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76A638A CE#803263 APPLICATION FOR, BUILDINGtPERMIT r I
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COUNTY OF LOS ANGELESf ; ADDRESS
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY-
JOHN
OCALITYJOHN A LAMBIE COUNTY ENGINEERT NEAREST
WILLIAM A JENSEN SUP T OF BUILDING +I CROSS ST
t DISTRI T�O/ GROUP TYP ESSED BY
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OR APPLICANT TO FILL IN�it 01 Y CONST
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1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION[ BRACING BOLTSAND STATE THAT THE IABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION
r WITH ALL COUNTY ORDINANCES AND STATE;LAWS REGULATING ,GA'S'VENT�DUCTS
BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE)WORK T s
~ AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON 10 VIOLA I + LATH INT % t
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.�S / JOHN F LEWIS PRINCIPAL ST URAL ENGINEER
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76A696A 0139325APPLICATI®N FOR BUILDING PERMIT 1
DIVISION OF BUILDING AND SAFETY BUILDING 'yo
ADDRESS
Deportment of County Engineer
County of Los Angeles LOCALITY 7 y
WM J FOX COUNTY ENGINEER NEAREST /
CASSATT D GRIFFIN SUP T OF BUILDING CROSS ST h 10 W'6. f A
DISTRICT NO I GROUP TYPE SEWER MAP G
FOR APPLICANT TO FILL IN
CONST 2: I" 7-
BUILDING p /� MAP STATE YES NO
ADDRESS 9F3Q i (,(/ Tr_ NUMBER O I HWY
LOT NO uC BLOCK USE ZONE SPECIAL
CONDITIONS
TRACT NO OF
SIZE OF LOT I NOW ON LOTS BUILDING YARD HWY STREET NAME EXIST
SETBACK WIDTH
USE OF /_"� FRONT J.�' ,0
EXISTING BLDG L p L iR-
n SIDE
OWNER Q,(� /�twl� P L
MAIL �T O TRACT DWELL 1 UNIT
ADDRESS 5 INDUSTRIAL
�C TEL 1 1 DWELL 1 UNIT
CITYC _ 6 PUBLIC BLDG
ARCHITECT OR TEL 2 DUPLEX I UNIT 7 ADDN ALT ETC
ENGINEER NO 3 APT UNITS 8 MISCEL
ADDRESS 4 COMMERCIAL
TEL
CONTRACTOR NO �y3 INSPECTION RECORD
6{
ADDRESS �e_ / __ � ^� '� ] _S �� 'J 1//1L
DESCRIPTION OF WORK v
NEW ADI'_'�' ALTER REPAIR DEMOLISH
NO OF N OF
S"
FT 2 'S6 S ORIES FAM I
SIZEES /
USE OF STRUCTURE 1
J44
SIGNATURE OF '�,,
APPLICANT _ APPROVALS
ADDRESS .* Q26 DATE INSPECTOR S SIGNATURE
FOUNDATION LOCATION �^/
o ��' P C >$ FORMS MATERIALS 3 1 ^�. 7 f
FEE f FgRACING BOLTAME FIRE S
S
VALUATION S
FEE FURNACE LOCATION n
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GAS VENT DUCTS f, 8
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH INT
AND STATE LAWS REGULATING BUILDING CONSTRUC /
TION ~
LATH EXT
SIGNATURE OF � HOUSE NUMBER COR
PERMITTEE RECT AND POSTED /
ADDRESS I FINAL
WM J FOX COUNTY ENGINEER - VALIDATION C N DIRLAM CHIEF BLDG INSPECTOR
`s&3 3 7 ON FEB 21 1 8 0 0
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�" DWISION OF B=ING AND SAFM rm
Deportment of County Engmeer
County of Los Angeles
WM J FOX COUNTY ENGINEER APPLLLIICATION
BUILFOR APPLICANT TO FILL IN ADD EISS
BUILDING ,,��11 LOCALITY iflI
ADDRESS V a,
NEAREST `
LOCALITY
CROSS ST SE-z
DISTRICT PLAN CK OR Rcc No ..�pERMIT
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NEAREST
NEAREST S(/
CROSS ST /J //P SeFaw
OWNER Q R CEIIVVEDD 183Yt DATE OF APPL DATE ISSUED V
MAIL a� p�GT� v� /
ADDRESS j. USE ZONE NO OF I TYP_€ I GROUP FIRE ZONE
TEL { PLANS sj�
CITY L�r NO +4y(��- -,(r•
ARCHITECT OR TEL ONING ` ATED
ENGINEER NO C.� APPROVED BY c» �G�
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ADDRESS SETBACK LINE 0`♦ / d���
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CONTRACTOR O BY �,�, S
ADDRESS
HOUSE`NUMBERING I
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LEGAL MAP NUMBER d NO ASSIGNED BY )rlS
DESCRIPTION I LOT NO /'z BLOCK
146 -4
TilJ � � � DATE �,' F,C
I QRRTIONS I INSPECTOR
TRACT
/ NO OFBLDGS
SIZE OF LOT Z NOW ON LOT 4..
USEOF �o FA OF O
EXISTING BLDG 7 FAMILIES
DESCRIPTION OF WORK �►���tr/� ��/�--
NEW • \ ALTERATION ADDITION
REPAIR NO
S ZEA 176 ROOMS / STORIES /
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CIXOVERINGL j �G G d I COVERING.S/�F/Af d.Z-A.� i f
USE OF STRUCTURE _
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/ APPROVALS
INSPECTOR 8 SIGNATURE DATE
FOUNDATION LOCATION
FORMS MATERIALS
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FRAME FIRE STOPS
PLICATION AND STATE THAT THE INFORMATION GIVEN 18
CORRECT BRACING BOLTS
1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE LOCATION
AND STATE LAWS REGULATING BUILDING CONSTRUCTION, GAS VENT DUCTS
SIGNATURE OFA4, I,/� L>'a X S LATH INT
PERMITTEE�� �'i i' .lam R, t[!!
ADDRESS LATH EXT
PLASTER INT
AUTHORIZED A6
" PLASTER EXT
FEE HOUSE NUMBER COR
RECT AND POSTED
VALUATION
FEE �—`�"'"� FINAL
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