HomeMy Public PortalAbout5356 MCCULLOCH AVE_Building__ 76A638A CE-#803 4/72 C tv -
... .�- APPLICATION FOR BUILDING PERMIT
.-,Q0t TTY OF LOS ANGELES
`DEPI�RTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL
BUILDING AND SAFETY DIVISION BUILDING
MAKE CHECKS PAYABLE TO: ADDRESS C_ULi_ 7C,4
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY
NEAREST
FOR APPLICANT TO FILL IN
Print or tvDe onlvl CROSS ST. CI>4,1
BUILDING �� G DISTRICT NO. OUP TYP1 1 � PROCESSED BY
ADDRESS `7 f��OQ CON
,p P/wl f STATISTICAL CLASSIFICATION SEWER MAP
LOT NO.PO9,• LAT 3 BLOCK CLASS NO.!!?-�DWELL.UNITS BK PG
TRACT ESR. C2. USE ZONE MAP
Y� /�/`� NO.OF BLDGS. NO. 06
SIZE OF LOT�/, J NOW ON LOT SPECIAL
USE OF fb rJ S CONDITIONS
EXISTING LDG.
OWNER TEL.El
��,� K FROM
, FRONT PROP_tA BLDG. CLLINE OF (STREET)
ADDRESS '�.t
. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
CITY HIGHWAY WIDTH FROM C.L.
ARCHITECT OR p. TEL. _
ENGINEER NO. BLDG.SETBACK FROM
ADDRESS SIDE PROP.LINE OF (STREET) O
TEL. TYPE OF EXISTING SETBACK IGHWAY + YARD = ' TOTAL
CONTRACTOR NO, HIGHWAY WIDTH FROM C C
ADDRESS NO LIC' + — W
H
CITY '�� CLASS CORNER CUTOFF YES ❑ NO ❑ Z
CONSTRUCTION LENDER
NAME AND BRANCH ���� JLD
REVERSE SIDE FOR SPECIAL APPROVALS
ADDRESS
SQ. FT. NO. OF NO. OF SIZE STORIES FAMILIESUSE OF 2STRUCTURE � — ?�� ��SIGNATURE APPLICANTW�VALUATION S x ' -APPROVALS DATE INS cr 'S SIONA TU RE
P.C. PMT. ! QC7 FOUNDATION: LOCATION
FEE$ FEES (� FORMS, MATERIALS r
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT i HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, LtiY
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS
STRUCTION. I 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 INSURANCE. LATH, EXT. .
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTEDe7 'pr
ADDRESS FINAL.
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATI �N/Ka M.O. GASH
I , 12361 FEB 23 1 3 D 6.00-