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76A69SACE#BOSI-62 APPLICATION FORBUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
WILLIAM A.JENSEN,SUPT OF BUILDING CROSS ST.
D.ISTRIC N T E D•,
FOR APPLICANT TO FILL IN �r'!) NST.
BUILDING /- /�a a STATISTICAL CLASSI ICATI N WK R MAP
ADDRESS (p
_ CLASS.NO.. DWELL.UNITS + OFO
-
LOT NO. v 70 Op _c a Qa BLOCK WATER CERTIFICATE:
BNOT REQUIRED RECEIVED
_ ❑•�_
TRACT S - e MAP HIGHWAY STATE MAJOR SECOND/OCAL
NO.OF LDGS. ' NO. 2 (CIRCLE)
SIZE OF LOT o .170 NOW ON LOT ' USE ZONE SPECIAL /
USE OFr CONDITIONS
W J
EXISTING BLDG. V /-
OWNER yy TEL ..+�� /
. {I° r. NO. 3Q. (Lt B01LDINGYARD HWY STREET NAME
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ADDRESS o FRONT %D /
ARCHITECTOR- TEL. P. L. Ap
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ENGINEER 0 NO. SIDE
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ADDRESS }/' f ,� j'/ G
TE l�U��F, /X! //• C
CONTRACTOR• NO: 6
ADDRESS0j
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DESCRIPTION OF WORK -� �'�" �' LI
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NEW• D AL- ER REPAIR DEMOLISH f f (,vim /• /' 1` �"`'� a
SO.FT. //�� +' NO,OF NO.OF
SIZE V STORIES FAMILIES
USE OF:
STRUCTURE - +) r
/ =11.1 ��.=%!'sL"q_..,- ✓'�• l ,J��•s��..a'.
SIGNATURE'O 1/�ir' jt i• �:'_•`'. Y LY� ':s�/.
APPLICANT-
f
VALUATION$ i
APPROVAIS"- fDA,TE/ INSPECTOR+S'SI.GNATURE
P:C. ' PMT. FOUNDATION: LOCATION /� Jl�/ , �
f
FEE $ FEE $ &Myl .• FORMS, MATERIALS / -/ ,(
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, - ,. A
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATANG ' GAS VENT, DUCTS
BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK ,• -
AUTHORIZED HEREBY 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 COMPENSATION INSURA E.'
o LATH-EXT.
SIGNATURE 01 fI'HOUSE NUMBS COR- I
PERMITTEE RECT AND P STED f + 1
ADORES. FINAL
f IV JOHN F. LEWIS, P INC FjAL,STRUC,l112AL EN
PLAN CHECK VALIDATION- CK. M.O. CASH _ PERMIT VALIDATION CK. M.O: GASH
"1 5.0 0�
Ergo 414 '1-1 SEP 1 '7 ' 1 D
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BA698A�E#809-10-56 APPLICATION FOR BUILDING PERMIT
"BUILDING AND SAFETY DIVISION BUILDING
ADDRESS
Department of County Engineer f, i�+,
County of Los Angeles LOCALITY y li'L .r.- �.. �` L,.• lei;
$JOHN A.LAMBIE,COUNTY ENGINEER NEAREST `
CASSATT D.GRIFFIN, SUPT OF BUILDING CROSS ST. �. Y''"" ^'" ~"Y�*- r._••
DISTRICT NO. GROUP SEWER MAP
FORAPPLICANTTO FILL IN ITYPE I "/ PG
CONST.
tBUILDING r r` r
ADDRESS ti. l i =i rA` 0A.g r'jy%u r STATISTICAL CLASSIFICATION
NITSaCLASS. NQs; `-1 DWELL. UNITS-1-
a- MAP
-
MAP Se STATE YES O res
NUMBER G�''! G• + HWY ,
TRACT ` ' I" �?Ioi f a�3 p�i r 1r� • USE ZONE SPECIAL
a• NO.OF BLDGS. CONDITIONS
.q f{'„-. f
SIZE OF LOT_,.It, ' J+'.: I NOW ON LOT t
USE OF �`` -5
EXISTING BLDG. +� �$'-o•,L+•$ IN'+° BUILDING EXIST..
YARD HWY STREET NAME
SETBACK WIDTH
OWNER X411 ` +a>: 1e A l+ ti..?i� ' °� FRONT ✓ r'
MAIL t P. L. ;.•C. (,s '�,`< ''�. 1'-• f.
�y,
ADDRESS IL; -.bµ 4o- F 11k.x IC^Iylrt-L SIDE
�o a TEo t P. L.
CITY >� f'i'"s'jS p S S i i NO.L'r, s v.3 4.
INSPECTION RECORD
.ARCHITECT O% TEL / }'
ENGINEER +I.'r i' ll?F NO.(+,T~-e.
r �
ADDRESS Ia :.r a ; r f, €3 A faSk-
�: TEL.
CONTRACTOR 4 1�/�.I 11J NO.
ADDRESS
DESCRIPTION OF WORK
NEW W ADD ALTER REPAIR DEMOLISH
SQ.FT. Jr) O. OF NO.OF
SIZL �`• STORIES FAMILIES
USE OF STRUCTURE s
APPROVALS
SIGNATURE OFi'
APPLICANT �+ may? ':� ,, +I ri 9.� ?.�^
DATE INSPECTOR'S SIGNATURE
r r1 w t J t jj��tf �i�r, y� - FOUNDATION:LOCATION
ADDRESS 1, +� •b .t J�, '�A K . r,V - � +
FORMS, MATERIALS
P,C, S FRAME: FIRE STOPS.
z •ax 'VT �} FEE BRACING,BOLTS
VALUATION S /' fr tJ FURNACE: LOCATION,
FEE GAS VENT, DUCTS
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH, INT.
PLICATION AND STATE THAT THE ABOVF,.I CORRECT AND
AGREE TO,.,OMPLY WITH ALL COUNTYf�R IN•ANCES AND
STATE LQ�WS ,REGUL+►T�I�IG BUILDxI G O�I�TRUCTION. LATH. EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMI EE 1JJI�� ��i`ar +` RECT AND POSTED
ADDRES i :S.J 1 r~+rt F€ eI1- .' Y',w,J-It- . FINAL
OHN A►.LAMBIE, COUNTY ENGINEER, f:( ' CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECS VALIDATION CK. M.O. I CASH Aj PERMIT VALIDATION CK. M.O.-. CASH
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