HomeMy Public PortalAbout5638 PAL MAL AVE_Building__ 76AO38A CE+B098B3 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER- ADDRESS DRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST
WILLIAM A JENSEN SUP T OF BUILDING CROSS ST
DISI RIGT Nq/ GRgIiP TYPE (�— R E
FOR APPLICANT TO FILL. IN C/1 `Jx —CJl coNsr
BUILDING J a// t STATISTICAL CLAS IFICATION SEWER MAP ,/�
ADDRESS ( CLASS NODWELL UNITS /– SK / ,FI3
LOT NO BLOCK WATER NOT REQUIRED RECEIVED v ✓
CERTIFICATE
TRACT MAP HIGHWAY
NO OF SLOGS ` NO ICIRCLEI STATE MAJOR SECOND LOCAL
SIZE OF LOT Q X : O p NOW ON LOT LLLIII�{�p SPECIAL
USE OF / y CONDITIONS
EXISTING BLDG - A",t
TEL
OWNER NO B LOING EXIST
e SETBACK YARD HWY STREET NAME ..WIDTH
ADDRESS SG a /e o FRONT O
ARCHITECT OR TEL P
ENGINEER 57-(. 3 (
/ NO/I S SIDE
ADDRESS S (p 3 qA r , P L C
CONTRACTOR I NO
J' O
OF
ADDRESS C
DESCRIPTION OF WORK G
6
N
NEW ADD ALTER REPAIR DEMOLISH Z
SO FTNO OF NO OF
SIZE D STORIES FAMILIES
USE OF
STRUCTURE
17
SIGNATURE OF
APPLICANT
VALUATION $ �.! .�-„T
APPROVALS DATE INSPECTOR BeICNAiu RE
FOUNDATION LOCATION
FEE $ FEE $ ♦' FORMS MATERIALS 7–
FRAME FIRE STOPS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT ANO AGREE TO COMPLY FURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CONSTRUCTION I 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
ING TO WORKMEN 5 COMPENSATION INSURANCE
LATH EXT
SIGNATUREPERMIITTEEIO f AND POSTED
,� HOUSE NUMBER COR
n 1 RECT
ADDRESS –\�F / vr.\2mFINAL
PLAN CHECK VALIDATION CK MO CASH JOHN F LEWIS PRINCIPAL STRUCTURAL EN R
PERMIT VALIDATION DK MD GASH •
LI"0 5 6 4Z JUN2 6 1 D 1 150
7SA538A CEK803 8-64APPLICATION FOR BUILDING PE MIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDREss G a
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST -
COLEMAN W JENKINS$UP T OF BUILDING CROSS ST IF
DISTRI T-N OR UP TY ESSED BY
FOR APPLICANT TO FILL IN / CONST
BUILDING STATISTICA�SSIFIC, ON S ER MAP
ADDRESS CLASS NO DWELL UNITS BK P
LOT NO -. J� USE ZONE MAP
NO
TRACT E I -
��/rI_ " L I SPECIAL -
NO OF BLDSB CONDITIQNSLLL
SIZE OF LOT NOW ON LOT '
USE OF
E'IBLDG SETBACK FROM
TA L FRONT PROP LINE 01 (STREET)
OWNERgf4ej m 9A&Qjj NO TYPE OF EXISTING SETBACK HIGHWAY -YARD = TOTALI
ADDRESS _ HIgWjHWAY WIDTHI M C L
A Q ✓ +
CITY
ARC TE T O TEL BLDG SETBACK FROM - -
ENGINEER NO SIDE PROP LINE OF (STREET)
TYPE OF I EXISTING ISETBACK. HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY IWIDTH I FROM C L I CL
TELT + = O
CONTRACTO NO U
ADORES NO CORNER CUTOFF YES El NO O
H
C y LICSEE REVERSE SIDE FOR SPECIAL APPROVALS w
DESCRIPTION OF WORKt-i _ o � wq- NCSs Z
NEW ADD ALTER REPAI DEMOLISH
SO FT NO OIES NO OF
SIZE STORFAMILIES O -� -
USE OF
STRUCTURE
Ij—
IGNATU E OF
APPLICANT
VALUATION$ O�
APPROVALS DATE INSPECTOR'SSIGNATURE
FOUNDATION LOCATION I
FEES RP-P FEE$ FORMS MATERIALS
FRAME, FIRE STOPS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT
ANO STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY FURNACE LOCATION -
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
AUTHORIZED
CON
O NBTRUCJONtERTIE�Y THAT II DOING THE WORN
AUTHORIZED HEREBYOT MPLOY AI ERSON IN VIOLA LATH INT
TION OF THE LABOR THESTATEATING TO WORKMEN S CTIO INRU RAN E LATH EXT
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RE AND POSTED
ADDRESS FINAL 7/7-/M f
JOHN F LEWIS PRINCIPAL STR RAL ENGINEER
PLAN CHECK VALIDATION DK M D CASH PERMIT VALIDATION CK M D CASH
L�Co 4 8 7 0' iiuG 2 3 � 0 8 00-