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7EAE9
59A CE 80910 e8 APPLICATION FOR BUILDING PERMIT 1
COUNTY OF LOS ANGELES 4- -BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST
CASSATT D GRIFFIN SUP T OF BUILDING CROSS ST
DISTRICT NO GROUP TYPE P ESSED BY
FOR APPLICANT TO FILL IN h' lj CONST
BUILDING STATISTICAL CLASSIFICATION SEWER MAP
4�5s BK
ADDRESS CLASS NO WELL UNITS
tY S f � t
MAP 4 TATE I a
LOT NO riPr BLOCK NUMBER HWY r YES
TRACT i2Qg8 USE ZONE N SPECIAL 17 t
NO OF BLDGS ` CONDITIONS
SIZE OF LOT NOW ON LOT 11 w
USE OF
EXISTING BLDG BUILDING YARD HWY STREET NAME EXIST
SETBACK WIDTH
OWNER R. Burge FRONT
A� 5 MAIL _ P L `
ADDRESS 119'2(�7 Roo HonC)O Pkky SIDE
CITY El INI T tie TY 3 5
16 P L
INSPECTION RECORD e
ARCHITECT OR TEL
ENGINEER NO �.
ADDRESS
CONTRACTOR Capri Homes In`cNQI 16�
ADDRESS 2 , Hondo Pk
e
DESCRIPTION OF WORK
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_ ✓G �'f' f '�"`� '�"
NEW X ADD ALTER REPAIR DEMOLISH
SQ FT NO OF NO OF
SIZE STORIES - — FAMILIESUSE
STR CFURE Single Fam3.ly Residence
d id' �o/"cry ��a%,�w�r'C "•�•1 �
SIGNATURE OF
APPLICANT APPROVALS DATE INSPECTOR S SIGNATURE
ADDRESS `� FOUNDATION LOCATION
' �� FORMS MATERIALS—
VALUATION$ D G FRAME FIRE STOPS D
BRACING BOLTSPC (�
FURNACEPMT LOCATION r
FEE $ �dI FEE $
_3 GAS VENT DUCTS
I H REBY ACKNOWLEDGE HAT'f HAVE READ THIS AP JLA7H INT
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
I,�.
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND r C SIJ'^' T
STATE LAWS REGU TING BU ING CONSTRUCTION LATH EXT �.
HOUSE NUMBER COR /
SIGNATURE OF uC Sf� RECT AND POSTED ) / )i�
PERMITTEE
,� L/ U
ADDRESS ��G Y't p�/� FINAL / ���
cK m o CLYDE N DIRLAM PRINCIPALS c CTU NAL ENGINEER
PLAN CHECK VALIDATION CASH O PERMIT VALIDATION O
0 0 8 2.6 2 3 D 1951
sE 8 1 n 3 9 Uo
2382