HomeMy Public PortalAbout9382 LOWER AZUSA RD_Building__ 16A638A CE#808 8-68 APPLICA`1jION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A.JENSEN, SUPT OF BUILDING CROSS ST.
DIST CT Ug. GR Ty
PE• P O Y
FOR APPLICANT TO FILL IN (� CO I
BUILDING STATISTICAL CL FICATION SEWER MAP
ADDRESS ,��a CLASS.NO. - DWELL.UNITS BK
LOT NO. BLOCK WATER NOT REQUIRED RECEIVED
CERTIFICATE:
TRACT MAP _/HIGHwaY
NO.OF BLDGS.
NO. (CIRCLE) STATE MAJOR SECON LOCAL
SIZE OF LOT NOW ON LOT USE ZONE SPECIAL
USE OF CONDITIONS
EXISTING BLDG.
TEL.
OWNER NO. BUILDING EXIST.
SETBACK YARD HWY REET NAME WIDTH
ADDRESS FRONTt:'- ----
ARCHITECT OR TEL. P. L.
ENGINEER NO. SIDE
P. L.
ADDRESS
TEL. 7. 0
CONTRACTO NOU%1 Z
ADDRESS 7' c . AG
DESCRIPTION OF WORK t �'�`'`�'�!' '"' Lo
F W
NEW ADD ALTER REPAIR DEMOLISH N
SQ.FT. NO.OF NO.OF z
SIZE STORIES FAMILI S
USE OF
STRUCTURE ®00
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SIGNATURE OF
APPLICANT
VALUATIONS ' /ga
APPROVALS DATE -INSPECTOR'S SIGNATURE
PC' FOUNDATION: LOCATION
FEE $ FEE $ 0 f FORMS, MATERIALS
FRAME: FIRE STOPS,
1 HEREBY ACKNOWLEDGE THAT 1 HAVE-READ THIS APPLICATION -BRACING BOLTS'
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. ') q r" ✓
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS. ��^• _ '/d�lfi
BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK r /�.•- �1��,;•
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 CO SATION INSURA
LATH.EXT. J
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE I RECT AND POSTED
ADDRESS
• FINAL• / a.ay� •/'�3��'
JOHN F. LEWIS, PRINCIPAL ST RAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH ' PERMIT VALIDATION 1cK. M.O. CASH'
LAGO G 4 1 9DEC 1 D- 4.0 ON
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