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TEMPLE CI`T'Y
7.......X#11 .", APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS J
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN. SUPT OF BUILDING CROSS ST. -
DISTRICT N GR TypE PRO BY
FOR APPLICANT TO FILL.IN `}; 0 CONST.
BUILDING? T� Q y� STATISTICAL CLAS FICATION / I SEWER MAP
ADDRESS ..JJ (/ CLASS.NO.-O—DWELL.UNITS�J BK PG
LOT NO. BLOCK WATER u
CERTIFICATE: NOT REQUIRED ❑ RECEIVED
TRACT 2� NO.OF BLDGS. /� NO, pL. O HIGHWAY
STATE MAJOR SECOND. LOCAL
S IZE OF LOT SSI XIJ4 NOW ON LOT /�/j{f US2YIFJE SPECIAL
USEOF _ � CONDITIONS
,.I
EXISTING BLDG. l� �J-+
OWNER J C-I NO. O BUILDING YARD HWY STREET NAME EXIST.
ADDRESS�63z_ ,F 4 per, SETBACK WIDTH
FRONT �O
ARCHITECT OR - TEL. P. L. _
ENGINEER NO. SIDE
P.L.
ADDRESS 1 TELINSPECTION RECORD a
CONTRACTOR . rP�GY' - NO. }T TE15 (,,�1 L O
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ADDRESS 32 `.: ZLt INKS Dr. I�J�I�� ""'v �`i :I S.'/•'.n/../1
DESCRIPTION OF WORD /l,l2q�G/ y1� /i . �� 3
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W
NEW ADD ALTER REPAIR DEMOLISH
rn
SO. FT. NO.OF , NO.OF Z
IZE - STORIES FAMILIES
USE OF
STR CTURE P H0. G
r
SIGNATURE OF
APPLICANT
VALUATION S
APPROVALS DATE INSPECTORS SIGNATURE
''}} FOUNDATION: LOCATION /D / //�,/
FEE SCX / U� FEE $ FORMS, MATERIALS 4,r.
FRAME: FIRE STOPS,
1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS 'I/• i/ —LI�/
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE. LOCATION, �lI' �U� ��f /./V"
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CONSTRUCTION.WILL CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA. LATH, INT.
TION OF THE LABOR CODE OF THE STATE OF IFORNIA RELAT� \ c�./�y'�i
ING TO WORKMEN'S COM N TION I uRw LATH, EXT. I // l4 *
SIGNATURE OF HOUSE NUMBER COR- /
PERMITTEE RECT AND POSTED I .)I,) �I�/`��y_45W
ADDRESSjjVaf2- FINAL ;2_111
CLYDE N. DIRLAM. PRINCIPAL ST URAL ENGINEER
PLAN CHECK VALIDATION CK M.G. CASH PERMIT VALIDATION oK" M.o. GSH
U,I:o 3 1 8 0 SEP 2 7 2 3 D 2 J.(i CEll
,a 3733 uC71c.' ' D A5 .00 k ��
Cl
vnou�Y�4....I-el APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING -
DEPARTMENT OF COUNTY ENGINEER nooREss _ -Q _
BUII.UING AND SAFETY DMSION LOCALITY , A9 A 4Q A /
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST. ( i
FOR APPLICANT TO FILL IN DISTNO. GR� TYPE PROC SSED Y
or •� CONST.
BUILDING /-'7 7 /'� STATISTICALC SSIFICATION SEWERMAP
ADDRESS J J �J — De Q � BK PG
CLASS. NO. DWELL.UNITS—1
LOT NO. BLOCK WATER NOT REQUIRED ®' RECEIVED
TRACT lO/`J {�/C7 CJ CERTIFICATE:
SIZE9F LOT�L7 /vt I�J-�/ I NOW ON LOTS Z NO. HIGHWAY
STATE MAJOR SECOND, OCAL
USE ZONE SPECIAL Z
USE OF ..1 CONDITION
EXISTING SLOG. PS Y C✓eL ;7
TEL.
OWNER F NO. U2,30 BUILDING EXIST.
YARD STREET NAME
.t (J SETBACK WIDTH
ADDRESS 2�' ><N9 e L: 1.7 /Y r FRONT / /
ARCHITECTOR TEL. P. ^)
ENGINEER NO. SIDE
ADDRESS TEL
, C)) •- . ICTIOEOR
CONTRACTOR NOZel� s
ADDRESSa
w
CN1 f `l IY�r m
DESCRIPTION OF W RK 0
V
UJ
D
NEW ADO ALTER REPAIR DEMOLISH U)
SQ.FT. ^ G NO-OF NO.OF Z
IZE t'/D STORIES FAMILIES -
OF
ITR TRUCTURE
SIGNATURE OF '
APPLICANT -
VALUATION R �'�
''''// APPROVALS /DATE INSPECTOR'S SIGNATURE
FEE $ FEE S y FOUNDATION: LOCATION �1
FORMS. MATERIALS �l/! 1%-
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 PE ON IN VIOLA- LATH.INT. /]..
TION OF THE LABOR CODE OF THE'STATEQF CAW 'ORNIA RELAT-
ING TO WORKMEN'S COMP ISATION I iSU(ANC
LATH,EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMIT E
OR-PERMITTE / RECT AND POSTED
ADDRESS "— 'P�» V FINAL ���G� /_/l..,iel..✓J/_ Y.r
CLYDE N. DIR LAM. PRINCIPAL STR CTURAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VAIMATION(6 M.o. CASH
5.4. 6 ITEC`?:9 1 D 6_0 0