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76A638A CE#803-6-5T APPLICAT"ION. FOR BUILDING PERMIT , .,.1.�
COUNTY' OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING' AND"SAFETY DIVISION LOCALITY
JOFIN A. LAMBIE,COUNTY ENGINEER NEAREST
CASSATT D.-GRIFFIN,SUPT OF BUILDING - - CROSS ST: -
DISTRICT NO. GROUP TYPE SEWER MAP
FOR--APPLICANT TO FILL IN' �$` � I coNsr'!� I i�K P
BUILDING f I -
ADDRESS ��� STATISTICAL CLASSIFICATION-
CLASS. NO. DWELL.UNITS
LOT NO. - �^ - BLOCK MAP - -STATE -
1 NUMBER HWY." YES O
TRACT ' USE ZO E 'SPECIAL - -
NO.OF BLDGS. J/N CONDITIONS -
SIZE OF LOT I NOW ON LOT J- - -
USE OF `'-
EXISTING.BLDG.I ,Q UILDINGEXIST. '
SETBACK YARD HWY .STREET NAME - WIDTH
OWNER., - I-L 1 + ,
FRONT
-MAIL !/ _ P.L:
ADDRESS 19 SIDE -
IEL. P.L.
CITY No. INSPECTION RECORD-
ARCHITECT OR TEL.
ENGINEER NO. -
ADDRESS
.. 'TEL._
CONTRACTOR NO.
IPLI
DRESS - ..
DESCRIPTION OF WORK'
W ADD ALTER REPAIR DEMOLISH -
FT. NO.OF NO.OF
E ' STORIES FAMILIES
E OF STRUCTURE
APPROVALSDATE •INSPECTOR'S SIGNATURE
DRESS FOUNDATION:.LOCATION
FORMS.MATERIALS
P.C. $ FRAME: FIRE STOPS.
_� ._ . FEE - BRACING, BOLTSLUATION $ FURNACE: LOCATION.
FEE 77 GAS VENT,DUCTS1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH, INT.CATION AND STATE THAT THE ABOVE IS CORRECT AND
'AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND '
STATE LAWS REG . ING BUIL CONSTRUC O_ LATH, EXT.
-SIGNATURE OF HOUSE NUMBER COR-PERMITTE ' RECT AND POSTED
ADDRESS � FINAL
l6/�
JOHN•A. LAMBIE,COUNTY ENGINEER, CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL ENG ER
PLAN CHECK VALIDATION ` K. M.O. CASH., PERMIT'VALIDATION CK. M.O. S
— i �
-4.0 34" Mr, -27 1. a 2.4 0 L
76A638A CE$G809 10-5S
APPLI0"9I®-G Fa'. ®,9 O tld...'M-'` ®Ta V,G 9. ��tl tl tl I .
- ..
BUILDING. AND SAFETY DIVISION ` BUIL°;'N ' .. -_
.. ADDRESS`' ��N�•C- 'fes(! .�.
- 'Departazent,'of County.Engineer
County of Los Angeles' LOCALITY ` -J
' .-JOHN,A. LAIVIBIE:-CouNTY`:ENGINEER NEAREST ., ' -
CASSATT D.GRIFF,IN,,SUP•T of BU. ILUING' - CROSSST. - '--
` - DISTRICT NO. ',GROUP TYPE SEWER Ml
.FO R..APPLICANT TO FILL IN, I,. I - Kl/ �
' / CONST. _
BUILDING - - -
ADDRESS _ STATISTICAL C&ASSIFICATION
r� ., - CLASS NO DWELL. UNITS
.LOT'NO..._ -,� BLOCK - -
:` : - NUMBER � '
TRACT C�. G .: r .. HWY -.�
-•T `_ - - - - U E ZONE - •`SPECIAL
- ES
` - •CONDITIONS --;. - Y
NO
L-." NO OF BLDGS: -
-SIZE OFA LOT �3' y,- �,D V:.'I' NOW ON LOT_ -
FUSE OF. -
EXISTING BLDG. �J/C,'G BUILDING - - - EXIST.YARD YARD HWY .STREET NAME -
SETBACK.. - .: ;•W IDTH':..
OWNE " FRONT 10
P77
MAIL _ -. P I -
ADDRESS` '_C, -� 1' SIDE
TEL
CITY NO...
ARCHITECT.OR TEL. INSPECTION RECORD
ENGINEER
`ADDRESS.'. .', - .. •.- -
'TEL.
'CONTRACTOR - .NO.
ES S
DESC ION•OF WORE
.NEW' ;'ADDV ALTER- REPAIR -'DEMOLISH,
,S'Z.'FT, '.NO. OF'' . .NO..OF - - -
•
STORIES.- „.. FAMILIES
USE-OF'STRUCTURE
-' - APPROVALS.- '•-
GNATURE OF` • - '- .. - .- .. ..
APPLICANT .DATTE - .INSPECTOR'SSIGNATURE .
`ADDRESS.. FOUNDATION:-LOCATION -
” FORMS:MATERIALS.- - -'
-P'. C. $ -• FRAME: FIRE,STOPS
FEE. _ .BRACING::,BOLTS
VALUATION /LJ L✓ $ t.
FURNACE: LOCATION'.
FEE.
...GAS'VENT;DUCTS
. .. '
`I'HEREBY,ACKNOWLEDGE THAT 1-HAVE READ THIS AP- LATti:;INT.
.PLICATION-AND STATE THATrTHE ABOVE.,IS^CORRECT-AND
AGREE TO COMPLY WITH.ALL COUNTY ORDINANCES AND, LATH,.EXT - -
STATE LAWS 'RE G BUILDI 1 ONSTRUCTI
SIGNATURE - �n � HOUSE NUMBER COR-
-,
OR -
'+ :�" GTi�IG= �,I,/.�} �LI;'e%.'f� RECT'AND`:POSTED -�
i
- .PERMITTE _ -
ADDRESS FINAL(B�
JOH'N'A.LAMBIE,'COUNTY ENGINEER " '. .+` CLYDE N. DIRLAM, PRINCI AL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION -bK.- m o, ".cnsH PERMIT VALIDATION, - CK: M.O.- .,CASH
2 E7
• ` - �; ?..� 4111 $EP a
,
DEPARTMENT .OF COUNTY INGUMM
DIVISION OF .BUILDING.AND SAFETYLDI
4..
A Y COUNTY OF L03"ANGELES
WILLIAM 'J - FOX, COUNTY ENGINEER ,„
+. •' ,, APPLIC�TION '-
CASSATT D.•.GRIFFIN, SUP,'T:DF'BUILDING
FOR APPLICA1yT. TO FILL IN FOR OFFICE.,V4g y QNLY
BUILDING �+ /
DISTRICT N REc.No p
ISTRIC O Pi.�.^47N CK:.O7R PERMI[T, N
ADDRESS �7 ® °'�LDLC1 '
LOCALITY /�C•/y: ` RECEIVED•BY DATEOrF,APPLI - DATE IS3YED
NEAREST / A'` C/ } ��7.�.�':. '';' O '( -53",
BU L NG -
" ADDRESS`' I
.OWNER• .f ��.VIfl��V 2:iJ
? .
MML`-'x • ,. rte !/'y LOCALITY ;!1'� J •` ° - i
ADDRESS �.'P"'. ® .,✓ p'4. 4�a N ®' ..:NEAREST! '`• . -
'CITY:..
d+N (m'l:dQ.f?16/ �I` NO' T/.fo I CROSS ST. ft 1 V•"�
ARCHITECT OR TEL'`.
FIRE NO. OF TYPE GROUP
ENGINEE NO..• ZONE . I PLANS a
ADDRESS BLDG" �'- I r' OR�D/iNO:
��/" _ � SETBACKiLINE �»� /�•..�"`� ".�o�/�C'" .'
/f �• I •„ USE 3 APPROVED� �
$ + CONTRA O- "./'h. -"'./""/ C� Gt /� NEL- _ ZONE t, BY.tG?G5%�^DATE
-_. - - yam. -NUMBERING,
HOUSE
ADDRESS ,.
-LEGAL ::,c •,` - MAPNUMBER 2:—" ..�'.� ANO. ASSIGNED BY - I
DESCR PTIONti, T NO. '<-� I.'BLOCK
JvCORRECTIONS'" -�
TRACT" /:
l0
NO. OF%BLDGS 1
,SIZE CF' LOT NOW ON LOT }'
USE 60 NO, OF
EXIBTING'BLDG. aM�cle
DESCRIPTION OF::WORE
e .Fs - _
ON
s REP IR` 1 '.DEMOLITION'.
TI r+ ADDITION D
c
SQ . / . / / . - :L�
SIZE DiC7.J' ROOMS.:'�7 '. STORIES
EXT;'WALL ROOF
COVERING =GLI(�;�� alY COVERING (;.d �•
USE OF STRUCTUit Q
r-
l _ APPROV• LS, -
4``-�' °/1 `• ° 'INSPECT 'S.SIGNATURE `•��DATE
•'FOUNDATION. LOCATION {_' = J/
FORMS: MATERIALS V ,�.•, "�E.f�./6� _'j.
-1 HEREBY=ACKNOWLEDGE_THAT-I:HAVE.'READ THIS'AP 'FRAME:• FIRESTOPS; v
PLICATIONfiAND STATE THAT THE INFORMATION GIVEN• IS' BRACING, BOLTS
CORRECT
1 AGREE TO;COMPLY WITH ALL COUNTY':ORDINANCES FURNACE: LOCATION c
ANA STATE LAWS REGULATING BUILDING CONSTRUCTION.'- N
., .•.. <: ,. .;: GAS VE .r. ;. •-
T DUCTS _•
SIGNATURfi INT
PERMITTEER.P./ ;( U" e .
• - 1- r LATH'. EXT.,
ADDRESS- Z• ^' •.. %� .
0
t
.• - PLASTER `INT 'i
AUTHORIZED AGT'
:o PLASTER E '•
$ P. C $
- ;'FEE �,"'`q ' .,i• ,:�,/ 4
. `. Y' HOUSE NUMBER COR- _
RECT AND POSTED
VALUATION °�d e qV
'� 'FEE.,ffi y1 -'.:� �.FINALv- ® ��
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