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SA689A CE#00310.58 APPLICATION FOR BUILDING PERMIT 1
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.
DISTRICT O. GROUP TYPE PR ESS I
FOR APPLICANT TO FILL IN I CONST:.
BUILDING STATISTICA�SSIFICATION SEWER MAP
ADDRESS BK_- G
CLASS.NO. DWELL.UNITS h J
LOT NO. BLOCKYES NO
n HWY.
MAP ry STATE
TRACT f /aGrp NUMBER
USE ZONE SPECIAL
NO.OF BLDGS. CONDITIONS
SIZE OF LOT Q NOW ON LOT h�I
USE OF , JJ /f
EXISTING BLDG. 1`71AN1 BUILDING EXIST.'-
YARD HWY STREET NAME
/ _ SETBACK WIDTH
OWNER (��/ S � C }t- A FRONTMAIL
ADDRESS&_be J PEa S%M lYl a& A VE: SIDEEa
nG[1 (Q
CITY N L P.L.
ARCH ITECT OR TEL. INSPECTION RECORD,
ENGINEER NO.
F
ADD ESS
TEL.
CONTRACTOR NO.
ADDRESS
DESCRIPTION OF WORK
NEW • ADD ALTER REPAIR DEMOLISH
SQ.FT.� NO.OF NO.OF y
SIZE STORIES , FAMILIES
USE OF STR URE
71
SIGNATURE OF APPROVALS
APPLICANT
.•„ . DATE 1NSPECT01t%SSIG.NATURE .
ADDRES O FOUNDATION: LOCATION .+
FORMS.MATERIAL'S
$ P.C. 4 FRAME: FIRE STOPS.
FEE BRACING.BOLTS J
VALUATION S 3• FURNACE: LOCATION.
FEE J GAS VENT,DUCTS
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP. LATH.INT.
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND LATH,EXT.
STATE LAWS REGULATING HUILDIN CONSTRUCTION.
SIGNATURE OF HOUSE NUMBER COR.
PERMITTEE RE.CT AND POSTED
ADDRES FINAL 7
CLYDE N.DIRLAM:PRINCfIPAL STRUC
PLAN CHECK VALIDATION CK. M.O. CANH PER=VALIDATION CK. M.O.
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"DEPARTNENT OF COUNTY ENGINM
UNION OF BUILDING AND SAFETY
��? COUNTY OF LOS ANGELES BUILDING
WILLIAM J. FOX. COUNTY ENGINEER APPLICATION
CASSATT D. GRIFFIN, SUPT OF BUILDING
FOR ARYCpq TO FILL IN FOR OFFICE USE ONLY
BUILDING " DISTRICT NO. PUN CK.OR REC.NO. PERMIT NO.
ADDRESS 15-40® S1 e- 6- . 63373- 'Lo 11 -43 5--#
LOCALITY 7NMA Cl R CEIVED BY DATE OF APPL. DATE ISSUED
NEAREST '
CROSS ST.
T BUILDING
ADDRESS S
OWNERR A41
MAIL
Q�
ADDRESS 277, G42 LOCALITY LC..
TEL-
CITY.
/ NEAREST +
CITY.
�� NO. ! +4 9- CROSS ST.
ENGINITECT EER OR TEL. ZONE I PLANS I TYPE
YI GROU _
ADDRESS BLDG. .f i' p
,g� e+d,� SETBACK LINEUSE
CONTRACTOR r q1 IJ�I NO. 0��7TV� ZONE / APPROVED AT
ADDRESS µ / / A� �� �Q ��E,r HOUSE 14UMBERING
LEGAL / MAP NUMBER 0 J NO. ASSIGNED BY
DESCRIPTION LOT NO. LJ BLOCK
CORRECTIONS
TRACT BLD
SIZE OF L /��,GSI
OT Ix ito NO. OR
� NOW ON LOT LOT
USE OF NO. OF
EXISTING BLDG. FAMILIES
DESCRIPTION OF WORK O -
NEW ALTERATION ADDITION
Z
REPAIR DEMOLITION
_ 1'
8Q. FT. NO.OF
& S/SIZE ROfOMS STORIES
ALLR
COVERING �/ �lJ I CO VE
USE OF STRUCTURE if
pan
6Y
APPROVALS
INSPECTOR'S SIGNATURE DATE
FOUNDATION:LOCATIONJ;v / q %�
FORMS, MATERIALS �� ^�A' �F! d
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FRAME: FIRE STOPS, .✓��
a PLICATION AND STATE THAT THE INFORMATION GIVEN IS BRACING. BOLTS
COI AE REE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE:LOCATION, J
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. GAS VENT, DUCTS
"enSIGNATURE OF ��/� LATH, INT.
PERMITTE ` LATH. EXT. 1,�f�r4 * i6
ADDRESS9 Set. 6s CJ 'rx
t PLASTER, INT.
AUTHORIZED AGT.
PLASTER, EXT.
FEE S rJ—J HOUSE NUMBER COR-
/ `" RECT AND POSTED / i )
VALUATION FEE $ �] , FINAL ��
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