HomeMy Public PortalAbout5434 PERSIMMON AVE_Building__ 76A638A CE 4803 4/70 �✓LJ['I'�/ `^� w�L
APPLICATION FOR BUILDIN6PERMI
COUNTY OF LOS ANGELES ASSESSOR
DEPARTMENT OF QOUNTX ENGINEER MAP BOOK PAGE PARCEL
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS V .J
COLEMAN W. JENKINS, SUPT OF BUILDING
LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
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BUILDING S��� {� ,� O DIy- CONST.
CONST.
ADDRESS C STRICT_6_,_ 0 (J
STATISTICAL CLASSIFICATION S ER� GMAPP
LOT BLOCK CLASS NO._�OWELL.UNITS BK __P
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SIZE OF LOT �Qd/1�� �' NOWONLOTS NO. J�
SPECIAL
USE OF if I CONDITIONS
EXISTING BLDG, 1'S—
TEL. p
OWNER T •S NO. O` BLDG.SETBACK FROM
ADDRESS — _ FRONT PROP.LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
CITY HIGHWAY WIDTH FROM C.L.
ARCHITECT OR TEL. +
ENGINEER NO.
BLDG,SETBACK FR
ADDRESS SIDE PROP.LINE OF (STREET)
TEL. TYPE OF EXISTING SETBACK HIGHWA •F YARD = TOTAL
CONTRACTOR NO. HIGHWAY WIDTH FROM C.L.
y
LIC. + = L
ADDRESS NO.
LIC.
CITY CLASS CORNER CUTOFF YES ❑ NO ❑ C
CONSTRUCTION LENDER
NAME AND BRANCH SE REVERSE SIDE FOR SPECIAL APP VALS a
v
ADDRESS ` Z
SQ. FT. •7 NO. OF ` NOOF
USIZE SE OF ADD
h STORIES 1 WES NEW
ADD ❑
C 1.i
STRUCTURE _ �1C`�F7 `, ALTER ❑ J
SIGNATURE OF REPAIR❑
APPLICANT e' DEMOI_ ❑
VALUATIONS APPROVALS r ATE INS PEC 'S SI ATURE 1.
Q FOUNDATION: LOCATION
FEE S FEES r FORMS. MATERIALS l
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION,
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, D CTS
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT. '
LABOR CODE OF THE STATE OF •CALIFORNIA IN RELATING TO
WORKMEN'S COMPENSATION INSURANCE. LATH, EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS 34 FINAL
JOHN F. LEWIS. PRIWCEIPAL STRUC . RAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH
nr_ 0 0 7 3r---' idAY 4 1 D 9.00-
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