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APPLICATION FOR BUILDING PERMIT - 1
DIVISION OF BUILDING AND SAFETY B U I
L DING
REBS '9 2Z
-
Deportment of County Engineer
County of Loa Angeles LOCALITY 77 C
WM.J. FOX. COUNTY ENGINEER NEAREST �f
CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST.
DISTRICT NO. GROUP TYPE SEWER MAP
FOR APPLICANT TO FILL. IN y +c
"Or—
/l ICONST� 9
ADDRESS MP
BUILDING 9P.L7/6 'L D NUM ER ota_G -HWY `YES O
LOT NO. n I D 1 BLOCK USEZONE SPECIAL
CONDITIONS
TRACT .^ 2 /
ti0.OF BLDG-. BUILDING EXIST.
SIZE OF LOT I NOW ON LOT YARD HWY STREET NAME
C SETBACK WIDTH
USE OF t ,ejt f /J FRONT
E%I6TING BLDG. /ol / X p L
OW 4,4-
NE R J n ✓ eIDE
P, L.
MAIL �`� O TRACT DWELL. I UNIT
' ADDRESS / 5 INDUSTRIAL
/� TEL. - 7 DWELL. I UNIT
CITY Y ;ut- A/ NO. 6 PUBLIC BLDG.
ARCHITECT OR ® TEL. 2 DUPLEX 1 UNIT ADON., ALT.. ETC.
ENGINEER NO. 3 APT. _UNITS
8 MISCEL.
ADDRESS 4 COMMERCIAL
CONTRACTOR (� T/o O INSPECTION RECORD
ADDRESS
DESCRIPTION OFA WORN o NS A t-
NEW ADD 'X ALTER REPAIR DEMOLISH -
6 ZE T• .� ' p9'TORI EB / FAMIOLFI ES
USE OF STRUCTURE
SIGNATURE OFle'2 ,�f� /
APPLICANT �{ e /• _ APPROVALS '/t
ADDRESS // C / L,O// J/ DATE INSPECT 'S SIGNATURE
FOUNDATION: LOCATION
$ P. C. 6 FORMS, MATERIALS
r� FEE FRAME: FIRE STOPS.
VALUATION BRACING. BOLTS �v
FEE FURNACE: LOCATION,
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GAS VENT.DUCTS /R
APPLICATION AND STATE THAT THE ABOVE 18 CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCE- LATH, INT. ✓
AND STATE LAWS REGULATING BUILDING CONSTRUC-
TION. LATH. EXT. \
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEEf ' RECT AND POSTED
ADDREs6 ry/ +' —�"� FINAL
WM.J. FOX,COUNTY ENGINEER / VALIDATION C. N. DIRLAM. CHIEF BLDG. INSPECTOR
L,ACO 4 6 9 1 APR 2 1 .1 2.0 0 In
7BA638A CEue03 B-BB APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY �At
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST '„ n
WILLIAM A. JENSEN. SUPT OF BUILDING CROSS ST. C%P�
DIST�tcT 7�O. GRO TYPE �T C SSED BY
FOR APPLICANT TO FML IN �: [J � L 'NST. V
BUILDING /J STATISTICAL CLASSIFICATION $ WER MAP
ADDRESS A /C 9.I ` SK PG
CLASS. NO. DWELL. UNITS
LOT NO 7 BLOCK WATER
CERTIFICATE: NOT REQUIRED 1-1RECEIVED
TRACT MAP HIGHWAY STATE MAJOR SECO ND, LOCAL
NO. OF
SLOGS. NO. (CIRCLE)
SIZE OF LOT y _J NOW ON LOT USE ZONE SPECIAL
USE OF t�-�' �N CONDITIONS
EXISTING BLDG. /II
Q T
OWNER D� / 1 N BUILDING EXIST.
SETBACK YARD HWV STREET NAME WIDTH
ADDRESS �L FRONT
ARCHITECT OR
ENGINEER NO. SIDE
P. L.
ADDRE L
AT4L' . O
CONT O. '� V
ADDRESS Ar
LL
Q
ESCRIPTION OF WORK G
W
a
NEW VID ALTER REPAIR DEMOLISH �
Z
SQ. FT. NO. OF NO, OF
SIZE STORIES FAMILIES
USE OF
$ CTURE
SIGNATU
APPLI
I
VALUATION $
APPROVALS IDATE NSPECTO 'S SIGNATURE
P.C. � PMT. FOUNDATION: LOCATION
FEE $ FEE S 0'Q FORMS. MATERIALS dQ/G1'T / "•�.�
�� FRAME: FIRE STOPS.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS /m './I�' VM'✓1.3Y✓/
ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION.
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCT$ ^J`------- ��•
BV ILO CONST CTION. I CERTIFY AT IN GOING THE WORK
AU
IZED HE Y 1 WILL NOT EM O Y PERSON IN VIOL LATH. INT.
TION O THE L OR COO[ OF T ST OF LIFORNI RELA
ING TO W KM COM NSATIO ANC
TH. EXT.
SIGNATU OUSE NUMBER COR.
PERMIT CT AND POSTED
ADORES
rI-
JOHN F. LEWIS. PRINCIPAL ST RAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. GASH PERMIT VALIDATION CK. M.O. GASH
V{(�
6.0 0
4 1 4 3 SEP 2�� 1 D
r
DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES BUILDING 1 ' ® P E�11
N
WM. J. FOX. CHIEF ENGINEER V
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
BUILDING DISTRICT
�NO_. PLAN-CK.NO. I �PERDMI/T/N /
ADDRESS ry / l 61 yfi-n
LOCALITY �� ( . � RECEIVED Y DATE OF APPL. I DAAT•\E 16SUED
NEAREST
CROSS BT I: �r.✓4/♦�a! ' ✓d" / �J v
OWNER /,9 (7 AA /L r BUILDING
tl a ADDRESS
MAIL SiO .4-c �
'1 0 .F a R� LOCALITY - —.i >' ✓-�-- / /
ADDRESS Jry/�
NEAREST
TEL. CROSS ST.
N"? 7 TYPECi
GROUP
ARCHITECT OR TEL S 7
ENGINEER ./
NO.
LOG. ++�� /�- ORD.NO.
B
ADDRESS SETBACKLINE �'�
n APPROVED /
CONTRACTOR 1�ii IT NOL By DATE
USE APPROVED
ADDRESS ZONE�I BY DATE
LEGAL /!V CORRECTIONS
DESCRIPTION LOT ND. BLOCK
TRACT /
NO.OF BLDGS. f
SIZE OF LOT OW ON LOT / (p/L/
USE OF —, NO.OF NO.OF
EXISTING BLD rG I FAMILIES ROOMS V ///iOC�ifJ GCT w"n72H `.�
DESCRIPTION OF WORK
NEW ALTERATION ADDITION Y 1�4� D
REPAIR MOVING DEMOLISH // �•� D
SOFT. �vo ROOMS STORIES / D
SIZE d
WALL ROOF
COVERING I COVERING dL- _N/
USE OF NEW
BUILDING
P {'
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS .:�T
APPLICATION AN6l STATE THAT THE ABOVE IS CORRECT INSPECTOR - DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION: LOCATION [�
AND STATE LAWS' E6ULgTING ILDING CONSTRUCTION.
FORMS.MATERIALS
\��CJI^//� az Y////4.. FRAME: FIRE STOP&.
91BNAT6RE OF � � BRACING.BOLTS
PERMITTEE' �.s/- /
LATH, INT.
AUTHORIZED AST LATHr EXT.
76A6.A-3 7-49 $ P.C.$ PLASTER,INT,
FEE PLASTER..EXT.,^,
VALUATION I FEE / r FINAL
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