HomeMy Public PortalAbout5522 MCCULLOCH AVE_Building__ 76A838A CE#8032-63 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
S ,5 > C l G 1.�
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY..DIVISION LOCALITY
JOHN A. LARBIE, COUNTY ENGINEER NEAREST
WILLIAM A.JENSEN,SUP'T OF BUILDING CROSS ST.
DISTR NO. GROUPTYPE OCE BY
FOR APPLICANT TO FILL IN Q CONST.
BUILDI STATISTICAL CLASSIFICATION SEWER MAP'
ADDRE
L CLASS.'NO. DWELL.UNITS
LOT Nr!4e4'-� BLOCK WATER NOT REQUIRED RECEIVED ❑
CERTIFICATE:
TRACT MAP � HIGHWAY
NO.OF BLDGS. ,® NO. J (CIRCLE) STATE MAJOR SECOND CA
SIZE OF LOT Q ��. �(y NOW ON LOT USE ZONE SPECIAL
USE OF - CONDITION Z
EXISTING BLDG. EL
OWNER NO / BUILDING I EXIST.
SETBACK YARD HWY STREET NAME WIDTH
ADDRESS Q OWAO FRONT
ARCHITECT OR TEL. P. L.
ENGINEER �— NO. SIDE
ADDRESS
0
TEL.
CONTRACTOR '/
ADDRESS }61�1i,'�tt( ���� .81�s•�+`�''� � n.°t,�s' .� ! O
DESCRIPTION QF WORK ( a
3-z 3-G 4-
ADD ALTER REPAIR .DEMOLISH .
SQ.FT. NO.OF NO.OF 1
SIZE 7'. ST.ORIES FAMILIES.
V USE OF _
i STRUCTURE �ai-fes y - _
• L.0--1.2
9-11
SIGNATURE OFA f
APPLICANT '
VALUATION $ �
APPROVALS Dj4T INSPECTOj-jS SIGNA U
P.C. s7 PM.T. ('�Q FOUNDATION: LOCATION )v' g E3
FEE $ 2 FEE $ +++� FORMS, MATERIALS / T
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO,COMPL'Y FURNACE: LOCATION.
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS
BUILDING CONSTRUCTION. I ,CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- �Ae —INT. (.7/
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- _
ING TO WORKMEN'S COMP ATION INSURANCE. LATH, EXT.
SIGNATURE . HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS FINAL
JOHN F. LEWIS. PRINCIPAL ST RAL ENGINEER
PLAN CHECK VALIDATION cK. M.O. CASH _ PERMIT VALIDATION . CK. M.O. CASH
Lk-0-0900Q OCT 123 'D 28.50A v
:1 3 4 3 -OCT 11 1 D -5 '7.0.0- q