HomeMy Public PortalAbout5623 GRACEWOOD AVE_Building__ i
DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES
GINEER �� ' �, t r BUILDING
WM. J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY ; - 3
DISTRICT-MO. PLAN CK. NO. PERMIT NO.
BUILDING �..
ADDRESS ( �. �A�: K/au� . l 7),7-S
LOCALITY R,FyCE1VED BY DATE OF APPL. DATE ISSUED
T.
NEAREST ('� I L"`y"N J ( 1�}•`�� 1 /- � .
CROSS ST. [ I V�p �J 4�/ BUILDING �y~ �c
1 1 0� T-4 IT -T ADDRESS - C OPQ c ,/(.r'✓'V
OWNER I t
MAIL
(r C '\ LOCALITY '�+ C
ADDRESS O N .
'1. " R t G 4r �o U �1NEAREST
C TEL. CROSS ST. '9
CITY _
NO. FIRE NO. OF „Z,... I TYPE GROUP
ARCHITECT OR TEL. ZONE PLANS --h
ENGINEER NO ✓ BLDG,
SETBACK LINE
ADDRESS �� � APPROVED _
.r; TEL BY DATE
CONTRACTOR NO. USE APPROVED
ZONE BY DATE
ADDRESS HOUSE NUMBERING
LEGAL L Q T
DESCRIPTION I LOT NO. I BLOCK MAF NUMBER / FIELD CHECK BY
TRACT
�" /'.I�" Q NO. ASSIGNED BYATF
�.. _ r"' T� !+�'� - _
,. I NO. OF BLDGS. CORRECTIONS
SIZE OF LOT ' a U NOW ON LOT /O IV e
USE OF I NO. OF
EXISTING BLDG, FAMILIES a L t 9/j 16
DESCRIPTION OF WORT II i. 'T rF
�'� t�d"i 1 tl � ON-T(> t1�•r c�l.f T uIPBc'D '
NEW I ALTERATION I I ADDITION I
elft T It'd' I 1.- -�0-I,►) 0
REPAIR I I DEMOLITION Q
Q. FT. NO. OF t
fIZE ROOMS STORIES Y
COVER NG` jj��/4:;_ I COVERING Ma ROOF C'
USE OF STRUCTURE
Ile
APPROVALS
'1 INSPECTOR'S SIGNATURE DATE
I
HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FOUNDATION: LOCATION
PLICATION AND STATE THAT THE IN
GIVEN IS FORMS, MATERIALS L "'TI�`'I w ^✓G1 �� r
CORRECT,
I AGREE TO COMPLY WITH THE CORRECTIONS LISTED FRAME: FIRE STOPS,
HEREON AND WITH ALL COUNTY ORDINANCES AND STATE BRACING, BOLTS L-�
LAWS REGULATING BU Ll �O UCTION. FURNACE: LOCATION,
GAS VENT, DUCTSg'-
SIGNATURB OF �/ Qom,
PERMITTE !^
LATH, INT.
ADDRESS
LATH, EXT. p�
AUTHORIZED AGT.
PLASTER, INT.
76AS28A- D893 10-50 .� P. C. 8
OO y` r -y 0(� FEE C7- ,+ j'0 PLASTER, EXT.
VALUATION r 8c
CSS t a,.
FEE � ` , FINAL
r '7:W7,4 P4- (_ / - yy
•A APPLICATION FOR BUCLDING PERMIT
FOR APPLICANT TO FILL IN (Print or type only)
BUILDING COUNTY OF LOS ANGELES
ADDRESS J C�rr�,2a� DEPARTMENT OF COUNTY ENGINEER
CITY ' , i� c i�' ZIP BUILDING AND SAFETY DIVISION
NO.OF BUILDING —! -h'a IAt&O-C>
OF LOT NOW ONN LOT LOT ADDRESS (O'
TRACT h�_ BLOCK LOT NO.TEL `` LOCALITY �� / z QC L���I��-` l - C T
OWNER
!/'�/ NEAREST
(j �/�s NO. %�� COSSST. �� — Q41<
ASSESSOR
ADDRESS �� �0� '�'1�" U MAP BOOK PAGE PARCEL
DISTRICT GROUP TYPE FIRE � ROCESSED BY
-CITY /.may 074 GiTZlp CONST. ZONE�>J
ARCHITECT OR TEL. v Z Q J
ENGINEER NO, STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS CLASS NO. DWELL.UNITS BK PG
EL
CONTRACTO (i411�11T lG+ticl! IV'.NOf_71_-v .6j USE ZONE MAPLIC r NO, s�
66 )
ADDRESS/_? A • .-.fT,P�X OV NO.�-7s 9;S- I SPECIAL
L
LIC CONDITIONS
CITY 401a A/ CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑
CONSTRUCTION LENDER// ✓ �������
NAME AND BRANCH /b/®J BLDG.SETBACK FROM
FRONT PROP.LINE OF (STREET)
ADDRESS CITY __ TOTAL SETBACK FROM TYPE Of EXISTING
HIGHWAY + YARD
SQ.FT. !/n NO.OF NO.OF i' CHECK FRONT PROP.LINE HIGHWAY WIDTH
SIZE O`� STORIES FAMILIES / ONE }
DESCRIPTION OF WORK NEW ❑ + O
BLDG.SETBACK FROM
ADD SIDE PROP.LINE OF (STREET) O
ALTER ❑ TOTAL SETBACK FROM TYPE OF EXISTING w
REPAIR ❑ HIGHWAY + YARD = SIDE PROP.LINE HIGHWAY WIDTH N
USE OF �s,,��'��"� __ Z
EXISTING BLDG..J;A146or �/f/��`% J04 •1( -DEMOL 1:1 +
APPRINTNTZ/- / TEL S-f�6L�f CORNER CUTOFF YES C] NO ❑
N OPEN SPACE YES ❑ NO ❑
BY(SIGNATURE(
���� 11 IN COASTAL PERMIT ZONE YES ❑ NO
Q
VALUATION.p L:Jr'•O
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 EMP OY ANY PERSON IN VIOLATION OF
THE LABOR CODE OF THE STATE OF CALIFO IN RELATING TO WORKMEN'S COM
PENSATION INSURANCE.
SIGNATURE OF
PERMITTEE y
ADDRESS
`,t>'4 TELNO.��I��OO DATEL BY .
CITY Q
MAKE CHECKS PAYABLE TO: FEE' P FEET$ Z Z S
HARVEY T. BRANDT.COUNTY ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION K. M.O. CASH
4 1 D 6 22- 5 •
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