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' 76ABSSA CEYSOS S-6S APPLICATION FOR BUILDING PERMIT .
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER AD DR ESS
BUILDING AND SAFETY DIVISION L O C A L I T Y
JOHN A. LAMBIE. COUNTY ENGINe[R NEAREST
COLEMAN W. JENKINS,SUP•T OF BUILDING CROSS STL
DIfrCn N O UP TYPE O BY
FOR APPLICANT TO FILL IN ((JJ CONIT.
■UILDING STATISTICAL DEIFICATION SEWER MAPF
ADDRELS CLAEE NO. DWELL UNITS BK/- Pct
LOT NO. BLOCK USE ZONE MAP -7--o
f} �,I I
A N 7-v
TRACT —�7 2 SPECIAL
SIZE OF LOT O q�, ` MO• OF
BLDGS.
�/ f/ MOW OX LOT
USE TI OGr�� I jam le__ BLDG. SETBACK FROM
TEL. r ` FRONT FROF. LIR[ OF (STREET)
OWN R NO. iF ( TYPE OF EXISTING /[T/ACKHI/HWAY YAA = TOTAL
AD DR HSE G C L.
CITY
RCHI EC THL. LD/, ACK FROM
—
NGINEHR NO. /IDt PRROP.OF. Lill OF / [[T
TYPE OF [II/TIN/ SET/ACK HIGHWAY + YARD — TOTAL
ADDRESS HIGHWAY WIDTH FROM C.L.
TEL. + _
CONTRACTOR NO
LIC CORNER CUTOFF YES NO
ADDREEE NO
CITY CLA"
Llc SEE REVERSE SIDE FOR SPECIAL APPROVALS
DESCRIPTION OF WORK
NEW ADD ALTER R9PAIR DEMOLISH ' V�
D0.FT. NO. OF NO. OF
SIZE STORIES FAMILIRS
USE OF
STRUCTURE
SIGNATURE OF
APPLICANT
VALUATIZ)N$ I —7 D Q l .00
APPROVALS DATE I R'/ TUR[
P.C. PMT. FOUNDATION, LOCATION
F[E S FEES FORMS MATERIALS
RAMS, FIRE STOPS,'
1 HEROY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING SOLTE
AND STATE THAT THE ABOVE I■ CORRECT AND AGREE TO COMPLY FURNACEI LOCATION
Y
WRTH ALL COUNTORDINANCES AND STATE LAWS REGULATING OAS VE U
•UILDINa CON Ir RUCTION. I CERTIFY THAT IN DOING THE WORK
RUTH OR RED HERESY I WILL NOT EMPLOY ANY P1301DN IN VIOLA- LATH. INT.
TION OF THt LA10f1 COD[ OF THE STATL
ROF CALIFORNIA RELAT-
ING TO WOKMEN'S Cn MPE N INSU LATH. EXT.
SIGNATURE OF HOUSE NUMBER COR-
PE`tMITTEE
ADDRESS F1 N A L
JOHN F. LEWIS. PRINCIPAL STRIICTIIAAL EN ER
PLAN C:I= VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. mo C' i
6010�8 NOV25 1 D 4.00- V
DEPARTIdENT OF BUILDING AND SAFETY APPLICATION FOR PIKRbm _
COUNTY OF LOS ANGFIXB BUILDING
Wm... FOX. OHI[F [NOINEER
PM7AJL
OR APPLICANT TO FILL. IN FOR OFFICE USE ONLY
DIJWTRI17T NO. PLAN OK.NO- r[RMIT NO.
R[CK11V[D RY DATE OF AITi- DAT[ISSLED
MUILDHe ADDR[!r LOOALITY
AD D REQ 9638 GlAlay
TEL jo $ulTy 1F4i NEARDT
OROltI eTFIRIC NO.or.
kDmmjtlprTlGJ4
OT OR T[L ZONE rLANO �� M�
Rip, OBD.NO.
■ETIAOK LIN[
ArrRIOVED
TOR 0.� eYUt[ ArrROVM
E ■Y DAT!AL CORRECTIONS I LOT No. ■LOOK Q
TAADT �- a - �•• —
NO.OF OLDRL
■IZK OF LOT HOW ON LOT
UK OF NO.OF HO.OF
R
N OF WORK
NEW ALTERATION ADDITION O
R10•AIR MOVING D[MOLINH p
mc;.FT. NO.OF
BIZ= ROOM1 ST3HIM
WALL ROOF
OOV[RIN■ OOV[RINO
Uf[OF N[MI
DUILDIN■
1 H[REMY AOKNOWIIDIJE THAT I HAV[ READ THIS APPROVALS
ArrUOATION AND XTATE THAT TH[ Aft OV[ 10 DORREOT IMlEOTOR DATE
AND ADREE TO DOMrLY WITH ALL OOUNTY ORDINANOEI FOUNDATMAT RL^LM OH
FORMS MATERIAIJ
AND MTAT[ LAMIf R ULAT O RU LDINO OONfTRU ON.
FRAM[I FIRI[STOP%
■ISNATURE OF ■RAGING ■OLTS
r ER M f7mir e�$4�
LATH, INT.
ALTHORIZED AST LATH, EXT.
76AA38A-7 oio r.O.• rL.ASTER.IMT.
q � O� F[[ PLANTER.EXT.
VALUATION FEE , 510 FI NAL VO-((-.,7 7'-i-^✓
76ABS CE 0803 A/70 v"
APPLICATION FOR BUILDIN PERMI
COUNTY OF LOS ANGELES ASSESSOR
DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL
BUILDING AND SAFETY DIVISION BUILDING r
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS
ns.2 C7
COLEMAN W. JENKINS, SUF'T OF BUILDING LOCALITY
FOR
PL �,L, rJ NEAREST
CROSS ST.
BUILDING DISTRICT N^O. G UP TYPE
`r _ _reE CONST.
ADDRESS aL�
PR BY
bTATISTICAL CL FICATION S ER MAP
LOT NO. BLOCK
CLASS NO DWELL,UNITS BK G
TRACT �JUSE ZONE MAP
SIZE OF LOT I/�-� d NOW ON LOTS , SPECIAL
USE OF //�� CONDITIONS
EXISTING BLDG. 6FP1 C
OWNER m,4-n--r-5-r,,6 0. 2 BLDG.SETBACK FROM
FRONT PROP.LINE OF (_TREET)
ADDRESS Z
`� OH�OF SETBACK HIGHWAY + YARjTOTAL
CITY be ff% .L OyDTHROM
ARCHITECT OR TEL. + _
ENGINEER NO.
BLDG.SETBACK FROM
ADDRESS SIDE PROP.LINE OF (STREET)
{ '/
TEL i TYPE OF ISTINO BETEIACK IOHYARD HWA = TOTAL
CONTRACTOR d ( /L N0. - D HIGHWAY WIDTH FROM C.L
LIC. + _
ADDRESS�� O, -
LIC.
CITY �. UO CLASS CORNER CUTOFF YEs ❑ NO ❑ �
CONSTRUCTION LENDER
NAME AND BRANC SEE REVERSE SIDE FOR SPECIAL APPROVALS La
CL
ADDRESS f
N
Z_
Sq. FT. NO. OF NO. OF NEW ❑
SIZE STORIES FAMILIES
USE OF ADD ❑ of
STRUCTURE
ALTER ❑
REPAIR El
SIGNATURE OF
APPLICANT Q �}� DENOL
VALUATION f .! a d L% APPROVALS DATE INSPECTOR'! 519HATUR[
P.C. PMT. FOUNDATION: LOCATION
FEE f FEES �� FORMS MATERIALS
FRAME: FIRE STOPS,
I HEREBY ACKNOWL6 G[ TCG HAV[ READ THIS APPLICATION BRACING BOLTS
AND STAT[ THAT THE O IE CORRECT AND AGREE TO COMPLY FURNACE: LOCATION,
WITH ALL ORDINAXC LAM! R[GU LATINS BUILDING COX- GAS VENT DUCTS
lTRUCTIOX. I C[RT Y AT IN DOING T E RK AUTHORIZED
HEREBY I WILL XO OY ANY PER IO LA TION OF THE LATH, INT.
LABOR COD[ OF H TAT[ OF IN RELATING TO
WORKMEN'! COMP ION INDURA .LATH, EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS FINAL
JOHN F. LEWIS. PRINCIPAL ST URAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATIO cK. M.O. CASH
0 -i n 0' i-A7 rj 1 D 9.00- `v'
L�G��
9ET9 10-46
TMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
OUNTY OF LOS ANGELES U I L D I N G
WM. J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN _ FOR OFFICE USE ONLY
DREILDIS
DISTRICT NO. PLAN CK. NO. PERMIT NO.
NSG
LOCALITY RECEYVED BY DATE OF APPL. DATE IS89ED
ppw-
NEAREST
CROSS ST. 1_
BUILDING .�
OWNER Qw,. ADDRESS �7 may �-
MAIL n c— i' LOCALITY
� � ! e,C�.
`
NEAREST 4
T CROSS ST.
CITY /I1 A NO. _
FIRE NO.OF TYPE GROUP
ARCHITECT OR TEL. ZONE - PLANS'r�
ENGINEER NO.
SLOG. r �'� ORD.ND.
ADDRESS _SETBACK LINE ,,.' !� '
TEL APPROVED._. -
CONTRACTOR .d.•'y NO. BY DATE'`
USE �j}�q APPROVED
ADDRESS ZONE '' / / BY DATE
F-I
LEGAL
DESCRI TIO.{N I LOTNO. BLOCK � CORRECTIONS
TRACT
NO.OF BLDGS.
SIZE OF LOT--5" �. 3 I NOW ON LOT `. G(
USE OF !\ NO.OF r NO.OF
EXISTING BLDG._. FAMILIES P RD OMB � '9449v
DESCRIPTION OF WORK
NEW ALTERATION ADDITION
O
A
REPAIR MOVING DEMOLISH Q
SQ. FT /� f� NO. OF Z
SIZE /Q X D ROOMS / STORIES � D
WALL ROOF t-
COVERING n I COVERING41g-;' ► .
USE OF NEW •/
BUILDING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION INSPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
FRAME: FIRE STOPS,
SIGNATURE OF BRACING,BOLTS
OWNER LATH,INT.:
AUTHORIZED AGT. i-
LATH,EXT.: -
P.C.Ill
PLASTER. INT.
17 FEE PLASTER; EXT.
VALUATION
FEE FINAL
1
r ,DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES g U 1 L D I N
WM. J. FOX. CHIEF ENGINEER
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
BUILDING / DISTRICT NO. PLAN CK.NO. PERMIT NO.
ADDRESS
LOCALITY RECEIVErY DATE OFAPPL. DATE ISSUED
NEAREST t e_
2 - I4 - 4
CROSS ST.
BUILDING 1 /
_OWNER ADDRESS I �.
MAIL �/7� `A V LOCALITY
ADDRESS
TEL. NEAREST
CITY NO. �' CROSS ST. U h s
FIRE TYPE GROUP
ARCHITECT OR TEL. ZONE �' PLANB PLANS
ENGINEER NO.
BLDG. �� f ORD.NO.
ADDRESS SETBACK LINE V 1 I i L.
APPROVED ,A
TEL. BY ATe /
CONTRACTOR DNO.
USE � APPROVED
ADDRESS ZONE DATE
LEGAL CORRECTIONS
DESCRIPTION I LOT NO. BLOCK
TRACT
J� (/ I. 3 I NO.OF BLDGB.
SIZE OF LOT /� � NOW ON LOT
USE OF T <. NO.OF NO.OF
EXISTING BLDG. 2 FAMILIES ROOMS
DESCRIPTION OF WORK
NEW ALTERATION I ADDITION
0
REPAIR MOVING DEMOLISH
2
Sq.FT. �+� NO.OF �'] I Z
SIZE y ROOMS CZ STORIES y
WALL ROOF r r
COVERING COVERING 3_V
USE OF NEW
BUILDING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION:: LOCATION INSPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
�����
.
FRAME: FIRE
BOLTS STOPS,
SIGNATURE OF
PERMITTEE
LATH, INT.
AUTHORIZED AGT
LATH, EXT.
76A638A 9-48
DBS-3 SUM SETS $ P.C.$ PLASTER,INT.
FEE PLASTER,EXT.
VALUATION �D• w FEE V FINAL
78A838A CEit803 8-63 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER
SS Z
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST.
DIST�T N G UP TYPE P CESSED BY
FOR APPLICANT TO FILL IN , /Q coNST.
BUILDING �� L STATISTICAL CLASSIFICATION EWER MAP
ADDRESS6 3 BK PG
CLASS. NO. DWELL. UNITS
LOT NO. / BLOCK WATER NOT REQUIRED1:1RECEI ED El
CERTIFICATE:
TRACT MAP HIGHWAY
NO.OF BLDGS. NO. ccIRCLE) STATE MAJ SECOND. LOCAL
SIZE OF LOT NOW ON LOT USE ZONE SPECIAL
USE OF v CONDITIONS
EXISTING BLDG.
TEL.
OWNER NO. BUILDING EXIST.
SETBACK YARD HWY STREET NAME WIDTH
ADDRESS FRONT
ARCHITECT OR TEL. P. L.
ENGINEER NO. SIDE
P. L. }
ADDRESCL
S
TEL. r i _ 1 _ r/ i O
� �
CONTRACTOR NO. V
Z44 �BIm
ADDRESS 0
DESCRIPTION OF WORK G
a
NEW D ALTER REPAIR DEMOLISH
SQ. FT. NO. OF NO. OF
SIZE STORIES FAMILIES
USE OF F
STRUCTURE
et
SIGNATURE OF
APPLICANT
VALUATION $ ���
APPROVALS DATE INSPECTORIS SIGNATURE
P.C. �iL'1 PMT FOUNDATION: LOCATION
FEE $ FEE $ FORMS, MATERIALS
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS
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 DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT.
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT
ING TO WORKMEN'S IN
COMPENSfTS
LATH. EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS - FINAL
JOHN F. LEWIS. PRINCIPAL STRUCTURAL NGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION & M.O. CASH
8 9 0 0:a JUN 5 1 D 9.0 0
DBS-3 25M S=T- - -1f
DEPARTMENT OF UILDING AND SAFE?"Y APPLICATIi_'r FOR PERMjLT
COUNTY OF LOS ANGELES V ® f
WM. J. FOX, CHIEF ENGINEER
NG
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
p
BUILDING ^ - DISTRICT NO. PLAN CK. NO. PERMIT NO.
`' P .� -
ADDRESS 7Z r
a•C�t,.•� � - -
LOCALITY " RECEIVED BY ,D TE Or APPL. DATE IYi D
NEAREST
CRGSS
ST. �
BUILDING �"`
OWNER �Y/� ,^!_ % �,ti•� "�"'� ADDRESS
MAIL
ADDRESS ) •- - LOCALITY
ITY fi - .i 1-4 TEL. CROSSNEARESST. r C
N O._
-2 �� FIRE NO.OF i TYPE ii GROUP
ARCHITECT OTEL. ZONE PLANS
_ENGINEER NO.
-.... BLDG. ORD. NO.
ADDRESS SETBACK LINE
TEL. APPROVED
CONTRACTOR NO. BY DATE
USE APPROVED
ADDRESS ZONE BY DATE
LEGAL
DESCRIPTION I LOT NO, I BLOCK CORRECTIONS
TRACT
> 1 NO. OF SLOGS.
_SIZE OF LOT ,�� Zh j I NOW ON LOT
USE OF "� NO.OF .I ,RA'.p. OF _
EXISTING BLDG.r I FAMILIt* OOMS
DESCRIPTION OF WORK P
NEW ALTERATION _ ADDITION - L(i�'. -
r '` O
REPAIR MOVING _ DEMOLISH -.C�k' � C,-� +,°�.v''j •`'-=�`�' "�'' "'� p
Sq. FT. O.OF Z
SIZE ---k Be/ ROOMS STORIES _
WALL ff ROOF
COVERING ^' .c_1_1`�y i COVERING
USE OF NEW t/• ^ _
BUILDING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS_
APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION, INSPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE STOPS,
SIGNATURE OF BRACING, BOLTS
OWNER " LATH, INT.:
AUTHORIZED AGT
LATH, EXT.:
$
P. C. S PLASTER, INT. -/�-�=-�--
t FEE PLASTER, EXT.P7 IW
VALUATION AL <" qy �ju
FEE FINtir- 'R hs i'' L 1 p��.
76A836Aa1.0603e-E4 APPLICATION FOR BUILD.IN PERMIT
COUNTY OF LOS ANGELES BUILDINO _ t
DEPARTMENT OF COUNTY ENGINEER ADOREfe
BUtI.DING AND SAFE'T'Y DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
COLEMAN W. JENKINBAUF'T.OF BUILDING CROSS DT.
TRI T
DIlNO ATYPE PR CE
FOR APPLICANT 'I'0 FILL IN R c0N,T.
DUILDINO STA TI TICAL S IFICATION SEWER•MAP
ADDRESS CLADS NO. DWELL.UNIT3 •BK . P _/
LOT NO. BLOCK YBEI ZONE MAP / ..
TRACT �+ QPECIAL '
NO. OF,LDSS. NDITIQNS
SIZE OF LOT
NOW ON LOT
USE OF 'I
BLDG. SETBACK FROM --
T L. FRONT PROP. LIN[ OF �� (STREET)
OWN R O• TYPE OF ERISTIN, SKTJBAPl. HIGHWAY YARD = TOTAL
C
ADDRES, 4? WAY rmym41
CITY _ /ACK FRAM
ARCHITECT OR EL. SIDE PROP. LIN[ OF STREET
HNOINEER NO.
TYPE OF [lfI1TlNS SETBACK HIGHWAY -{- YARD = TOTAL.
ADDRESS HISHWAY- WIDTH FROM C.L.
TEL. + - 0
CONT ACTO NO
ADDRHSS LIC. CORNER CUTOFF YH, NO O
CITY r I ASS LIC -SEE REVERSE SIDE FOR SPECIAL APPROVALS
DESCRIPTION OF WORK n
z
NEW ADD ITERRIEPAIR DBMOLISH
SQ.FT. .NO. OF NO. OF- .
SIZE STORIkS, FAMILIES
USE OF
STRUCTURE
SIGNATURE OF
APPLICANT
VALUATION
APPROVALS DAT[ IN■P[C-TOR'/ ISNATUR[
P.C. PMT. �� FOUNDATION, LOCATION
�iI, PEE$ ._� FOR M THRIA LA
1 HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION DE ACING BOLTA
AND STAT[ THAT THE ABOVE If CORRECT AND AOREE TO COMPLY FURNACEI LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS RKOULATINO I OAS YIXNT, DUCTS
7U ILDINO C'ONSTRUCTIOk..I CERTIFY THAT. 111 DOING THE WQRK
AUTHORIm
IZHERESY I WILL NOt EMPLOY ANY PERSON IN VIOLA- LATH. INT.
TION OF THE LABR CODE OF THE STATE OF COALIFORNIA FKLAT.
` ENO TO WORKMEN'S Cn M IN - LATH. EXT.
IONATURE OFFfdUSE NUMBEiR COR
ERMITTEE RFICT AND POSTED
ADDRESS FINAL
JOHN F.�� PRINCIPAL STR1.�WCT RAL E/�Jp-{'•' ����)
PIAN CHECK VALIDATION CK. 40. CAS _ tL.ill�I�LEWIS.• V�6A ION C
H K. M.O. CASK/
.7,0 57% FEB 9 1 D 6,0 Or, P
7- >/ C /7y
PERMIT
76A638A CE#803 8 63 APPLICATION FOR BUILDING .
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS iC
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. _ .IL✓ 'ij /
DISTRICT NO. �. TYPE E B
FOR APPLICANT TO FILL IN Q CONST.
r
BUILDING /- �/ STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS ` C' / BK PG
CLASS. NO. DWELL. UNITS
LOT NO. BLOCK WATER NOT REQUIRED ❑ RECEIVED ❑
CERTIFICATE:
TRACT MAPHIGHWAY
NO.OF BLDGS. NO. (CIRCLE) STATE MAJOR SECOND, LOCAL
SIZE OF LOT NOW ON LOT USE ZONE SPECIAL
USE OF CONDITIONS
EXISTING BLDG.
TEL.
OWNER NO. BUILDING EXIST.
SETBACK YARD HWY STREET NAME WIDTH
ADDRESS "�f`�
- '/y y /*?0&
-yC. _1/ c, FRONT
ARCHITECT OR TEL. P. L.
ENGINEER NO. SIDE
ADDRESS d
TEL. U
CONTRACTOR NO.
ADDRESS
G
DESCRIPTION OF WORK
a
MEW ADD ALTER REPAIR DEMOLISH '
h
T. NO.OF NO. OF _...� 9-r,.�r�. _..,c�, Z
SIZE STORIES FAMILIES '
y f.
USE OF l d
STRUCTURE
a
SIGNATURE OF
APPLICANT
VALUATION $ ?j S ��
APPROVALS DATE INSPECTOR'S SIGNATURE
P.C.
PMT FOUNDATION: LOCATION
FEE $ FEE $ FORMS. MATERIALS ,vL-
FRAME: FIRE STOPS.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS
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 DOING THE WORK
AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT.
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT-
ING TO WORKMEN'S COMPENSATION INSURANCE. LATH. EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERM ITTEE
OR-PERMITTEE RECT AND POSTED /
f ADDRESS FINAL _ —�
JOHN F. LEWIS. PRINCIPALS RU TURAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. 4EP
LA,o 8 8 4 1—o JUN 2 1 D 0.0 0