HomeMy Public PortalAbout4839 PERSIMMON AVE_Building__ 76A638A CE#803 8-64 APPLICATION FOR BU ILDI G P R 4,�03
COUNTY OF LOS ANGELES BUILDING IE
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS,SUP'T OF BUILDING CROSS S
111
DISTRI T N GROUP TYPE PRO E Y
OR APPLICANT TO FILL IN CONST.
BUILD NGZt 9LAL=ASTATISTICAL C ASSIFICATION SEWER MAP
ADDRESS01) CLASS NO.STATISTICAL
ELL UNITS B PGZ
LOT NO. BLOCK USE ZONE MAP �1 �-�—
NO.
TRACT SPECIAL _
d NO. OF BLDOS
IIISIZE OF LOT . CONDITIONS i ate• O
1 NOW ON LOT
SE OF
EXISTING
BLDG. SETBACK FROM601r
TEL. FRONT PROP. LINE OF EET)
OWNER ! aA) NO. •--. -
TYPE OF EXISTING SETBACK HIGHWAY + YARD - TOTAL
ADDRESS J HIGHWAY WIDTH
FROM C.L. J� n
CITY �C�" ! 5 / + �LJ 1 -0
BLDG. S TRACK FROM
ARCHITECT OR TEL.
ENGINEER NO. SIDE PROP, LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C.L. d
CONTRACTOR yyG + = 0
ADDRESS (/L. �JOCORNER CUTOFF YES NO O
CITY LILCA S 5 SEE RE PPI.OAC
, w P�OVALS u
�T
DESCRIPTION OF WORK a
NEW ADD ALTER REPAIR DEMOLISH Note: erml s ,r. u.t
M
. 12-3,5
NO. OF NO. OF i I' I c te'•.erl ou+ at the L. A. Co. Road Dept., Altaden
SIZE / 2-3STORIES FAMILIES
Office, or T. C. Co. Engineer's Office imme iate,y In order o ava-fir
USE OF
STRUCTURE
until Permit has been issued. Apply for parkway tree permit at T.
City Hall,
SIGNATURE OF
APPLICANT
VALUATION$ / 0--{1--t�
APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. q/ /Y PMT. FOUNDATION, LOCATION
FEE$p\ / FEE$ c.� FORMS, MATERIALS
FRAME, FIRE STOPS, �.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION ..-�--'X.4 )
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS
9UILDI 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 CODE OF THE STATE OF C LIFORNIA RELAT-
ING TO WORKMEN'S COMPENSATION�U RANCE.
LATH. EXT.
SIGNATURE OFHOUSE NUMBER COR-
PERMITTEE � RECT AND POSTED
ADDRESS A L
dZE
JOHN F. LEWIS, PRINCIPALS TYRAL ENGINEER
PLAN CHECK VALIDATION cK. /M.O. CASH - PERMIT VALIDATI cK. M.o CASH
17 2 3 D -[---, 6.75=
AW