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APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDREs _
BUILDING AND SAFETY DNI ION LOCALITY
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST.
DISTRICT NO. GROUP CTYPE ONST. PROCESSED BY
FOR APPLICANT TO FILL IN O y
BUILDING STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS �� ( Q ( j BK PG
CLASS. NO.�DWELL. UNITS
LOT NO. Q - 'BLOCK WATER NOT REQUIRED RECEIVED
2pt^� CERTIFICATE:
TRACT V860 _ MAP NlcNwwY STATE MAJOR SECOND. f
NO.pF BLOGS. NO. O ICIRCLE)
SIZE OF LOT $ O NOW ON LOT a USE ZONE SPECIAL
USE OFCONDITIONS
EXISTING BLDG.
4 II_/
n TEL.
OWNER C a 443-57 BUILDING EXIST.
1 SETBACK YARD HWY STREET NAME WIDTH
ADDRESS 5041 Baldwin, T• City FRONT
ARCHITECT O TEL P. L.
ENGINEER NO. SIDE }
1�n�f1� �s t�.t P. L ! d
ADDRESS µ221y Aralia Rd., Altadena Q
CONTRACTOR B.B.C. NO. — Z - V
ADDRESS5041 Ba]dwin Temple City
DESCRIPTION OF WORK W
rt *-j loo A a
ZEW ADD A T REPAIR DEMOLISH f
. FT. NO. OF NO OF
SIZE S 2. FAMILIES l
USE OF
STRUCTURE Res nC Garag
SIGNATURE OF /. Y��
APPLICANT _ _
VALUATION$ y f
APPROVALS 'AT9 NIIPIU Towp SIGNATURE
P.C. PMT. FOUNDATION: LOCATION
FEE $ FEE $ �_ FORMS. MATERIALS I
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
BUILDIC
NG CONSTRUCTION
I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT.
TION OF THE LABOR C�� Oi TME STATE Oi CALIFORNIA IELAT.
IN O TO WORNMEN'S 6M6ATION INSURANCE. LATH. EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDREss FINAL
JOHN F. LEWIS. PRINCIPAL STRUPkURAL ENGINEER
PLAN CHECK VALIDATION M.O. CASH _ PE J41T VALIDATION CK. N.G. CASH
L,dA 7 6 8 1 ., %Pil 14 z 3 0 3 �
r 5 0 7
APPLICATION FOR BUILDING PER IT Z
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY /
JOHN A.LAMBIE,COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN SUPT OF BUILDING CROSS ST. CJS"
NO. GROUP TYPE r'
FOR APPLICANT DISTRICT LL S PSSED BY
= I CONST��I
BUILDING SEWER MAP
ADDRESS MM ,�.. STATISTICAL CLASSIFICATION BK G4�
LOT NO., dv ®P/l�B/V� JLOT BLOCK CLASS. NO. LJMAP DDyWELUNITS�L. -1, .
1
NUMBER L�Q�(�/"/ HWY. YES J
TRACT /, �/ USSEZONE SPECIAL
SIZE OF LOT �O 7, C�� NOW ON LOTNO.OF SLOGS (J_� ' CONDITIONS
USE OF /
EXISTING BLDG. BUILDINGEXIST.
SETBACK YARD HWY RE TNAM WIDTH
OWNER MAIL / /' (� FRONT s /J F
ADDRESSJ�_- v SIDE
TE � O P.L.
�TY "ERT OR
ENGIN
INSPECTION RECORD
ETEL.
ENGINEER NO.
ADORES �•
CONTRACTOR NOT^ a•BG17
ADDRESS
ESCRIPTION OF WORK
L
NE ADD ALTER REPAIR DEMOLISH AA
SD.FT. NO. F NO.OF -
SIZE '� STORIOES FAMILIES '}
USE OF STRUCTURE
SIGNATURE APPROVALS
APPLICA DATE INSPECTOR'S SIGNATURE
ADDRESS �. FOUNDATION: LOCATION •/
FORMS.MATERIALS
$ P.C. SFRAME: FIRE STOPS.
C/J�! FEE BRACING, BOLTS %F
VALUATION V FEE : 77, FURNACE:
RNACE:AS TLOCATIS"
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH,INT.
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY - H ALL COUNTY ORDINANCES AND
STATE LAWS RE Mf TING W :IN CONST�{U CTION. LATH,EXT.
GNATURE O VA X(. HOUSE NUMBER COR-
SI D•1 •S�. L Y �-1
PERMIT ��/1_ RECT AND POSTED
aDOREss FINAL �0 _�b •1 9 rLr.,
CLYDE N. DIRLAM. PRINCIPAL ST RAL ENGINEER
PLAN CH=VALIDATION CK. M.O. CASH PERMW VALIDATION CK. M.O. CASH
LAC,13 4 7 29tJiJ;Y 252 3 h 15 .0 0 s 0,
,R 7281 Jud 30 1A 3 0.0 0