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HomeMy Public PortalAbout4939 GLICKMAN AVE_Building__ 7BA638A CE#8033-66 APPLICATION FOR BUILDI N//'OG PERM COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY Temple City JOHN A. LAMBIE. COUNTY ENGINEER NEAREST COLEMAN W. JENKINS,SUP•T OF BUILDING CROSS ST. Lower Azusat Rd. DIST NO_ GROUP TYPE P O D FOR APPLICANT TO .FILL IN CONST. BUILDING STATISTICAL CLASSIFICATION SEW-ER MAP ADDRESS 4939 N. Glickman CLASS NO.�DWELL UNITS BK L PGS7� LOT NO. BLOCK USE ZONE MAP O NO. -TRACT . SPECIAL ' NO. OF SLOGS. CONDITIONS ' SIZE OF LOT NOW ON LOT - USE OF E IST NG fiIpG. Rproof BLDG. SETBACK FROM Ulrich NO.. AT6-3677 FRONT PROP. LINE OR (STREET) OWNER Mrs. Mar TYPE OF EXISTING SETBAC HIGHWAY -F YARD = TOTAL ADDRESS N G HIGHWAY WIDTH FRO L. CITY Temple City - - + ARCHITECT OR TEL. BLDG. SETBACK F M , ENGINEER - NO. SIDE PROP. LI OF _ (STREET) TYPE OF ISTINO SETBACK HIGHWAY + YARD TOTAL ADDRESS HIGHWAY IDTH FROM C.L. CONTRACTOR Virgin Roof 287-0507 - + - ADDRESS 600 So. San Gabrj a 160 650 CORNER CUTOFF YES .NO a O CITY CLA SEE REVERSE SIDE FOR SPECIAL APPROVALS DESCRIPTION OF W C:) 7 W d NEW ADD ALTER PAIR MO ISH SQ.FT. NO. OF F SIZE STORIES FAMILIES LAPPLfCANT ]2erQgf house & att. garage mmp. roof- F VIRGIN ROOF CO. S 4 1. 2 I1 •00 APPROVALS DATE INSPECTOR'S SIGNATURE FOUNDATION, LOCATION FEE$ FEE$ 6.00 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 WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS 9UILD I NG CONSTRUCTION. 1 CERTIFY THAT. IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSO IN VIOLA- LATH. INT. TION OF THE LABO CODE OF THE ATE OF CALIFO NIA RELAT- ING TO WORKMEN'S. O'1PENSATION IN RANCI LATH. EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTa EE RE AND POSTED arcia en, ec y. �.- ADDRESS F1 NAL Sari Gabriel JOHN F. LEWIS, PRINCIPAL S CT RAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATIO CK. - M.O CASH �.. i APPLICATION FOR COUNTY OF LOS ANGELES OF COUNTY 93 U I LD I N G PERMIT DEPARTMENT BUILDING AND SAFETY DIVISION ENGINEER FOR APPLICANT TO FILL IN ADDRESS ✓'�� BUILDING C `�L ADDRESS ��/�//�J!/ ✓T�/6 LOCALITY CITY T/ CROSS cry ZIP NEAREST �/ L 917929 CROSS S . SIZE OF LOT �G s2/x R J NOW ON LOTS. / MAP BOOK 7— ASSESSOR PAGE PARCEL TRACT I©N ! BLOCK /9 LOT NO. / DISTRICT GROUP TYPE FIRE SSED B r"` Fy CONST. ZONE TEL -7,-Z' .2j ��. OWNER J5U r ,S-✓Ii�C� No.9"7y-7/7/ STATISTICAL CLASSIFICATION SEWER ADDRESS .5A/7/c CLASS NO. 2DWELL.UNITS BK PG CITY ZIP ZONE IMAI to ARCHITECT OR TEL. ENGINEER NO. SPECIAL CONDITIONS ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO❑ TEL. CONTRACTOR d/✓ll�/�� NO. BLDG.SETBACK FROM LIC. FRONT PROP.LINE OF (STREET) ADDRESS NO. TOTAL SETBACK FROM TYPE OF EXISTING HIGHWAY + YARD = LIC. FRONT PROP.LINE HIGHWAY WIDTH CITY CLASS _ CONSTRUCTION LENDER + CL O NAME AND BRANCH BLDG.SETBACK FROM U ADDRESS CITY SIDE PROP.LINE OF (STREET) O SQ.FT. NO.OF NO.OF CHECK HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING SIZE 37-1- 1 STORIES FAMILIES ONE SIDE PROP.LINE HIGHWAY WIDTH N ® + = Z DESCRIPTION OF WORK NEW ADD ❑ CORNER CUTOFF YES ❑ NO ❑ C7 ALTER ❑ IN OPEN SPACE YES ❑ NO ❑ REPAIR ElUSE OF BLDG. R EMOL ❑ IN COASTAL PERMIT ZONE YES ❑ NOEXI ❑ APPLICANT y / TEL y-'12, :t j (PRINT( ��/�/�' S.. i�r®�V NO.r�y V.71y� BY(SIGNATURE) / I HEREBY ACKNOW GE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS C RRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM- PENSATION INSURANCE. i SIGNATURE OF FINALC ^? � BY PERMITTEE DATE 4 ADDRESS TEL. P.C. Fee$ Permit Fee CITY NO. Q Issuance Fee / VALUATION$ 28 0 Total Fee PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION %<-&-2%/ CASH OPS 76A638A CE B803A 8/77 DEPARTMENT OF COUNTY ENGINEER DIVISION OF BUILDING AND SAFETY COUNTY OF LOS ANGELES BUILDING WILLIAM J. FOX, COUNTY ENGINEER APPLICATION CASSATT 0. GRIFFIN, SUP'T OF BUILDING FOR APPWANT TO FILL IN FOR OFFICE USE ONLY DISTRICT NO. PLAN CK.OR REC'No. PERMIT NO. BUILDING e- - 7tr' ADDRESS /3.7 (AZId �3 A 6 07y )!n LOCALITY T RECEIVN;D BY DATE OF APPL. DXTE ISSFUEb 'm e G y NEAREST / ;�' CROSS ST. 4- 1 Vt?' BUILD'NG Irlel*.oAl 14 Vc OWNER liAns,Al l>P"o')Yjc)( ADDRESS MAIL LOCALITY 7XAf AVe-X.* r, ADDRESS AREIT I Y'r OA T L. 0"ST. CITY /L A- NEO' IR ARCHITECT OR TEL FIRE NO. OF Z I TYPE GRO�y ENGINEER &V NO.' ZONE PLANS V_ I BLDG. ORD NO ADDRESS SETBACK LINE A TEL Us E APPROVED CONTRACTO!j 44 NO.64-2 ZON BY PATE ADDRESS A-0 tY bAh&'vOl -Vf�- 1;h' JMBERING LEGAL MAPNUMBE 0 NO. ASSIGNED BY DESCRIPTION I LOT NO. I BLOCK A TRACT CORRECTIONS NO. OF BLDGS. SIZE OF LOT71 S� 2321 2� NOW ON LOT. . I USE OF NO. OF EXISTINGBLDG. FAMILI.. DESCRIPT10ii-OF WORK 0 NEW ALTERATION __ADDITION � x REPAIR DE > r 'jEFT. IF do j2-t 6A PAs 'R,'O- MS STORIES EXT. WALL I ROOF -COVERING . COVERING USE OF STRUCTURE Add r-TZ-0 Al A- /6/ry Q ')' cv&--e z7Z lw;r Ap-sej APPROVALS 13 2 2 3 ' &-P!t 6A-114 /�L- 0 INSPECTOR'S SIGNATURE DATE 6-A IQ A. FOUNDATION- LOCATION FORMS, MATERIALS HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FRAME: FIRESTOPS, IN PLICATION AND STATE THAT THE FORMATION GIVEN IS BRACING, BOLTS CORRECT. 1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION. D GAS VENT, DUCTS AN STATE L LA L bIG CONSTRUCTION. D�A R EEG TIN BUI D LATH, INT. SIGNAT RE PERM[ LATH. EXT. ADDRE .10or AUTHORIZED AGT. PLASTER, INT. PLASTER, EXT. 00 00 P. C $ 0 FEE' HOUSE NUMBER COR- RECT AND POSTED " 3z $: VALUATION $ 04 FFI FINAL 76A'-311A DOS 3 9-52. ` 78AS38A CE/NN 8092%80 APPLICATION FOR BUILDING PERMIT Z COUNTY OF LOS ANGELES BUILDING K DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALI 0­7.z (b rL L JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST. DISTRICT NO. UP TYPE P OCESSED BY FOR APPLICANT TO FILL IN Vim;E CONST. BUILDING �! � �,`�M A STATISTICAL CLASSIFICATION SEWER MAP ADDRESS T •� // BK PG CLASS.NOQ-?1—DWELL.UNITS LOT NO. /�L BLOCK NUMBER �� HWY. YES NO TRACT USE ZONE SPECIAL NO.OF SLOGS. " CONDITIONS SIZE OF LOT NOW ON LOT 14 USE OF EXISTING BLDG. BUILDING EXIST. JTEL SETBACK YARD HWY STREET NAME yy1DTH OWNERp,C.9• Jr;jL/T- /�j, (f� e,<6!NO. FRONT ADDRESS 43,9 4�/ 19N SIDE ARCH ITECTOR T- r- /fE�L� P.L. ENGINEER / INSPECTION RECORD ADDRESS O O !// .-- -L TEL J i 0 a CONTRACTOR 0 ,,9'N/,/ 1'�Q /J NO��J-•/��q O ( ADDRESS (,p/�_� ,/ V DESCRIPTION OF WORK ( H NEWS/ ADD ALTER REPAIR DEMOLISH W SQ.FT. NO.OF NO.OF QI SIZE STORIES FAMILIES USE OF STRUCTURE .e= % 6�•Q - SIGNATURE OF APPLICANT VALUATION r APPROVALS QATE INSPECTOR'S SIGNATURE FEE F� FEE $ /'ZFOUNDATION: LOCATION f �, CD FORMS,MATERIALS r FRAME: FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- BRACING, BOLTS PLICATION AND STATE THAT THE ABOVE IS CORRECT AND 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. I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE WORKMEN'S COMPE SATION LAWS OF CALIFORNIA. LATH,EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTEM RECT AND POSTED ADDRESS e FINAL CLYDE N. DIRLAM, PRINCIPAL STrCK. RAL ENGINEER LI PLAN CHECK VADATION aK. M.O. CASH PERMIT VALIDATIONM.O. CASH I pklo ` 18 1 0 12.CI 04&nt/ 089-3 23M SETS 6-46 DEPARTMgNT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES WM. J. FOX, CHIEF ENGINEER B U '"L ® ' N G FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING or, ,� }} DISTRICT NO. PLAN CK. NO. PERMIT NO. ADDRESS 1 =91✓��' LOCALITY 014J er ',t y.Kfc VED_By DATE OF APPL. DATE ISSUED NEAREST I{/!/fI�/�0� 6�l 2� ! ,.�fC. �O zz ,G ...�..f CROSS ST. BUILDING OWNER ADDRESS S MAIL /d LOCALITY ADDRESS TEL NEAREST t CROSS 9T. CITY NO. ARCHITECFIRE NO.OF I TYPE i I GROUP .,. T TEL. ZONE PLANS //�/ ENGINEER NO. BLDG. /�� _/ - ORD. NO. ADDRESS SETBACK LINE TEL. APPROVED CONTRACTOR ��'l,a,'+... NO. BY DATE USE ,'j' APPROVED ADDRESS ZONE,, BY DATE LEGAL CORRECTIONS DESCRIPTION I LOT NO. I BLOCK TRACT ,. - ':.�0�-r !? R AG NO. OF SLOGS. SIZE OF LOT NOW ON LOT USE OF NO.OF_- NO. OF._;..,. EXISTING BLDG, I FAMll.lp I ROOMS DESCRIPTION OF WORK NEW ALTERATION _ADDITION D REPAIR MOVING DEMOLISH 1 110�y7 - O_ Sq. FT. � OF Z SIZE D fAtOOM'B/ STORI)BWALL r COVERING 4)1 COVrEaRIND _.� /���f(/ USE OF NEW f '` - _ // (� a- BUILDING ��' 'r J f APPROVALS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ANQ„STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION, INSPECTOR DATE AND AGREE T4'C0 LY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS AND STATE LAWS RULATING BUILDING CONSTRUCTION. FRAME: FIRE STOPS, SIGNATURE'S ////y,�/' �j/ �(�' BRACING, BOLTS 3/ /y 7 „ OWNER +,/` "�'Ii/c /�i�V'+r -. sr- f 11CrH, INT.: AUTHORIZED AGT LATH, EXT.: ! 6 _ i �" P C. , PLASTER, IN_T. O FEE PLASTER, EXT. (oOa A VALUATION FEC /j FINAL 3 '�-/%7 �.r APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN (Print or type only) BuleoNG COUNTY OF LOS ANGELES ADDRESS 15I"`9_39 &J.1CeZ1,4A1 4VI57DEPARTMENT OF COUNTY ENGINEER CITY T[ ZIP 917R,0 BUILDING AND SAFETY DIVISION NO. BUILDING SIZE OF LOT Z x ',s'NOWOONBLOTS ADDRESS 9 3 I I c�� f � TRACT l BLOCK T �/ LOT NOO. �J LOCALITY T.NEAREST ]-, , e_ 0,� )_ OWNER OL. � Sa / OiY ,�"rEL. 91 " ,77'/<U� CROSS ST. L G ASSESSOR ADDRESS {� MAP BOOK PAGE PARCEL _ DISTRICT GROUP TYPE FIRE 4XZ_ CITY ,� P f� G ZIP ONS T. ZONE ARCHITECT OR ,� TEL �( O iJ v`�'�ti 3 ENGINEER S/jer NO. STATISTICAL CLASSIFICATION SEVieA MAP ADDRESS SA /t CLASS NO. :70_DWELL.UNITS 4 BKS?PG TEL. CONTRACTOR S`%�[r N USE ZONE NOP Zo ADDRESS 'S/g' /_ NO LIC' _ SPECIAL CLIC. CONDITIONS CITY CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑ CONSTRUCTION LENDER NAME AND BRANCH N_4aN�= BLDG.SETBACK FROM FRONT PROP.LINE OF (STREET) ADDRESS CITY HIGHWAY } YARD TOTAL SETBACK FROM TYPE OF EXISTING SQ. FT. NO. OF NO. OF CHECK FRONT PROP. LINE HIGHWAY WIDTH SIZE STORIES FAMILIES ONE } - d DESCRIPTION OF WORK NEW ® O LDG.SETBACK �S"��.�IC Z• 49,c 6Z#161" «j •/e ADD ❑ SIDE PROP.LI NEOFOM (STREET) � /VALTER ❑ - TOTAL SETBACK FROM TYPE OF EXISTING HIGHWAY } YARD - SIDE PROP. LINE HIGHWAY WIDTH W -REPAIR[I USE _ [L h EXISOT NG BLDG. P/ T/PL S/�/'/VG� EMOL ❑ } Z APPLICANT ,, ! ,{,/ �j� TEL �+ CORNER CUTOFF YES ❑ NO ❑ (PRINT) �.(./y� -J♦ !f1A (/k1 N0. ,J��r' IN OPEN SPACE YES ❑ NO ❑ BY (SIGNATURE)� IN COASTAL PERMIT ZONE YES ❑ NO ❑ VALUATION$ SS_ry .DLr I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COMPENSATION INSURANCE. SIGNATURE OF PERMITTEE. ADDRESS _s 13V 'F��G tl- L -� TEL?,d7?,0o FINAL '��7 BY CITY ���/�.� G�TY NO. Q DATE / , SIA Fl: (:I11 ChS P:1)'113i t I O P'C' C Q PMT. FEE + FEE HARVEY T. BRANDT. COUNTY ENGINEER 01.2-0 1 2 f, %refr oO iV �, PLAN'CHECK VALIDATION CK M O CASH PERMIT VALIDATION CK. M O. CASH 76A638A CE*803 5/74 APPLICATION FOR BUILDING PERMIT 'FOR APPLICANT TO FILL IN (Print or type only) BUILDING COUNTY OF LOS ANGELES ADDRESS ��I3�{ .�r1'Izkw,o \ve DEPARTMENT OF COUNTY ENGINEER CITYTc_ \e C ZIP `11 1`0 BUILDING AND SAFETY DIVISION NO.OF BLDGS. BUILDING SIZE OF LOT NOW ON LOT ADDRESS ( !i TRACT 9 BLOCK LOT NO. LOCALITY TEL.l, NEAREST OWNER 0L_A (h\L_:-Vo t.) NO. SUIS 3021 CROSS ST. _...RJ p ASSESSOR ADDRESS y 3q `'Lai hlV e MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE ROC SED BY -CITY T° \2 C ZIP \-I$U 61 CONST ZO ARCHITECT OR TEL. ` ' ENGINEER NO. STATISTICAL CLASSIFICATION SEWER MAP ADDRESS CLASS NO. DWELL.UNITS BKS .Z TEL. CONTRACTOR NO. S{SE.Z9NE NMA OP O LIC. /�'� ADDRESS NO. SPECIAL LIC. 0,tONDITIONS CITY �+ CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ CONSTRUCTION LENDER NAME AND BRANCH BLDG.SETBACK FROM FRONT PROP.LINE OF (STREET) ADDRESS CITY TOTAL SETBACK FROM TYPE OF EXISTING SQ.FT. NO.OF NO.OF CHECK HIGHWAY + YARD = FRONT PROP.LINE HIGHWAY WIDTH SIZE STORIES FAMILIES ONE DESCRIPTION OF WORK S NEW ❑ + O ADD ❑ BLDG.SETBACK FROM (STREET) O SIDE PROP.LINE OF ALTER ❑ ~ n C O Ver I naj = TOTAL SETBACK FROM TYPE OF EXISTING w HIGHWAY + YARD SIDE PROP.LINE HIGHWAYI WIDTH N USE OF l v) I IV lr'L9 C C n REPAIR ❑ Z EXISTING BLDG. Q I DEMOL 13 + APPLICANT TEL CORNER CUTOFF YES ❑ NO ❑ (PRINT( NO.'A IN OPEN SPACE YES ❑ NO ❑ BY(SIGNATURE) ` IN COASTAL PERMIT ZONE YES ❑ NO Q ❑ VALUATION.p `��—^ �-S IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION.1 CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM- PENSATION INSURAN�.l�� . SIGNATURE OF PERMITTEE ADDRESS FINAL ') !� BY TEL. DATE i /✓ f G` "fr""�....f, CITY NO=TO: MAKE CHECKS PAFE $ FET $HARVEY T.BRANDT,COj * PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION cK. M.O. CASH �1/7 0 r.JAN U QS 76A638A CE#803 3-76 APPLICATION FOR BUILDING PERMIT ILDING FOR APPLICANT TO FILL IN ADDRESS LDING ADIDRESS--S �G �� LOCALITY NEAREST CITY J� /•L�� G�T/ ZIP /I / (7 CROSS ST. NO.OF BLDGS. ASSESSOR SIZE OF LOT i NOW ON LOT MAP BOOK PAGE PARCEL TRACT�C����/.� BLOCK LOT NO. DISTRICT QQ GROUP TYPE FIRE OCE D BY �lTELV CONST` ,� ZONE OWNER DIC/1I' 1-11,4 "�1� NO�H.2-3ozl V STATISTICAL CLASSIFICATION SEWER MAP ADDRESS eJ /!/� CLASS NO. oZ DWELL.UNITS �� BK`S CITY ZIP USE ZONE MAP c2 O U ARCHITECT OR TEL, n NO. ENGINEER NO. /� SPECIAL CONDITIONS ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ CONTRACTOR NO. BLDG.SETBACK FROM LIC. FRONT PROP.LINE OF (STREET) ADDRESS 17I NO. HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING tr LIC. FRONT PROP.LINE HIGHWAY WIDTH CITY CLASS _ CONSTRUCTION LENDER + _ cL >_ NAME AND BRANCH BLDG.SETBACK FROM OU SIDE PROP.LINE OF (STREET( ADDRESS CITY 0 SQ.FT. NO.OF NO.OF CHECK HIGHWAY + YARD = TO SETBACK FROM TYPE OF EXISTING U SIZE STORIES FAMILIES ONE IDE PROP.LINE WIDTH HIGHWAY a N DESCRIPTION OF WORK Q 71550/: 151�4v NEW ❑ + ��f�sT//I�L dQ�I�gGL IN D/N/ ,pD ❑ CORNER CUTOFF YES ❑ NO ❑ /V/w& /Ebo," f z3&be1J " Cu1567 ALTER ❑ IN OPEN SPACE YES ❑ NO ❑ REPAIR USEOF BLDG. DEMOL ❑ IN COASTAL PERM( ONE YES ❑ NOEXISTIN ❑ APPLICANT TELA PRINT( de l �,,�ro N No.1711&V a BY(SIGNATURE) IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE O THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM PENSATION INSURANCE. SIGNATURE OF \ \�� _ FINAL j j C BY PERMITTEE +` DATE ADDRESS TEL. P.C. Fee$ Permit Fee CITY NO. Q Issuance Fee VALUATION.p '� CJ '� Total Fee PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. O. CASH 54 4 ()S 76A6388 CE N803B 6/76 'q COUNTY OF LOS ANGELES P L I CAT I O N FOR DEPARTMENT OF COUNTY ENGINEER BUILDING PERMIT BUILDING AND SAFETY DIVISION BUILDING FORAPPLICANTTO FILL IN ADDRESS a..ti� tJ NG ADD EBU I ISS �y.,/ LOCALITY NEAREST CITY r�j/ �� ��// ZIP �Q CROSS ST. SIZE OF LOT,Z ,, 2x7"/, NOW ON LOTS 2 MAPESSOR BOOK PAGE PARC 41_ �g DISTRICT GROUP TYPE FIRE PROC ED BY TRACT/Q J2 BLOCK LOT NO. , 1 CONSV ZO n, TEL.9;IPA � t�L C� �( OWNER aj,# rc72/� NO• STATISTICAL CLASSIFICATION ��// SEWER MAP ADDRESS Y�3 (0�(/�,' /J 'y'yLZ- CLASS NO,�'' DWELL,UNITS L_BKS -21!�G CITY S.� �.= ZIP -S �r',EjZONE NOP ARCHITECT OR TEL. �/ SPECIAL ENGINEER s� ` NO. 7o CONDITIONS ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑ CONTRACTOR S/9 = HEEL. BLDG.SETBACK FROM o. LIC. FRONT PROP.LINE OF -� (STREET) ADDRESS NO. HIGHWAY t YARD TOTAL SETBACK FROM TYPE OF EXISTING FRONT PROP. LINE HIGHWAY WIDTH CITY CLASS _ n CONSTRUCTION LENDER 1-0 - Q `�' (0u NAME AND BRANCH BLDG.SETBACK FROM a' ADDRESS CITY SIDE PROP.LINE OF (STREET) SQ. FT. o NO. OF NO. OF CHECK HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING SIZE �p STORIES / FAMILIES ONE SIDE PROP. LINE HIGHWAY WIDTH � DESCRIPTION OF WORK NEW ❑ t a r�NF ADD CORNER CUTOFF YES ❑ NO C] Z ALTER ❑ F REPAIR IN OPEN SPACE YES ❑ NO ❑ EXISUSE OT NG BLDG, PY/,. ✓isj� C% EMOL ❑ IN COASTAL PERMIT ZONE YES ❑ NO ❑ APPLICANT TEL d Q (PRINT) NO. n BY (SIGNATURE) /L e` I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO ✓ WORKMEN'S COMPENSATION INSURANCE. h AJ �i1/L SIGNATURE OF FINAL _ 1/ �VV PERMITTEE DATE ADDRESS k rx7_ TEL. CITY TG-i No. S✓��.` P.C.Ffe!e$ �cS-- Permit Fee / ,je OJ Oki ��{ C ` Issuance Fee VALUATION$ J /�oO6 ;3", /0' C TO ee PLAN CHECK VA TION CK. M.O. CASH _ PERMIT VALIDAT NVQ (c,,',) M O. CASH 3 3 - A':• E o to ' �� 4 5.4 � 2 7 6r:N1AR 22 jj 2 0 2 5 •`� �j .7 7 {��{ `� 1 r► c^r 76A638A CE#8038 12/75 2 ` • i-lMAk 22 1 , 1 V 9-5 0 `�`