HomeMy Public PortalAbout4941 PERSIMMON AVE_Building__ 76A638A CE4803 9-67
AF-PLIA..ATION FOR BUILDI G PERM
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COU14TY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPT OF BUILDING NEAREST
CROSS ST.
DISTRICT NO XRTYPE71�/&
R APPLICANT TO FILL INCONST.(Print or type only)
' STATISTICAL C A TION SEWER MAP
` CLASS NO.�DWELL,UNITS BK �PG' J � �jn5r BLOCK USE ZONE MAPNO.y` SPECIAL`' NO.OF BLDGS. CONDITIONS
Jr /�(J NOW ON LOT
SE OF
BLDP. BLDG.SETBACK FROM
TEL. FRONT PROP.LINE OF (STREET)
OWNER NO. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C.L.
/ C/
CITY ��pr/ O + 0
BLDG.SETBACK FROM
ARCHITECT OFf TEL. SIDE PROP.LINE OF (STREET)
ENGINEER NO. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C.L.
TEL. + = y
CONTRACTOR NO. n.
LIC. C
ADDRESS NO. CORNER CUTOFF YES ❑ NO ❑ c_:
CITY LIC.
L SS SEE REVERSE SIDE FOR SPECIAL APPROVALS F-
DESCRIPTION OF WORK a
NEW / ALTER REPAIR DEMOLISH 02e
SQ. FT. NO. OF NO. OFa
SIZE �e / Q STORIES FAMILIES
USE OF L. 6 61 lD J'
STRUCTURE C
SIGNATURE OF
APPLICANT
VALUATION $ �jq-P��
LL GG APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. PMT, FOUNDATION: LOCATION _
FEE$ FEE $ "�• (�� FORMS, MATERIALS
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY FURNACE: LOCATION,
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS 1
BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA.
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT. LATH, INT. 1000
ING TO WORKMEN'S COMPENSATION INSURANCE.
LATH, EXT.
SIGNATURE O HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED ire
ADDRESS. FINAL
JOHN F. LEWIS. PRINCIPAL ST TURAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK M.O. CASH
Uka3537 tit12 1 D 12.00- Q
e�'�v
lJ
76A638A C.1903 8-64APPLICATION FOR BUIL ING PER IT
COUNTY OF LOS ANGELES BUILDING F
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY C '
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS,SUP T or BUILDING CROSS ST.
DISTRICT N GROU TYPE PF O D
FOR APPLICANT TO FILL IN CONST. (//L/
BUILDING STATISTIC L C,�ASSI FICA T ION SEWER MAP
ADDRESS „`� /1/ CLASS NO. I DWELL UNITS B PG
LOT NO.s BLOCK USE ZONE MAP /
NO.
TRACT SPECIAL _
NO. OF SLOGS. /71 CONDITIONS.
SIZE OF LOT NOW ON LOT `J
USE OF
EXISTING BLDG, BLDG. SETBACK FROM
TEL. FRONT PROP. LINE OF TREET)
OWNER �� NO. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS �UQ („ AL HWAY WIDT FROM C.L.
I _ _
CITY
ARCHITECT OR TEL. BLDG. SETBACK FROM
ENGINEER NO. SIDE PROP, LINE Of (STREET)
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL }
ADDRESS HIGHWAY WIDTH FROM C.L.
TEL. + _ 0
CONTRA CTO / A NO
ADDRESS�!/� .0 NO aZ CORNER CUTOFF YES NO 0
H
CITY �. - [ LL /• — SEE REVERSE SIDE FOR SPECIAL APPROVALS w
DESCRIPTION OF WORK LO
NEW ADD ALTER REPAIR DEMOLISH
SQ.FT.j NO. OF NO. OF
SIZE / o STORIES FA MI LI FS
USE OF
STRUCTUR *j.4j.jjAj,jr,� itj InjG
a
SIGNATOR
ALA N T
VALUATIONS � � \ ^/ �.f�
APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. C ZS PMT. - FOUNDATION, LOCATION
FEE S O FEES 4 FORMS, MATERIALS
FRAME, FIRE STOPS, -
I HEREBY ACKNOWLEDGE THAT I 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 '
9UILD I NG CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK y
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH. INT. J
TION OF.THELABOR CODE OF THE STATE OF CALIFORNV�ELAT-
ING TOWORKME NSATION SURANCE.
LATH. EXT.
SIGNAT �jl {' OUSE NUMBER COR- .�
PER TE RECT AND POSTED
ADDRESS - Fl NAL 'O//' i,,,• r Y-
JOHN F. LEWIS PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION (—cis.—) M.O. CASH PERMIT VALIDATION CK M.O CASH
L-Lo 9 j s 2- FEB 11 2 3 D 3 0.2 5 a _—'
LA;o 0 8 4 7 IMAR 19 iu, 6 7.j 0- 011 IQ