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711AG38A CZOBOB W.64 APPLICATION FOK BU ILDI G PERMIT
-!COUNTY OF LOS ANGELES BUILDING _
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY i
JOHN A. LAMBIE•. COUNTY ENGINEER NEAREST
COLEMAN W. JENKINSSUP'T OF BUILDING CROSS ST.
DISTRI T N GROUP TYPE. P SSED BY
FO APPLICANT TO FILL IN CONST.y
BUILDING y rn STATISTICALCLASSIFICATION
UNITS SE ER MAP
ADDRESS /� CLASS NO. `I BK PG
LOT NO. BLOCK USE•ZONE MAP
N O. x(y LJ
TRACT V SPECIAL ^;
N0. OF SLOGS. CONop
DITIONS
SIZE OF LOT�f NOW ON LOT
USE OF �.o/���/�g
EXISTING �+ 4Qr�7lr/TGo� BLDG. SETBACK FROM
D of �N,t1 D NOL FRONT PROP. LINE OF (STREET)
OWNER TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS —C) ILCtFI� HI WAY W10 H 'F OM C.L.
CITY NAOr�I J l� I +
ARCHITECT OR TEL. BLDG. SETBACK FROM L
ENGINEER NO. SIDE PROP. LINE OF _ (STREET)
TYPE OF EXISTING SETBACK HIGHWAY + YARD — TOTAL
ADDRESS ,,qq p t HIGHWAY WIDTH FROM C.L. d
CONTRACTOR /G NOL 7 �)J��O7 + — OV
LICADDRESS . L°IL. NO CORNER CUTOFF YES NO O
CITY �L YIJ�r+ CL �� SEE REVERSE SIDE FOR SPECIAL APPROVALS w
DESCRIPTION OF WORK • �' GL r �- � ;,• �. '"-.� ��-Z
��/� ,-rte f•., f e�.
NEW ADD ALTER REPAIR DEMOLISH f —�
FT. NO. OF NO. OF
SIZE �(0 STORIES FAMILIES I .�
USE OF
STRUCTURE
Q tI�l7' ���r1 ,I�! �!3 f.C� a W'+��.• �.rSarN"s:i��•;• •�l t v';;,l f
SIGNATURE OF
APPLICANT
VALUATION$ e
J� r APPROVALS DATE N INSPECTOR'SSIG NATURE
FEE$ � FEE.$ �{ a FOUNDATION,FORMSMATERIALSON
FRAME, FIRE STOPS, d�/ 11 •`
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT /V/.� r7 `�'7�/Y✓(7�'e: °'%��
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION P"-
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS /61 AIVI waw_
9UILD I NG CONSTRUCTION. I CERTIFY THAT. IN DOING THE WORK { I v •"'�
AUTHORIZED HEREBYI WI NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT.
TION OF THE LABOR CO F TME ST OF CALIFORNIA RELAT.
ING TO WORKMEN'S C PE TION 1 U NCE. LATH. EXT. ;_ x
SIGNATURE OF t HOUSE NUMBER COR-
PERM ITT
OR-PERMITTEE RECT AND POSTED
fvVV-rr_
ADDRESSAl F I N A L
JOHN F. LEWIS. PRINCIPAL STCKM.0
RAL ENGINEER
cK.
PLAN CHECK VALIDATION M.O. CASH _ PERMIT VALIDATION CASH
�f7ic4 30:n 031323 0 3725A
cl
3 4,V 'u,31 s. 6 7 4.50-
• �;��:i `
7,-11,4Jr
76A688A CE08091-67 APPLICATION FOR BUILDING PERMIT -•� •
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY '
JOHN A. LAMBIE.COUNTY ENGINEER NEAREST
COLEMAN W. JENKINSAUP'T OF BUILDING CROSS ST. 4 "
DISTRICT NO. GROUR TYPE PR ED BY
FOR APPLICANT TO FILL IN , O �Idd CONST
BUILDING STATISTIC A CLASSIFICATION S WER MAP
ADDRESS CLASS NO DWELL UNITS BK Pa
^�2
LOT NO. BLOCK USE ZONEMAP
TRAC __ � NO. �d a '
T
f200 SPECIAL
N0. OF SLOGS. CONDI Ti,
NS
SIZE OF.LOT NOW ON LOT
USE OF
_9XISTING BLDG. BLDG. SETBACK FROM
TEL. FRONT PROP. LINE OR �/�•/< (STREET)
OWNER NO. TYPE OF EXISTING SETBACK HIGHWAY 7 YARD = TOTAL
ADDRESS HIGHWAY W113THFROM C.L.
CITY LS.AMAX2
ARCHIEC TEL. BLDG. SETBACK FROM
ENGINEER g NO. SIDE PROP. LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTH_ FROM C.L.
TEL. �9 + _
CONTRACTOR O _ ,
LIC CORNER CUTOFF YESNO I
ADDRESS NO
CITYLIC .SEE REVaW.j6UDMpFMWSWECMSWPftOVALS I
DESCRIPTION OF WORK AJ�
EW ADD ALTER REPAIR DEMOLISH
SQ.FT. No;rw Parmits for curb, gutter, sidewal&,end`d 3'ewey apprGAa '
SIZE STORIES FAMILIES d I 005 snoutBe Taken
e, ., ^ ^ -x
USE OF ` C. Co. ,ar' fti ^i r ardor 4o ave
STRUCTURE
k, lengthy delay. Survey & Design work-takes t time ands H
SIGNATURE OF
APPLICANT
VALUATION$ .Q •00 APPROVALS DATE!!!"'LLL!lIPPP�iiifitttlNSPECPTO✓SIONATURE
P.C. y PMT. FOUNDATION, LOCATION
FEE.$ i�J FEE. FORMS,MATERIALS -
FRAME, FIRE STOPS,
1 HEREBY,ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS
9UILDINa CONSTRUCTION. 1 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 STATE OF CALIFORNIA RELAT-
ING TO WORKMEN'S COMPENSATION INSURANCE. LATH. EXT.
SIGNATUREOF � - � HOUSE NUMBER COR-
PERM ITT!
REC AND POSTED n
ADDRESS zz LPPr FINAL lZ/` Y'LOAX
�\) JOHN F. LEWIS. PRINCIPAL ST URAL ENGINEER
(
PLAN CHECK VALIDATION \CK. J M.O. CASH PERMIT VALIDATION CK. M.O CASH
02 8.4% AUG.2 5 2 1—D/ 5.6 3-
- ._.. . 0 2 8 5- AUG 25 1 0 ` 2 2.50- Q