HomeMy Public PortalAbout5956 GOLDEN WEST AVE_Building__ 76A638A CE#803 8-64 APPLICATION FOR BUILDING PERM,
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DMSION LOCALITY Z r
JOHN A. LAMBIE, COUNTY ENGINEER' - NEAREST -
COLEMAN W JENKINSAUP'T OF BL�LDING - CROSS ST
OISTRICTNOM GrR - TYPE "� R♦?' D
FOR APPLICANT.'TO FILL IN �'' CONST !�
BUILDING5 STATISTICAL SSIFICATION SEWER MAP
ADDRESS + � - CLASS NO DWELL UNITS -BK G /^{/
LOT NO BLOCK USE ZONE MAP -- �J 0
NO. GC_
TRACT - - - SPECIAL
NO OF BLDGS - CONDITIONS -
SIZE OF LOT NO ON LOT
USE OF'
EXI BLDG SETBACK FROM
TEL - FRONT PROP LINE OF _ (STREET)-
OWNER a NO TYPE OF EXISTING SETBACK ,HIGHWAY + YARD' = TOTAL
,ADDRESS HIGHWAY WIDTH FRQM C L
CITY / ` BLDG SETBALN FROM -
ARCHITECT OR - TEL - SIDE PROP LINE OF I9 TREET)
ENGINEER NO
TYPE OF EXISTING SETBACK HIGHWAY YARD = TOTAL
ADDRESS ' HIGHWAY WIDTH
FR'OM C LCL
CONTRACTOR NOLJ/ 5`J.y « "' + /D _ - /� OV
ADDR ESSZ NO / 76 V _ CORNER CUTOFF YES NO O
CITY LID G _37 SEE REVERSE SIDE 'FOR SPECIAL APPROVALS
DESCRIPTION OF WORKCL
Z_
NEW ADD ALTER REPAIR DEMOLISH '
SQ,FT - NO OF NO OP
SIZE STORIES FAMILIES
USE OF"
STRUCTURE
-SIGNATURE OF
" APPLICANT - -
ZVALUATION$ - APPROVALS, DATE INSPECTOR'SSIGNATURE
P C r ,� FOUNDATION, LOCATION
FEE$ FEE$ FORMS,-MATERIALS-__ �
FRAME, FIRE STOPS, / f"
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTJ
AND STATE THAT THE ABOVE IS CORRECT AND-AGREE TO COMPLY, FURNACE: LOCATION
WITH ALL COUNTY ORDINANCES AND STATE.LAWS REGULATING GAS VENT DUCTS
91_lILDING 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 CALI NIA RELAT-
ING TO WORKMEN'S COMPE SATI N IN RA LATH EXT
SIGNATURE OF HOUSE NUMBER COR- - ` `,•/
PERMITTEE RECT AND POSTED
ADDRESS-2--6-57I N A L
eN
PLAN CHECK VALIDATION ' CK M O CASH _ JOHNPERMIT VALIDATION TRCKTURM o N CASH
L�.07 6 9 S� JAN20 1 0 .1 1.50"-
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