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78A898A CE#809 I1137 APPLICATION FOR BUILDING PERMIT 1
COUNTY OF LOS ANGELES BUILDING C�
DEPARTMENT OF COUNTY ENGINEER ADDRESS LJ
BUILDING AND SAFETY DIVISION LOCALITY G
JOHN A LAMBIE COUNTY ENGINEER NEAREST
CASSATT D GRIFFIN SUP T OF BUILDING CROSS ST
DISTRICT O G UP SEWER MAP
FOR APPLICANT TO FILL IN E BK PG
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ADDRESS JJ �!I STATISTICA SSIFI TION
CLASS NO DWELL UNITS---]
LOT NO BLOCK MAP STATE YES O
?S7 NUMBER HWY
TRACT USE ZONE SPECIAL
NO OF BLDGS CONDITIONS
SIZE OF LOT .J x l D NOW ON LOT Ar
USE OF
EXISTING BLDG BUILDING YARD HWY STREET NAME EXIST
SETBACK WIDTH
OWNER C r FRONT
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ADDRESS L -,/ 1 SQ 4 `f SIDE
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CITY S A f/ No 7Q53
ARCHITECT OR TEL INSPECTION RECORD
ENGINEER NO
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DESC TION OF WORK
NEW ADD ALTER REPAIR DEMOLISH
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7 C� DATE INSPECTORSSIGNATURE
ADDRESS � G. Z^'J r r FOUNDATION LOCATION
FORMS MATERIALS
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VALUATION S FURNACE LOCATION
FEE J GAS VENT DUCTS
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP LATH INT
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COVNTY,40RDINANCES AND
STATE LAWS REGU U DI CONSTRUCTION LATH EXT
SIGNATURE OF HOUSE NUMBER COR
PERMITTE RECT AND POSTED / Q
ADDRESS Z '"�' QH //e �` FINAL
CLYDE N DIRLAM PRINCIPAL STR URAL ENGINEER
PLAN CHECK VALIDATION CK mo CASH PERMIT VALIDATION cK M o CASH
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76A8 #609 I1 s7 APPLICATION FOR BUILDING PERMIT" 1
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER `/ADDRESS vJT
BUILDING AND SAFETY DMSION I LOCALITY / ,
JOHN A LAMBIE COUNTY ENGINEER NEAREST
CASSATT D GRIFFIN SUP T OF BUILDING CROSS ST
DISTRICT NO GROUP TYPE SEWER MAP
FOR APPLICANT TO FILL IN ]CONST_T T
BUILDING STATISTICAL CLASSIFICATION
ADDRESS
CLASS NO / DWELL UNITS
LOT NO BLOCK MAP STATE
NUMBER HWY YES NO
TRACT USE ZONE SPECIAL
Q NO
N07OF CONDITIONS
SIZE OF LOT /� NOW ON LOT (�
USE OF s-19900
EXISTING BLDG BUILDING YARD HWY STREET NAME EXIST
SETBACK WIDTH
OWNER FRONT
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ADDRES p99l. 7,2 �/ - SIDE
TEL 7 9� P L
CITY No J INSPECTION RECORD
A RCA ITECT OR TEL
ENGINEER NO
ADDRESS
TEL
CONTRACTOR NO a
ADDRESS ✓
DESCRIPTION OF WORK
NEW V ADD ALTER REPAIR DEMOLISH
SCI FT NO OF NO OF
SIZE Q STORIES FAMILIES
USE OF STRUCTURE
SIGNATUREOF APPROVALS
APPLICANT111I//lVV/
G7 z DATE INSPECTOR S SIGNATURE
ADDRESS
FOUNDATION LOCATION ���/ /►C /
FORMS MATERIALS
PFEEFEE
FRAME FIRE STOPS
�. BRACING BOLTSVALUATION O $ «� FURNACE LOCATION
_ � GAS VENT DUCTS yp
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP LATH INT
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PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND J
STATE LAWS RGULAT BU LD G CONSTRUCTION LATH EXT + �Q
SIGNATURE OF HOUSE NUMBER COR
PERMITTE RECT AND POSTED
ADDRESS A-4 ✓ FINAL V�
CLYDE N DIRLAM PRINCIPAL STRUCTU GINEER
PIAN CHECK VALIDATION cK M o CASH { PERMIT VALIDATION cK M o casts
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