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1.55 APPLICATION FOR BUILDING PERMIT
11.9 D
DIVISION OF BUILDING AND SAFETY BUILDING _
•-
Deportment of County Engineer ADDRESS
County of Los Angeles LOCALITY —
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN, SUPT OF BUILDING CROSS ST
FOR APPLICANT TO FILL IN SELW
DISTRICT NO. GROUP TYPE SEWER MAP
K PG.
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ADDRESS { /,✓ 11�� L�'�,ST V jr NUMBER STATE YES
�y HWY
LOT NO a BLOCK USE ZOJ•IE SPECIAL
p �q / CONDITIONS
TRACT J� /� (iNO OF -
SIZE OF LOT 5V k t13 d I NOW ON LOTS 49#- BUILDING EXIST
USE O
�J SETBACK YARD HWY STREET NAME WIDTH
EX STNG BLDG Rel)�I se -r fejk FPROINT I yka
OWNERl�ar�nogh ,{� O a�rl�C' SI
MAILI` L
ADDRESS �G 7'G /��' p f
/• Y 3 O TRACT DWELL. I UNIT 5 INDUSTRIAL
CITY 7_441,0iG C ; NO TELfrr-�'��7` t DWELL02-3 1 UNIT 6 PUBLIC BLDG.
ARCHITECT OR -I TEL. 2 DUPLEX 2 UNITS
ENGINEER /1 NO. 3 APT. UNITS DN ALT.. ETC.
8 M ,
ADDRESS 4 COMMERCIAL
CONTRACTOR 444e_r NO' INSPECTION RECORD
ADDRESS
X
DESCRIPTION OF WORK
NEW X ADD -ALTER REPAIR DEMOLISH
SO FT. NO OF NO OF
SIZE rt7 4� STORIES FAMILIES r
USE OF STRUCTURE _
SIGNATURE OF
APPLICANT APPROVALS
ADDRESS DATE- INSPECTORS SIGNATURE
FOUNDATION LOCATION
P C. $ -��- FORMS.MATERIALS
.�/i�L� �•" FEE FRAME FIRE STOPS.
VALUATION $z r BRACING. BOLTS O G 'SZ •� rrl'C`�uiwG4.,•,•�
FEE / � FURNACE LOCATION.
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GAS VENT. DUCTS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH. INT I�
,AND STATE LAWS GULATING BUIL NG CONSTRUC-
TION. LATH, EXT
SIGNATURE OF t
HOUSE NUMBER COR- �
PERMITTEE RECT AND POSTED e�
ADDRESS FINAL
JOHN A.LAMBIE.COUNTY ENGINEER VALIDATION CLYDE N. DIRLAM. CHIEF BLDG. INSPECTOR
CK MO CASH
L&2 4 o ,1 LM MV15 1 2.0 0
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