HomeMy Public PortalAbout10238 GREEN ST_Building__ APPLICATION FOR BU LDING PERMIT
LR AF'S41'ANT TO FILL IN (Print or type only)
COUNTY OF LOS ANGELES
BUIL,.,JG
ADDRESS , DEPARTMENT OF COUNTY ENGINEER
CITY Efil )I-e 40. ZIPBUILLDING AND SAFETY DIVISION
SI F 10 NOW ON LOT ADIDRESS LDING OZ J���ICrGG v
J
T R I BLOCK LOT NO. LOCALITY (_>17 TELNEAREST
T
OWNER CWA- k NO. � CROSSST.
ASSESSOR
ADDRESS �'�j� �'' MAP BOOK PAGE PARCEL
...; DISTRICT GROUP TYPE FIREPR SED BY
-CITY C_� ZIP 0� L CONST. ZONf�
ARCHITEC OR TEL. l.7
ENGINEER NO. STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS CLASS NO. `�� DWELL.UNITS BK(9 PG
vV L.
CONTRACTOR N USE ZONE MAP
SPECIAL
ADDRESS {Z, of / AJI NLIC OZ CONDITIO S
CITY C� �I/4► CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑
CONSTRUCTION LENDER
NAME AND BRANCH BLDG.SETBACK FROM / l
FRONT PROP.LINE OF ✓� �--�� w (STREET)
ADDRES CITY TOTAL SETBACK FROM TYPE OF EXISTING
SQ.F NO.OF r NO.OF CHECK HIGHWAY + YARD = FRONT PROP,LINE HIGHWAY WIDTH
SIZE STORIES 1 FAMILIES ONE }
DESCRIPTION OF WORK,41V
D � ANEWDD ❑ + O
BLDG.SETBACK FROM SIDE PROP.LINE OF (STREET) O
ALTER ❑ TOTAL SETBACK FROM TYPE OF EXISTING w
HIGHWAY + YARD = SIDE PROP.LINE HIGHWAY WIDTH N
USE OF N6 REPAIR 11:1E] Z
EXISTING BLDG. 1 YDEMOL +
APPLICANT TEL CORNER CUTOFF YES ❑ NO ❑
(PRINT) NO.
IN OPEN SPACE YES ❑ NO ❑
BY(SIGNATURE) IN COASTAL PERMIT ZONE YES ❑ NO ❑
VALUATION$ I, U //,
I HEREBY 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 EMPLOY ANY PERSON IN VIOLATION OF
THE LABOR CODE OF THE STAW OF CALIFORNIA IN REL TING TO WORKMEN'S COM-
PENSATION INSURANCE.
SIGNATURE OF
PERMITTEE
ADDRESS
,je-O �I FINAL BY
CITY
Li: �^��. N07 Q DATE
MAKE CHECKS PAYABLE TO: FEE' $ FEET $
HARVEY T.BRANDT,COUNTY ENGINEER
�q. �S
PLAN CHECK VALIDATION CK. M.O. CASH i PERMIT VALIDATIONM.O. CASH
CK.
17brt 1 1 89.25
®s 76A638A CE#803 3-75
APPLICATION FOR BUILDING PERMIT
FOR,AI�JPLICANT TO FILL IN (Print or type only)
BUILDING COUNTY OF LOS ANGELES
ADDRESS DEPARTMENT OF COUNTY ENGINEER
CIT ZIP BUILDING AND SAFETY DIVISION
O.OF BLDGS. BUILDING
SIZE OF LOT OW ON LOT ADDRESS
4
44CL -CK LOT NO. Z Z LOCALITY
TEL. EAREST
OWNER NO. %ROSS ST.
ASSESSOR
ADDRE 1DY MAP BOOK PAGE PARCEL
DISTRICT I GR TYPE FIRE SED BY
CITY p NS,T.
ARCHITECT OV TEL. �5- •', 'rte
ENGINEER NO.
STATISTICAL CLASSIFICATION S WER M
ADDRESS CLASS NO, �/ DWELL.UNITS BF�7G
CONTRACTO IG NOL. -USE ZONE MAP
LIC. //s� NO. <J Q
ADDRESS p, ZyVsi� Ur ,i1 SPECIAL
LIC. ` CONDITIONS
CITY CLASS
ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑
CONSTRUCTION LENDER
NAME AND BRANCH C" BLDG.SETBACK FROM
FRONT ROP,LINE OF (STREET)
ADDRESS
HIGHWA } YARD TOTAL SETBACK FROM TYPE OF EXISTING
SQ. FT. NO. OF NO. OF CHECK FRONT PROP. LINE HIGHWAY WIDTH
SIZE FT,
STORIES FAMILIES ONE
r
DESCRIPTION OF WORK NEW ❑ } OM U
ADD � SIBLDG.S P ACK LINE F
A-ZJ ///`CCC SIDE PR ,LINE OF (STREET) C)
❑ O
ALTER HIGHWAY D = TOTAL SETBACK FROM TYPE OF EXISTING H
REPAIR❑ HIGHWAY WIDTH a
},
USE OF } = N
EXISTING BLDG.
EMOL Z
APPLICANT TEL CORNER CUTOFF YES ❑ NO E]
RINT) NO.
BY (SIGNATURE) IN OPEN SPACE YES ❑ NO ❑
IN COASTAL PERMIT ZONE YES ❑ NO ❑
VALUATION$
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT EM OT',R/IY PERSON IN VIOL CON OF THE
LABOR CODE OF T STATE `OF CALIFORNIA I ,RELATING TO
WORKMEN'S COM NSATION JJASURANCE.
SIGNATURE '
PERMITTE
ADDRESS ,
FINAL
CITY TE NOL DATE /1,� ��j✓ `'�---"
UKE CHECKS PA}A13LE l'Or FEE $ (/ FEE
HARVEY T. BRANDT, COUNTY ENGINEER / —�
PLAN'CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIONcK. M.O. CASH
6 0.2v'0-,Rlfi! 25 1 9 1 5.0 0 •`
76A638A CE#803 5/74
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7BA638A CE#803-6-57 APPLICATION FOR BUILDING PERMJT Z
COUNTY OF LOS ANGELES BUILDING Y�
DEPARTMENT OF COUNTY ENGINEER ADDRESS Q(i
BUILDING AND SAFETY DIVISION LOCALITY /
JOHN A.LAMBIE,COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST.
FOR APPLICANT TO FILL IN
DISTRICT NO. GROUP TYPEBK
MAP PG
BUILDI / 3
co
NG
ADORE .Z- �A ( STATISTICAL CLASSIFICATION
ADD
LOTRE C BLOCK CLASS.NO.--/—DWELL.UNITS�I
MAP STATE
NUMBER J/8 HWY. YES NO
TRACT USE Z NE SPECIAL
NO.OF SLOGS /1T] CONDITIONS
SIZE OF LOT�� 72•s� NOW ON LOT�e/I�(f
USEOF
EXISTING BLDG. BUILDINGEXIST.
YARD HWY ST ET NAME
,, SETBACK WIDTH
OWNER � FRONT
MAIL P.L.
ADDRESS SIDE
TEL. P.L.
CITY NO.S 31 Z7 INSPECTION RECORD
ARCHITECT OR TEL.
ENGINEER NO.
ADDRESS
CONTRACTO O f e J.272,7
ADDRESS I Z V, 1- �, S • 1 ��
DESCRIPTION OF WORK
ADD ALTER REPAIR DEMOLISH
SQ.FT. NO.OF NO.OF 1
SIZE / Q STORIES FAMILIES
USE OF STRUCTURE
•�fit1
SIGNATURE APPROVALS
APPLICAN
DATE INSPECTOR'S SIGNATURE
ADDRESS FOUNDATION: LOCATION "
FORMS.MATERIALS
$ / ^'7 l P.P•C• S - FRAME: FIRE STOPS.
V FEE BRACING.BOLTS
VALUATION FURNACE: LOCATION. _
FEE GAS VENT,DUCTS Q
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH,INT.
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUN ORDINANCES AND y�;• /�I
STATE LAWS R TING B G CONSTRUCTIO LATH,EXT. .✓`'" /''^•f-f
SIGNATURE HOUSE NUMBER COR- �'
PERM ITT �'� � RECTANDPOSTED
, S'4' '�9 FINAL
ADDRESS A.4 _ r
JOHN A. LAMBIE,COUNTY ENGINEER. CLYDE N. DIRLAM, PRINCIPAL STRUC URAL ENGINEER
PLAN CHECK VALIDATION M.O. CASH PERMIT VALIDATION C M.O. CASH
9M T!'7 101 6 16.75 � a
. o? oo3 MAR 14 1 A 33.50
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