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iQAS38A C6,S803 S-SS sAPPLICATION FOR BU ILDVIGlg---FPERM IT -� , k•;1.
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BU11DING AND SAFETY DMSION LOCAL
JOHN A.LAMBIE•COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN SUPT OF BUILDING CROSS ST.
DISTRICT NO. GRO TYPE I P O
FOR APPLICANT'TO FILL IN CONST.
BUILDING g `` Q SEWER MAP
ADDRESS ` /G,h/73 TL.Q/v� s STATISTICAL CLASSIFICATION
BK� Cy,
LOT NO. �-1 `>` ` 'Y S CLASS.NO. 'DWELL. NITS b
BLOCK MAP �/f �1 STATE ' YES O
Q� NUMBER y V HWY.
TRACT USE ZONE SPECIAL
NO.OF BLDGS. h CONDITIONS!"
SIZE OF LOT I)C / OO- I NOW ON LOT- G
USE OF
EXISTINGBUILDING EXIST.
YARD- HWY STREET NAME
OWNER / / Sill/ �� f-,� SETBACK WIDTH •
MAIL ^nn FRONT"' _
ADDRESS O /z r Z 7L�/ll� A7C' SIDE
I_ �� c, "Y NOL' P.L. ,
ARCHITECT , TEL
/ �-y�/ /A / INSPECTION RECORD
ENGINEER &J-L . /.72�iMf'CtC�L NO.A7,I'-ja '
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/ACNO �9 lof
CONTRACTOR , - - H '
S •`LCL Z�• So.Pt�el�',QO. fzC NONYZ• � - '. _
DESCRIPTION-OF WORKNAJ
NEW '-' ADD ALTER REPAIR DEMOLISH
SO.FT. NO.OF NO.OF QQ
SIZE STORIES FAMILIES-C;'
USE OF STRUCT RE C 2frGjg Q 1)'Q
�, / 4 7 • fir
PO 2 o'v' o (tet/ / -5-'f
SIGNATURE OF �j APPROVALS
APPLICANT
n DATE •INSPECTOR-S•SI TURE-
ADDRESS -2 'k4 C-oP&-<� ,{ r�C FOUNDATION- LOCATION
, ,FORMS,MATERIALS
$
P.C. $
zFRAME: FIRE STOPS.
FEE BRACING• BOLTS
VALUATION ` ` �, $ FURNACE:LOCATION,
FEE GAS VENT.DUCTS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP. L'ATH,'INT.
PLICATION AND'STATE THAT THE ABOVE-IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND LATH,EXT.
STATE LAWS TI G BUILDING_ CONSTRUCTION.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTE RECT AND POSTED "
ADDRESS �'I- r FINAL '
CLYDE N.DIRLAM, PRINCIPAL STR T INEER
PLAN CHECK VALWATION c M.O. CASH , . PERMIT VALIDATION CK. {M.O. I CASH
3;2' 3, A :, 4-5-:L5 A
T`' i :• ti : . _ _ 2'9 T,1'% M 3 1 A .. ®•,
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