HomeMy Public PortalAbout4902 ENCINITA AVE_Building__ 76A638A CE#803 9-68
APPLICATION FOR BUILDING PERM
COUNTY OF LOS ANGELES BUILDING yj
DEPARTMENT OF COUNTY ENGINEER ADDRESS [/
BUILDING AND SAFETY DIVISION LOCALITY L I'
JOHN A LAMBIE, COUNTY ENGINEER NEAREST '
COLEMAN W. JENKINS, SUP T OF BUILDING CROSS ST
FOR APPLICANT TO FILL IN DISTRICT NO G P TYPE PR CESs v
`�' /91 CONST
(Print or type only)
BUILDING STATISTICAL CLAS IFICATION SEWER MAP
ADDRESSn1tas. CLASS NO DWELL UNITS PG
LOT NO BLOCK USE ZONEMAP
NO
SPE
TRACT SPEC/ CONDIT ONS
NO OF BLDGS
SIZE OF LOT NOW ON LOT
USE OF
EXISTING BLDG - BLDG SETBACK FROM
TEL FRONT PROP LINE OF _(STREET)
OWNER NO 284-6501
TYPE OF EXISTING SETBACK HIGHWAY + YARD - TOTAL
ADDRESS HIGHWAY WIDTH FROM C L
CITY A113.amhra,, Calif-
BLDG KFROM
ARCHITECT OR TEL SIDE PROP LI (STREET)
ENGINEER NO TYPE OF EXISTING SETBACK H + YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C L
y
CONTRACTOR Co TOL 288-40 - + - a
C
C:
Ic
ADDRESS 529 E. Valley Bly4o 186086 CORNER CUTOFF YES ❑ NO ❑
CITY CLASS _ SEE REVERSE SIDE FOR SPECIAL APPROVALS u.
CONSTRUCTION LENDER a
u.
NAME AND BRANCH Z
ADDRESS
SQ FT NO OF NO OF NEW ❑
SIZE STORIES FAMILIES
USE OF ADD ❑
STRUCTURE
ALTER ❑
SIGNATURE OF REPAIR
APPLICA DEMOL ❑
VALUATION $ 353 -
.ate APPROVALS DATE INSPECTOR'S SIGNATURE
P C PMT L�r,� FOUNDATION LOCATION
FEE $ FEE S - 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 ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS
STRUCTIONI CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT
LABOR CODE OF T E STAT OF IFORNIA IN RELATING TO
WORKMEN'S COMP S ION UR CE
LATH, EXT
SIGNATU HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS 51229 F- Valley Blvd- S-G- FINAL
JOHN F LEWIS P I CIPAL STR RAL ENGINEER
PLAN CHECK VALIDATION CK M O CASH _ PERMIT VALIDATION CK MO CASH
1 4�5 aC", AW 15 1 D 9.0 0
o /
BUILDING BUILDING , " �0� „/✓� �.;� y
ADDRESS
APPLICATION LOCALITY &tziz
NEAREST
DIVISION OF BUILDING AND SAFETY CROBB 9T.
Department of County Engineer DISTRICT NO. RECEIPT PERMIT NO.
County of Los Angeles � f7A/34 lel 39 -5
WM. J. FOX, COUNTY ENGINEER GROUP DA E RECEIVED DATE ISSUED
CAHSATT D. GRIFFIN, BuP'T or BUILDING
FOR APPLICANT TO FILL IN TYPE CONST. RECE VED BY IH u BJY 7
atz� MAIM
MAILOWNER V NUMBER SHOE YES' NO
ADDRESS
USE ZONE SPECIAL
TELN� CONDITIONS
CITY NO y��
ARCHITECT O TEL
ENGINEER NO.
BUILDING YARD HWY STREET NAME EXIST.
SETBACK WIDTH
ADDRESS _ FRONT
CONTRACTOR,',?,,&,..,/ / NO
oz (J}��fD� 9 E —�n—
«?,�
ADDRESS Id -J P L
ATE CORRECTIONS INSPECTOR
ADDRESS 0
6
LOT NO. //
TRACT
Z,3 QG
91ZE OF LOT ,-'�L� x ,?/ 10 I NOW ON LOT �L2 e,
Q
USE OF
FXIRTING BLDG
DESCRIPTION OF WORK A
`/ o
NEW v ADD ALTER REPAIR DEMOLISH Z
SO FT. 'q�/-j NO. OF / NO.OF >
SIZE d 'y i STORIES ,/ FAM ILIEB r
USE OF ST, UCTLJRE
t
NO OF
EMPLOYEE'
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP-
PLICATION AND STATE THAT THE INFORMATION GIVEN IS APPROVALS IN9PECTORIS SIGNATURE DATE
CORRECT.
I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION. LOCATION A fl ,. ,q
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FORMS,MATERIALS �E
' FRAME FIRESTOPS,_
SIGNATURE OF G BRACING,BOLT' f'
PERMITTEE FURNACE• LOCATION,
2 I7 OAS VENT,DUCTS
ADDREB
LATH, INT.
AUTHORIZED AST k
LATH, EXT.
$ P C $ 00 HOUSE NUMBER COR-
FEE /� — RECT AND POSTED
VALUATION O (JV -/ SS FINAL 4� S
FEE
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