HomeMy Public PortalAbout9168 FORTSON DR_Building__ TEMPLE. COTY
79AG30A CE#803 2/40 APPLICATION FOR BUILDING PE MIT , .-
COUNTY OF LOS ANGELESBUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER _NEAREST A
WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST. 9
DISTRICT NO.` -GROUP I TYPE P SED BY "
FOR APPLICANT TO FILL IN �j CONST.
BUILDING71 STATISTICAL CLASSIFICATION SE ER MAP
ADDRESS a � B P
nn __ CLASS.NOO - DWELL.UNITS
LOT NO. BLOCK MAP STAT YES NO
NUMBER HWY.
TRACT USE ZONE SPECIAL
NO.OF BLDGS. /fes 7 CONDITIONS
SIZE OF LOT a b I NOW ON LOT' V y1'i I
USE OF,
EXISTING BLDG. . BUILDING EXIST.
TEL
TBACK YARD HWY _ STREET AME 06 WIDTH
OWNER `' 1 NO . tll Fr RONT
P. L.
ADDRESS-- SIDE IL
ARCH ITEC OR TEL. P.L.
ENGINEER No. INSPECTION RECORD
ADDRESS
TEL. :�! a
CONTRACTOR \\ O.• i-C O
ADDRESS .V V
DESCRIPTIO OF WORK
O
N ADD ALTER REPAIR DEMOLISH
SQ.FT. // NO.OF NO.OF a
SIZE- iT () - STORIES FAMILIEl
USEOF
D
STRUCTURE I - -
SIGNATURE OF 17
APPLICANT
VALUATION$
APPROVALS DATE _INSPECTOR'S SIGNATURE
P.C. - PMT. FOUNDATION: LOCATION
FEE $- FEE $ �� FORMS,MATERIALS
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FRACIN STOPS,
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND BRAACING,, BOLTS
FURNACE: LOCATION,
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND ,
GAS VENT.DUCTS -
STATE' LAWS REGULATING BUILDING CONSTRUCTION.
I CERTIFY THAT IN' DOING THE WORK AUTHORIZED 1 LATH, INT.
WILL NOT EMPLOY Y PERSON IN VIOLATION OF THE
WORKMEN'S COMP CALIFORNIA. LATH,EXT.
ATION LAWS OF '1 6
SIGNATURE'OF HOUSE.NUMBER COR-
PERMITTEr/l RECT AND POSTED
ADDRESS FINAL
f CLYDE N. DIRLAM, PRI CIPAL,STIRAL ENGINEER
PLAN.CHECK VALIDATION CK. M.O." CASH PERMT VALIDATION CK.,- M.O. CASH
LA1L,o 4 7 9 9 No APR 1 G 9.U,U, :M ®P ;
(e,s 76'638A
CX803 1'REV-1 1/78) L'tL
APPLICATIONFOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO.FILL IN BUILDING /
ADDRESS
BUILDING /.
ADDRESS �l'I((, C y 5�J'l LOCALITY
NEAREST
CITY Z''/(_ f/�_ ZIP / CROSS ST
L NO OF BLDGSASSESSOR.
SIZE OF LOT %O NOW ON LOT 2-- MAP BOOK•• PAGE I PARCEL
TRACT / BLOCK LOT NO DISTRICT :GROUP TYPE J' FIRE ZONE PROCE ED BY
/ �0 L `3 CONS
OWNER (A!'t��( %� �CrCI NO Q�
y h STATISTICAL CLASSIFICATION W rR MAP
ADDRESS /ci �`• �) -tom/� �//l CLASS NO `2 DWELL UNITS Al BK/ � eG
CITY 1� ZIP'
ARCHITECT OR TEL r
ENGINEER NO VALUATION
ADDRESS BLDG SETBACK FROM
TEL FRONT PROP LINE OF (STREET)
CONTRACTOR NO HIGHWAY + YARD __ TOTAL SETBACK FROM TYPE OF EXISTING
LIC FRONT PROP LINE HIGHWAY WIDTH
ADDRESS 0 NO
LIC +
CITY CLASS
CONSTRUCTION LENDER BLDG SETBACK FROM S
NAME AND BRANCH � � SIDE PROP LINE OF (STREET(
��� �
HIGHWAY + YARD _ TOTAL SETBACK FROM I TYPE OF EXISTING d.
ADDRESS TY SIDE PROP LINE IHIGHWAY WIDTH- Q
SO FTvy O OF O OF CHECK + = V
SIZE /S STORIES 02' FAMILIES / ONE at
USE ZONE MAP q �,
DESCRIPTION OF WORK [1� / j (� NEVy [jf
SPECIAL
/ J
ADD �'
/� CONDITIONS
� -d J Dl3Yl� I'L BY Z
ALTER ❑ F NAL /rA
REPAIR DATE
USE OF v
DEMOL ❑
EXISTING BLDG Off _ O .
APPLICANT TEL -�`
PRINT( / z) NO- C D^S`7
221067:2A
BY(SIGNATURE( '�� (J, l` •> ;# o-o io••o
1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE _ xTHAT '
AND LAWS ABOVE
GULATI G BUILDINGTHE IS CORRECTDCONS RUCAGREETITION II C RTIFY THATCOMPLY ITHLINORDINANCES DOING THE Z 2 0 0- 4,00
WORK AUTHORIZED HEREBY IW ILL NOT EMPLOY ANY PERSON IN VIOLATION OF U
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN S COM-_ Z ;,o o o 5 i�0 0 cx
PENSATION INSURANCEg
0 6 0,9-'8} .0 • -
SIGNATURE OF .�
PERMITTEErA-
ADDRESS
p # o o'0 0 01 '
TEL
CITY NO `�`'�� c 2 - 308,50
//�� Q
PC Fee$ . Permit Fee ` 04. 1 � > ;0•030850:01:
L5 Issuance Fee 7
r d
. B Total Fee 36 d S0• f
7CA838A CE 4803-9-60 ALRCATRO � R BILL -j PERMIT � ,
COUNTY OF LOS ANGELES BUILDING
ADDRESS
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST. /_ T,
DISTRICT NO. I GROUP T)'PE \1'`L. P OC SSED BY /
FOR APPLICANT TO FILL IN ; 1 _ I CONST. ,IV I
BUILDING STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS 1-.- roIT . BK PG
CLASS.NO DWELL. UNITS '_I
LOT NO. /� BLOCK MAP _y STATE YES NO
! NUMBER �- ' HWY.
TRACT / USEZONE SPECIAL
NO OF BLDGS. If CONDITIONS
SIZE OF LOT 17C 3(� I NOW ON LOT 9
USE OFl
EXISTING B G. BU'LDING YARD -)WY STREETr AME EXIST.
s✓ TEL. BACK WIDTH
OWNER NO. ONT �i !
ADDRESS SIDE
ARCHITEC OR EL. P L
ENGINEER r NO INSPECTION RECORD y,
ADDRESS L`-
Ov
CONTRACTOR, NOrr" p• ,,
ADDRESS ' O
15ESCRiPTIOg,bF WORK u
W
- r N
NEW A ALTER REPAIR DEMOLISH
SQ FT NO.OF NO OF / .,��•,e?�r.. '+ .'•`�+> t+.+�
SIZE STORIES FAMILIES r ` -
U S E OF f ?/�/ !r A —•<.•.+_a'l'"J-hs r'
STR TUR
f,^ ^,. F ti.✓a�:A" "u•�,i'3�'h ee''."'y 'fi h•' ,y,,.:.nai,.rl- -_— /
IAO
SIGNATURE OF
APPLICANT '
I
VALUATION ,t. Gr--"C
APPROVALS GATE INSPECTOR'S SIGNATURE _
P C. PMT, 411 FOUNDATION LOCATION ' i ,� .! b'',:
FEE I I FEE $ FORMS. MATERIALS G,s !�G.� �T,,`�';v-� -► __
FRAME: FIRE STOPS, ' ,I �•.�' .y '
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS - � •': 1`•'.•�' _ " '�•'d�r -:..__ �,
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, '
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CONSTRUCTION I CERTIFY THAT IN THE PERFORMANCE
OF THE WORK FOR WHICH THIS PERMIT IS ISSUED I SHALL NOT LATH, INT
EMPLOY ANY PEYFLI)
ANY MANNER SO AS TO BECOME SUBU ECT _ -
TO THE WORKMMPENSATION LAWS OF CALIFORNIA C,p
LATH, EXT.
SIGNATURE OHOUSE NUMBER CORPERMITTE RECT AND POSTED
ADDRESS FINAL
CLYDE N. DIP.LAM. PRINCIPAL STRyc RAL ENGINEER _
PLAN CHECK VALIDATION CK. M.O. CASH PERMUT VALIDATION M.O. CASH
.J �1