HomeMy Public PortalAbout5010 PAL MAL AVE_Building__ 76A638P,.4CE 0803 1'2/69
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES ASSESSOR
DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL
BUILDING AND SAFETY DIVISION BUILDING e--- / (
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS %..l ,r�. ,�G ` c' % ` J
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COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY � [—p
FOR APPLICANT TO FILL IN NEAREST
Print or tvDe onlyA CROSS ST.
/ IT ISTRINO. GROUP pV �PF� EDBY
�ESS
I ' ONST
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STATISTICAL CLASSIFICATION �
SEWER MAP
LO NO BLOCK ((��
CLASS NO. Z/ BK(._ PG-32.
TRACT USE ZONE MAP li
NO.OF BLDGS. NO.
SIZE OF LOT NOW ON LOT SPECIAL
USE OF CONDITIONS
EXISTING BLDG.
OWNER %r A TEL.
NO. BLDG.SETBACK FROM
ADDR SS f FRONT PROP.LINE OF �`� (STREET)
l
' TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
CITYHIGHWAY WIDTH FROM C.L.
ARCHIL ECT be TEL. J i L +
ENGINEER NO. BLDG.SETBACK FROM
ADDRESS SIDE PROP.LINE OF (STREET)
TEL. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
CONTRALTO /yL1 � Mp, HIGHWAY WIDTH FROM C.L.
ADDRESS NO.' +
LIC. C
CITY CLASS CORNER CUTOFF YES ❑ NO
CONSTRUCTION LENDER, s
NAME AND BRANCH
.. SEE REVERSE SIDE FOR SPECIAL APPROVALS c
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ADDRES , C
r'T 1 ,i!' �� y'
co
SQ. FT, y�I1��I1O. OF; NO. OF ❑
SIZE STORIES I FAMILIES WEW
USEOF ADD
STRUCTURE ,,-
ALTER [:]
SIGNATURE �/ 1 i REPAIR❑
APPLIC
/ DEMOL ❑
VA6.1 IO APPROVALS DATE. INSPECTOR'S SIGNATURE
P.C. PMT. FOUNDATION: LOCATION 1
FEE$ FEE$ �� S FORMS, MATERIALS f.,_ `�_$�• `� ',�:'i'_� , F
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS (f•" �/ �: -// �.,�1J"J/r-°!-i i✓
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY FURNACE: LOCATION,
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS
STRUCTION. IC
THAT IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT.41 �dn
LABOR CODE OF TH TATE OF •CALIFORNIA IN RELATING TO _
WORKMEN'S COMPE. A7 QN NRANC !J /
PER ATTE OF �� ' H. EXT,
HOUSE NUMBER COR-
RECT AND POSTED
ADDR'Ess FINAL
JOHN F. LEWIS. PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATIO . cK. M.O. CASH
r53409 im. ' iD .2
• 175*
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