HomeMy Public PortalAbout5348 MCCULLOCH AVE_Building__ 76A638A CE#8089.61APPLICATION FOR. BUILDING PERMI '
COUNTY OF.LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS n -�
BUILDING AND SAFETY DIVISION LOCALI --61-7
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST..
DIST CT GROY C Y
FOR APPLICANT TO FILL IN. Q coNsr.'
,BUILDING -STATISTICAL CLASSIFICATION SEWER MAP
DDRES3 � B
CLASS.NO_jO_DWELL.UNITS
LO LOCK WATER NOT REQUIRED RECEIVED
CERTIFICATE: J�
TR CT p F'eL CI fir) NO OF BLDGS NO. oC_��? HIGHWAY
Y STATE MAJOR SECOND, CAL
SIZE OF LOT /�X uC /!� I NOW ON.LOT I USE ZONE SPECIAL
USE OF CONDITIONS
'EXISTING BLDG.• �W E L L/n/6 '. X ,_� F ; .,
OWNER E;LV T NO.4 'O i BUILDING EXIST.
YARD HWY STREET NAME
SETBACK o� WIDTH
ADDRESS 8 0 j7 /rllSS/e/1I 1//P.� Pn_-0r f&-.4A FRONT rf.L/7
ARCHITECT ORTEL. P.L.
ENGINEER .NO.
SIDE d'•
P.L. O
ADDRESS INSPECTION RECORD 99
EL.
CONTRACTOR f TNO. C
ADDRESS J&Q j'jn1Atf& A2u5A AD 7:C''. �~ w
•DESCRIPTION OF WORK- �- h
NEW ADD ALTER REPAIR DEMOLISH
SQ.FT. NO.OF NO.OF
IZE S STORIES FAMILIES
USE OF• '�T� ,�/7 ► �.. `� � �,� .
STRUCTURE = a n
SIGNATURE OF
APPLICANT
VALUATION S
1i 7
APPROVALS D/ATx INSPECTpR'S SSII�G�NA#URRE
P.C. O PMT. FO FORMS,MATERIALSON /�7/!G f�l:✓'"-J.i�"
FEE S FEE S, ,I
FRAME:FIRE STOPS,
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THF ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE:LOCATION, t-y
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- LATH,INT. .���-4 p"„•- K
TION OF THE LABOR CODE OF.THE STATE OF CALIFORNIA RELAT-
ING TO WORKMEN'S COMPENSATION INSURANCE. LATH,EXT. I - a J
SIGNATURE HRECT AND POSTED
PER
PERMITTEE
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ADDRES elFINAL
CLYDE N. DIRLAM, PRINCIPAL STRL=WRAL ENGINEER
PLAN CHECK VALIDATION cK: m.o. CASH PERMIT VALIDATION m.o. cAGH'
2668 " 52, D 25C '_"
L/1_ J 7 6'0 July -1 50.00 +a�
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