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76A638AC648038-64 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING /
DEPARTMENT OF COUNTY ENGINEER ADDRESS �'
BUILDING AND SAFETY DIVISION LOCALITY {�C
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS,SUP'T.OF BUILDING CROSS ST.
DICT P O. GROUP TYPE, jrROCESSED BY
FOR APPLICANT TO FILL IN '5. CONST.
BUILDING
/� o STATISTICAL CLASSIFICATION SEWER MAP
ADDRESSV Y3 /'/ �sG CLASS NO. DWELL UNITS . BK PG/-
LOT NO. �i� BLOCK USE ZONE I MAP
NO. -
TRACTdiff, J� f� - ':�/" SPECIAL
NO. OF BLDG$. CONDITIONS
SIZE OF LOT NOW ON LOT
USE Ol
,.,ST,NG EILDG. BLDG. SETBACK FROM
EL. FRONT PROP. LINE OF (STREET.)
OWNER - NO• TYPE OF EXISTING SETBACK HIGHWAY + YARD TOTAL
ADDRESS / �. HIGHWAY WIDTH -F FROM C.L.
CITY
TE
ARCHITECT 0ORL-. BLDG. SETBACK FROM
ENGINEER NO. SIDE PROP. LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS �'"' �J HIGHWAY WIDTH FROM C.L. CL
CONTRACTOR 5 1' (//7" NOLICL. ,l�7L -�' = O
ADDRESS a�,Jj '� NO�H �G✓ CORNER CUTOFF YES NO O
CITY c� s — -J SEE REVERSE SIDE FOR SPECIAL APPROVALS
DESCRIPTION OF WORK h
Z_
NEW ADD ALTER REPAIR DEMOLISH
SQ.FT. NO. OF
SIZE STORIES FAMILIES
USE OF
STRUCTURE -
SIGNATURE OF
APPLICANT
VALUA
APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. PMT. Q �' FOUNDATION, LOCATION
FEE$ FEE$ �� 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 FURNACE: LOCATION
WITH ALL COUNTY ORDINANCES AND- STATE LAWS REGULATING GAS VENT. DUCTS
9U ILD(NG 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 ALIFORNIA RELAT.
ING TO WORKMEN'S OMPENSATION IN RA{ LATH. EXT.
SIGNATURE OF /J_ HOUSE NUMBER COR-
PERMITTEE �//, RECT AND POSTED
ADDRESS
JOHN F. LEWIS, PRINCIPALSUCK.
RAL ENGINEER
PLAN HECK VALIDATION cK. M.O. CASH _ PERMIT VALIDATIONM.O. CASH
v
• 1
DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES BUILDING
WM. J. FOX, CHIEF ENGINEER
eL-ANSBLDG. FIRE DISTRICT NO. I PLAN CHK. FEE PERMIT No.
FILED SETS I ZONE _ZONE RECEIPT NO. _
TYPE OF .�• �- ,...._.�,.:_..:_....
BLDG. 1 II Ill IV V, X GROUP y_a DATEIFA IRECEIVED' BY DATE ISSUED
BLDG. SETBACK LINE
- ORD. NO. - I -
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
0 --_-- BUILDING
O w NAME "" A.D.
U W f
W Z ADDRESS LOCALITY
Z NEAREST t
U W CITY CROSS ST. "�
C STATE
Q LICENSE NO. TEL. No. I I NAME .-j.'� 1 4
0 )
0 NAME Z MAIL 3 ADDRESS a IGS
E- -
U 0
Q ADDRESS CITY i.a-.�:Cc^ TEL NO. -
0: -
Z CITY J R
LOT 1 SIZE OF LOT
V STATE (Q'1U NO. OF BLDGS.
LICENSE NO. TEL. No. ld(n BLOCK NOW ON LOT
O P ,.y J USE OF BLDG.
CLASS OF WORK TRACT' / NOW ON LOT
-- II DESCRIPTION OF WORK
ADDITIONNEW
AL ERATION- REPAIR I I MOVIING DEMOLISH
USE OF 1NO. OF
BLDG. 1 .( ....�C /f V / r...ROOMS I
SIZE OF "� I STORIfs No. OF
BLDG. FAMILIES CORRECTIONS
SPECIFICATIONS ��-
FOUNDATION
MATERIAL EXTERIOR PIERS .—y— ~ ---
THICKNESSTOP
THICKNESS—BOTTOM
-- J
DEPTH IN GROUND Q
Z
SUPERSTRUCTURE ---
SIZE; SPACING SPAN
R. W. PLATES (SILL) \T.L•+__.
GIRDERS
JOISTS—FLOOR
JOISTS--CEILING
BEARING WALLS -
PARTITIONS
ROOF RAFTERS 7,;� ` V FINAL APPROVAL
SILL BOLTS '
COVERING y'
�f DATE F INSPECTOR'S NAM[ -
WALL � I ROOF ,+•. I HEREBY ACKNOWLEDGE THAT 1 HAVE,READ THIS
`a APPLICA-T+CFW'%SND STATE THAT THE ABOVE IS CORRECT
AND REQ TOl COMPLY WITH ALL COUNTY ORDINANCES
P.C. FEE S AND'STATE,�+YWS REGULATING BUILDING CONSTRUCTION.
SIGN
VALUATIONS •� FEE $� OWNER OR hUTHOf312FI3 AGI"NT
08-3 5-38