HomeMy Public PortalAbout4849 GLICKMAN AVE_Building__ A OA 1 EP� MI QUIRED
A CR WORK
DOI�,E I THE ROAD T OF WAY.
76Ae 9ACE#8056-s9 APPLICATION FOR B ILDING P �#T -� 1
COUNTY OF LOS ANGELES BUILDING
ADDRESS
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
CASSATT D. GRIFFIN, SUPT OF BUILDING CROSS ST. j
DISTRICT GROUP GROUP -TYPE � PPER
SED BY
FOR APPLICANT TO FILL IN Lt 'S coNsr. 17
BUILDING - STATISTICAL CLASSIFICATION /SEMAPF PG
ADDRESS C /77 ��` CLASS.NO.�DWELL.UNITS 5 /
LOT NO. BLOCK MAP J//aa STATE YES
NUMBER /`J HWY.
USE ZONE �
TRACT ��� SPECIAL 7j/ :
NO. OF BLDGS. W /r CONDITIONS
SIZE OF LOT „elf'�I NOW ON LOT �/
USE OF
EXISTING BLDG. BUILDINGEXIST.
SETBACK YARD HWY ET )"�.ME WIDTH
OWNER / FRONT
MAIL P.L.
ADDRESS ,{y" /� SIDE
pp
TEL P.L.
CITY,44,� '51 .A No / .? INSPECTION RECORD
ARCHITECT OR TEL.
ENGINEER NO.
ADDRESS
TEL.
CONTRACTOR NO. -
ADDRESS
DESCRIPTION OF WORK
NEW .< ADD ALTER REPAIR DEMOLISH
SQ. FT. NO. OF NO. OF
SIZE .2 STORIES FAMILIES
USE OF ol
STRUCTURE
SIGNATURE :` ,
APPLICANT /
APPROVAS DATE INSPECTOR'S SIGNATURE
ADDRESS �
y 7 • FOUNDATION: LOCATION
FORMS. MATERIALS
VALUATION $ � U I FRAME: FIRE STOPS,
BRACING,BOLTS
P.C. PMT. 2 �� FURNACE: LOCATION,
FEE $ I FEE $3b GAS VENT,DUCTS
r
1 H REBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH, INT,
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATE LAWS REG TING BUILDING,iCONSTRUCTION. LATH,EXT.
HOUSE NUMBER COR-
SIGNATUR -..; Y -� r E'fa RECT AND POSTED
PERMITT
ADDR s FINAL
CLYDE N. DIRLAM, PRINCIPAL ST CTU AL ENGINEER
PLAN CHECK VALIDATION OM.O. CASH PERMIT VALIDATION CK. M.O. CASH
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