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76A638A CE #8031/7APPLICATION FOR BUILDING PERM-IT �
COUNTY OF LOS ANGELES ASSESSOR
DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL
BUILDING AND SAFETY DIVISION BUILDING
ADDRESS D
COLEMAN W. JENKINS, SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL 'IN NEAREST -
CROSS ST.
Print ort a oril -
A DISTRICT NO. GROUP TYPE -• • PRO D B
BUILDING � Lon a1Ew /` --, CONST.
ADDRESS FdC
STATISTICAL CLASSIFICATION —/ SEWER MAP
LOT NO d, BLOCK CLASS NO.=Z DWELL.UNITS BK PG-' -
TRACT & , Q3 - USE ZONE MAP, O
NO.OF BLDGS. NO. -
SIZE OF LOT NOW ON LOT SPECIAL"' ;
USE OF CONDITIONS
EXISTING BLDG.
OWNER To. J �Gwj -
4.UN 'f BLDG.SETBACK FROM • . .
ADDRESS Q m , FRONT PROP.L''INEOF, --, (STREET)
TYPE OF EXISTING SETBACK HIGHWAY -�} YARD = TOTAL ,
CITY Gr� l�0'j HIGHWAY WIDTH ,FROM C.L. •<
ARCHITECT OR TEL. _.+ _
ENGINEER NO. --
BLDG.SETBACK FROM
ADDRESS SIDE PROP.LINE OF �' (STREET)
TEL. - TYPE OF EXISTING SETBACK' HIGH W +- YARD = - TOTAL
CONTRACTOR NO. HIGHWAY WIDTH FROM C.L. C7
LIC. _
ADDRESS - NO, _ + - - O
LIC. ~
CITY CLASS CORNER CUTOFF YES ❑ NO ❑ a
CONSTRUCTIONLENDER
cn
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NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS
ADDRESS
411370SQFT. NO. OF NO. OF NEW ❑
SIZE .STORIES FAMILIES
USE P
OD
STRUCTURE ALTER ❑ •,/�. .� - ,
REPAIR❑ - 23-, .
v -
SIGNATURE OF -
APPLICANT DEMOL
VALUATION'$ ( v v r APPROVALS DATE' INSPECTOR'S SIGNATURE
FOUNDATION: LOCATION
FEE S FEE $_ L'_Co FORMS, MATERIALS ,
FRAME: FISTOPS, - -
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACIRE NG BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION,
WITHALL ORDINANCES AND LAWS*REGULATING BUILDING CON- 'GAS,VENT, DUCTS
STR UC TION. 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 T� ,
WORKMEN'S COMPENSATION INSURANCE
I LATH, EXT.
SIGNATURE OF HOUSE NUMBER,COR-
PERMITTEE'
OR-PERMITTEE- ,RECT AND POSTED .,o..,,
ADDRESS FINAL - S
�-
JOHN F. LEWIS. PRI CIP STRUCTURAL ENGI EER
PLAN CHECK VALIDATION CK M o CASH _ PERMIT VALIDAT N CK M CASH
LA_`o'7 3 -6 6 " AUG 4 '2 Q ,
D13-3 8-40 25M APPLICATION FOR TERMIT
DEPARTMENT OF RUILDINC.-ANP, SAFETY
COUNTY OF LOS ANGELIES
WM. J. FOX, CHIEF ENGINEER
NO. OF �� BLDG.C' - ORD.,NO. DISTRICT NO. --PLAN CK. NO. ' PERMIT NO.
PLANS SETBACK LINE :" •'�% 1 i1 "F.7^ r. a L��
FIRE APPROVED ".- p ✓ ` Q
ZONE BY '` '. -~.. -DATE,:: RECEIVED
ECEIV,E.D�,...BY. - gDATE OF APPL. ^f DATE ISSUED -
USE A \' APPROVED
ZONE ` ` - BY DATE -
:APPLICANT- FILL. IN 41EAVILY OUTLINED PORTION- ONLY
• •_' __ BUILDING .�
p NAME F /7 Y S �_/1� ...' t ADDRESS19
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RESS U/I/7�6`J��bf: Y7 l�P.F- �w�- LOCALITY -
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= Z -,n��-/Q� Y - ? NEAREST-
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STATE - ..2-64 .,W
LICENSE NO:- - - - "NO. NAME ,�yrr-rfd:
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NAME .�ta6%Z. r� '�°' 0 ADDRESS .JA,�e` ar t 1',r te`. ,._ .,�. ^4
TEL
Q= ADDRESS J/ ��� I. � c�'�E"" •..: °` CITY. - NO•�/ � �,r� d
Ir
Z 1 HEREBY"ACKNOWLEDGE,THAT- 1 'HAVE READ-THIS,
..OCITY _. �� APPLICATION.AND STATE THAT THE.ABOVE IS CORRECT
U STATE / - TEL. AND,AGREE TO COMPLY WITH ALL COUNTY.ORDINANCES'
LICENSE NO.{� 4D NO. 71 76�• AND STATE'LAWS REGULATING BUIL_DING CONSTRUCTION.
O SIGNATURE OF
ZZ LOT. NO. 7_ SIZE OF.LOT/�D,K/G�r OWNER '
. Q .. NO. OF HLDGS-w` - AUTHORIZEDAGT.
t7 BLOCK NOW ON LOT -- \"1.T _ _
j y o •... CORRECTIONS
A TRACT
D USE OF BLDGS. I "�
NOW ON LOT- `V G• \'`.R#• - i �� - - C.
DESCRIPTION OF WORK'
USE 00
BUILDING
\. J z
0
NEW. TYPE I GROUP '
NO. OF NO. OF
ALTERATION' ROOMS FAMILIES , -
ADDITION SIZE �, ``.VV C)
REPAIR STORIES
MOVING I WALL COVERING 4-: a� tea m
DEMOLISH, I ROOF COVERING �+•�..\sn_.q -r!`
P.
c.-S/ FINAL APPROVAL
$ FEE G �^ / ) A
. _ 4 $ -- ( INSPECTOR'S
VALUATION FEE \ � DATF_
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78AG98A CE*803 7.66 AY Y LICATION FOR BUIlLDING C '9 M-IT�`�..� .�.
BUILDING AND SAFETY DIVISION Bu1LDING
Department of County Engineer ADDRESS
County of Los Angeles LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
_ CASSATT D. GRIFFIN, SUPT OF BUILDING CROSS ST.
DISTRICT NO. GROUP I TYPE- EWER MAP
FOR-APPLICANT TO FILL IN SK PG
CONST..
BUILDING
ADDRESS STATISTICAL CLASSIFICATION '
LOT NO. / BLOCK CLASS. NO. DWELL. UNITS -
MAP STATE YES O.
�-+ NUMBER HWY -
TRACT J 9/S 3 USE ZONE -SPECIAL
_
NO. OF BLDGS. CONDITIONS
SIZE OF LOT �Q()/Y /� , NOW ON LOT I_ .,J�
USE OF 7NO -
EXISTINGBLDG. BUILDING EXIST.
SETBACK YARD HWY STREET NAME WIDTH
OWNER p _ YFRONT
MAIL - P. L. �J
ADDRESS Q �i'M I SIDE
TEL. 7�/ P. L.
CITY NO' INSPECTION RECORD
ARCHITECT OR TEL. _
ENGINEER B - NO. _
ADDRESSTEL.
CONTRACTOR NO. '
ADDRESS
DESCRIPTION OF WORK `NEW ADD ALTER REPAIR. DEMOLISH _
SO. FT. NO..OF• NO.OF
SIZE - Zoo STORIES FAMILIES
USE OF STRUCTURE
06 6
APPROVALS '
SIGNATURE OF -
APPLICANT '�`- DATE INSPECTOR'S SIGNATURE
ADDRESS D. FOUNDATION: LOCATION ,
FORMS, MATERIALS
P. C. $ FRAME: FIRE STOPS.
FEE `BRACING. BOLTS
VALUATION. $ d(,t FURNACE: LOCATION. _
FEE. GAS VENT, DUCTS
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP-, LATH, INT.
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITHrAL,,L COUNTY ORDINANCES AND 'LATH. EXT.
STATE LAWS IJ�ING UILDING TRUCTION. -
SIGNATURE OF �([f HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED g,
'ADDRESS LI �" d FINAL'
INAL
JOHN A.LAMBIE, COUNTY ENGIN R, CLYDE N. DIRLAM, PRINCIPAL STRUCTURALR
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
.ACO 71 6� '01� APR 15 1 2'.0.0 In
76A638A CEtI803�6-65 APPLICATION FOR BUILDING PERMIT _
' COUNTY OF LOS ANGELES BUILDING
^pEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOC A L I T Y
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST - _• "
COLEMAN W. JENKINS.SUP•T OF BUILDING I.CROSS ST ew � '
_ DISTRICT NO-- GROUP TYPE - - PROCE •B Y'
FOR-APPLICANT TO FILL IN CONST.' -
67
BUILDING STATISTICAL ASSIFICATION SEWER MAP:`'''
ADDRESS /- "� � -
'�`� p CLASS NO DWELL UNITS P',
LOT
PG Z•
LOT NO BLOCKUSE ZONE MAP
TRACT O 3 - SPECIAL
SIZE OF ,OT. i -
' CONDITIONS
NO OF BLDGS.' •• -
NOW ON LOT _
USEOF �-•
ISTI BLDG. SETBACK-FR OM
�. TEL FRONT PROP: LINE OF TREET,) .
'OWNE TYPE OFEXISTING SETBACK NI GHWAY, - �-YARD_'_= _TOTAL ,
ADDRESS HIGHWAY WIDTHFROM C L -
CITY BLDG:-SE BACK FROM
ARCHITECT OR TEL
ENGINEER NO SIDE PROP LINE OF
/� L.
_ TYPE OF EXISTING SETBACK NIGH WAY`"+ - ,'YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C L
£ TEL - - r + - d
CONTRACTOR NO G - O
LIC CORNER CUTOFF YE NO V
ADDRESS IJ A NO
CC
CITY ' -- c s ,SEE-REVERSE SIDE FOR SPECIAL APPROVALS OO,-
DESCRIPTION OF WORK _ 1 ✓�� j/91P�
NEW ADD X ALTER REPAIR DEMOLISH
SQ.FT. 'NO OF NO OF _
SIZE S.T.ORIES FAMILIES _
USE O STRUC (
SIGNATURE*OF� •• - -
APPLICANT -
Goc
VALUATION ''APPROVALS DATE- INSPECT 'S SIGNATURE
P.C. w PMT ✓C`v FOUNDATION, LOCATION
FE FEE$ FORMS, MATERIALS -
- -FRAME, FIRE STOPS, '/ G _
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION. BRACT NG-BOLT t -
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS -
9UILDING CONSTRUCTION I CERTIFY THAT AN 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'S COMPENSATION INSURANOE _
` ' LA-TH. EXT. - '
SIGNATURE OF'P-��//�•L*/W\ HOUSE NUMBER COR- - ..
PERMITTEE - RECT AND'POSTED
ADDRESS
. F�I N A L
PLAN CHECK VALIDATION CK. MO CASH JOHN F. LEWIS. PRINCIPAL STR URAL ENGINEER '
PERMIT VALIDATI.ON CK M.O - CASH
LA(f 0 .9'9.0"'Do APR 4. 1 A 1 1.J O N Q