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BUILOINIi
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APPLICATION LEGALITY ,
NEAREST -ff__e�
DIVISION OF BUILDING AND SAFETY CROSS ST.
Department of Ooanty �'ngllleeS DISTRICT NO. RECEIPT NO. PERMIT NO.
county of Los Angeles �� .. /_ Ae 1-/ 4`1
WM. J. FOX, COUNTY ENGINEER GROUP DATE RECEIVED DATE FOGUED
CASSATT D. GRIFFIN, 9uwr OF BUILDING
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FOR APPLICANT TO FILL IN. TYPE CO ST. RECEIVED BY IB_SUED'D BY
OWNERMAP ,
MAIL /) ` �`1 NUMBER �/ / (d BHWYE _NC
ADDRES (((lll
USE ZONE SPECIAL
CITY Np ��f`/' / CONDITIONS
ARCHITECT OR TEL / �o(S pn-
ENGINEER NO.
BUILDING YARD HWY STREET NAME EXIST.
ADORES B BETBACK �/ WIDTH
TEL PR L T sG e r E P
CONTRACTOR NO.
SIDE
P.L
ADDRESS
BUILDING _/ ,tt C��' DATE COR/R�EC/TI/ONS /INSPECTOR
ADDRESS / L� OR A y / ! / .i FJ
LOT NO. BLOCK y
TRACT NO.OF `�' /� / 14W
SIZE OF LOT jj / I NOW ON LOTS `'7",All
,i/�U�rf/7f����
USE OF LJ l 4 AKeN,- .
E ,BTI .B
DESCRIPTION OF WORK �y/r� � /rni�i c dJ•arc
NEW ADD ALTERREPAIR DEMOLISH Z
so.FT. �7 NO.DF NO.OF Y
SIZE �- O STORIES FAMILIES / r
USE OF STRUCTURE ✓t ,/ro/,/,r/A;,i°jWA I,%e l,'
NO.OF �
EMPLOYEES
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP-
VPLICATION AND STATE THAT THE INFORMATION GIVEN 18 APPROVALS INSPECTOR'S SIGNATURE 'DATE
'`CORRECT.
I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION: LOCATION '
vAND
BTATE LAWS REGULATING BUILDING CONBTRUOTION. FORME.MATERIALS
FRAME: FIRE STOPS,
SIGNATURE Or � BRACING.BOLTS
PERMITTE FURNACE: LOCATION,
/� /�, (� BAB VENT,DUCTS
ADDRESN.Z L' LG (!1 _ 115, ,. _ , P 1 fg
LATH, INT. /6 .O
AUTHORIZED AOT. /
I/ LATH, EXT.
$ [s ` � � FEE,R HOUSE NUMBER COR- J
( .�-� / ! RECT AND POSTED Q� /
VALUATION FEE B! h_I FINAL
,` 7GA638A D883 4-54
76A638A CE #803 4/72 l`
APPLICATION FOR BUILDING PERMIT fl
COUNTY OF LOS ANGELES _ASSESSOR
DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL i•.
BUILDING AND SAFETY DIVISION BUILDING
MAKE CHECKS PAYABLE TO: ADDRESS
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY 1_ c--
FOR APPLICANT TO FILL IN NEAREST
Print ort a onl CROSS ST.' ���'cL 1,/, ac t-
BUILDING 7 GP�1 DISTRICT NO. GRO� CONST,TYPE C SEDBY�J
ADDRESS 725 1,
LOT NO. BLOCK
STATISTICAL CLASSIFICATION SEWER MAP -
�
CLASS NO.` % DWELL.UNITS BK PG.
TRACT g [�� +7 USE ZONEI MAP
NO.OF BLDGS. NO. '���t-0
SIZE OF L07-7j� (p NOW ON LOT ^� SPECIAL
USE OF CONDITIONS
EXISTING BLDG.
TEL.
OWNERDAA 014 NO. BLDG.SETBACK FROM
ADDRESS FRONT PROP.LINE OF TREET)
TYPE OF EXISTING SETBACK I HIGHWAY } YA = TOTAL
�-
CITY L r y HIGHWAY WIDTH FROM C.L.
ARCHITECT OR TEL. j
ENGINEER NO. BLDG.SETBACK FROM ,/ (STREET)
ADDRESS ((77 a� SIDE PROP.LINE OF C
CONTRACTOR �� 97- NO. 2 HI HWAY TYPE EWIDTH FROM bx.L. /GSIWAY +" YARD = TOTAL
LIC
ADDRESS 1 / C
�`� Gr �TLQ, NO
- .L� E+g1� + = LL
CITY CP ,/ CLASS CORNER ZUTOFF YES ❑ NO ❑ Z
CONSTRUCTION LENDER
NAME AND BRANCH SEE REVERSE SIDEp�FO�R,, PECIAL APPROVALS
ADDRESS I Jwi ,lflrk r9 /tP_.QN � /
SQ. FT. NO. OF NO. OF NEW
SIZE STORIES FAMILIESUSE OFA p
El
STRUCTURE $j�URE Ce G (liD
i� ALTER ❑
SIGNATURE OF REPAIR
APPLICANT DEMOL ❑
1 `� a
VALUATIONS 1 ( Q APPROVALS DATE INSPECTOR'S-SIGNATURE
P.CFEES "7'—iFEES PMT .� ,� aJj rOFORMS!MATERIIALSION
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT 1 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. 1 CERT(F•Y' THATa;.IN DOING THE WORK AUTHORIZED
HEREBY I WILL NO:r,' •O.Y•:ANY-PERSON IN VIOLATION OF THE ..S�IIII q
LABOR CODE OFA'-HE, -AiIi OF -`CAL.IFORNIA IN REL TING TO LATH, INT. - `1 l
WORKMEN'S COMPE NS ION�.1. UAANC E. LATH, EXT. -
SIGNATURE O HOUSE NUMBER COR-
PERMITTEE _ - -RECT AND POSTED-
ADDRESS .� VD,
I.NAL y
7 7-3-10
PLAN CHECK VALIDATION Ck. M.O. CASH _ PERMITVA TION CK. M.O. CASH
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