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F6688CE#803-9C9.1-61 APPLICATION FOP. BUIL.®IN PEFZNII`}C'
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COUNTY OF LOS ANGELS° BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST �s .
WILLIAM A.JENSEN SUPT OF BUILDING CROSS ST.
DIST ICT N GRO P •�ypF P DB_
FOR APPLICANT TO FILL IN CONST.jr
BUILDING STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS /bbi l ��'-'� / BK PG
tt-/� [('��J CLASS.NO. DWELL.UNITS
LOT NO.W',/OOFff-, 6 BLOCK WATER NOT REQUIRED ® RECEIVED
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f TRACT MAP HIGHWAY
o / / I NO.OF SLOGS. NO. z-o Oa (CIRCLE) STATE MAJOR SECOND, OCA
SIZE OF LOT"d `��ljj1,J DO ONOW ON LOT USE ZONE SPECIA
USE OF
EXISTING BLD JG(r.)?,II ,9. '—GA . //� y�7v� t�r� CONDITION
OWNERAf ff-#&,o? / D F9h�i0 NO,#7.,
/may �� BUILDING ARD HWY TR NAME EXIST.
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ARCHITECT OR EL. FPROL T
ENGINEER NO. SIDE
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DESCRIPTION OF WO
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SQ.FT. 1 NO.OF NO.OF ?
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USE OF i
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APPLICANT F
.VALUATION$
APPROVALS ..DATE INSPECTOR'S SIGNATURE
U FOUNDATION:LOCATION
F E $ '` FEE $ S� FORMS,MATERIALS
FRAME:FIRE STOPS,
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS. 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 d,
BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH,INT.
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- O/
ING TO WORKMEN'S COMPENSATION INSURANCE. LATH,EXT..
SIGNATURE OF C j? HOUSE NUMBER'COR-
PERMITTEE RECT AND POSTED
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ADDRESS � � e % tFINAL
CLYDE N. DIRLAM, PRINCIPAL STRRAL ENGINEER
PLAN CZ= VALIDATION 0-M.0'. CASA PERMIT VALIDATION cKy� M.O. CASH
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76A638A CE#8032-63 APPI....ICA'T"ION FOR BUILDING PERM1 '
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS r
BUILDING AND SAFETY DIVISION LOCALITY ( ®J
JOHN A.LAMBIE. COUNTY ENGINEER NEAREST
WILLIAM A.JENSEN.SUPT OF BUILDING CROSS ST.
DI .T ICT O. GROUP T E CESSED BY
FOR APPLICANT TO FILL IN 3 CONS .
BUILDINGSTATISTICAL CLASSIFICATION WER MAP.
ADDRESS BK
CLASS. NO. DWELL.UNITS f
LOT N 0.%o 6 p. L L ` BLOCK WATER NOT REQUIRED RECEIVED
.CERTIFICATE:
TRACT MAPHIGHWAY' STATE MAJOR SECOND, OCA
NO.OF BLDGS. n NO. r , •,CIRCLE)
SIZE OF LOT NOW ON LOT 2r USE ZONE SPECIAL Lj
USE-OF CONDITIONS
EXISTING.BLDG._
TEL'J�'`'S' '
OWNER NO. BUILDING YARD HWYTREET N ME EXIST.
' SETBACK WIDTH
'ADDRESS LC" FRONT
ARCHITECT OR TEL. P• L. �i
ENGINEER NO. SIDE I r
O..
P: L. _ /
ADDRESS O
TELT/LiLa.�l� �/Llt�
CONTRACTOR NO. - I fig
dl.S � -- O
ADDRESS , F-
DESCRIPTI N OF WORK S o��� ''
NEW // ADD ALTER REPAIR DEMOLISH • z .1 ` r+� A � I
SQ.FT. NO.OF NO. OF n Ir . ►�I .Ai ',;,-W
SIZE 3 STORIES FAMILIES
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USE OF
STRUCTURE I?✓ fv
SIGNATURE OF
APPLICANT w
VALUATION L-
AP OVALS DATE, IN CCTO SIGNATURE
P.C. PMT. FOUNDATION: LOCATION +5 /
FEE S 'FEE $ FORMS, MATERIALS / c/
FRAME: FIRE STOPS.
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING. BOLTS _(t7 •� / ./ .[s�.'�1.�
AND STATE THAT THE ABOVE'IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION,
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- �� ��,,`�'��jrfi., �,..
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT. LATH. INT. R QJ .sit/ 4•r..a. t�&f.::�"dt''f"t
ING TO WORKMEN'S COMPENSATION SURANCE.
LATH.'EXT. . .2� 'f;�'3 � 1/+?i� A
SIGNPERMATURE ITTEE OF HOUSE NUMBER RECT AND POSTED
R
ADDRESS r FINAL
JOHN F. LEWIS. PRIINCIPAL STRUCTURAL EN INFER
PLAN'CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH
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