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7EA889A Ci48096-58 APPLICATION FOR BUILDING PERMIT 1
COUNTY OF LOS ANGELES BUILDING J !7/ �'�'
DEPARTMENT OF COUNTY ENGINEER ADDRESS a (p ( i e_ &0_6- LA..) C�d
BUILDING AND SAFETY DIVISION LOCALITY -A
JOHN A.LAMBIE,COUNTY ENGINEER NEAREST ) °
CASSATT D.GRIFFIN,j&;OF BUILDING CROSS ST. �[„ ���"""
DISTRICTNO. GROUP I TYPE y PROCESSED Wr
FOR APPLICANT TO FILL IN CONST.v
BUILDING /_ STATISTICAL ASSIFICATION I S€BWKR MAP
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ADDRESS (O
CLASS.NO. DWELL. UNITS
LOT NO. MAP d TATSE
YES O
7 /� NUMBER
TRACT -.S ,y!}[ �� 1 N S A h P 4*-- USE ZONE SPECIAL
NO.OF BLDGS. y CONDITIONS
SIZE F LOT ?U I NOW ON LOT f /} c�
USE OF
EXISTING BLDG. BL4t&ING EXIST.
T SETBACK YARD STREET NAME WIDTH
OWNER }-' �A--�((�� �S [�� FRONT / s I
MAIL P.L.
� I�r �� [f
ADDRESS ern 2( r2 pE.(�P.Lu CTC I1 P.
CITY A,t� CSA 17 t�- No' I
ARCHITECT OR TEL. NSPECTION RECORD
ENGINEER NO.
ADDRESS
CONTRACTOR dd '�
ADDRESS
DESCRIPTION OF WORK
NEW ADD ALTER REPAIR DEMOLISH
SCI.FT. ,y' NO.OF NO.OF (Sw
SIZE C/ STORIES FAMILIES/
USE OF STRUCTURE J,,r I \ I
•r, ..� t
SIGNATURE OF APPROVALS
APPLICANT
ADDRESS �. DATE INSPECTOR'S SIGNATURE
FOUNDATION: LOCATION
FORMS.MATERIALS
$ (� ! P.C. $ `� FRAME: FIRE STOPS.
FEE BRACING, BOLTS
VALUATION IV v'-F+' $ ��jj 6n rT FURNACE: LOCATION,
FEE �L,J GAS VENT. DUCTS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH, INT. !�
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATE LAWS REG NG UIL�►NG C NSTRUCTION, LATH, EXT.
SIGNATURE OF _. HOUSE NUMBER COR- c
PERMITTEE RECT AND POSTED f ?
ADDRESS FINAL
CLYDE N. DIRLAM, PRINCIPAL STRljrwTURAL ENGINEER
PLAN CHECK VALIDATION cK M.O. CASH PERMIT VALIDATION c j M.O. CASH
! C5460�. OCT 22 3 A 15,00iP
LAW^5714- OCT14 1 A 3 0.0 0