HomeMy Public PortalAbout10867 GRAND AVE_Building__ 79A000A CE#8032/00 APPLICATION FOR BUILDING PERMIT I
COUNTY OF LOS ANGELES ADD Els,/ Da 6S f v l
DEPARTMENT OF COUNTY ENGINEER -
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN SUP'T OF BUILDING CROSS ST. .!l,,;� " ✓t
DISTRICT O. GROUPTyPE __ P ESSED BY
FOR APPLICANT TO FILL IN , �7 I CONST. I '
,p STATISTICAL CLASSIFICATION I S BK MAP
BUILDING /,/O tJ (D r Gil wpo �� r
CLASS.NO. DWELL.UNITS
LOT NO. BLOCK MAP - STATE
NUMBER HWY. YES O'er
TRACT O �`O USE ZONE SPECIAL
NO.OF BLDGS. /� CONDITIONS
SIZE OF LOT/�� K So I NOW ON LOT /J l} /
USE OF ✓
EXISTING BLDG. X-41 BUILDINGEXIST.
TEL YARD HWY REET NAM
/ r. SETBACK WIDTH
OWNER ' �`�� G O NO.mfr >S• FRONT -�
h C)I: J vC �lA'A /Vl� P.L. �h
ADDRESS fSIDE
ARCHITECT OR TEL. P.L.
ENGINEER NO. INSPECTION RECORD
ADDRESS /
TEL. f� WC.=� - - a
CONTRACTOR CrGCf�G�/ NO.
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ADDRESS 7/ L V
DESCRIPTION OF WORK a
H
NEW ADD ALTER REPAIR DEMOLISH W
SQ.FT. - NO.OF ` NO.OF
SIZE STORIES / FAMILIES USE OF
STR CTURE //T
SIGNATURE -
APPLICANT /�+,
VALUAT N$ O 0 f Cj-fl
APPROVALS DATE INSPECTOR'S SIGNATURE
PI PMT �L FOUNDATION: LOCATION
FE FEE $ FORMS,MATERIALS l (a
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1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FRAME: FIRE STOPS,BRACING, BOLTS I '�
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND FURNACE: LOCATION,
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND GAS VENT,DUCTS
STATE LAWS REGULATING BUILDING CONSTRUCTION.
1 CERTIFY THAT IN DOING THE WORK AUTHORIZED 1 LATH, INT.
WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE ,
WORKMEN'S COMPENS.4TION LAWS OF LIFORNIA. fl
LATH,EXT.
SIGNATURE HOUSE NUMBER COR-
PERMITTE RECT AND POSTED
ADDRE FINAL
CLYDE N. DIRLAM, PRINCIPAL ST RAL ENGINEER
PLAN CHECK VALIDATION CK. M.C. CASH PERMIT VALIDATION CK. M.O. CASH
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