HomeMy Public PortalAbout5114 PERSIMMON AVE_Building__ DEPARDEM OF COUNTY ENGIIIiM
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DIVISION OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES I I
WILLIAM J. FOX, COUNTY ENGINEER APPLICATION EJ
CASSATT D. GRIFFIN, SUPT OR BUILDING
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
DISTRICT NO. PUN CK.OR Rbc.No. 1 PERMIT NO.
BUILDING ADDRESS S/I 0 kL 4_-�l-� I®�
LOCALITY Pd C RECEIVED BY DATE OF APPL. DATE ISSUED
NEAREST
CROSS ST BUILDING
OWNER / - �� �� ADDRESS "1I14 � f �/� ��'e
MAIL LOCALITY
ADDRESS �jr
�1
N
/� TEL. / NEAREST
CITY /•' tom' O -j V?G' CROSS ST.
lv�� O�
ARCHITECT ORTEL, FIRE -,
NO. OF TYPE GROUP T
ENGINEER NO. ZONE I PLANS —1 _v_ ,�-�+
ADDRESS BLDG. L D NO.
/� SETBACK LINE Y
CONTRACTOR./- % J!/G�✓J NO. ��D� USE - BAYPROVED DATE
ZONE
ADDRESS 72�" +��t /[j r (�
HOUSE NUMBERING
LEGAL MAP NUMBED ® � ( NIO. ASSIGNED BY
DESCRIPTION I LOT NO. 7 I BLOCK
7 �� CORRECTIONS
TRACT
SIZE OF LOT fi/t`�V+ �I NOW ON LOTS
USE OF NO. OF
EXISTING BLDG. FAMILIes
DESCRIPTION OF WORK O
RNEW
AIR 11—DEMOLITION I ALTERATION ADDITION I Z
Z
a
r
SQ. FT. NO. OF M
SIZE D ROOMS STORIES ,/ �•
CWALL
OVERING TOOF I COVER N (?n Nj
USE OF STRUCTURE
APPROVALS
rs INSPECTOR'S SIGNATURE DATE
FOUNDATION:LOCATION
FORMS, MATERIALS
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FRAME: FIRE STOPS,
PLICATION AND STATE THAT THE INFORMATION GIVEN IS BRACING, BOLTS r
CORRECT. r i
I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE:LOCATION,
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. GAS VENT, DUCTS
SIGNATURE OF ; LATH, INT.
PERMTrf6 A.
~ Gi
t LATH. EXT.
ADD 6 r J 21 6��I
PLASTER, INT.
AUTHORIZED A6 -
n/�,.� d PLASTER, EXT.
$ / V V" �� P. C. $ O�J HOUSE NUMBER COR-
C7
OR-
a FEE ,{ RECT AND POSTED . �r-
NVALUATION FEE $`IO 'o FINAL
.- ____ �
7GA638ACE#8038-64 APPLICATION FORBUILDI G PERMIT u
COUNTY OF LOS ANGELES BUILDING . s +-
DEPARTMENT OF COUNTY ENGINEER ADDRESS v 7
BUILDING AND SAFETY DIVISION- LOCALITY
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS,SUP'T.OF BUILDING CROSS ST.
FOR APPLICANT TO FILL IN °� T o t CONST. PR �5 e
BUILDING g� STATISTI(C)AL CLA IFICATION SE ER MAP
ADDRESS 1'LD-f-.S-�/`� Itif•p. nu'1iL CLASS NO.�D ELL UNITS BK PG
LOT NO. BLOCK 211
ONE MAP ��
NO.TRACT SPECIAL
NO. OF SLOGS. CONDITIONS
SIZE OF LOT NOW ON LOT
USE OF
E"'T'
IS INC DG. BLDG. SETBACK FROM
OWNER * EL.L�YgI �. 0 FRONT PROP. LINE OF - (STREET)
.�7 TYPE OF !EXISTING SETBACK HIGHWAY + YARD - TOTAL
ADORESSSr 1F L / DT •F OM C.L.
.I, _
CITY Tr BLDG. SETBACK FROM
ARCHITECT OR TEL.
ENGINEER NO. SIDE PROP. LINE OF (STREET)
TYPE OF EXISTING SETBACKHIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM C.L, a
TEL. } = C
CONTRACTOR NO I U
LIC CORNER CUTOFF YES El
ADDRESSEj
a'
ADDRESS NO Q
CITY CLASS SEE REVERSE SIDE FOR SPECIAL APPROVALS w
DESCRIPTION OF WORK N
• Z_
NEW ADD ALTER REPAIR DEMOLISH
SQ,FT. NO. OF NO. OF
SIZE STORIES FAMILIES
USE OF
STRUCTURE.
SIGNATURE OF . ,
APPLICANT
VALUATION$ if �9 APPROVALS DATE INSPECTOR'S SIGNATURE
FOUNDATION, LOCATION
F E$ FEE$ FORMS, MATERIALS
FRAME; FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION ,BRACING BOLT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS
-BUILD[
NG CONSTRUCTION. I CERTIFY THAT. IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. •s
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT. ,
ING TO WORKMEN'S MPENSATION INSURANCE. LATH. EXT.
SIGNATURE OF -HOUSE NUMBER COR-
PE,RMITTEE RECT AND POSTED-
AD DRESS
OSTED.ADDRESS FINAL'
JOHN F. LEWIS. PRIN [PAL STRUCTURAL EN ER
PLAN CHECK VALIDATION CK. M.O. CASH - - PERMIT VALIDATION CK. M.O. CASH
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