HomeMy Public PortalAbout8624 ROCCUS LN_Building__ I8A638A CE#SOS 8.89 APPLICATION FOR BUILDING PERMIT
_ COUNTY OF LOS ANGELES BUILDING /)
DEPARTMENT OF COUNTY ENGINEER ADDRESS IFO�
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A.JENSEN,SUPT OF BUILDING CROSS ST.
DISTRICT DID. I GROUP TYPE jl
OC BY
FOR APPLICANT TO FILL IN CONST.
BUILDINGSTATISTICAL CLASSIFICATION SEWER MAP
ADDRESS BK PG'
CLASS. NO.--O—DWELL.UNITS
LOT NO. BLOCK WATER NOT REQUIRED1:1RECEIVED
-2A/25-
/ CERTIFICATE:
TRACT Y NO.OF MAP BLDGL4PNO. Z O O HIGHWAY
ISTATE MAJOR SECON
(CIRCLE)
D, OCAL
SIZE OF LOT NOW ON LOT USE ZONE SPECIAL
USE OF CONDITIONS
EXISTING BLDG.
TEL. '
OWNE ,p/ g&&
Z BUILDING EXIST.
SETBACK YARD HWY STREET,NAME WIDTH
ADDRESS_d' /3 C. .yY FRONT
ARCHITECT OR TEL. P. L.
E N G I N E E g�S/ NO //i'L SIDE
ADDRESS �/ �� �f//Q. f,
TEL. %r1halSS�2N 1.1 l eSIC
CONTRACTOR Oj6'rti NO. 1
ADDRESS `-IIIA 1 S D d'-G c r1A a�f� i1 09
. o
DESCRIPTION OF WORK u
Ru
Ru
ADD ALTER REPAIR DEMOLISH
SQ.FT. NO.OF NO. OF z
SIZE STORIES FAMILIEV F
USE OF
STRUCTURE if�XLa
,,
SIGNATURE OF
APPLICAN p
VALUATION $ /S 3 dO� �� OO APP OVALS ' DAT INSPECTOR'S SIGNATURE 9
P.C. YA, PMT.• FOUNDATION: LOCATION
FEE $ D Op V FEE $ p FORMS, MATERIALS !j / •�/ ,;:,%ate,� 414,
FRAME: FIRE STOPS, // //•I I'.l�f�pj _-l./ '
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION...
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS '!(v 7/•��C� ���,.n�-`)a}JIt�).,o
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 CO ENSATION INSURANCE.
LATH.EXT. a���T<j� G� kLl
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEERECT AND POSTED �� J
FINAL
ADDRESS
JOHN F. LEWIS, PRINCIPAL STR URAL ENGINEER
PLAN CHECK VALIDATION cK. M.O. CASH PERMT VALIDATION CK. M.O. CASH
LACo 1 15 9w JUL 10 2 3 .A ,-' 3 0,2 5A "I
- _.. Lti 2571%-o AUG 13 1 A 6 4.0 0