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7GA638A CE#8032-63 APPLICATION FOR BUILDI�NG�, PERMIT �.
COUNTY OF LOS ANGELES ABUILDING DDRESS j ( d / _/
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST A '
WILLIAM A.JENSEN, SUPT OF BUILDING CROSS ST.
DISTRICT fN ;- GROUP TYPE _MESSED BY
FOR APPLICANT TO FILL IN V fJV CONST.
BUILDINGSTATISTICAL CLASSIFICATION S WER MAP
ADDRESS (� -BK G' G
J/a�yy; CLASS. NOS DWELL.UNITS `-
LOT NO. "BL K WATER . NOT REQUIRED RECEIVED
CERTIFICATE: UnhL
TRACT MAP cq� � HIGHWAY STATE MAJOR SECOND OCAL
NO.OF BLDGS. NO.'%e (CIRCLE)
SIZE OF LOT NOW ON LOT USE ZONE PECIAL
USE OF CONDITIONS
EXISTING BLDG: IIL.S ��L
TE
OWNER YCZ N Qt BUILDING YARD HWY STRE NAME EXIST.
//00 SETBACK WIDTH
ADDRESS 16 '1 e. -C• FRONT v�
ARCHITECT OR TEL. P. L.
ENGINEER NO. SIDE I }
P. L.
ADDRESS y
TEL. O
CONTRACTOR NO.
ADDRESS O
DESCRIPTION OF WORK w
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ADD ALTER REPAIR DEMOLISH .Z
Q. FT. NO.OF NO. OF --- _
SIZE Q STORIES FAMILIES
USE OF
STRUCTURE
SIGNATURE OF
APPLICANT f
VALUATION S
APPROVALS PATE INSPECTORS SIGNATURE
P.C. PMT �G FOUNDATION: LOCATION
FEE $ — FEE.$ i FORMS. MATERIALS {'1,(•� r 'F.Cr-J.? 'lri
FRAME: FIRE STOPS.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS 30 66� ��T-+'� •��
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. Y
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-
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT. LATH. INT. /
ING TO WORKMEN'S COMPENSATION INSUR ICE. LATH. EXT.
SIGNATURE O HOUSE NUMBER COR-
'.2
PERMITTEERECT AND POSTED
zeADDRESS FINAL �yCi sl f
JOHN F. LEWIS. PRINCIPAL ST RAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH
9'7'2'5—%0 AN 4 1 D 1 1..5 0 N q
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FOA638A'CEAS.Ga 8.88 APPLICA`T'ION FOR'BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING /9 -
DEPARTMENT -OF COUNTY ENGINEER ADDRESS (/
BUILDING AND-SAFETY DIVISION LOCALITY
JOHN A. LAMBIE• COUNTY ENGINEER NEAREST 4
WILLIAM A.JENSEN,SUPT OF BUILDING CROSS ST. ,
DISTRICT NX G TYPE P E D B
FOR APPLICANT TO FILL IN �" CONST.
BUILDING. - STATI AL CLAS ATION ER MAP
ADDRESS' K
CLASS. NO / DWELL.UNITS
LOT NO.!WA
BLOCK WATER NOT'REQUIRED❑ RECEIVED
^ CERTIFICATE:_
TRACT `0t'!t7 MAP HIGHWAY STATE MAJOR SECON ,LOCAL
NO.OF BLDGS./ NO (CIRCLE)
SIZE OF LOT SQ '•1 iM NOW ON LOT USS O E SPECIAL
USE OF (j'(J CONDITIONS _
vc
EXISTING BLDG. -PS
OWNER NOTE • �1CM BUILDING • EXIST.
SETBACK YARD H•WY STREET NAME WIDTH
ADDRESS o_ C FRONT
ARCHITECT-OR TEL. P. L. (f v
ENGINEER NO. SIDE
ADDRESS �I�41� f
TEL. ���3,:• y
7 '.i. ".y'r•'°y ti a n •..�
-CONTRACTOR NO.
f,�
ADDRESS �• r c .:/. IM
! c
DESCRIPTION OF WORK 1J+i l `__� :." .''•;.,'• • 'i e'
j. Ru
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NEW ADD ALTER REPAIR DEMOLISH ' ct ����/�� " 1A
SQ.FT. NO.OF NO.OF /`� 2.0(4 ll�:&y4f 'tomi/`�:' L��,e� d/li z
SIZE - - STORIES FAMILIES ° // fu•
USE OF /�,�.•�� ✓ /_ _ i /�.1,,� R `
STRUCTURE �pl�� K�,� /�l!9R� � '3' f.��(1'' ( •�•.��
SIGNATURE OF �+
APPLIC4NT !71
VALUATION $i '� -
APPROVALS (DATE INSPECTOR'S SIGNATURE
P.C. PMTee�� FOUNDATION: LOCATION ,d�jj� ti-�'
FEE $ '' FEE'S /15 FORMS, MATERIALS ARw �:P _
FRAME: FIRE STOPS. / 'G f
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS A
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. (•
WIT COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS f • ♦�i�/
BUILD INGCONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK 'r _
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. ���.tr j'Qr
TION OF THE LABORNOR CODE OF THE STATE OF CALIFRELAT- , f{
ING TO WORKMEN'S COMPENSATION INSURAN q`J+ ,7 r-7"1{•
LATH.EXT. ®� r�,!J,�• _• � 1"'`d.I
SIGNATURE OF `') HOUSE NUMBER COR-
PERMITTEE ` RECT AND POSTED v
.ADDRESS.C2 i I 2audAft aim= 7< FINAL /;,z
JOHNF. LEWIS. PFt,NCIPXL STRUCTURAL ENGI r
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. ASH
1;uo 0 Z) i D i
IDs 76A638A
CE#803(,EV.I I/78)
J-
APPLIdATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING,, ND SAFETY
F R AP ICANT IN TO ILL ADIDRESS
LDING
BUILDING
ADDRESS ��7 !9?G LOCALITY
��w NEAREST
CITY / i ZIP CROSSST.
`'
NO.OF BLDGS. ASSESSOR
SIZE OF LOT AtF/ (� NOW ON LOT MAP BOOK PAGE PARCEL
TRACT• b DISTRICT GROUP TYPE FIRE PROCESSEDQY
BLOCK LOT. F. CONT ZONE r
TEL. ���
OWNER NO.
STATISTICAL CLASSIFICATION � SEWER MAP
ADDRESS CLASS NO. DWELL.UNITS---j .
�J BK3 C PG
CITY ZIP
ARCHITE O TEL. s DO
ENGINEER NO. Q VALUATION �DOO
ADDRESS BLDG.SETBACK FROM
FRONT PROP.LINE OF (STREET)
CONT L B d l KJQ TOTAL SETBACK FROM 'TYPE OF EXISTING .
LIC. �Q HIGHWAY + YARD = FRONT PROP.LINE HIGHWAY WIDTH
ADD I ���DIO. L 617
LIC. +
CITY CLASS c7
CONSTRUCTION LENDER BLDG.SETBACK FROM
SIDE PROP.LINE OF (STREET)
NAME AND BRANCH }
HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING IL
ADDRESS CITY - SIDE PROP.LINE HIGHWAY WIDTH V
SQ.FT O.OF NO.OF CHECK + _
SIZ TORIES F ILIES ONE
�CU✓ MAP
/DESCRIPTION RK NEW 00 SPECIAL
ADD j
CONDITIONS fj�L
T ALTER ❑ FINAL �j �� Z
r REPAIR El
!'F'7i,1 aS t� c p +, `Ji1rF.'': i A SAT�R.
EXISTTIING BLDG.USE F DEMOL ❑ G Z
APPLICANT TEL
(PRINT) NO.
°— P757,2A
BY(SIGNATURE)'
Y o 0 0 0 2 1
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE V
THAT THE ABOVE IS COR ND TO COMPLY WITH ALL ORDINANCES W
AND LAWS REGULATIN UILDING CONST CTI .I CERTIFY THAT IN DOING THE S 2 0 - 40,32
WORK AUTHORIZED REBY I WILL NOT PL Y PERSON IN VIOLATION OF t.7 ,
THE LABOR CODE O HE STATE OF RNIA N TING TO WORKMEN'S COM- Z =
PENSATION,NSU E.' o o o pv 2 U
• d
SIGNATURE
�- 11,02-79
PERMITTEE -
ADDRESS Z '757.3A
TEL. 0 # o o ° o 0 1
CITY NO.
2 ° - 79,00
P.C.Fee$ Permit Fee �`C > o 0 7 _
9,0o
Issuance Fee
W
Total Fee leC
DIVISION OF BUILDING AND SAFETY
"— -"! Department of County Engineer
County of Los Angeles
WM. J. FOX, COUNTY ENGINEER APPLICATION
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
DISTRICT NO. PLAN CK.OR REO.No. PERMIT NO.
BUILDING + 1n ,�� lei
ADDRESS
AA r RECEIVED BY DATE OFAPPL. �iDATEpISSUE0
L30ALITY
PC6AREBT
CROSS ST. »w.�f L<._ /�I.�-a.-+- tit.�R. BUILDING
ADDRESS
OWNER
MAIL LOCALITY
ADDRESS J-j 9 19 ;�- ��, („r
_ itiv..G... N}C4REST
CROSS ST. Z 0Gd.491.W
CITY �!.-/ter+^ r�+�i ��eJlwif No. I FIREI f'-'
NO.OF A TYPE¢ GROUP
ZONE PLANS
AROHITECT OR nn (✓ TEL
ENGINEER '_4'eA40 NO. BLDG. ORD. NO.
SETBACK LINE
ADDRESS USE
L ZONE BY
PROVED
TEDATE
CONTRACTOR / lJ� NO. HOUSE NUMBERING
ADDRESS MAP NUMBER / NO. ASSIGNED BY
LEGAL CORRECTIONS _
DEBORIPTION LOT NO. ?I BLOCK �.i '6v 7_71-1
�
TRAOT L � �`/ �!1B ()��+ G6r
No. or
SIZE OF LOT I l �1 , `� ?� NOW ON LOT BLDG&32.,A_
USE OF NO.OF
EXISTING BLDG. FAMILIER
DESCRIPTION OF WORK93
v
NEW ALTERATION ADDITION Z
D
r
REPAIR' DEMOLITION
NO.or
9 ZE S RO MB �� ` STORIES
EXT.WALL �e REO£
COVERING I_•�.*1 r �] OOVERINS �f- '
UBE OF STRUCTURE
INSPECTION FOR APPROVALS
OCOUPANCYAS INSPECTDRFBSIGNATURE ATE
FOUNDATION:LOCATION
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FORMS, MATERIALS f
PLICATION AND STATE THAT THE INFORMATION GIVEN IS FRAME: FIRE STOPS, �f
CORRECT. BRACING,BOLTS
1 AGREE TO OOMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION,
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. GRN
VENT,DUCTS 0-21
SIGNATURE 12 `_- LATH, INT.
PERMITTEr r lf� rs�► Al! `
J
ADDRESS LATH. EXT.
PLASTER, INT. 14
AUTHORIZED AMT.
PLASTER, EXT.
$ Z 6] Q FFE
C.B SE HOUE NUMBER COR-RECT AND POSTEDVALUATION E Br FINAL
76A638A 088 3 1-53 ���