HomeMy Public PortalAbout10239 GREEN ST_Building__ TEPAPLE CITY
7QA66AA CE#808.1-61 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS l _'� } I, ( j ` -
BUILDING AND SAFETY DMSION LOCALITY-
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST �f
WILLIAM A. JENSEN SUPT OP BUILDING CROSS ST.
DISTRICT NO. GRO TYPE PIRotEr BY
FOR APPLICANT TO FILL IN J ( .j CONST. =
BUILDING ^ /��7 STATISTICALCLA IFICATION SE ER MAP
te}
ADDRESS j' -PK P
CLASS. NO. - DWELL.UNITS�I �, /'/ fl
LOT NO. i l 7 'a BLOCK WATER
nn CERTIFICATE: NOT REQUIREDla
RECEIVED
TRACT 4/ J .L' 3-/Iw MAP HIGHWAY STATE MAJOR SECON LOCAL
SIZE OF LOT
j\� / I NOW ON LOTNO.OF S SO ZONE SPECIAL LE)
USE OF J+ ' CONDITIONS
EXISTING BLDG. e r
TEL
OWNER NO. ` BUILDING YARD HWY STREET NAME EXIST.
���H�7��si �� �� SETBACK WIDTH
ADDRESS, / Pwd+ FRONT
ARCHITECT R EL. P.L. C - .'/ .�..4
ENGINEER NO. SIDE
P.L. }
ADDRESS CL
TEL. INSPECTION RECORD CL
CONTRACTOR '^ NO. 7V
ADDRESS - r O
DESCRIPTION OF WORKCIL
u
w
NEW ADD ALTER REPAIR EMOLISH 1 N
Z
III
SC!.FT. NO.OF
$IZE STORIES FAMILIES
USE OF
STRUCTURE a'&7si4
SIGNATURE OF
APPLICANT
VALUATION L?--Zl
APPROVALS DATE INSPECTOR'S SIGNATURE
!! FOUNDATION: LOCATION
FEE $ FEE $ L �� t. FORMS,MATERIALS
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION.
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CONSTRUCTION. ICERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERS IN VIOLA- LATH, INT.
TION OF THE LABOR CODE OF THE STATE OF C LIF NIA RELAT.
S N
ING TO WORKMEN'S CO R NON IN A
LATH.EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE- /7 RECT AND POSTED
ADDRESS ��? `- rFINAL
CLYDE N. DIRLAM, PRINCIPAL ST RAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
4606 JAN �
L�ILS