HomeMy Public PortalAbout4961 LOMA AVE_Building__ 76A638A CE V603 4/7APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES ASSESSOR
DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL
BUILDING AND SAFETY DMSION BUILDING
MAKE CHECKS PAYABLE TO: ADDRESS
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY
FOR APPLICANT TO FILL IN NEAREST
Print or type only) CROSS ST.
TRICBUILDING- - DISNCO. C'c3lCONTYPE CES BY
ADDRESS �� Llj�yy�
LOT NO BLOCK
STATISTICAL CLASSIFICATION WER-MAP
- CLASS NO. ��`�DWELL,UNITS BK
TRACT US ONE MAP
NO.OF SLOGS. NO �1
SIZE OF LOT NOW ON LOT � SPECIAL
USE OF - CONDITIONS
EXISTING BLDG, r 4
TEL-. -
OWNER NO BLDG SETBACK FROM
ADDRESS FRONT PROP.LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
CITY HIGHWAY WIDTH FROM C L - - -
ARCHITECT OR TEL. + _
ENGINEER NO.
BLDG.SETBACK,FROM
Ga-
ADDRESS SIOEPROP LINEOFCD
(STREET) V
TEL. TYPE OF EXISTING SETBACK HIGHWAY- + -YARD = TOTAL
CONTRACTO / - NO. � f��y HIGHWAY WIDTH FROM C.L. O
ALl
DDRESS �fJ� (i NO �� �37 + - pW„
_ f•-c LIC. _ N
CITY .�c X3/7 CLASS CORNER CUTOFF YES ❑ NO ❑ Z
.CONSTRUCTION
NNCHNDER SEE REVERSE SIDE FOR SPECIAL APPROVALS
ADDRESS
SQ FT NO OF NO OF NEW
SIZE STORIES FAMILIES
USE OF J ADD. ❑
STRUCTURE Z„r /
/ ALTER ❑
losf b, REPAIR❑
SIGNATURE OF 1
APPLICANT DEMOL ❑
VALUATION $ APPROVALS = DATE IN ECTOR'S IGNA TURE
FOUNDATION: LOCATION
T
FEE $ FEE $ FORMS, MATERIALS ✓ 1
FRAME: FIRE STOPS,
1 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 ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT
LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO
WORKMEN'S COMPENSATION INSURANCE
LATH, EXT.
SIGNATURE OF HOUSE-HOUSE-NUMBER COR-
PERMITTEE�_ RECT AND POSTED
ADDRESS FINAL��Lf�/j�lE�i FINAL y17'j
PLAN CHECK VALIDATION CK M O CASH _ PERMIT ALIDATIO CK M 0 CASH
f'�, 0 0 9 0773 t-M 2 0 0 1- 2,00-
r
2,00-
TEMPLE- IT
a•
79AS30A Ce#SOS-61 APLrLC"ATYON' F..OR BUILDING PERMIT
COUNTY OF LOS ANGELES BUIL ' `
DEPARTMENT OF'COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A.'LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN Surd OF BUILDING CROSS ST DC7 _
DIS ICT N R TYPE P BY
FOR�APP,LICANT TO FILL IN " L/�� CONST. Q
BUILDING _ STATISTIC ALC IFICATION S ER MAP.
ADDRESS - K` 6G
CLASS NO DWELL UNITS
L04�10 BLOCK WATER
CERTIFICATE NOT REQUIRED ,RECEIVED
TRACT - ` MAP HIGHWAY -
!� f O/� I NO OF BLDGS NO ICIRCLE) STATE MAJOR SECOND, OCAL
SIZE OF LO i_ 7 NOW ON LOT " ! USZ ZON PECIAL
USE OF. - _ - CONDITIONS
EXISTING BLDG.
OWNERfie NO VOG BUILDINGEXIST
SETBACK YAR HWY STREET NAME WIDTH
ADDRESS v FRONT
ARCHITECT,OR TEL P L
ENGINEEgem NO SIDE
_ ADD SS P L
r TEL. _INSPECTION RECORD .' Q
CONTRACTO '0 { MO.
L �, a U
ADDRESS r .�*'�r�$l a� r�_ 'r,?'{�S.a +` ':'&"
.'DESCRIPTION OF WORK 1 i -��.�� l � , O
EW ADD .NALTER REPAIR DEMOLISH
FT. > �'}� NO OF NO OF C pCf// cL�! ,7 z
IZE / �� STORIES - FAMILIES �}� ,,{',,,,t�(prf
USE O F ^ t".' �';^e' -.l; ..EG{ L.L.3®F' Io'
STRUCTURE 6./ ,� - _
' SIGNATURE O
APPLICANT Jnr
VALUATION
APPROVALS DATE INSPECTOR'S SIGNATURE
"PC 74 PMT FOUNDATION. LOCATION
FEE $ s _/ FEE FORMS, MATERIALS
FRAME FIRE STOPS, l
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING,BOLTS / A. '
AND STATE THAT THE ABOVE'I S'CO RRECT AND AGREE TO COMPLY FURNACE-'L'OCATION,
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CONSTRUCTION 1 CERTIFY THAT IN DOING THE WORK ,
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH, INT �, it �00
.
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT-
ING TO WORKMEN'S COMPENSATION INSURANCE
F
LATH,EXT
SIGNATURE OF ✓Y\�L/ // HOUSE NUMBER COR-
PE
OR- /
PERMITTEERECT AND POSTED
ADDRESS FINAL
CLYDE N. DIRLAM, PRINCIPAL'STR URAL ENGINEER
LID
PLAN CHECK VALIDATION CK M.D. CASH PE19M VAATION cK. M.o. CASH
' 0 9 4 2 3 ID ' 1 ,90?_5�
�,_ L.1 U0"1 14 4 0CT 8 1 D 39.50-