HomeMy Public PortalAbout10118 LA ROSA DR_Building__ `
IS REQUIRED
'DE CF
R ANY MATERIAL ST RAGE OR WORK
DONE 1N THE ROAD RIGHT OF W
mu..1.#.s2/10 APPLICATION FOR BUILDING PEWIT 1
COUNTY OF LOS ANGELES BUILDING %
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST.
DIS TR CT NO. UP TYPE PRO SSED BY
FOR APPLICANT TO FILL IN Q CONST
BUILDING /_4 p-S� STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS L / KD BK PG
CLASS.NO. DWELL.UNITS
LOT NO. Z BLOCK MAP STATE'5;r2— NUMBER HWY. YES NO
/'
TRACT / O USEZONE SPECIAL
NO.OF BLDGS. % CONDITIONS 4..
SIZE OF LOT O Q I NOW ON LOT [/
USE OF
EXISTING 'r BUILDING EXIST.
TEL. YARD HWY REET NAME
SETBACK WIDTH
OWN NO. �.6 FRONT
P.
ADDRESS I �. M �M SIDE
ARCHITECT OR
ENGINEER NO. INSPECTION RECORD
ADDRESS
/• TEL.
CONTRACTOR i- I` �I�1• NO. e1���� i O
ADDRESS '"LYl3 R kr- V l+� - �� V
DESCRIPTION OF WORK 0
O
ADD ! AL ER REPAIR DEMOLISH
SO. F5 ZET Il / STORIES FAMIOF rn
IES
USEOF
CTURE
STRUCTURE PLO wLLliu ax G(>t
SIGNATURE OF
APPLICANT
VALUATIONS �� �V7" /pdO I /Z�f0U .
APPROVALS DATE INSP CTDR'S SIGNATURE
P.C. PMT. UG FOUNDATION: LOCATION
FEE $ FEE $ FORMS,MATERIALS
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- F BRACING, BOLTTSS //�t L'f '171
PL/CATION AND STATE THAT THE ABOVE IS CORRECT AND FURNACE: LOCATION. '
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND GAS VENT,DUCTS
STATE LAWS REGULATING BUILDING CONSTRUCTION. 1a+ Imo. --
1 CERTIFY THAT IN DOING THE WORK AUTHORIZED I LATH, INT. 1� 1 A I .N
WILL NOT EMPLOY ANY PERSON IN LATION F T E
WORKMEN'S COMP NSATION S F CALIFO A. LATH.EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTE RECT AND POSTED �(
ADDRESS FINAL
CLYDE N. DIRLAM, PRINCIPAL STIR RAL ENGINEER
PLAN CHECK VALIDATION m M.O. CASH PERMIT VALIDATION OK. M.O. CASH
3 7 7 o JUL 11 2 3 U 19.513 .i
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