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TEASMA CE 4803 I ET APPLICATION FOR BUILDING PERMIT ,
COUNTY OF LOS ANGELES INAUU ILD s
DEPARTMENT OF COUNTY ENGEER
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST
WILLIAM A JENSEN SUP T DF BUILDING CROSS ST
FOR APPLICANT TO FILL IN DISTRSOT N G TYON� P SS ED BY
FUSE
ING STATISTICAL CLASSIFICATION 6E ER MAP
ESS _
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CLASS NO DWELL UNITS
O BLOCK WATER NOT REQUIRED RECEIVED
CERTIFICATE
T MAP HIDHWAr STATE MAJOR SECOND OC
NO O SLOGS N (CIRCLE)
OF LOT NOW ON LOT US[ZONE SPECIAL
F /1 I CONDITIONS
EXISTING BLDG
TEL
OWN NO BUILDING YARD HWY RE AME E%IST
ADORES Q /[/� /J �//W� SETBACK W D H
FRONT
ARCHITECT OR TEL P L
ENGINEER NO SIDE r
ADDRESS P L D_
Lam/ O
CONTRACTOR fG�CII JN/W ZZs= v
ADDRESS Gam/ 0
DESCRIPT10fi OF WORK o
N
NEW ADD ALTER REPAIR MOLTS Z
60 FT NO OFIII
SIZE S O ES FAMILIES
USE OF
STRUCTURE
SIGNATURE OF
APPLICANT
VALUATIONS
APPROVALS DATE INSPECTOR BBICHATURE
PC PMT FOUNDATION LOCATION
FEES FEES FORMS MATERIALS
FRAME FIRE STOPS
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING 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 CODC OF THE STATE OF CALIFORNIA RELAT
IND TO WORKMEN S COMPO ION INSU NC LATH EXT
S IGNA REO HOUSE NUMBER COR
PERM( RECT AND PER
ADDRESS 94NAL _4,
JOHN F LEWIS PRINCIPAL ST URAL ENGINEER
PLAN CHECK VALIDATION CK M D CASH _ PERMIT VALIDATION UK M D CASH
X 5 9 8 3:o FEB 27 1 D 4.0 0—
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Floss�°�• APAIC)�TION FOR BUILDIN_G,.PERMIT 1
Dr4MON OF BUMDING AND SAFETY Aoowea"B° rI q N. l L
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Coae o! 1.06 Angelea LOCALITY
JOHN A LAAi BIE COUNTY ENGINEER NEARS
CARSATT D GRIFFIN OUP T or 8YI1.13pr CROSS ST fT 11Y_1
FOR APPLICANT TO F= IN DISTRICT NO GROUP ,n,PB 8!BER -MAP
BU 05 JJ CONST1 F5
ADDRESS �� MAP STATE cig
�T NUMBER O ,pp '1HWY YES
LOT NO 6 FILE ' BLOCK VSHaSPECIAL
41 CONDITIONS 1 F✓S 11
TRACT I `�1� -11463
NO OF SLOGS
SIZE OF LOT NOW ON LOT BUILDING YARD HWY STREET NAME E%18'f
USE OF SETBACK L WIDTH
EXISTING BLDG FRROLNT 61 TFL MAL 64 '
OWNER SIDE
L
MAIL
ADDRESS O TRACT DWELL 1 UNIT
TEL 1 DWELL 1 UNIT 9 INDUSTRIAL
CITY NO 8 PUBLIC BLDG
ARCHITECT OR TEL 2 DUPLE( Z' Y UNITE
ENGINEER NO 9 An -UNIT$ a B MISC18CALT, HTC
eL
ADDRESS 4 1 TEL 4 COMMERCIAL
CONTRACTOR NO INSPECTION RECORD
ADDRESS
DESCREMON OF WORK
NEW ADD ALTER REPAIR DEMOLISH
8 ZH Q TBT^"L STOR ES PAMNO L IES
U OP RUCTU
La P6>R44 d - BPTwtw NSa;24,
SIGNATURE OF
APPLICANT APPROVALS
ADDRESS DATE INSPECTOR S SIGNATURE
^ff� or r IM
S FOUNDATION LOCN
PEE FORMS
PRAM! FIRE
IRH ST BTOPB
VALUATION S BRACING SOLTB
HH 1 O G FURNACE LOCATION
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS OAS VENT DUCTS
APPLICATION AND STATE THAT THE ABOVE IB CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH INT
AND STATE LAWS REGULATING BUILDING CONSTRUC-
TION
� LATH EXT
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADORES AL
JOHN A.I AMBIE COUNTY oKeirtimat �ATION CLYDE N. DIRLAM. CHIEF BLDG INSPECTOR
RC2397A EV15 1 600 0
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T��B7eAO efieAPPLICATION FOR BUILDING PERMIT Z
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DIVISION OF BUILDING AND SAFETY AODRDE6. �5 N.
Deportment of County Engineer _5
County of Los Angeles LOCALITY C
INK J. FOX. COUNTY ENGINEER NEAREST
CASSATT D. GRIFFIN, 9uP•T of BUILRING CROS'ST.
DISTRICT t ' GROUP TYPE SEWER MA
FOR APPLICANT TO 1FfIIL IN 1 ICONS
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ADDRBUILDESS MAP STATE
{ �- Y NUM ER �O HWY
�-
USEZONE SPECIAL
LOT NO: qy SLCCB /1., CONDITIONS�iNLvPBT/ iR7�fA /ll'�1�
TRACT jp
NO. OF BLDGSETBACK WIDITHTH
9.
SIZE OF LOT NOW ON LOT BUILDING YARD HWY STREET NAME FA
USE OF O1
IXIB
TING NGBLDIDE
OWNER h L �/' ,y SJL
P. L.
MAIL JOTRACT DWELL. 1 UNITADDRESS �/ 5 INDUSTRIAL
DWELL. I UNIT
CITY UNO. [Y 6 PUBLIC BLDG.
ARCHITECT OR TEL• DUPLEX 1 UNIT 7ADDN.. ALT.. ETC.
ENGINEER NO. APT. _UNITS
8 MISCEL.
ADDRESS COMMERCIAL
CONTRACTOR C.,l:.i�l'�.�e_�i NO. INSPECTION RECORD
ADDRESS �1�' D
DESCRIPTION OF WORK i
i
NEW ADD coweem
90. FT. NO. OF NO.Ow i
_SIZE STORIES
USE OFRE
,ATRUCP/ .✓ .///rte
If
SIGNATUREOF
APPLICANTellAPPROVALS -�
_ADDRESS .r )-,.G.dv✓�• DATE INSPE R•S SIGNATURE
FOUNDATION: LOCATION
FORMS,MATERIALS '
qq UAI FRAME: FIRE STOPS.
VALUATION / Ci
•l� `�
FURNACE: LOCATION.
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GAB VENT. DUCTS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT A y
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH. INT. /1
AND STATE LAWS REGULA ING BUILDING CONSTRUC•
TION.
J/ LATH. EXT.
SIGNATURE OP ' '_"•�� ��lJ�/ -+7 HOUSE NUMBER COR-
PERMITTEE' 1 �j fff RECT AND POSTED
ADDRESS_. FINAL
WM.J. FOX. COUNTY ENGINEER VALIDATION C. N. DIRLAM. CH
IEp BLDG. INSPECTOR
E06 5 1 5 AUG -11 1 6 _A� 9 2 7 RU^1 %) (� n
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