HomeMy Public PortalAbout5403 PERSIMMON AVE_Building__ 'GA888A CE#80810-88 APPLICATION ION P®R BUILDING PERMIT �.
COUNTY OF LOS ANGELES BUILDING i
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST r
CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST. .
DISTRICT NO. GIr I CPE .y¢-} B�'L,t
FOR APPLICANT TO FILL IN coNsr.
BUILDING 6- STATISTICALaaCL--AASSIFICATION �S1E ER MAP
ADDRESS CLASS.Noel3_DWELL.UNITS=J`'r BK }?G
LOT NO. BLOCK AP STATE
NUMBER Y�ft HWY. YES O
/� / USE ZONE SPECIAL
TRACT CONDITIONS
J / NO.OF.BLDGS J
SIZE OF LOT 0 d / I NOW ON LOT.
USE OF /
EXISTING BLD . ( BUILDING YARD HWY STREET NAME EXIST.
SETBACK WIDTH
OWNER FRONT
MAILP.L.
ADDRES Q SIDE
TELP.L.
CITY NO. INSPECTION RECORD
ARCHerEcTORTEL.
ENGINEER NO.
ADDRESS
TEL.
CONTRACTOR NO.
ADDRESS
DESCRIPTION OF WORK
L NEW 1/ADD ALTER REPAIR DEMOLISH
SQ.FT. NO.OF NO.OF
SIZE STORIES NAMILIES V
_ USE OF r
STRUCTURE
SIGNATURE OF
APPLICANT APPROVALS DATE INSPECTOR'S SIGNATURE
ADDRESS FOUNDATION:LOCATION
FORMS,MATERIALS
VALUATION$ D6� FRAME:FIRE STOPS,
BRACING,BOLTS
—FEE S �- I FEE $C c�IPMT. FURNACE:GAS VENT D CTS N,
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH.INT.
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY ITH ALL COUNTY ORDI ANCES AND
STATE LAWS R G TING UIL• STR --LATH,EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTE Y'�� RECT AND POSTED
ADDRES `'
CLYDE N. DIRLAM,PRINCIPAL STRUCTURAL E
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION aK. M.O. SH
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