLISH N
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SIIZET STORIES / FAMIO IES
USE OF
STRUCTURE
SIGNATURE OF
-APPLICANT
VALUATION$ e
APPROVALS QATEINSFECTOR S SIGNATURE
J PMT FO FLS UNDATMATERIAS LOCATION Q (d/ / ,'iFEE
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I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS �OA-� 7If.�•V 1
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION,
,'.WITIH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
'BUILDING CONSTRUCTION I CERTIFY THAT IN THE PERFORMANCE
OF THE WORK FOR WHICH THIS PERMIT IS ISSUED I SHALL NOT LATH, INT '� • i
EMPLOY ANY PERSON IN ANY ML4NN ER SO AS TO COM EjSU BU ECT
TO THE WORKMEN 5 COMP TION LAWS O IFOR IA LATH, EXT ", ''� ►` � �
SIGNATURE'OF HOUSE NUMBER COR-
PERMITTE /� -t ,.. RECT AND POSTED
ADDRESS r� o. `f A le,'-FINAL
PLAN CHECK VALIDATION cK M O. CASH CLYDE PERMIT VALIDATIONTR CK RAALL ENrGINH ER
41 6,6 4 :a <<An 3 0 2 3 D
�y �4665 .o i,' R30 1 D 39 ,0 M