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74AGSOA CE 4022/90 APPLICATION FOR BUILDING PERMIT � 1
COUNTY OF LOS ANGELES ABU ILD
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DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST
WILLIAM A JENSEN SUP T OF BUILDING I CROSS ST
DISTRICT NO ROUP I TYPE P S Y
FOR APPLICANT TO FILL IN CONST
BUILDING STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS �' 3 z- H G
CLASS NO DWELL UNITS
LOT N BLOCK MAP STATEP
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NUMBER HWY YES O
TRACT ` ? y USE ZONE SPECIAL /` �J
NO OF BLDGS CONDITIONS C �L1y-
SIZE OF LOT I NOW ON LOT
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EXISTING BLDG BUILDING EXIST
TEL SETBACK YARD HWY STREET NAME WIDTH
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ARCHITECT OR T L P L
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DESCRIPTION OF WORK f� ""� �� O
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APPROVALS DATE, INSPECTOR S SIGNATURE
P C r QO PMT ev FOUNDATION LOCATION
FEE $ FEE $ FORMS MATERIALS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP FRAME FIRE STOPS % r
BRACING BOLTS � .>;,.��
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND FURNACE LOCATION �'c
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND GAS VENT DUCTS
STATE LAWS REGULATING BUILDING CONSTRUCTION
I CERTIFY THAT IN DOING THE WORK AUTHORIZED I LATH INT
WILL NOT EMPLOY AN-w PERSON IN VIOLATION OF THE
WORKMEN S CO N ION LAWS OF CALIFORNIA LATH EXT !L'
SIGNATURE OF HOUSE NUMBER COR
PERMITTE RECT AND POSTED
ADDREss FINAL
CLYDE N DIRLAM PRINCIPAL ST R RAL ENGINEER
PLAN CHECK VALIDATION CK M O CASH PERNIIT VALIDATION cK M O CASH
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78A838A CE#803 B 83 APPLICATION F R BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST
WILLIAM A JENSEN SUP T OF BUILDING CROSS ST
DISTRICT NO GR UP TYPE P SSED BY
FOR APPLICANT TO FILL IN I CONST 2
BUILDINGjj
STATISTICAL CLASSIFICATION SE ERM P
ADDRESS - Pi + `� BK PG
CLASS NO DWELL UNITS
LOT NO Y BLOCK WATER NOT REQUIREDRECEIVED ❑
CERTIFICATE
TRACT MAP HIGHWAY
NO OF BLDGS NO (CIRCLE) STATE MAJOR SECOND L CAL
SIZE OF LOT NOW ON LOT USE ZONE SPECIAL
USE OF CONDITIONS
EXISTING BLDG
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OWNER N p!� BUILDING EXIST
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10 APPROVALS DATE INSPECTOR S SIGNATURE
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FEE $ 1 FEE $C/fi/f f FORMS MATERIALS
FRAME FIRE STOPS
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION I BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING I GAS VENT DUCTS
BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT
TION OF THE LABOR CODC OF THE STATE OF CA IFORNIA RELAT
ING TO WORKMEN S COMPENSATION INSURANCE LATH EXT
1
SIGNATURE OF HOUSE NUMBER COR
PERMITTEE I RECT AND POSTED
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ADDRESS FINAL 7 AA
JOHN F LEWIS PR NC PAL STRU=IARAL ENGINEER
PLAN CHECK VALIDATION CK M o CASH I PERMIT VALIDATIO cK M o CASH
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76A638A CE#803 5 65 APPLICATION FOR BUILDIN PERMIT 7
COUNTY OF LOS'ANGELES BUILDING�� F
DEPAIP.AAEr4T OF COUNTY ENGINEER A D DRESS
BUILDING AND SAFETY DMSION LOCALITY w R `
JOHN A LAMBIE COUNTY ENGINEER NEAREST C
COLEMAN W JENKINS SUP T OF BUILDING CROSS ST
DISTRICT NO G TYPE ES
FOR APPLICANT TO FILL IN 0 CONST
BUILDING STto — ATISTICAL
AL C� DW EILL UI OITS SEWER MAP
ADDRESS � CY BK ( }
LOT NO AoRe BLOCK/ USE ZONE MAPNo
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NO OF BLDGS p �r CONDITIONS
SIZE OF LOT NOW ON LOT
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OWNER e / / D TYPE OF EXISTING SETBACK HIGHWAY + YARD - TOTAL
ADDRESS /V /�L� HIGHWAY WIDTH FROM C L - d
CITY BLDG SETBACK FROM
ARCHITECT OR TEL SIDE PROP LINE OF �— (STREET)
ENGINEER NO _ ~
TYPE OF EXISTING SETBACK HIGHWAY + YARD = ,. TOTAL
ADDRESS HIGHWAY WIDTH FROM C L
CONTRACTOR /
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ADDRESS %V LIC / CORNER CUTOFF YES NO V
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CITY G� cls SEE REVERSE SIDE FOR SPECIAL APPROVALS O
DESCRIPTION OF WORK r v
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SIGNATURE OF
APPLICANT
VALUATION$ lo-rf APPROVALS DATE INSPECTOR S SIGNATURE
FEE$ FEE$ 5 FOUNDATION LOCATION
FORMS MATERIALS
FRAME FIRE STOPS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS —2 �l� f
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS A
9UILD NG CONSTRUCTION CERTIFY THAT IN DOING THE WORK
AUTHO
ARIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT
TION OF THE LABOR CO OF THE STATE OF CALI ORNIA RELAT
ING TO WORKMEN SCO PE SATION INSU ANC
LATH EXT /
SIGNATURE OF HOUSE NUMBER COR
PERMITTEE RECT AND POSTED .epi'`BTI F'a
r
ADDRESSm- /Q Fl NAL
JOHN F LEWIS PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION CK M O CASH _ PERMIT VALIDATION CK M C CASH
Llit,O 4 1 3 5'�? AUG 12 1 D 1 5.0 0
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