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DEPARTM W OF COUNTY ENGINEER
DIVISION OF BUILDING AND SAFETY
COUNTY
�-
COUNTY OF LOS ANGELES t
WILLIAM J. FOX, COUNTY ENGINEER APPLICATION
CASSATT D. GRIFFIN, SUPT OR BUILDING
OR APPLICANT TO FILL IN FOR OFFICE,_.USE ONLY
BUILDING' n '^r/ y DISTRICT NO. PUN CK.OR REc.No. PERMIT NO..
ADDRESS al�V QM�q r I1I�fd t
° LOCALITY ` e .f 1- 4 C ;*T\/ RECEIVE D Y DATE OF APPL. pADATE IS3 ED
NEAREST
CROSS ST• C UV L 0.
- BUILDING
OWNERGEoli6 �d
ADDRESS
MAIL LOCALITY
ADDRESS S�MG' 0wO 4 -
TE . NEAREST' e�
CITY NOL. /�,1�1 7 1 �$g6 CROSS ST.00� /e_2 ,
FIRE NO. OF TY.PE.. v GROUP
ARCHITECT OR TEL. t
ENGINEER NO. ZONES PLANS. —
c ADDRESS BLDG- �pRD,[�N'
SETBACK LINE
_ TEL. - USE �J APPROVED f
CONTRA OR N ZON �P H BY t DATE
HOUSE NUMBERS NG o
ADDRESS
LEGAL' , MAP NUMBER_ NO. ASSIGNED BY
DESCRIPTION L T NO.IP—l/(I BLOCK
-a CORRECTIONS
TRACT
♦ ♦ / '
NO. OF BLDGS.
SIZE OF LOT I NOW ON LOT �N40 d pry �-V--:
USE OF /I NO. OF
EXISTING BLDG. �! c��riI FAMILIES 9 �_�t✓j f/i/67�. /l/C�T// / -•/�
DESCRIPTION OF WORK
4...__ ...�
REPAIREI,.V I. DEMOLITION I—I ALTERATION ADDITION D
r
3Q, FT. NO. OF
SIZE `TDO 5F+ ROOMS STORIF,8 ®9
EXT. WALL ROOF
COVERING r(Ay'1e_ I COVERING
' USE O STRUC URE'
- V
APPROVALS
INSPECTOR'S SIGNATURE DATE
FOUNDATION: LOCATION
a FORMS, MATERIALS _
1-HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- ° FRAME: FIRE STOPS,
PLICATION AND STATE.THAT THE INFORMATION GIVEN IS ` BRACING, BOLTS
CORRECT. FURNACE: LOCATION,
1AGREE TO COMPLY WITH ALL COUNTY, ORDINANCES GAS VENT, DUCTS.
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
SIGNATURE OF ,¢�J/�1 LATH, INT.
PERMITTEES / t M` /�c-fl-om
LATH. EXT.
ADDRESS '?, 14fyl DAtiNI S 10P IU' crp,'
PLASTER, INT, '
AUTHORIZED AGT.
b ,,//�� PLASTER, EXT.
13
V0" FEE S HOUSE NUMBER COR-
RECT AND POSTED
VALUATION FEE >$ FINAL
76A698A 08S3 8-82 -
DEPARTMENT OF BUILDING AND SAFET'a .�-a1 A1,PL'ICATT011T'r'OR PERMIT
COUNTY OF LOS ANGELES
�. WM. J. FOX, CHIEF ENGINEER
a g � N Rq
a
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
DISTRICT NO. PLAN CK.NO. PERMIT NO.
BUILDING _ • /'; t..�
ADDRESS �Q�� '�/Q.//%Lb�� ��///� ""�..e.. t✓/{ (/
LOCALITY T.A-3'9RECEJVED By DATE OFAPPL. DATE ISSUED
NEAREST
CROSS 3T. /3/J!Q 2• u - ..
BUILDING
. OWNER At&� r'y B —ADDRESS
MAIL s. LOCALITY �e.,M,t....1 .= _._.. `...J•�"i,.S,.y -
ADDRESS 26/JQ - L/QJNJP ,9Y.*tee '
�,• `NEAREST
� /e. LN O . CROSS REST.
FIRE NO.OF TYPE +GROUP
ARCHITECTORTEL. ZONE -PLANS
ENGINEER ,� �NO. -
-- BLDG. f• ORD. O.
ADDRESS SETBACK LINE / ` J •�/
APPROVED
TEL. BY -DATE
CONTRACTOR NO.- i
/ I - USE /� APPROVED
_ ADDRESS ►\./J ZONE /-Y BY DATE
LEGAL CORRECTIONS
DESCRIPTION LOT- �D. BLOCK
/TACT� Y . : .
T/ J�
J9 V NO.OF BLDG..
SIZE F LOT Old �sCd if I NOW ON LOUSE OF
T .. .- -
EXISTING BLDOl_Q4 �' i` Cd' I F� Es DF I NO.OF -
ROOM9
DESCRIPTION OF WORK
NEW ALTERATION ADDITIONQyve
� Fe � tO
REPAIR MOVING DEMOLISH
G7
SD.FT. / / ND.DFQ v D
SIZE /' {� ROOMS STORIES / _ �,,,..
WALL C✓✓ - ROOF
COVERING rC O io COVERING a 0*1.
USE OF NEW `y�y-�-
BUILDING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS '
APPLI CATION:AND STATE ?HAT THE ABOVE IS CORRECT FOUNDATION: LOCATION INSPECTOR _ DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCESFORMS,MATERIALS '
_. AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
FRAME: FIRE STOPS, C/
SIGNATURE OF • 4. BRACING,BOLTS
PERMITTEE LATH,INT.:
AUTHORIZED AOT .LATH,EXT.:
OBS-3 5OM SETS 7-47 $ P C. PLASTER,INT.
FEE PLASTER,EXT.
VALUATION �� Q FEE 1 J FINAL -1-" 'a'