HomeMy Public PortalAbout5544 PAL MAL AVE_Building__ ®s 76""A
CBNBO!IIR&V 41/76I
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILLMHIGHWAY
BUILDINGAJ
ADDRESS
BUILDING
ADDRESS LOCALITY
NEAREST
CITY ZIPCROSS SE
O OF BEASSESSOR
SIZE OF LOT__ eeNOW ON MAP BOOK PAGE PARCEL
TRAK.C" K DI$iRIR GROUP TYPE FIRE CONST ZONE PROC ED BY
, �OWNERSTATISTICAL CLASSIFICATION EWER MAP
ADDRESS ItJCLASS NO DWELL UNITS BK PG
OT ZIPlARCHITECT OR VALUATION $pZv V c�ENGINEER ADDRESS Bl ACK FROM
FRONT PROP LINE OF ISTREETI
CONTRACTOR TOTAL SETBACK FROM TYPEOF EXISTING
HIGHWAY + VARD FRONT PROP LINE HIGHWAY WIDTH
ADDRESS CITY CONSTRUCTION LENDERBLDG SETBACK FROM
NAME AND BRANCH SIDE PROP LINE OF ISTREETI
+ YARD TOTAL SETBACK FROM TYPE OF EXISTING
ADDRESS CITY SIDE PROP LINE HIGHWAY WIDTH
SOIT NO OF NO OF CHECK + Y
SIZE STORIES FAMILIES ONE ILL
DESCRIPTION OF WORK NEW PC F"$ Permit Fee yr
ADD nc7 s$
Issuance Fee
ALTER
REPAIR El Total Fee
USE OF
EXISTING BLDG DEMOL cl =
APPLICANT TEL
IPRINTI R cwzwNO AfA, t
O
BY ISIGNATUREK
I HEREBY ACKNOWLEDGE THAT I HAVE THIS APPLICATION AND STATE
THAT THE ABOVE I$GORRKf AND AGREE COMPLY WITH All ORDINANCES
AND LAWS REGLAATING BIRIDING CONSiR ON 1 CERTIFY THAT N DOKNG THE S
WOR(AUTHORIZED HEREBY I WILL NOT EMPLOY MY PERSON IN VIOLATION OF V
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN S COM
PENSATION INSURANCE
SIGNATURE OF ;1424,9A
PERMITTEE
ADDRESS #
aTY?�IiYE' C�/7y NO i 2 • • 3&0 0
0
z0yE AP • • • 3 4.0 0;'
SPECIAL
CONDITIONS .0508-79
BY
DATE �/0/7 �
APPLICATION FOR
BUILDING PERMIT
FOR APPLICANT TO FILL IN ADDRESS s-6 't7"xl 41
BUILDING
ADDRESS t LOCALITY
�1 NEAREST
CITY (�( ZIP CROSS ST.
� /
NO.OF BLDGS. ASSESSOR
SIZE OF LOT Xj NOW ON LOT MAPBOOK PAGE PARCEL
TRAC K LOT NO DISTRICT GROUP TYPE FIRE P ED Y
NO. p CONST ZON
PIOCI TEL. 5 QO �2 ^V
STATISTICAL CLASSIFICATION SEWERAfAP
Q
CLASS NO. DWELL.UNITS L BK Llpf-
CITY ZIP ZONEMAP , v
ARCHITECTOR TEL /// 1/ NO. p�-C��
ENGINEER NO. /LJC/ SPECIAL
CONDITIONS
ADDRESS R AD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑
CONTRACTOR •AI W d NL. 'O! BLDG.SETBACK FROM
LIC FRONT PROP.LINE OF ISTREETI
ADDRESS 0 i". N ITOTAL SETBACKFROM TYPE OF E%ISTING
LIC. HIGHWAY + YARD FRONT PROP.LINE HIGHWAY WIDTH
CITY ^� Ca
CONSTRUCTI N LENDER +
NAME AND BRANCH OBLDG.SETBACK M V
ADDRESS CITU SIDE PROP.LINED (STREET;
$Q.FT. SNT F NO.OF CHECK HIGHWAY + YAR TOT ETB KF M TYPE OF EXISTING U
SIZE J STORIES FAMILIES ONE R. HIGHWAY WIDTH a
N
+ Z
DESCRIPTION OF WORK NEW ❑ _
DN ADD ® CORNER CUTOFF YES NO
ALTER IN OPEN SPACE YES ❑ NO ❑
USE OF REPAIRL IN COASTAL PERMIT ZONE YES ❑ NO ❑
EXISTING BLDG. DEMOL
APPLICANT TEL
(PRINT) NO.
BY ISIGNATURE t.
HEREBY ACKNW OGE THAT I HAVE READ THIS APPUCGN AND STATE
U
THAI THE ABOVE RRKT AND AGREE TO COMPLY WITH ALL ORDINANCES
AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE /�v A,
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION Of Y ✓
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S CO,
PENSATION INSURANCE.
SIGNATURE FINAL DATE _7/ BY
PERMITTEE ((// - C
ADDRESS GG��
TEL, P.C. Fee$ Permit Fee J
CITY NO.
Issuance Fee
VALUATION$' p og
Total Fee
PLAtVQYtIt�RTI�I�(�PPS��gT �Q _ PERMIT VALIDATION CN. M.O. CASH
3 7 -im to s o 160.00
�
POLICY HOLDER_. -
o, , '�LI�VONIMER: 17 "71f H /"3 �vFD
•�••atb••/a APPLICATION FOR BUILDING PERMIT Z
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENG24M ADDRESS
BUDDING AND SAFETY DrMON LOCALITY
JOHN A LAMBIE, COUNTY ENOINum NEAREST
A CROSS BT
3187RICT NO OR TYPE B
FOR C TO FILL IN Q coNsr a.
BUILDING STATIBTIGLC IFIGTION 8 ER MAP
ADDReff
,464WZIM BK
CLASS NO WELL 11
LOT N BLOCK MAP O STATE YESNUMBER HWY
TRACT USEZONE SPECIAL
NO OF SLOGS CONDITIONS
SIZE OF LOT NOW ON LOT
USE OF
MSTIM04LO(L BUILDING
TEL SETBACK YARD HWY BTRE NAME EXIST
OWNER NO FRONT / O
P L
ADDR BIDE
ARCH ITECT OR TEL L
ENGINEER INSPECTION RECORD
ADDRESS
CONTRACTO 7 I 0
O
ADDR V
DESCRIPTION OF WORK {{{01
NEW✓/IDD ALTER REPAIR DEMOLISH
SO FT NO OF NO OF
SIZE 11ajo STARIES FAMILIES
USE of
ST UCTU E
V
SIGNATURE O
APPLICANT
VALUATION f `
�
APPROVALS DATE INSPSCTOR S SIGNATURE
PC PMT FOUNDATION LOCATION p
FEE FEE FORMS MATERIALS G l
I HEREBY ACKNOWLEDGE THAT I HAVE READ TX18 AP- FRAME FIRM STOPS
PLICATION AND STATE THAT THE ABOVE 18 CORRECT AND BRACING BOLTS b In
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND FURNACE LOCATION
STATE LAWS REGULATING BUILDING CONSTRUCTION GA8 VENT DUCTS
I CERTIFY THAT IN DOING THE WORK AUTHORIZED i LATH INT
WILL NOT EMPLOY ANY PERSON N TION OF E
WORKMEN S CO ION B FO LATH EXT y
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE- REST AND POSTED
-----------------
ADDRESS FINA
_ CLYDE N DIRLAM. PR NCIPALSTR RAL ENGINEER
PLAN CHECK VALIDATION aL 1110 C"" PEBb= VALIDATION r o CAIIIn
U&5736Z 11UG30230 130C, ' �
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LACo 5 9 3 7 SFP 2 1 D 3 6 0 0 1.;