HomeMy Public PortalAbout5632 GLICKMAN AVE_Building__ t
7YA888ACE4180,_. . APPLICATION FOR BUIL ING PERMIT
COUNTY OF LOS ANGELES BUILDINGSS ( .3 ,2 6
DEPARTMENT OF COUNTY ENGINEER ADORE
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST.
DISTRICT NO iGROUP TTP PRO ESSED BY
FOR APPLICANT TO FILL IN , ! I CONST.
BUILDING STATISTICAL CLASSIFICATION I EWER MAP
ADDRESS
�� 4JT._" �i1 CLASS. NO. DWELL. UNITS-_/-I If
LOT NO p� �CK MAP STATE YES NO
NUMBER D HWY.
T ACTS �`�•' 4: 'FL!
L['� ✓t C Y b USE ZONE CONDITION TSPECIAL 3='�_:36
�
LDGS. /? /
SIZE OF LOT k-- on NOW N LOT f r
USE OF
EXISTING BLDG. BUILDING YARD HWY STREET NAME EXIST.
j TEL. S BACK WIDTH
OWNER r NO. / ONT
�h P.
ADDRESS SIDE
ARCHITECT OR TEL. P.L.
ENGINEER NO. INSPECTION RECORD
}
ADDRESS _ _ CL
TEL. l �� - - v,[L..,. O
CONTRACTORNO. V
ADDRESS O
DESCRIPTION OF WORE W
eE ADD ALTER REPAIR DEMOLISH
NO.OF
N
SO.FT. J //�� NO.OF /� / - '"�' ' _ ✓._..`s"�- $.., - _.
SIZE / (p ��(� STORIES / FAMILIES
USE OF
STRUCTURE •ter S c / / EKG `�'c•p ..,, ',:.�
irIeo prA e' en,a r
4-Q
SIGNATURE OF �I
APPLICANT
I
VALUATION$ O
APPROVALS DATE INSPECTOR'S SIGNATURE
P C I I PMT.. FOUNDATION: LOCATION
FEE FEE $ f FORMS. MATERIALS
FRAME: FIRE STOPS.
1 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 A
BUILDING CONSTRUCTION, I CERTIFY THAT IN THE PERFORMANCE r!
OF THE WORK FOR WHICH THIS PERMIT IS ISSUED I SHALL NOT LATH, INT. '
EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBUECT
TO THE WOR EN'S COMPENSATION LA OF CALIFORNIA. s �C
LATH,EXT.
SIGNATURE OF HOUSE NUMBER COR
-
PERMITTE RECT AND POSTED
ADDRESS FINAL
CLYDE N. DIRLAM, PRINCIPAL STR L ENGINEER
PLAN CHECK VALIDATION (CASH PERMIT VALIDATION (C>/M.o. CASH
5 3 7 .qui ?5 1 b �