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76ASSM CE#803 z/eo- APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF' COUNTY ENGINEER ADD
BUILDING AND SAFETY,DMSION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST'
WILLIAM A. JENSEN'SUP•T OF BUILDING CROSS ST
DIST ICT N GROUP TYPE PR SED BY
FOR APPLICANT TO FILL INCONST.
BUILDING C/ 7 STATISTICAL CLASSIFICATION S R MAP
ADDRESS ] (�
CLASS.NO DWELL UNITS IVJ
T,NO. iZ - BLOCK MAP -- STATE YES' O
NUMBER HWY.
TRACT USE ZONE SPECIAL
// NO OF BLDGS. CONDITIONS
'
SIZE OF LOT •C K O U I NOW ON LOT/�'I-cT� -
USE OF
EXISTING BLDGqq BUILDING YARD HWY REET NAME EXIST.,
OWNER NO.TEL. I?/S SFRONTK - _ WIDTH
�J P L.
ADDRESS 7 w' +�"� SIDE
ARCHITECT OR TEL. P•L-•
ENGINEER NO INSPECTION RECORD
ADDRESS -
„ o ► �7 TEL.
CONTRACTOR [x-•[ NO
ADDRESS - V
DESCRIPTION OF WORK O
EW ADD ALTER REPAIR DEMOLISH k7f `
'FT. 17 NO OF NO OF
IZE l Y� �`�^'_ Jpy
S 1 STORIES FAMILIES 1/1610 /� �(C� �� � A .` M /,sa(J�I
USE OF ! :�
STRUCTURE lvlttp2twL / i
SIGNATURE OF"
APPLICANT
VALUATION$ Z �f Q
APPROVALS ATEA�/"" INSPECTOR'S SIGNATURE
E FEE
$ �� • � FORMS,MATERIA
_ FO LS LOCATION
F
I HEREBY ACKNOWLEDGE THAT I HAVE REA THIS AP- FRAME FIRE STOPS,
BRACING, BOLTS
PLICATION 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. // J
I CERTIFY THAT IN DOING THE WORK AUTHORIZED 1 LATH, INT. Gv /r!nr
WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
WORKMEN'S COMPENSA IO LAWS OF CALIF RNIA. - LATH,EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE L '� ° RECT AND POSTED �,7 A
ADDRESS FINAL � / U C/
CLYDE N. DIRLAM,/PRI CIPAL STIR URAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION— M.O. CASH
�3 9 22 3 0 tlM 14 2 3 D' 1 .c 0 �? =
LiT0 4 u 8 3 c Afi 31- 2 ,a 42.00
/ �41,
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76A638A,CE#803 8-64'AP PLICATION- FOR BU I DI NG PER- ,IT-
r� COUNTY OF LOS ANGELES BUILDING '
t_
-DEPARTMENT OF COUNTY ENGINEER ADDRESS'
BUILDING AND SAFETY DIVISION LO C A L I z
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST �7 n /� •- _
,COLEMAN W JENKINS,SUF'T OF BUILDING CROSS ST 'ell
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DISTRICT NO -?GROUP " •TYPE "P SSED"BY
FOR APPLICANT TO FILL IN _ CONST tc
BUILDINGt STATISTICAL CLASSIFICATION, +• .- 1•`SE ER MAP
ADDRESS �� / PJ ��i,',�J� CLASS NODWELL UNITS - BK PGZk
LOT NO BLO ZONE- MAP -NO
TRACT - SPECIAL _ -
_ NO OF SLOGS CONDITIONS _
SIZE OF LOT ` ,/JNOW ON LOT
USE OF ' �L�•A 'J JG—/YCLr�
EISTI-No 131-OG
BLDG SETBACK FROM
[— /4'� LV tC K NOL�:7 G�-3.�'� FRONT PROP. LINE OF - - (STREET) ,
OWNER TYPE OF EXISTING SETBACK. H13HWAY' YARD = TOTAL'
ADDRESS p�.+Zi LG.�Le%� HIGHWAY 'f M C L '
CITY !� •� �-.✓'!
ARCHITECT OR - TEL BLDG 9 TBACK-FROM - - -- - -
ENGINEER' NO SIDE PROP: LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY' + YARD = TOTAL >
ADDRESS • - HIGHWAY WIDTH FROM C L. - a:-
-TEL + = 0 -
CONTRACTOR NOLIC -
ADDRESS' NO CORNER CUTOFF YES NO - O
H
Y LIC SEE REVERSE SIDE FOR SPECIAL APPROVALS .,,V•1
DESCRIPTION OF WORK n
/ Z
NEW ADD✓ ALTER REPAIR DEMOLISH
SQ,FT . 7T—
, NO OF NO OF
SIZE '-+l k) STORIES FAMILIES -
USE.OF
'STRUCTURE 'T'•^ -
SIGNATURE OF-,,!:;O'-
APPLICANT
F APPLICANT /�( _ C�;��•9d'
VALUATION$ 1�
119 ,-(f (� APPROVALS 'D AT EJ�I N8P ECTOR',8Sig NATURE
FEE$ `�� 7 FEE$ G. O FOUNDATION
O FORMS!MA'TERCIALSLOCATION.
FRAME, FIRE-STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT J f ,
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION
WITH' ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS f !
BUILDING CONSTRUCTION I CERTIFY THAT IN DOING -THE WORK - - --
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA. LATH INT
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT
ING TO WORKMEN 5 CO�P EN SI ON IN URANCE LATH EXT
SIGNATURE OFf HOUSE NUMBER COR-
PER
OR-
PERMITTEE REC AND POSTED y + -
ADDRESS _ FI NAL -
JOHN F LEWIS PRINCIPAL STRUCTURAL EN NEER
;'PLAN CHECK VALIDATION CK M O CASH _ PERMIT VALIDATION CK MO
CAISH ;
_ D 4.00
IS Q'� 7 , �iT 1 "�
JL638A'CE#8038-64 APPLICATION FOR BUILD NG PERM1
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS , -
BUILDING' AND SAFETY DMSION LOCALITY L
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST _.
} COLEMAN W JENKINSSUP•T OF BUILDING �' CROSS ST "
DISTRICT NO GROUP TYPE PR BY '
FOR APPLICANT TO FILL IN �' CoysT
BUILDING �j STATISTICA CLASSIFICATION• °SEW R MAP
ADDRESS (f L - f�y
�� d CLASS NO DWEL UNITS --BK PG
LOT NO BLOCK. ZONE MAP
NO n
S/9 -
TRACTyt/W /'i14tI • L4,4�L/ eo SPECIAL F. ,
" NO OF BLDGS CONDITIONS
SIZE OF LOT - NOW ON.LOT WV ,^J
USE OFNo o �G yy.LFC t `�IF /�L. BLDG SETBACK FROM - -
OWNER (.^ -/ �7 ►"� ie-K NO
TEL
FRONT PROP LINE OF - =_(STREET) `
J _ TYPE,OF EXISTING SETBACK .HIGHWAY _- YARD:. - _TOTAL
ADDRESS L �Lr7�2 t1 HIGHWAY 'F M C L- '
-CITY .'/ f/ r -e .+:,
BLDG SETBACK FROM
ARCHITECT OR TEL
ENGINEER NO SIDE PROP LINE OF I (STREET)
TYPE OF _ EXISTING SETBACK HIGHWAY + --YA'RD' = TOTAL
ADDRESS f HIGHWAY WIDTH FROM C L - 0
TEL + _
CONTRACTOR No
'ADDRESS NO LIC CORNER CUTOFF YES E] - NO a O•
F-
CITY LC LASSIC SEE REVERSE SIDE FOR SPECIAL APPROVALS w
DESCRIPTION OF WORK Z
NEW AD ALTER REPAIR DEMOLISH
SQ.FT �, NO OF NO OF -
SIZE J - STORIES FAMILIES -USE OF /;' �rr -
STRUCTURE
' 'SIGNATURE OF - '
APPLICANT
VALUATION$ APPROVALS -DATE _ INSPECTOR'SSIGNATURE
P CPMT FOUNDATION, LOCATION
-FEE$ FEE$ FORMS, MATERIALS
FRAME, FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT -
AND'STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION-
WITH ALL 'COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT 'DUCTS '
9UILOINGCONSTRUCTION I CERTIFY THAT IN DOING THE WORK -, -
AUTHORIZED HEREBY I WILL NANY RSON IN ioLA- LATH DINT '
TION_ OF'TH*KMEPENSAQTURANC
OF OF LIFORNIA ELAT.
ING TO WORLATH EXTSIGNATURHOUSE NUMBER,COR-.PERMITTERE -AND POSTED'IADDRESS Fl NAL
JOHN F LEWIS 4RINCIPAL,,STR RAL ENGINEER
PLAN CHECK VALIDATION CK . MO CASH _ PERMIT VALIDATION- CK M 0 CASH