HomeMy Public PortalAbout6046 GOLDEN WEST AVE_Building__ 76A698A DBB.9 12.34 APPLICATIONFOR BUILDING PERM-IT
DMSION OF BUILDING AND SAFETY App EISS CP D 5P'4 iY (f'AZ.G'1-;71S/ k1/a-a.d,—
Department of County Engineer
County of Los_Angeles
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W,M.X.-FOX, COUNTY ENGINEER y� �gjA•
CASSATT D:GRIFFIN, SUPT OF BUILDING NEARECROSS ST
DISTRICT NOGROUP WER MAP -
FOR APPLICANT TO-FILL IN TYPE CK FG.
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BUILDING /• /� //�J/ �j
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ADDRESS d f '"fVi (n b L D l`_'/V 11! NUMAPMBER t O J STAT YES \El0]
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LOT NO. - BLOCK USE ZONE SPECIAL
CONDITIONS - -
TRACT,.
NO OF SLOGS. -y .
SIZE OF LOT ��• X Z a L7 NOW ON LOT BUILDING YARD HWY "STREET NAME EXIST
USE OF - SETBACK - WIDTH
EXISTING BLDG S (p �„ _gA FRONT 4,R1 �' ,;r v ,�•��.q* / r)
OWNER b /4 SIDE Od4V (1,' G.r'1 /i%l. d./ (1.�
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ADDRESS _
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TEL. I DWELL. 1 UNIT 5INDUSTRIALtie
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CITY NO
2 DUPLEX_UNIT S PUBLIC BLDG
ARCHITECT OR TEL.
ENGINEER NO. 3 APT -UNITS - 7 ADDN ,ALT, ETC
.ADDRESS /� p ' • _ 4 COMMERCIAL 8 MISCEL
TELCONTRACTL20 —
OR r n(�"� She JPA/NO.Ad �� 7 INSPECTION •RECORD
AD6RESSL2 CJ /I�LG?1//GC.Q1 L /"(GN - - _ - --- - -- -- - - �- -
' DESCRIPTION OF WORK -
s-/�s�s'
NEW ADD °ALTER •REPAIR DEMOLISH A/��, f,r,lg�f ���/nF� F.�Y .�,�.��
SO. FT. ` NO OF ` NO OF
SIZE ( ST �(/ORIES / FAMILIES •� _
USE OF-STRUCTURE
�a
SIGNATURE OF
APPLICANT APPROVALS - -
ADDRE - DATE INSPECTOR'S SIGNATURE
C� FOUNDATION 'LOCATION 00
P C. $ FORMS, MATERIALS �L• rlA ,
FEE FRAME FIRE STOPS,
VALUATION E 'mai"` BRACING, BOLTS
FEE FURNACE- LOCATION,
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS GAS VENT, DUCTS
APPLICATION AND STATE THATABOVE IS CORRECT LgTH, INT •IT 6�IA 8► /Q p [t
AND AGREE TO COMPLY A L C UNTY ORDINANCES
AND STATE L ING UI DING CONSTRUC-
TION.
_ LATH, EXT.
--SIGNATURE OF HOUSE NUMBER COR- -
PERMIT RECT AND.POSTED ,,�J
ADDRESS - FINAL (�• � / /
WM. J. FOX, COUNTY ENGINEER VALIDATION -
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in -'
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DEPUTY J - • - - DEPUTY,.
BY BY //��p//�,
® DEPUTY - DEPUTY ,
CE#803 jR'V 11/78)
_____T_APPLI_CATIO.N FOR BUILDING. PERMIT
COUNTY OF LOS ANGELES : BUILDING AND SAFETY. '
BUILDING O
_. FOR APPLICANT TO.F.ILL IN ADDREss.- -
BUILDING
ADDRESS L WE sr LOCALITY_ E,
�7 NEAREST
CITY /T ZIP / CROSSST
NO OF BLDGS ASSESSOR_
SIZE,OF LOT NOW ON LOT MAP BOOK PAGE - PARCEL,
DISTRICT GROUP 'TYPE FIRE PROCESSED BY
TRACT BLOCK' r LOT NO CONST' �rZONE_
_ L
OTEO -E s .U�
WNER E AN
STATISTICAL CLASSIFICATION"' SEWER MA
ADDRESS y CLASS NO DWELL UNITS �BK IPG, _
CITY ZIP
R
ARCHITECT'O0,1&;4j,-
�
ENGINEER- - N'- TEL NO - ;o�_ .Jr. VALUATION'
ADDRESSG _ BLDG SETBACK FROM
TEL c'�/ FRONT PROP LINE OF (STREET)
CONTRALTO NO ` HIGHWAY + YARD •_ TOTAL SETBACK FROM TYPE OF EXISTING
n LIC FRONT PROP LINE HIGHWAY WIDTH t
ADDRESS /02 ,QC 'NO D
LIC: -M +
CITY `
CONSTRUCTION LENDER - S4 __ Y -CLASStV" BLDG SETBACK FROM
SIDE PROP LINE OF (STREET)
NAME AND BRANCH
HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING p,
ADDRESS CITY SIDE PROP LINE IHIGHWAYI WIDTH, Q
SO FTNO OF NO OF CHECK +
SIZE STORIES r FAMILIES L 'ONE" ! r
USE ZONE MAP �t �J _ O
DES RIPTION OF WORK • NEW-• NO`- - p0 /
SPECIAL
/02 ADD' ❑ / CONDI
:� •��/ ? ALTER ❑ FINAL B `
ct (O c> REPAIR •❑ DATE
USE OF ❑ +"L Y,: �-
DEMOL ��,�
EXISTING BLDG _ _ � !GJ'�^'�: .� •�_ t ZO _ ,.. �• -
APPLICANT TEL h _�!
IPRINTI NO (•�/' Q
BY(SIGNATURE(;
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE uY # o o o o-2 1 ;•
,THAT THE ABOVE IS CORRECT AND AGREE TO,COMPLY WITH ALL ORDINANCES
'AND LAWS REGULATING-BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE _ _ - •2 O o /� 3 Z C.•v - r•-�
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF I-V W- lJ ,
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN S_COM, 2 _
PENSATION INSURA - h• M o O o'4 5:3 6
SIGNATURE 0 5,2 2�—8 0
PERMITTEE L
ADDRESS oieOd - t 2 Z 0 4 7.5
CITY /T� - - T _ ..-. .__ 0 0 0 00 1 _
- - - - - 2'o -o-88. 00' ,
P C Fee$ 61s-j� Permit Fee f) >
f o - 89006 ,
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Issuance Fee _�,W t��Z2=�Q .
Total Fee _