HomeMy Public PortalAbout5616 MCCULLOCH AVE_Building__ 9A699A CE}t908.8.60
APPLICATION FOR® ���IYml6/B Y l V l H..�■�H O Y ll L
COUNTY OF LOS ANGELES BUILDING T*
DEPARTMENT OF COUNTY ENGINEER ADORES �f
BUILDING AND SAFETY DMSION LOCALITY �J
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST `
WILLIAM A.JENSEN SUPT OF BUILDING CROSS ST.
DISTRICT�IV0. GROUP TYPE PR ES BY
FOR APPLICANT TO FILL IN (� CON I
STATISTICAL CLASSIFICATION SEWER MAP
BUILDING I BK PG
ADDRESS
CLASS.NO. DWELL.UNITS
BLOCK MAP STATE
LOT NO. NO-
NUMBER 0 HWY. YES
e TRACT �'� USE ZONE SPECIAL
/ NO.OF BLDGS., CONDITION ,
SIZE OF LOT (I q,0 0— SIO I NOW ON LOT ® �. r ��Of•.
USE OF
EXISTING BLDG. BUILDING "YARD HWY STREET NAME EXIST.
•� TEL.p SETBACK WIDTH
OWNER 5 J sq. NO.Q U`�p1 FRONT o) n/
T P. L.
ADDRESS .S 0 Iq' Fg)f 14Q,4lei to G!!Tlj SIDE
ARCHITECT OR TEL. P.L.
ENGINEER NO. INSPECTION RECORD
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ADDRESS A J� / O.
CONTRACTOR
Iovrcr Azusa Road. �'v7� Lr��. �l.fir` -�".► �iF-/�
ADDRESS Q 111
DESdfiftOlinw 06W45 �:' (Z ti;.P,�.•a =��� -:.,, u
/ W
N ADD ALTER REPAIR DEMOLISH Z
SQ.FT. NO.OF
SIZE 112-7. STORIESQDg FAMILIE�D/�
USE OF p
STRUCTURE �
SIGNATURE OF
APPLICANT
VALUATION$ / I
APPROVALS DAME/ INSPEOT 'S SIGNATURE
FOUNDATION: LOCATION
F E $ / FEE $ `q FORMS,MATERIALS
FRAME:FIRE STOPS,
1 HEREBY ACKNOWLEDGE THAT I HAVE READ TN19 APPLICATION BRACING,BOLTS �� �'�/ :-+ r✓`
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE:LOCATION,
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CONSTRUCTION. I CERTIFY THAT IN THE PERFORMANCE A
OF THE WORK FOR WHICH THIS PERMIT IS ISSUED I SHALL NOT LATH,INT.
EMPLOY ANY PERSON IN ANY MANNER 50 AS TO BECOME SUBUECT w
TO THE WORKMEN'S COMPENSATION LAWS OF CALIFORNIA.
• CATH,EXT.
SIGNATURE OFC� HOUSE NUMBER COR- /� / .,�.`•�
PERMITTE a-,�Z RECT AND POSTED 1 2 �I �J �• ✓.
ADORES
d wt6 /9 u ayfpl�j FINAL
CLYDE N. DIRLAM, PRINCIPAL STRRAL ENGINEER
PLAN CHECK VALIDATION M.O. CASH PERMIT VALIDATION cM.O. CASH
LAP 2 4 7 2% SEP 1 � 2 3 D � 9.5 0 A w
L _;u 2 0, 2 1 SEP 1 D3 9.0 i i
(WA ��