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96A638A OER8035-65 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESSn—
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS,SUP'T OF BUILDING CROSS ST.
I- STATISTICAL
RICT NO. TYPE. P 5 BY
FOR APPLICANT TO FILL INiV� CONST. (�
BUILDING SI� JJ����f //�� CLASSIFICATION SE R MAP
ADORESS7 SS NO._/—DWELL UNITS -- SK PGLOT NO. z BLOCKZONE MAP 0TRACT � `SPECIAL
NO. OF BLOBS. CONDITIONS
SIZE OF LOT NOW ON LOT
USE OFP L
E%I$ ING BLDG. BLDG. SETBACK FROM
e, 4a� �(��` FRONT PROP. LINE OF ,(STREET)
OWNER C /7 OT TYPE OF EXISTING SETBACK HIGHWAY + YARD - TOTAL
ADDRESS
C G+ HI HWAY WIDTH FROM C.L.
CITY W FJ �� T 0 •a O +
ARCHITECT OR TEL. BLDE. S TRACK FROM
ENGINEER NO, SIDE PROP. LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C.L.
TEL. �(+ + - d
CONTRACTOR NO ll O
LIC c CORNER CUTOFF YES NO 0
ADDRESS '� NO
K
CITY //du c s SEE REVERSE SIDE FOR SPECIAL APPROVALS O
DESCRIPTION OF WORK �— w
_ i c ' iuG a
NE ADD ALTER REPAIR DEMOLISH
SQ.FT. J // AA (� NO. OF NO. OF
SIZE /46 d STORIES FAMI LIF_S
USE OF
STRUCTURE RIES, n.-r4C,4 15h7
SIGNATURE OF
APPLICANT
VALUATIONS 0 /J4l 1/(/ A APPROVALS DATE INSPESTOR'S SIGNATURE
FEE$ FEES i D FOUNDATION,
O FORMS!MATERIALSON A/ij Al/ 'A—
L FRAME, FIRE STOPS, 7 //9 N�w /
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION
WITHALL COUNTY ORD)NANC ED AND STATE LAWS REGULATING GAS VENT. DUCTS
GUILD NO CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT.
TION OF THE LABOR CODE OF THE STATE Cl CALIFORNIA NELAT- /
ING TO WORKMEN'S COMPENSATION INSURANCF�
/ LATH. EXT.
SIGNATURE OF �J HOUSE NUMBER W +
PERMITTEE RECT AND POSTED I A
ADDRESSz FINAL '� F�
N
JOHN F. LEWIS, PRINCIPAL ST C URAL ENGINEER
I PLAN CHECK VALIDATION cK. M.D. CASH _ PERMIT VALIDATION cK M.D CASH
Llii o 0 1 0 4-� MAR 1 2 3 A
37.251
ip1Co 0 5 3 4 D MAR 16 1 A �8// 1.5 0- 4