HomeMy Public PortalAbout10053 RANDWICK DR_Building__ 76A698ACE#8088-64 APPLICATION FOR BUILDIN PERMI Oc�
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS joo,53 f1 /VQ c
BUILDING 'AND SAFETY DMSION LOCALITY a ne-
JOHN A. LAMBIE•. COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS.SUP'T OF BUILDING CROSS ST. t?
FOR APPLICANT TO FILL IN DISTRICT NO, _. GROUP T. P ESSED B
CONSY
BUILDING ' STATISTICAL CLASSIFICATION SE ER MAP
ADDRESS g� � U) [G / CLASS NO._0 DWELL UNITS BK PG
LOT NO. [ BLOCK US ZONE 'MAP
J^� NO.
TRACT SPECIAL
'>� NOW ON
BLOBS.
�^ CONDITIONS
SIZE OF LOT � Q ,
USE OF `
EXIS NG BLDG, -"� BLDG. SETBACK FROM,&j
TEL. L FRONT PROP. LINE OF `y -� (STREET)
OWNER GV +' NO.r �Q dV TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS 1/� k� rJ/y �j HIGHWAY WIDTH FROMC.L.
CITY /� C/ I + +
ARCHITECT OR TEL. BLDG. SETBACK FROM
ENGINEER NO. SIDE PROP. LINE OF _ (STREET)
TYPE OF EXISTING SETBACK HIGHWAY i- - YARD - TOTAL }
ADDRESS HIGHWAY WIDTH FROM C.L. G.
hh TEL. + = 0
CONTRACTOR Q A R d NO 7 1 /dD
ADDRESS q/6/ lr � S LI !�/ T�(� CORNER CUTOFF YES NO O
CITY G cls SEE REVERSE SIDE FOR SPECIAL APPROVALS W
D SCRIPTIO OF WORK Z
NEW ADD ALTER REPAIR DEMOLISH *-CPS
b
SQ.FT. / NO. OF NO. OF ^1 I'CPJ r 1:1.0 C-+0� W d ! jl
SIZE STORIES FAM)LIESUSE OF �
ri �L% ib C ,J . T 4vor WR--s ---
STRUCTURE — GA 2 IL
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SIGNATURE OF/ i 0 elL V
APPLICANT -
VALUATION$ �Q D
APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. ,SSU PMT. B U FOUNDATION, LOCATION // J
FEE$ FEE$ FORMS, MATERIALS._. nZ.'G4
FRAME, FIRE STOPS, p rJ
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION --
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS
9UILDI NG CONSTRUCTION. I CERTIFY THAT. IN DOING THE WORK (oh
AUTHORIZED HEREBY-1 WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. f0 3 �
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT-
ING TO WORKMEN'S C7 PE SATION INSURANCE. LATH. EXT. _ �p 'A• (pJ L �O'CI
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE REC _.AND POSTED
ADDRESS Fl NAL
NJ JOHN F. LEWIS, PRINCIPAL ST ,Uffi`'h ENGINEER
ALAN CHECK VALIDATION C M.O. CASH PERMIT VALIDATION CK. M.O C�`ASH__�l
L`i�,o 8 0 7 3 FES 1 2 3 5.5 0 A � LO
L►iUo 9 2 6 7 Ga 1-.AR 8 1 D 71