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7BA638A Ce#BOB•1-81 APPLICATION FOR BUILDING PERMIT
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COUNTY OF LOS ANGELES BUILDING
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DEPARTMENT OF COUNTY ENGygm
BUILDING AND SAFETY DMSION LOCALITY
JOHN A. LAMBIE, COUNTY EmomEER NEAREST
WILLIAM A.JENSEN SUPT OF BUILDING CROSS ST.
FOR APPLICANT TO MIN DISTRICT NO. G .TYPE PR BY
G 0 V CONST.
BUILDING STATISTICAL CLASSIFICATION /� SEWER MAP
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ADDRESS 6053 Now Oak CLASS.NO.-?—DWELL.UNITS
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LOTNO. d BLOCK WATER NOT REQUIRED RECEIVED
CERTIFICATE:
TRACT '�( MAP -p 007 HIGHWAY
SIZE OF LOT NOW ON LOTS NO. d�7'�' (CIRCLE) STATE MAJOR SECOND, CAL
3 USE ZONE SPECIAL
USE OF CONDITIONS
EXISTING BLDG. E�sS' 11z I�
OWNER Mabel B. Dean TN BUILDING EXIST.
ADDRESS 6053 N. Oak SETBACK YARD HWY STREET NAME WIDTH
FRONT oq
ARCHITECT OR TEL. P.L. L' a (/
ENGINEER NO. SIDE
P.L. }
ADDRESS p Ip INSPECTION RECORD o.
CONTRACTORVir in Roof C o• j p{'>1 1�ry 050 I(y V
ADDRESS 600 S. San Gabriel Bl. m
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DESCRIPTION OF WORK S. G. G
W
o.
NEW ADD ALTEREPAIR DEMOLISH h
Z
SQ.FT. NO. NO.OF
IZE STORIES FAMILIES
USE OF
STRUCTURE
Re-roof se & Wage
SIGNATURE O ,i
APPLICANT
VALUATION$18.00
APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. PMT. OUNDATON:
FEE 5 FEE s6.00 F YORMSI MATER ALSON
FRAME:FIRE STOPS,
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY FURNACE:LOCATION,
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH,INT.
TION OF THE LABOR CODE OF THE STAT CALIFORNIA RELAT-
ING TO WORKMEN'S C ENSATION 1 U A cE. LATH,EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEF RECT AND POSTED
ADDRESS GOO S.San a riel Blvd. - _ 3 .:��
FINAL
San Gabriel, Calif. CLYDE N. DIRLAM, PRINCIPAL ST R RAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CARR PEEM VALIDATION cK. M.O. CARR
Lt tJo 7 3 0 3 JUL 1, 0 1 D 6.0 0
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7SA88SA CE#6035-BIAPPLICATION FOR BUILDING PERMIT
COUNTY' OF:LOS ANGELES BUILDING `
DEPARTBOW OF COUNTY ENGINEER" AD°REss �G.J
BUII.1 Ai AND SAFETY DMSION LOCAL'ITY
JOH A. LAMBIE, COUNTY ENQINEER NEAREST '
WILLIAM A.-JENSEN SUPT OF BUILDING CROSS ST. c7
DIS ICT N GR . E PR HY
• FOR APPLICANT TO FILL IN 5 TyFE "
B DING
U'L �Dy STATISTICAL CLASS FICATION S ER MAP !
ADDRESS �
�1 CLASS.-NC DWELL.UNITS
LOT NO. 3�a1 ,./ BLOCK WATER I NOT REQUIRED RECEIVED
TRACT JA� CERTIFICATE:
MAP /% HIGHWAY TATE MAJOR SECON , LOCAL
�c q NO,OF BLDGS. NO. � (CIRCLE)
512E OF LOT.c� /s4 KNOW OIN LOT USE ZdNE SPECIAL
USE'OF ' CONDITIONS
'EXISTING 13L�DG. A.t,Q,
OWNER T i�/Je h a NO. El
SETBACK YARD HWY STREET NAME WjDT.
ADDRESS ��c7 3 /Y �J/I �s�@ / FRONT
ARCHITECT OR TEL. - P.L:
ENGINEER NO. SIDE - .
P L
ADDRESS ONIN CTI
CONTRACTANO �/ r`U � � ��lee- yRE RD's
ADDRESSKu
Li�/�/JOIGiM�s� �YP /• c�� r / !_s J s'�__' V
DESCRIPTION OF WORgX' 44�Z aIL
NEW ADD ALTER REPAIR DEMOLISH '
SQ:FT. NO.OF NO.OF
IZE 0 STORIES FAMILIES
USE OF
STRUCTURE CJ/ C:Ok �.
u "-P dT S1 ..
SIGNATURE OF e
APPLICANT
VALUATION$
APPROVALS . DATE/ . INSPECTOR'S SIGNATURE
F E $ FPMT'PM
EE $ ! lTv FOUNDATION:LOCATION
FORMS,MATERIALS
FRAME:FIRE'STOPS,
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS
H
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. 1 CERTIFY THAT IN DOING'THE WORK
AUTHOR IZED,H EREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH,INT.
TION.OF THE LABOR CODE OF,THE STATE OF CALIFORNIA RELAT-
ING TO WORKMEN'S COMPENS ION INSURANCE. - - '
SIGNATURE OF LATH,EXT.
-� HOUSE'NUMBER COR-
PERMITTEE ���-� REGTAND POSTED
ADDRESS-IlLa 'f1 -W s"'e ..FINAL,
CLYDE N.:DIRLAM, PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION CK. M.D. CASH ; PERNUT VALIDATIONcK. M.O.• CASH
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