HomeMy Public PortalAbout9185 JAYLEE DR_Building_1/12/1971_add bdrm 76A638ACE•#8033-69 APPLICATION FOR BUILDING PERMIT
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COLINTY,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 S T.
FOR APPLICANT TO FILL IN DISTRIC.LNO. GROUP TYPE ST. PR ESSED BY
s.
(PRINT OR TYPE ONLY) � ��J
BUILDINGyA + PC [Q /�J� '7�/' STATISTICAL C I (CATION SEWER MAP
ADDRESS / T YLE4,
CLASS NO. DWELL.UNITS BK PG
LOT NO. . BLOCK USE ZONE MAP
9 7 NO.
TRACT / y 3 f / SPECIAL
s NO. OF SLOGS. CONDITIONS
SIZE OF LOT yC %% - NOV ON LOT
USE OF r�+ _
EXISTING BLDG. FS% C BLDG. SETBACK FROM
OWNER L - /4 L J NOL
TYPE OF, EXISTING SETBACK HIGHWAY + . ARD = TOTAL
ADDRESS T �tC`C' HIGHWAY WIDTH FROMC.L.
CITY
ARCHITECT OR - TEL. •BLDG.SETBACK FROM SIDE PROP. LINE OF (STREET)
ENGINEER NO.
TYPE OF EXISTING SF�.T"BACK HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WDTH-. OM C.L.
.`
CONTRACTOR CT/VS �Q. N0TEL.. - j '
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ADDRESS 2—/:Z , NO p CORNER CUTOFF - L YES ❑ NO ❑ - C
CITY C CLASS -% SEE REVERSE SIDE FOR SPECIA " PPROVALS
CONSTRUCTION LENDER C
NAME AND BRANCH L
/ LL
ADDRESS 1f.� 1, v
SQ. FTN0. OF N0, OF Z
.
SIZE + STORIES FAMILIES NEW ❑
USE OF ` �,/ ADD
STRUCTURE ❑
ALTER
REPAIR ❑
SIGNATURE OF DEMOL ❑
APPLICANT
VALUATION $ &ZperAPPROVALS- DATE INS" CTOR'S IGNATURE
PMT. �ZS" FOUNDATION: LOCATION - / l
FEE $ FEE $ 17 `�� FORMS MATERIALS % All l e-
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I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION FRAME: FIRE STOPS,
BRACING BOLTS
ANO 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. m ,
OF THE STATE OF CALIFORNIA IN RELA 'TO WORKMEN'S COM- -
PENSATION INSURANCE. LATH, EXT. -
SIGNATURE OF & C_..,,v+"
PERMITTEE HOUSE NUMBER CORRECT
e 1A AND POSTED % „••
ADDRES 2-•' FINAL ��
JOHN F. LEWIS, PR NCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION CK. M.0. CASH - PERMIT VALIDATION CK. M.O. CASH
l Ara 3.l 6JAN 12 1 D 1 7.25~ a:
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