HomeMy Public PortalAbout4978 LOMA AVE_Building__ DEPARTMENT lDF—EtI:DING AND SA A+ y APPLICATION FOR PERNUT
r COUNTY OF LOS ANGELES 195irB Un
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WM. J. FOX, CHIEF ENGINEER
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FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
�[ p� DISTRICT NO. PLAN
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JNO. /�PtERMI`IT�,NO.
BUILDING
ADDRESS &t V ,� 37,0 6 v 'T`� v
LOCALITY RECEIVED<<BY DATE OF APPL. DATE ISSUED
NEAREST t,, _ ��
CROSS ST, BUILDIN m
® 4F'N/! ADDRE
OWNER
MAIL
LOCALITY
ADDRESS 1 Ave,,
NEAREST ��//
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TEL CROSS ST. //Yi 7 Ci /v� /YUP
CITY .a/Ai y NO. �l/i .� 73 ZONE I PLANS 7 I SPE I GROU
ARCH IT OR TEL. _--
ENGINEER NO. BLDG. ORD. NO.
.. - SETBACK LINE
ADDRESSAPPROVED
/ TEL. BY DATE
CONTRACTOR (l(/ OY45 rL NO. USE APPROVED
F, ONE BY DATE
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ADDRESS HOUSE NUMBERING
LEGAL
t DESCRIPTION I LOT NO. _ ,I BLOCK MAP NUMBER �-d�JL//7 FIELD CHEF K BY
TRACT s�0 ® e s `� NO. ASSIGNED BY_l use 4)AT
NO. OF BLDGS.yy�� CORRECTIONS .
SIZE OF LOT /�•/ �'/Gy 7 L I NOW ON LOT pnC0� -
EXISTING BLDG. / I FAMILIES 0
DESCRIPTION OF WORK
NEW I I ALTERATION I I ADDITION I T
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REPAIR I I DEMOLITION
SQ. FT. NO. OF ✓ A �� � O
SIZE 3 ROOMS 5 STORIES r
EXT. WALL ROOF �A
COVERING Q�Ij�e I COVERING C6 jAP
USE OF STRUCTURE1111T.
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APPROVALS
INSPECTOR'S SIGNATURE 'DATE
j 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FOUNDATION: LOCATION
PLICATION AND STATE THAT THE INFORMATION GIVEN IS FORMS, MATERIALS ..
�- CORRECT. -
1 AGREB TO COMPLY WITH THE CORRECTIONS LISTED FRAME: FIRE STOPS,
HEREON AND WITH ALL COUNTY ORDINANCES AND STATE {. BRACING, BOLTS
LAWS REGULATING BUILDING CONSTRUCTION. FURNACE: LOCATION,
GAS VENT, DUCTS / ��'
SIGNATURE OF/ �j � ,/Q E
PERM`� AS_/¢IT'�TEff G�6 l_ e"�f ,
/L -. -_£!a.'�; � ;^� "{�' LATH, INT. AAs- 'S''
ADDRBS$, �� � �n
LATH, EXT. '�.f�.C.,h... (�� -y?
AUTHORIZED AGT. '
` PLASTER, INT.
76AE3BA, DBss 10-80 P.
FEE Z`� PLASTER, EXT.
VALUATION / FEE $� FINAL
76A638A CE9803 5-65 APP U
LC I ATION FOR B ILDI G PERMIT
COUNTY OF LOS ANGELES BUILDING �C3J�I�
DEPARTMENT OF COUNTY ENGINEER ADDRESS P-
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE'. COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS,SUP'T OF BUILDING CROSS ST.
DISTRIC N G O TYPE PR S � Y.
FOR APPLICANT TO-FILL IN CONST.
[ADD
ILDING STATISTICAL C IF CATION SE ER MAP
DRESSLexw, CLASS NO. DWELL UNITS. Q.
T NO. / `S�LOCK USE ZONE MAP
NO.
TRACT#e, .`; SPECIAL -
NO. OF BLDGS. CONDITIONS
E OF LOT `j NOW ON LOT
E OF
ISTING BLD BLDG. SETBACK FROM
L. FRONT PROP. LINE OF (STREET)
NER TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
RESSi HIGHWAY WIDTH FROM C.L.
Y
CHITECT R TEL. BLDG. SETBACK FROMGINEER NO. SIDE PROP. LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY }-' YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C.L.
TEL. + = d
CONTRACTOR NO L
O
LIC V
ADDRESS LINO CORNER CUTOFF YES NO
dC
CITY CILASS SEE REVERSE SIDE FOR SPECIAL APPROVALS
DESCRIPTION OF WORK CG
rP v
NEW ADD ALTER REPAIR DEMOLISH Z
T. NO. OF NO. OF
SIZE STORIES FAMILIES
USE OF � - �/� � •
STRUCTURE `� A
SIGNATURE OF -
APPLICANT
w/ rte.✓'
VALUATION ' �.� APPROVALS DATE INSPECTOR'S PIGNATURE
P.C. PMT. FOUNDATION, LOCATION _
FEE$ FEE$ �. FORMS, MATERIALS _
FRAME, FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS
9UILDI NG CONSTRUCTION. I CERTIFY THAT. IN DOING THE WORK
AUTHORIZED HEREBY IWILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT.
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT-
ING TO WORKMEN'S CO PENSATION INSURANCE.
LATH. EXT.
SIGNATURE OF HOUSE NUMBER COR-
PEf2MITTES•. RECT AND POSTED
ADDRESS Fl NAL
JOHN F. LEWIS. PRINCIPAL STRUCTURAL ENG-I-tJEER
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT.VALIDATION CK. M.O CASN
;�, 3 b 2 � JUL Q 1 D 6,Q 0 N
76A638A CE 4803 1/71 I �
K APPLICATION FOR BUILDfNG PERM ,T
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 tVDe only) CROSS ST.
BUILDING Q YJ AA�� - DISTRICT NO. GROUP TYPE P - E D B'
ADDRESS q / / g 1,D M ,4 / )�r..� CONST.
�Uw _
STATISTICAL CLASSIFICATION SEWER MAP
LOT NO. BLOCK / �—
CLASS NO,
DWELL,UNITS "6K- PG
TRACT �J USE ZONE[CONDITIONS
MA0.P "`- 0
SIZE OF LOT 7f- X��// / U � NOWOON LOTS ^ SPECIAL
USE OF n�� L �. � I
EXISTING BLDG. F� TE . q
OWNER BVI!`C` U Z L. D ile-ff NOL 8`j7-
OWNER - - - -
'L p BLDG.SETBACK FROM
T
ADDRESS pl�J)7 g Q rn� FRONT PROP,LINE OF - - (STREET)
TYPE OFSETBACK
CITY T )I/-IW IL �� ' / H GHW YEW WIDTH FROM C.L. HIGHWAY } YARD = TOTAL
ARCHITECT OR i(J�n/� _ TEL. }
ENGINEER �y NO. BLDG.SETBACK FRO
ADDRESS C+ SIDE PROP.LINE OF (STREET)
CONTRACTOR J r� �ST Q/✓� ,TEL V_?V" HIGHWAY EW DTHG FROM C.L.SETBACK HIGHWAY } YARD = TOTAL O
p NO. V
ADDRESS /ID.� I E' r/� NO.
t C
e/� �+ o O
CITYYO' �L /" OA/T� CLASS ` 7 CORNER CUTOFF YES ❑ NO ❑_ Lu
CONSTRUCTION LENDER N
NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS z
ADDRESS
SQ. FT. NO. OF NO. OF NEW
SIZE STORIES FAMILIES
USE OF N L ADD ❑
STRUCTURE SDG/e '
ALTER ❑
SIGNATURE OF REPAIR❑
APPLICANT DEMOL ❑
VALUATION $ y/T � � APPROVALS DATE' INSP Toq's,slcN TU RE
P.C. PMT. FOUNDATION: LOCATION
FEE S FEE $ C/ !-/ FORMS, MATERIALS
FRAME: FIRE STOPS,
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 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 COMPEN ATION NSURANCE.
_„A LATH, EXT.
SIGNATURE OF /�//J
PERMITTEE .�� HOUSE NUMBER COR- --
rA
/ �Z WGN P,'X ^'Sa' �Mr RECT AND POSTED
ADDRESS - /('
FINAL
JOHN F. LEWIS. PRI IPAL STRUC RAL ENGINEER
PLAN CHECK VALIDATION CK. M.D. CASH _ PERMIT VA AT N CK. M.O. CASH
LCSO 5 g 4 3� 0AY 4 1 D 9..��J N
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