HomeMy Public PortalAbout9122 PRIMROSE AVE_Building__ 78A688A CE 11808. 1-61 APPLICATION FOR BUILDING PERMIT ll
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 CROSS ST. ,.`.
DISTRICT NO TYPE R ES/ --U BY
FOR APPLICANT TO FILL IN j C1 CONST. 2, � (-
BUILDING STATISTICAL C�ICATION SEWER MAP
ADDRESS K
CLASS.NO. DWELL.UNITS
LOT NO. BLOCK WATER NOT REQUIRED RECEIVED
CERTIFICATE:
TRACT 0,6rJ 13 MAP,,,,,,��j /�
/,L � I NOW ON LOTS ` NO. l' / I(GRCLE) STATE MAJOR SECOND LOCAL
SIZE OF LOT -USE ZONE SPECIAL
USE OF CONDITIONS
EXISTING BLDG.
OWNER Nf a 0 BUIL ING EXIST.
SETBACK YARD HWY STREET NAME WIDTH
ADDRESS FRONT
ARCHITECT OR TEL. P.'L.
ENGINEER -.''-- NO.ti SIDE
ADDRESS INSPECTION RECORD p
TE
CONTRACTO ,y NOL. U
ADDRESS ! 0
DESCRIPTION OF WORK u
W
IL
NEW ADD ALTER REPAIR DEMOLISHSQ h
pp
ZET 18 I / STORIES ! FAMILIES C�
USE OF
STRUCTURE .Q, (.`�
L $1LLG C11 v Y
IGNATURE OF
APPLICANT
VALUATION$ , �� (-2=
APPROVALS DATE INSPECTOR'S SIGNATURE
FOUNDATION: LOCATION
FEE $ FEE $ - t FORMS, MATERIALS
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION,
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY IWILL NOT EMPLOY ANY PERSON IN VIOLA. [FINAL
TH,INT.
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT.
ING TOWORKMEN'S COMPENSATION INSURANCE. TH,EXT.
SIGNATURE OF USE NUMBER COR-
PERMITTEE ECT AND POSTED
ADDRESS � I
CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL ENG
PLAN CHECK VALIDATION CK. M.O. CASH PERM VALIDATION CK. M.O. CASH
> 7os : VEC 6 1 0 2.00``yr%/