HomeMy Public PortalAbout5638 PERSIMMON AVE_Building__ TEMPLE CIT.
;gyp APPLICATION FOR BUILDING PERMIT 1
COUNTY OF LOS AEGEM BUILDING
DVABTNM OF COUNTY ENGM= ADDRESS
NUMD IG AND SAFETY DIMON LOCALITY
JOHN-A.LAMME.COUNTY EmaimmR NK"mw
Wf N JENSEN.Sup-r or Numnim CROW ST.
_ D18TR1 GROUP TYPE
.
FOR TO F=IN CONST.
BUILDINGSTAT! L CA1F1CATION BEWER MAP
ADDRESS _
CL1188.NO N
LOT No. o .'BLOCK MAP STATS YES
NUMBER
TRACT USS MONS I SPECIAL
NO.OF BLDGB.
CONDITIONS
8D3 OF LOT NOW ON LOT _
USE OF • -
EXISTING B O UILDINGEXIST.
TSL SETBACK YARD HWY BTRSRTNAMS - WI
OWNER NO, FRONT r
P.L
ADDR 'nor SIDE
ARCHI OR L
EVOlN86R NO yfpr,� ]N8H=ONM=B
ADDRESS ^ f�I
CONTRACTOR NO.
•pr TEL. • s',/ q .y
ADDRESS awdaz
OE OF WOGS '- •� `f' -r. m
.SSC -g,* r�
NEW D AL REPAIR DEMOLISH
ea.FT. NO.OF No.OF .l •,/ 1 e :s: Y d'[��
SIZE STORIES FAMILIES , p• �
iTRUtTURS E o J.
s
-3 Z
SIGNATURE OF
APPLICANT
VALUATION 9
APPROVALS DATE INSFECTOR'S 816MATUM
Fp,� �� FOUNDATION:LOCATION
ran 9 FORMS MATERIALS
PI
!HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AR BRACE I N 01 HORLTB .a
PLICATION AND eYATS THAT THE ABOVE is CORRECT AND FURNACE:rLOC LOCATION
L
GAS AGREE%COMPLY WITH ALL COUNTY ORDINANCES AND
SPATE LAWS REGULATING BUILDING CON817RUCTION.
1 CERTIFY THAT IN DOING THE WORK AUTHORIZED 1 LATH INT,
WILL NOT EMPLOY ANY PXRSONAN VIOLATION OF THE
WORKMEN'S COM TIONLpU1. LATH,EXT.
BIDNATURS HOUSE NUMBER COib•
PERP Rl=AND POG A SO
ADDRESS pAgg FINALIQs•
CLYDE N.DIRLAM. PRaNCIPAL CT ENGINEER
PLAN CE= VMMATIOE a L M,O. alas PEBNaT VALIDATI aX. M.O. CAM
z5 3 1' j;a '? 1. p M 1.C,
ti: •'m.
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44
76A698A CE. '808 6-62 APPLICATION .FOR.,BU'I.LDING PELT
COUNTY OF LOS ANGELES BUILDING:
DEPARTMENT OF COUNTY. ENGINEER' . ADDRESS..
BUILDING AND 'SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A.JENSEN,SUPT OF BUILDING L CROSS ST.
DISTRICT N. TYPE
FOR APPLICANT TO FILL IN CONST.
BUILDING / ,�� ��/j , STATISTICAL CLAS FICATION S ER MAP '
ADDRESS eo `� K
CLASS:NO. DWELL.UNITS r
`LOT NO. BLOCK WATER ' NOT REQUIRED�ECEIVED
913 S' CERTIFICATE: CLLJ��
TRACT. MAP HIGHWAY STATE MAJOR SECON LOCAL
/ NO.OF BLDGS. NO. (CIRCLE)
SIZE OF LOT � / NOW ON OI USE ZONE SPECIAL
USE OF CONDITIONS
EXISTING BLDG. TL
fiyy+�^j_�J�'ry
OWNER G 7��/G ! NO %/� ,
EXIST.
STREET
rr' SETBACK YARD HWY STREET NAME WIDTH
ADDRESS�5f/ ()j21� �� FRONTOGI
ARCHITECT OR TEL. �yrrjJ �P.•L. V
14
ENGINEER" �,i� NO. fi/ SIDE
P. L. >
ADDRESS5-14M O
CONTRACTOR L
ADDRESS . 0 /•,` � ��1.Y_�- �.. f �fR.tia4'.a � .�f_ - .Z':J.�a,,d/ t!,
Az dl cm
DESCRIPTION OF WORK ��q�° /.
�L61sA / i mTAP7 a Iz M' �ffV P Jn'�1 Ai I S:.4 T 'U.
NEW ADD REPAIR DEMOLISH �• a
SQ. 4
F - NO.OF NO,OF 1 `'
SIZE STORIES FAMILIES >f T7 J ♦ /`---1 ,'s� '�y
USE OF T�,vf I I',! °1 f� F�f�. •. d •.1•i7 '. �`-
STRUCTURE !Y d s s ! , ° • se` s ,* '
SIGNATURE
APPLICANT - r• ,/ r,r'
VALUATION $ V
APPROVALS DATE. „IVAPECTjjWS SIGN URE
P.C. pW17, FOUNDATION: LOCATION
FEE $ FEE $ .; FORMS, MATERIALS - o
FRAME: FIRE.STOPS,
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING 'BOLTS" -
AND STATE THAT-THE ABOVE IB CORRECT AND AGREE TO COMPLY :,FU.R MACE: LOCATION,
VIIITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING. -GAS VENT; DUCTS '� '�'�^�'��"""�-- "'�•
BUILDING CONSTRUCTION, I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- :LATH. INT:
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT.
ING TO WORKMEN'S COM ENSATION INSURANCE f r T. ®a,�1 �. ,• .' .s?'.•�=;
SIGNATURE OF �j. UMBER COR- ' I
PERMITTEE // �•F r•.[LAE
ND POSTED
ADDRESS W / MIN AI !F
9,G3 •C�tr�r ,
JOHN F. LEWIS;.PRIrNCI1YAL'STRUCTURAL EN R
PLAN CHECK VALIDATION CK. M.O. CASH'` _ PERMIT VALIDATION CK, CAS ,-
�>411;0 6 1 D 6:0 0~