HomeMy Public PortalAbout5445 PAL MAL AVE_Building__ APPLICATION FOR BU LDING PERMIT
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COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN ADDR s /� -- J 4� CC{
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ADIDRESSSvys P4 t /_A L CALITY � �
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CITY' GLS ~/T ZIP / 7�(J CROSSST, ,G-,...tm�
NO.OF BLDGS. ASSESSOR
SIZEOF LOT NOW ON LOT MAP BOOK PAGE PARCEL
DISTRICT GROUP TYPE FIRE PRO ESSED BY
TRACT
[+ +BLOCK LOT NO.TELr7d `� CONST. ZONE
OWNER .Jd ,v JTONL'- NO. v
fJ /� STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS T / I�G / 4 f- r/
CLASS NO. �DWELL.U I5 I BK �-PG
CITY '7-'F/s1 LE- If /� zip `9178'0
ARCHITECT OR TEL VALUATION �j �����
ENGINEER NO.
I ADDRESS BLDG.SETBACK FROM
/' '7 TEL FRpNT PROP.LINE OF � ISTREETI
CONTRACTOR�f/NOG Ll1 N/�R G3 NO.Z BJH B HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING
ADDRESS �Z I ��tr C- C, N0.360cC Z 7 FRON7 PROP LINE HIGHWAY WIDTH
ary F .sPG� C r r Loss (3"/ C +'ZO SCJ
CONSTRUCTION LENDER BLDG.SETBACK FROM
NAME AND BRANCH SIDE PROP.LINE OF ISTREETI
HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING 6
ADDRESS CITY SIDE PROP.LINE HIGHWAY WIDTH C
SO.FT. NO.OF NO.OF CHECK + V
SIZE STORIES / 1,
AMILIES / ONE
USE ZONE MAP
DESCRIPTION OF WORK r ✓I N G Ron y E I NEW (1I// NO. C W
SPECIAL
ADD -�'t CONDITIONS y
ALTER FINAL /C— BV Z
REPAIR
❑ DATE S J r
USEOF DEMOL LJ
EXISTING BLDG.
APPLICANT TEL D
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BY ISIGNATUREI u> 1 8 5 5 5 A
TN AND STATE
THAT THE ABOVE ACKNOWLEDGEEBY 5CORCTTHAT AND( HAVE AGREE TOAD THIS COMPLY WITHLL
gq ORDINANCES W R 0 • • • 0 L
AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE V
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF 2 61. 00
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATINGTO WORKMEN SCOM- 2
PENSAFON INSURANCE.' q . • . VL 1. O CJ
SIGNATURE OF 1 O-p Q
PERMITTEE Y
ADDRESS -2- <
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TEL O
CITY NO.Z SJ/�� G
P.C. Fee$ Permit Fee `-�T >
F
Issaaate Fee n
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Total Fee
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., APPLICATION FOR BUILDING PER T
COUNTY OF LOS ANGELES BUILDING - �R
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DMSION LOCALITY nU Ir I 4-1
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST Yf
WILLIAM A. JENSEN SUPT OI BUILDING CROSS ST.
DISTQ1 CTeN UP TYPE
FOR APPLICANT TO FILL IN Jr U TYPE T. /Z )
r QQ STATISTICALLL.FICATION SEWER MAP
ADDRESS S / rl�+ �m�« N
CLASS.NO. DWEUNITS
LOT NO. BLOCK WATER NOT REQUIRED RECEIVED
CERTIFICATE: Li
TRACT MAP HIGHWAY
NO.OF BLDGS. NO. (CIRCLE) STATE MAJOR SECON LOCAL.
SIZE OF LOT JT 7 NOW ON LOT USE ZO PECIAL
USE OF CONDITIONS
EXISTING BLDG.
/ TEL. I
OWNER �Oh _572w le NO. SI473 BUIL INC YARD' HWY STREET NAME EXIST.
ETB
ADDRESS
RCH'TE
r " SFRONTK WIDTH
ARCHITECT OR �T P. L. 37 a
ENGINEER / // /-• SIDE - O
P.L. l'o
ADDRESS E INSPECTION RECORD
CONTRACTOR
0
ADDRESS U
DESCRIPTION OF WORK - f a
z_
NEW ADDA ALTER REPAIR DEMOLISH ..) �, •�f
SQ. FT. NO.OF NO.OF
IZE STORIESUSE OF
FAMILIES
STRUCTURE CO�OGZ
SIGNATURE O
APPLICANT
VALUATION $
aG
APPROVALS DATE, INSPECTOR` SIGNATURE
FEE $ FEE $ FOUNDATION: LOCATION //�
FORMS, MATERIA LS 0 4V„
FRAME: FIR ESTOPS. /1 / G
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS TO APPLICATION BRACING BQLT$
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE:LOCATION. -
OWITHUIL ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WORK GAS VENT, DUCTS
BUILDING D HEREBY I ON. I CERTIFY THAT IN PORNO THE WORK
AUTNOR12ED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- TFC INT.
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT-
ING TO WORKMEN COMP N8 ION IUSUPA NCE. LATH.EXT. �� I
SIGNATURE O� (i1•� HOUSE NUMBER COR- '
III PERMITTEE �y RIOT AND POSTED
ADDRESS— -fL-� FINAL �: )- •�-" ,..`
CLYDE N. DIRLAM. PRI cIrAL STRUCTURAL ENc IR
PLAN CHECK VALIDATION cN. SLo. wsR PERMIT VALIDATION cN. N.G.
U 1312 APRln 1 D 8.00 o-