HomeMy Public PortalAbout10250 RANDWICK DR_Building__ TEMPLE PL ITT
rela"ell#.o&I-., APPLICATION FOR BUIL.DINGPERMIT I
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGDMER ADDRESS _
BUILDING AND SAFETY DMSION LOCALITY _
JOHN A. LAMBIE, COUNTY ENQINEER NEAREST
WILLIAM A.:JENSEN SUPT OF BUILDING CROSS ST.
FOR APPLICANT TO FILL IN
DISTRICT NO. GR P_ CON'gyp _ PwqEsSED BY
BUILDING ,y STATIS 1 CLAS IFICATION S R MAP
ADDRES .(y I�DWIGL� Dom•. K a;.
CLASS.NO. DWELL.UNITS
LOT NO. _ BLOCK WATER NOT REQUIRED RECEIVED'
CERTIFICATE:
TRACT O MAPHIGHWAY
IVO.OF BLDGS.�
N O
(CIRCLE) STATE MAJOR SECOND CAL
SIZE OF LOT'. /047 - NOW ON LOT USE.ZONE SPECIAL
USE OF CONDITIONS
EXISTING BLDG.
' TEL.
OWNER N ). 7"� I BUIL INC• EXIST.
/� /� YARD HWY STREET NAME
ADDRESS 02-4 LG •GAY' &dJ- SETBACK WIDTH'
FRONT
ARCHITECT OR TEL. P.L. 1150
ENGINEER NO. SIDE
ADDRESS "�� TEL INSPECTION RECORD p
CONTRACTOR ,V. VI/ LO•_Tl'0 • V
ADDRESS 4 G 3
- 0
DESCRIPTION OF WORK
W
C
NEW ADD ALTER REPAIR DEMOLISH N
IZE R NO.OF IVO.OF ?
STORIES FAMILIES
USE OF
STRUCTURE
f
SIGNATURE OF
APPLICANT
VALUATION$
APPROVALS DATE/ INSPECTOR'S SIGNATURE
qqPMT. FOUNDATION:LOCATIONPC
FEE Cif FEE S FORMS.MATERIALS
FRAME:FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT'THE ABOVE IS CORRECT AND AGREE:TO COMPLY FURNACES LOCATION, /' Y'
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VERT DUCTS
BUILDING CONSTRUCTION. I'CERTIFY THAT IN DOING THE..WORK r(11r
AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH,INT.
TION OF THE LABOR CODE OF THE STAT OF ALIFORNIA RELAT-
ING TO WORKMEN'S CO E ATIO IN CE. LATH.EXT. 4
SIGNATURE OF HOUSE NUMBER COR-
' PERMITTEE / RECT AND POSTED
ADDRESS '_ �! ` FINAL
CLYDE N. DIRLAM,•-PRINCIPAL STR, V At EN (NEER
ECK
PLAN CHVALIDATION M.O. CASH PERNIIT VALIDATION cK. M.o. cases
6 1 7Q1 410v 7 2 3 D ' 26.75A
LACo 7 5 5 3- MVM8 1 D 5 7.0 0 W