HomeMy Public PortalAbout10965 GRAND AVE_Building__ 75A638A CE 9803 3-69 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING % <'—
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPT OF BUILDING NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN
DISTRICT NO. GROUP TYPE CONST. PROCES <
"
(PRINT OR TYPE ONLY)
BUILDING STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS f L' r°: CLASS NO. DWELL.UNITS BK PG
Yn
r
LOT BLOCK USE ZONE MAP
NO.
TRACj SPECIAL
N0. OF BLOGS. CONDITIONS
SIZE pF LOT NOW ON LOT
USE 0.�.,, t:
EXISTI G DG. moo I dw= BLDG. SETBACK FROM
TEL. FRONT PROP. LINE OF (STREET)
OWNER -.,.r N0. TYPE OF EXISTING SETBACK HIGHWAY + YARDS - TOTAL
HIGHWAYI WIDTH FROM C.L.
ADDRESS ?
T
+
CITY
ARCHITECT OR TEL. BLDG.SETBACK FROM
ENGINEER N0. SIDE PROP. LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C.L.
Q_
=
CONTRACTOR S :y TEL. + ON
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ADDRESS "4 :, NO.I,'.',' CORNER CUTOFF YES ❑ N'0. ❑ J
CITY - CLASS., SEE REVERSE SIDE FOR SPECIAL APPROVALS }
CONSTRUCTION LENDER Ax
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NAME AND BRANCH Z
ADDRESS - 0
SQ. FT. NO. OF NO. OF - ❑OF :
:E
STORIES FAMILIES NEW _ H
LAPPLICANT
» ADD ❑
ALTERREPAIR DEMOL TSI'+ APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. PMT. FOUNDATION: LOCATION
FEE $ '7FEE $ FORMS MATERIALS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION FRAME: FIRE STOPS,
BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION,
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUC- GAS VENT DUCTS
TION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I
WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE LATH, INT.
OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM-
PENSATION INSURANCE. .. LATH, EXT.
SIGNATURE OF 5 "'_- HOUSE NUMBER CORRECT
PERMITTEE `. , � Az r + *• AND POSTED
ADDRESS— -`x ..�a .�, C;a;t4"',
r-=-^ 'j P'� ".'��--! ai--='i—lac ---:J,
FINAL
JOHN F. LEWIS, PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH - PERMIT VALIDATION CK. M.0. CASH
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