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COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER 'ADDRESS —
BUILDING AND SAFETY DIVISION LOCALIT /b
JOHN A LAMBIE, COUNTY ENGINEER NEAREST
CASSATT D GRIFFIN, SUPT OF BUILDING CROSS ST
DISTRIC NO f GROUPTYPE PR CESSED BY
FOR APPLICANT TO FILL IN �� I CONsr
BUILDING, STATISTICAL CLASSIFICATION SEWER MAP
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LOT NO BLOCK MAP STATE YES NO '
NUMBER HWY
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NEW ADD ALTER REPAIR DEMOLISH
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HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH, INT
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY H ALL COUNTY ORDINANCES AND �A-�o�(_�s,d•1
' STATE LAWS R lJL 1 BU L ING NSTRUCTION LATH EXT
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70AG38A CE#8098_02 APPLICATION FOR BUILDING PERMIT Zr
COUNTY OF LOS ANGELES _ BUI ElsN
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALLY
JOHN A LAMBIE, COUNTY ENGINEER NEAREST
CASSATT D GRIFFIN, SUPT OF BUILDING CROSS ST
DISTRIC NO If G OU TYPE PCESSED BY
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NUMBER o�O HWY
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I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP-
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND LATH INT
AGREE TO COMPLY WITH ALL COUNTY O DINANCES AND
STATE LAWS R LATING B DING CONSTRUCTION LASH EXT I
SIGNATURE o HOUSE NUMBER COR-
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ADDRESS FINAL
cK M o cases CLYDE N DIRLAM, PIRINCIPAL STR K RnAL ENGINEER
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A�' iUDING76A638A CE#8038-64•APPLICATI N FOR PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS' /
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST
COLEMAN W JENKINS,SUP T OF BUILDING CROSS ST
DISTRI T NG OUP TYPE SSED BY
FOR APPLICANT TO FILL IN• CONST
BUI I _ STATISTICAL CLASSIFICATION SEkERAP
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SIDE PROP LINE OF ( IRE T)
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P C _ PMT FOUNDATION, LOCATION pr,-� cbsay
FEE __ ✓✓ /(Y/
R AME, FIRE STOPS, �Ih /ri ������
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT ! G(/)) -P's.'ifi ' SP"
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
SUILOING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA <L"�A`T-H INTI
TION OF THE LABOR CODC OF THE STATE OF CALIFORNIA RELAT
ING TO WORKMEN 5 COMP NSATION INSURANCE 1 LATH EXT 'd
SIGNATURE OF/ J
ll�� HOUSE NUMBER COR-
PERMITTEE --77 RECT AND POSTED
ADDRESS L° Fl NAL
JOHN F LEWIS PRINCIPAL ST URAL ENGINEER
PLAN CHECK VALIDATION CK M O CASH _ PERMIT VALIDATION CK M O CASH
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