HomeMy Public PortalAbout10132 LA ROSA DR_Building__ ,F>63�4 #BD3 _WAPPLICATION FOR BUILDING PERMIT ,,
COUNTY OF LOS ANGELES BUILDING
EPARTMENT OF COUNTY ENGINEER ADDRESS Lt.`
BUII DING AND SAFETY DMSION Louun�
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN 6u PT OP BUILDING GROSS ST.
DISTNO. P TypE PR
RI GR UBY
FOR APPLICANT TO FILL IN CONST SS
B ILOING/ STATISTICAL CLASSIFICATION SEWERMAP
A O ESS -O C' CLASS.NO.IDWELL. UNITS K
L NO.A !E� {�O CCK `• WATERCERTIFICATE: NOT REQUIRED RECEIVED Li
TRACT O MAP HIGHWAY
NO.OF SLOGS. NO. 0 (CIRCLE) STATE MAJOR SECOND. CAL
SIZE O I NOW ON LOT USE ZONE SPECIAL
USE OF ] CONDITION
EXISTING BLDG. SI /,y�� 'g-1/14,I0
_ N
/J TEL.{ t I !'�
OWNE l4 NO. A3 BUILDINGARD HWY ST EET NAME EXIST.
SETBACK WIDTH
ADORESS u rT� FRONT1
ARCHITECT OR TEL. P. L.
D r L
ENGINEER NO. SIDE O
P. L. U
ADDRESS TEL r• INSPECTION RECORD C
CONTRACTOR t—LO NO- _i O
h
ADDRESS Lt - U
W
DESCRIPTION OF WORN Q.IVII
z
NEW ADD ALTER REPAIR DEMOLISH
SI ZE STORIES FAMILIES
/
USE OF
STRUCTURE
SIGNATURE OF
APPLICANT
VALUATION S
t•.n APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. .•a v PMT. FOUNDATION: LOCATION I
FEE E FEE S FORMS, MATERIALS -.+
FRAME: FIRE STOPS. . I(_
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
BUILDI NO CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK Ii _
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA. LATH. INT.
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT-
ING TS, NO WORKMEN'S MPENSATION INSURANCE. { i
LATH,EXT.
PER
MAITTE E O MOUSE NUMBER COR• /
RlCT AND POSTED
ADDRESS,`7,•7 FINAL
�^ CLYDE N. DIRLAM. PRINCIPAL STRU AL ENGINEER
PLAN CHECK VALIDATION M.D. wR PERMIT VALIDATION CK M.O. CASH
U?-. '_ 494 : IIIOV2)7e3D 22.50a
(,C,5 7 5 1 : DEC 5 1 D 4 5.G 0
76A638A CE#8035 , APPLICATION FOR BUILDINWPERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DMSION LOCALITY
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN SUPT OF RUHLG%M0 CROSS ST.
DISTR N I GROUP I TYPE PROLE D BY I
FOR APPLICANT TO FILL IN coNST.
BUILDING - i/ /./nom STATI TICALCLASSIFICATION SEWER MAP
ADDRESS 3 V� OQ-Q. �- / //''''••�� B P
CLASS. NO. yDWELL. UNITS
LOT NO qq LOCK WATER NOT REQUIRED RECEIVED
TRACT / D 1; 0.I CERTIFICATE: //'��
MA
I
NO BLDGS. NOP MRCLEI STATE MAJOR SECOND, CAL
SIZE OF LO O ,S'O IN ON LOT Us- ZONE SPECIAL
USE OF CONDITIONS
EXISTINGBLDG. �� _1
TEL Il. f _j
OWNE /\ NO. 'I UI LD ICNARD STREET NAME EXIST.
SETBACK WIDTH
ADDRES FRONT
ARCHITECT OR TEL. - P. L. d
ENGINEER NO. SIDE
P.L. U
ADDRESS 4
CONTRACTOR L'/L
iw NO. r /INSPECTION RELOAD
O
y ' v
ADDRESS DESCRIPTION OF WORK a
NEW ADD ALTER REPAIR ! DEMOLISH
SO.FT. - NO.OF \NO.OF ./
IZE STORIES FAMILIES /
USE OF
STRUCTURE I
SIGNATURE OF
APPLICA T
VALUATION$
APPROVALS DATE INSPECTOR'S SIGNATURE
FEE FPMT.
EE $ �YJ FOUNDATION: LOCATION
FORMS, MATERIALS /
`- FRAME: FIRE STOPS,
IHEREBY 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. I CERTIFY THAT IN DOINGTHEWORK '
AUTHOR IZED,H EREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH,INT. 1
TION OF THE LABOR CODE OF.THE STATE OF CALIFORNIA RCLAT-
ING TO WORKMEN'S OMPENSATION INSURANCE.
LATH,EXT.
SIGNATURE O HOUSE NUMBER COR-
FERMITTEF RECT AND PCO/SATED /
ADDREss FINAL ^G3+:' /D272//v
CLYDE N. DIRLAM, PRINCIPAL STR�p)URAL ENGINEER
PLAN CHECK VALIDATION CIL M.O. W H PERMIT VALIDATION (_�>` M.o. CASH
los 4 9 2 Ilan 2) 7 1 0 2..00
76A636A CE R803 1/71 � eel' e"
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES ASSESSOR
DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL
BUILDING AND SAFETY DIVISION BUILDING
ADDRESS
COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
Print or typ. oDl CROSS ST.
BUILDING 1 lJ DISTRICT NO. GROUP TYPE _ R ESEED BY
ADDRESS �� �\ S (.� G• O (, GU ONST. �-�
�) BLOCK
LOT NO. STATISTICAL CLASSIFICATION SEWER MAP
Cj`p , /
U I CLASS NO. �nLL
DWE ,UNITS_ BICC_ PGy7
TRACT nn USE ZONE MAP
SIZE OF LOT T/n I-S U NOW ON LOTS I f SPECICCAL
USE OF �� - CONDITIONS
EXISTING BLDG. �/
OWNER . -� ' (1+--Tr NOL IJ BLD SETBACK FROM
A DDR ESS �u+ , Z0 SQ. FRON OP.LINE OF (STREET)
TYPE OF EXISTI ETBACK HIGHWAY } YARD = TOTAL
CITY (� I� ( HIGHWAY WIDTH F .L. _
ARCHITECT OR TEL. } _
ENGINEER NO.
BLDG.SETSACK FROM
ADDRESS SIDE PROP.LINEOF 15TREETI
TEL. TYPE OF E%ISTING SETBACK HIGHWAY } YARD = TOTAL a
CONTRACTOR �('J lei r NO. HIGHWAY WIDTH FROM C.L.
U
ADDRESS NO' } = O
LIQ
CITY CLASS CORNER CUTOFF YES_❑ NO W
CONSTRUCTION LENDER y
NAME AND BRANCH Nor) (t. SEE REVERSE SIDE FOR SPECIAL APPROVALS ?
ADDRESS e /`}N
S . T V TI jaTOR1E5 FAOMIOLFES USE F '3NEW
STRUOCTURE o� (AI I DD Li It
VV ALTER ❑
SIGNATURE OF REPAIR[:]
APPLICANT DEMOL ❑
VALUATION S f APPROVALS DAT INev OR's s GrvA TORE
P.C. PMT. FOUNDATION: LOCATION
FEE $ FEE S CEJ FORMS, MATERIALS /
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS
ANO STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY FURNACE: LOCATION,
WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS
STRUC TION. 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT EMPLOY ANY PERSON INVIOLATION OF THE LATH, INT.
LABOR CODE OF THE STATE OF 'CALIFORNIA IN RELATING TO
WORKMEN'S COMPENSATION INSURANCE. LATH,-EXT.
SIGNATURE OF< �V A//,/,� , f� HOUSE NUMBER COR-
PERMIT TEE_ SLS' �✓��F�"'✓✓✓^^^�+VVV RECT AND POSTED
If
ADDRESS /0—/GI � Ga, &BCCI ( - L_�
FINAL
JOHN F. LEWIS. PRIN PAL STRUCTURAL ENG
PLAN CHECK VALIDATION CK. M.D. CASH _ PERMIT VALIDATION CK. M.O. CASH
$G02 1 0 7�- SFY 1 1 0 h-^3.00-