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APPLICATION FOR* BUILDING PERMIT 1
5 ;-
DIVISION
DIVISION OF BUILDING AND SAFETY BUILDING ��,J/����
Department of County Engineer ADDRESS
County of LOS Angeles LOCALITY
WM.J. FOX, COUNTY ENGINEER NEAREST �` r
CASSATT D.GRIFFIN.Sup T OF BUILDING CROSS ST. /l
DISTRICT NO. GROUP SEWER MAP
FOR APPLICANT TO FILL IN TYPE ICONS
BPGT. � '� G
BUILDING -
aCHWY
T— MAP ADDRESSNUMBER STATE
ES
LOT NO. y' % BLOCK USE ZONE SPECIAL -�
f CONDITIONS t W ` &%e_e- �e
TRACT ,/,�IoV
d YI !Ve S/�� o 6_457
J NO.OF BLDGS. /�
SIZE OF LOT /�O NOW ON LOT / BUILDING HWY STREET NAME EXIST.
YARD
USE OF J� /� SETBACK WIDTH
EXISTING BLDGA. /J�fjO�,/��i.� FPROLT `O
OWNER �{/ 6 SIDE
MAIL P.
ADDRESS dgi
TEL. 1 DWELL. I UNIT' 5 INDUSTRIAL
CITY , /r (.moo NO. `
2 DUPLEX UNIT— 6 PUBLIC BLDG.
ARCHITECT OR - TEL.
ENGINEER NO. g APT. UNITS 7 ADDN.',ALT.,ETC.
ADDRESS 4 COMMERCIAL 8 MISCEL.
CONTRACTOOP g• a, �/P NO. •��/ INSPEC- RECORD
ADDRESSrtp0��7/J///�//ff�%/�SF• CJ-/J
DESCRIPTION OF WORK
NEW ADD ALTER REPAIR DEMOLISH
SQ. FT. / NO OF FAMIOLFIES.'
SIZE 'A STORIES
USE OF STRUCTUR ;
• i
SIGNATURE
APPLICAN F APPROVALS
ADDRESS C DATE INSPECTOR'S SIGNATURE
E S FOUNDATION: LOCATION
j3 O FORMS. MATERIALS
FEE FRAME: FIRE STOPS.
VALUATION BRACING.BOLTS
FEE $ FURNACE: LOCATION,
GAS VENT, DUCTS
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH. INT.
AND STATE LAWS REGULATING BUILDING CONSTRUC-
TION. LATH, EXT.
SIGNATURE OF � � HOUSE'NUMBER COR-
PERMITTEE--- 42t; RE CT AND POSTED
ADDRES 'v dr1w. FINAL
WNL J. FOX. CouNrY-FmGINz VALIDATION
BY 1.14-5 Zu,"'M. 4.'.1 :6 l 1 0 d.g.b BY
` — DEPUTY EPUTY
BY BY
® DEPUTY DEPUTY