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I0A890A CE#009.1-61 APPLICATION FOR B .
UILDING PERMIT
COUNTY OF LOS ANGELES BUILDING ® P-G
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DMSION LOCALITY
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST t
WILLIAM A.JENSEN SUPT OF BUILDING CROSS ST.
DISTRICT NO. GROUP TYPE PROCESSED BY
FOR APPLICANT TO FILL.IN v I CONST.
BUILDING STATISTICAL CLASSIFICATION SEW RMAP
ADDRESS 14N� �G6L I �. BK PG
CLASS.NO.-i! UNIT
.LtOTNO. BLOCK WATER
CERTIFICATE: NOT REQUIRED ❑ RECEIVED
°TRACT .1Q MAHIGHWAY STATE MAJOR SECOND. A
NO.OF BLDGS.� NOr�— r (CIRCLE)
SIZE OF LOT. �}( �® I NOW ON LOT USE TONE SPECIAL
USE6)?/ CONDITIONS
EXISTING
�NG BLDG. i
OWNER P. 8O- NO. I
BUILDING YARD HWY STREET NAMEEXIST.
ADDRESS J"�Jry `T I'(E erry �(JQ- SETBACK WIDTH
FRONT
ARCHITECT OR TEL. P.L.
ENGINEER NO. SIDE
P.L.
ADDRESS /� TEL ) INSPECTION RECORD �, D ,� O
CONTRACTOR 43' ���� D Cy. NO.• -2,ft y 1 U
ADDRESS X12-4 Pcf Grp V Tl`M;I ,_ 61�!}' ViY1 _.�1�.
DESCRIPTION OF WORK 1 !' �' AU'./// ,L
ADD ALTER REPAIR DEMOLISH
-SO.FT. NO.OF NO.OF
§IZE No_Sg STORIES ! FAMILIES/
STRUCTURE
SIGNATURE OF
APPLICANT
VALUATION$ "
r
APPROVALS IDATE INSPECTORS SIGNATURE
P.Cwill
. PMT. FOUNDATION:LOCATION
FEE $ ` FEE $ �-- FORMS.MATERIALS /I/
G`
FRAME:FIRE STOPS, I
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING,BOLTS i/
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE:LOCATION, 1 �
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTSIt
BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK 1
AUTHORIZED HEREBY 1 WILL NOT-MP !Ayft PERSON IN VIOLA- LATH.INT.
TION OF THE LABOR CODE OF THE ST E CALIFOR IA RELAT-
ING TO WORKMEN'S CO TON S ANCE.
LATH,EXT.
SIGNATURE OF HOUSE NUMBER COR- ""
7
PERMITTE � � .
RECT AND POSTED � s•'
ADDRESS FINAL G� A
CLYDE N. DIRLAM, PRINCIPAL ST URAL ENGINEER
IT
PLAN CHECK VALIDATION M.o. cAsR PERMVALIDATION M.G. CASH
Limo$%d 2' 3.o NDU 72 -3 D 3 2.0 01 Q .
LAU0 7 3 1 3 0 Nov 2 3 1 D - 6 4.0 O~
1
r � •
C
i
76A898A CE#S08 6-82 APPLICATION FOR BUILDING PERMIT' '
COUNTY OF'LOS ANGELES BUILDING � r2q, ^ ,I.1
DEPARTMENT OF COUNTY ENGINEER ADDRESS I WG
BUILDING AND SAFETY DIVISION LOCALITY /09/ 1
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST 4
WILLIAM A.JENSEN,SUPT OF BUILDING CROSS ST.
DISOT N GROUP TYPE ROC @ BY
FOR APPLICANT TO FILL IN CONST.
BUILDING /e STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS
y3 CLASS. NO..�DWELL.UNITS ,� PG
LOT NO.. BLOCK WATER NOT REQUIRED RECEIVED ❑
CERTIFICATE:
TRACT MAP HIGHWAY STATE MAJOR SECONDOCi4L
NO.OF BLDGS.� NO. (CIRCLE)
SIZE OF LOT NOW ON LOT USE ZONE SPECIAL
USE , CONDITIONS
EXISTING
le�.�NG BLDG.
OWNER r, �F7i (�4� 0 � BUILDING YARD HWY STREET NAME EXIST.
SETBACK WIDTH
ADDRESS �/ J'f'I�' - FRONT
ENGIiTNEER /// /-�jccl NO. SIDE >
ADDRESS CP W03 Ga P L C
r / L
CONTRACTOR`osv[d'l 191-5 NTlo2GY ��:. r✓
ADDRESS grJ '' __ 6e Gr D:
1 t
DESCRIPTION OF WORK ��? �"r /' r. t.•{. - r% �, (��n, L
NEW ADD • ALTER REPAIR / DEMOLISH
FT. GG NO.
SIZE OF ( NO. OF /
V STORIES FA I.L.I.ES-
USEOF ��II--••
STRUCTURi�.rWI/'YJ
5'T. Rz. W-1 Z06,. C&
SIGNATURE OFeo
APPLICANT yG .
VALUATION $ C
APPROVAL'S DAtTE INSPECTOR'S Sl ATNYRE
P.C. PMT. FOUNDATION: LOCATION
FEE $ ✓ FEE $ S FORMS, MATERIALS L
FRAME: FIRE STOPS, \ +1
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. I
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS
BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK �•
AUTHORIZED HEREBY i WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT.
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT-
ING TO WORKMEN'S MPENSATION INSURANCE. LATH, EXT. r t
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE ✓ RECT AND POSTED
ADDRESS ' FINAL
JOHN F.-LEWIS. PRINCIPAL STWUCTURAL ENGINEER
PLAN C VALIDATION M.O. CASH PERMIT VALIDATION- Q M.O. CASH
2763- hPR 23 D
1 3.75 -
!tjLo 2.7 6 411PR 1 1 D 1 5.00-