HomeMy Public PortalAbout5212 ENCINITA AVE_Building__ 76AGSSA CE#803 10.56 APPLICATION OR ,BVIL®1 NSA 9 ERMI ! 1'
BUILDING AND SAFETY DIVISION AD'LD'NG
ADDRESS ' '
Departmeni of County Engineer
County of Los Angeles _ LOCAL.I'rY• ' i "
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST _
_ CASSATT D.GRIFFIN, SUP'T OF BUILDING CROSS ST..
DISTRICT NO., GROUP F `SEWER MAP -
FOR APPLICANT TO FILL IN TYPE BK' G
CONST.
BUILDING
ADDRESS sj ,F/✓C�/V�>A V STATISTICAL CLASSIFICATION ,
LOCK CLASS:NO�DWELL. UNITS I y'
LOT NO. .Z i4J>'/y B MAP _ _ STATE
NUMBER - HWY , ' YES O
TRACT �.��J� USEZONE SPECIAL -
NO. OF•BLDGS. q`�IJ CONDITIONS _
SIZE OF LOT xGl X �.�.3 „ I NOW ON LOT
-USE OF
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SETBACK S
YARD HWY TREET NAME WIDTH,
OWNER L O/11/�u/��7% L��.S OD,f'/4L G FRONT 1 "�
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ADDRESS ' O "/�Fadl idr >J / .- SIDE
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CITY .�/�Lr L-��T•� - NO./`�76"�ff�.2
ARCHITECT OR' TEL. INSPECTION.RECORD
ENGINEER - - - - -
ADDRESS - - -
,
CONTRACTOR ' TEL.NO. - -
ADDRESS -
DESCRIPTION OF WORg
NEW , ADD ALTER REPAIR -DEMO - - •• c
SQ. FT. NO.OF ` NO OF
ORIES /
SIZE ST / FAMILIES
USE OF,STRUCTURE
APPROVALS '
SIGNATURE OF
APPLICANT - DATE INSPECTOR'S SIGNATURE
ADDRESS -FOUNDATION: LOCATION -
FORMS, MATERIALS
$^ '� P.C. S FRAME: FIRE STOPS.
FEE BRACING. BOLTS
VALUATION FURNACE: LOCATION.
GAS VENT. DUCTS
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH. INT: -
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND I
AGREE TO COMPLY WIT ALL COU TY O INANCES AND
STATE LAWS REGU NGf BUI N RUCTION. LATH. EXT. -
SIGNATURE OF (T,L( HOUSE NUMBER COR-
PERMITTEE _[ERECT AND POSTED
ADDRESS_- • _*
' FfIVAL 1
JOHN A. LAMBIE. COUNTY E GINEER. CLYDE N. DIRLAM. P INc AL STRUCTURA�'L GI
• PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.o. CABH
JUL
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