HomeMy Public PortalAbout10628 DAINES DR_Building__ ,OJ,.L CE1.C.P/.,o APPLICATION FOR BUILDING PERMIT .
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUHDING AND SAFETY DIVISION LOCALITY
JOHN LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST. _
DISTRICT NO. GROU TYPE ESSED,8Y
FOR APPLICANT TO FlLL`.'IN g!C/ coNsr.
ImA
BUILDING / STATISTICAL CLASSIFICATION S ER MAPK
SPG'
ADDRESS CLASS.NO-L DWELL.UNITS
LOT NO. BLOCK I,
MAP STATE
NUMBER HWY. YES NO
TRACT (J - LIE ZONE' SPECIAL /{�i
�• NO.OF SLID CONDITIONS }/ / Z
SIZE OF LOT (/ I NOW ON LOT j
USE OF
EXISTING BLDG. BUILDING YARD HWY STREET NAME _ EXIST. -
SETBACK WIDTH
' OWNERAge FRONT
,ry P. L.
ADDRESSJW& CG — SIDE
ARCHITECT OR TEL: P-
ENGINEER NO.
`~) INSPECTION RECORD-
ADDRESS _
CONTRACT O Ndw* odO
Q IG _ ti0e�'.
ADDRESS - � V
DESCRIPTION OF WORK F'
NEW •ADD ALTER REPAIR DEMOLISH
SO.FT. ONO.OF O
SIZE FAMILIES
USE OF
STRUCTUR , FI
SIGNATUREOF
y( � '
APPLICANT 1 4 l
VALUATIONS
APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. r. Je - PMT. 0-w FOUNDATION: LOCATION /�
FEE $ ze
FEE $ FORMS,MATERIALS 1aCJI
FRAME: FIRE STOPS, �f
I HEREBY ACKNOWLEDGE THAT I HAVE READ HIS AP- BRACING, BOLTS '•S/ •Y"i--�
PLICATION AND STATE THAT THE ABOVE ISICORRECT AND FURNACE: LOCATION,
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND GAS VENT,DUCTS
STATE LAWS REGULATING BUILDING CONSTRUCTION.
1 CERTIFY THAT IN DOING THE WORK AUTHORIZED 1 LATH. INT.
WILL NOT EMPLOY ANY PERSON IN,VIOLATION OF THE j
y
WORKMEN'S COMP ATION LA ^OF CALI ORNIA. LATH,EXT. '_. .L1' 1��11 •�`/� �//
SIGNATVREIF 't HOUSE NUMBER RECT AND POSTEDR'
PERM ITTE
ADDRESS FINAL
CLYDE N. DIRLAM• PRINCIPAL STR TUBAL ENGINEER
PLAN CHECK VALIDATION K M.o. cAs PERMIT VALIDATION (cK.j M.O. CABR,
' 5 1i3 6 ,{ ,
L GA. APD 1 0 2 3 19.5 0 5 M, ®.