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APPLICATION FOR BUILDING PERI IT �
ti COUNTY OF LOS ANGELES ASSESSOR
DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESSD l a
COLEMAN W. JENKINS, SUPT OF BUILDING -
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
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BUILDING DISTRICT N GRO P TYPE P D BYV
CONST
ADDRESS �S a Z �- =�
((77 STATISTICASIFICATION SEWER MAP
LOT NO. BL9CK
CLASS NO. DWELL,UNITS BKPG
TRACT aZ 4 �V USE ZONE MAP LOA/ll
NO.OF BLDGS. / NO.
SIZE OF LOT 1C S-d NOW ON LOT / SPECIAL
USE OF S
EXISTING BLDG. (�2
TEL
OWNER d o /V - t NOL;
- ` BLDG.SETBACK FROM
ADDRESS �S(' L p w .p y FRONT PROP.LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
CITY ��+ �� �! 71 HIGHWAY WIDTH FROM C.L.
ARCHITECT OR TEL. �7 + .2-0 = (;La
ENGINEER NO.
BLDG.SETBACK FROM
ADDRESSSIDE PROP.LINE OF (STREET)
J // TEL. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
CONTRACTOR GtLa�tiKd ,31.c NO. HIGHWAY WIDTH FROM C.L. }
LIC.
ADDRESS.22/ + C NO. SS -G L
El LIC.. NO
❑
CITY � All/[ CLASS � - CORNER.CUTOFF YES ❑ �
CONSTRUCTION LENDER _ H
NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS t
- a
ADDRESS'
SQ. FT. NO. OF NO. OF NEW
SIZE V® STORIES FAMILIES ❑
USE OF' ADD
STRUCTURE
• ALTER ❑
REPAIR❑
SIGNATURE OF p
APPLICANT DEMOLOro
❑
VALUATION S ' 'Vv APPROVALS DATE INSP�E' TOR'S SIGNATURE
BIG
P.C. PMT. FOUNDATION: LOCATION
FEES FEES 1 FORMS, MATERIALS n �/
FRAME: RE FISTOPS, /
1 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 CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT.
LABOR CODEOF THE STATE OF -CALIFORNIA IN RELATING TO
WORKMEN'S COMPENSATION INSUR47CE. LATH, EXT.
LAE, I
SIGNATURE OF . HOUSE NUMBER COR-
PERMITTEE RECT AND POSTEDAw
ADDRESS.L FINAL
JOHN F. LEWIS. PRINCIPAL STRUCTURAL E EER
PLAN CHECK VALIDATION - CK. M.D. CASH _ PERMIT VALIDATION CK. M.O. GAS `
1 "r_ 0 3 3 4 "M19 p 1 7 5N
6AS38A CE#809.7.56 A"'ll Y P L I C A T I O a FOR .B U I Lr®I NG P M IT - -
BUILDING AND SAFETY DIVISION BUILDING .
ADDRESS
Department of County Engineer
County of Los Angeles LOCALITY
JOHN A.LAMBIE,.COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST
DISTRICIPO. GROUP TYPE SEWER MAP -
FOR APPLICANT TO FILL IN. ,� �' I CONST. I
BUILDING -STATISTICAL C SIFICATION I
ADDRESS -
CLASS. NO. DWELL. UNITS
LOT NO. �� �. BLOCK-
MAP / STATE YES O
NUMBER �`\D 1P HWY
TRACT U E Z N SPECIAL
NO.OF BLDGS. .CONDITIONS
SIZE OF LOT. I NOW ON LOT
USE OF
EXISTING BLDG. BUILDING EXIS ,
YARD , HWY - STREET NAME
SETBACK W IDTIi
OWNER [L ; FRONTAIL �� ®'
ADDRESS S`D a6.c�TP S[DE -
.�' `— TEL P L.
CITY NO. INSPECTION RECORD
ARCHITECT OR TEL.
ENGINEER '` :NO.
a
ADDRESS ��-1
TE
CONTRACTON y
ADDRESS �'- Y
DESCRIPTION OF WORK
NEW ADD ALTER- REPAIR DEMOLISH :
SQ. FT. NO.OF NO.OF
SIZE. STORIES FAMILIES
USE OF STRUCTURE
F
APPROVALS
SIGNATURE
APPLICANT� qq DATE INSPECTORS SIGNATURE
ADDRESS �^f^ FOUNDATION:LOCATION
FORMS. MATERIALS
$ �I ®0
P.C. g FRAME: FIRE STOPS.
J L/r FEE BRACING.BOLTS
S FURNACE: LOCATION.
VALUATION FEE. GAS VENT. DUCTS.'
i
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH. INT.
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND' LATH. EXT.
STATE LAWS G ! BUILD G CONSTRUCTION."
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDREs FINAL
OHN A.LAMBIE.COUNTY ENGINEER, CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION c' M.O. CASH
0'23 5 '�5 JUL 16 1- . 2.0 0
r.'
- o`-
'BA698A DBS-88•BrA PLICATION `FOR-BUILDING PERMIT
®
DIVISION OF BUILDING AND SAFETY AuI Elss •'��t�'?. -
Deportment of County Engineer — a
County of Los Angeles LOCALITY '
_ WM.J.FOX,COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN.SuP1T of BUILDING CROSS ST.
DISTRICT NO. GROUP TYPE BK MA PG
FOR APPLICANT TO_FILL IN I CONST.
BUILDING MAP STATE
ADDRESS NUMBER HWY YES. MO
LOT NO. . BLOCK USE ZONE SPECIAL
CONDITIONS
TRACT )-•y d� 5000
SIZE OF LOT 6+ A / ✓ I NOW ON LOTS SETBAICK NG YARD HWY STREET NAME WIIDTH
USE OF FRONT
EXISTING BLDG. P L.
OWNER k04-& SIDE "
P.L.
MAIL
ADDRESG .0 CS� �" O TRACT DWELL. I UNIT 5 INDUSTRIAL
CITY f_LG��!J / NO. / �`t (/ 1 DWELL- I UNIT' 6 PUBLIC BLDG.
ARCHITECT Old' TEL. 2 DUPLEX 9 UNIT -7 ADDN..AL-T.. ETC.
ENGINEER NO. 3 APT. UNITS
8 MISCEL.
ADDRESS 4 COMMERCIAL "
_ {n
/n� TEL. INSPECTION RECORD
CONTRACTOR 4 NO.
ADDRESS
DESCRIPTION OF WORE
NEW ADD ALTER REPAIR -DEMOLISH
Q. FT. - _ NO.OF NO.OF
SIZE STORIES FAMILIES -
UBE OF STRUCTURE
�fJ 0 Ur r�_1�V�tn+a-cLi.
SIGNATURE OF "1 A 1 Xtrf a'' IV.fAil�yi/In�t� APPROVALS
APPLICANI 'LT
ADDRESS pl.L^n.fi/yU/ IiAAV DATE INSPECTOR'S SIGNATURE
Y FOUNDATION:LOCATION
P.C. IB FORMS:MATERIALS
CJ FEE FRAME:FIRE STOPS.
BRACING.BOLTSFEBFURNACE:LOCATION1HEREBY ACKNOWLEDGE THAT I HAVE READ THISGAS VENT,DUCTS[VALUATION
PPLICATION AND STATE THAT THE ABOVE IS CORRECT l
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH,INT. `
AND STATE LAWS REGULATING BUILDINd CONSTRUE-
TION. LATH.EXT.
SIGNATURE OF �j�„� w HOUSE NUMBER COR-
PERMITTEE RECT'AND POSTED
ADDRESS �- � � "a � FINAL
WM.J.FOX,COUNTY lkNGINEER VALIDATION C.N.DIRLAM.CHIEF BLDG.INSPECTOR
Of 21 1 2.0-0