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APPLICATION FOR BUILDING PERMIT Z
DIVIMON OF BUILDING AND SAFETY AD SING
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of LOCALITY 1
CA SIATT D GRIFJ FOX FINU Stn TT OW BUILNTY [DINO N=:ST ZL
OI[TRIOT NO. GROUP TYPE B[KR MAP
FOR APPLICANT TO FILL IN 7YICONST
BUILDING 'YAP .� ,Id Sw Y[p NO
ADDRESS NUMBER "
I• r USE ZONE SPECIAL
LOT NO O P' BLOCK CONDITIONS
TRACT Su N N L) I E IUNO OF I
SIZE OP LOT 5_0A ISO NOW ON LOTS SETBACK YARD HWY ET NWIDTH
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ADDRESS IWbI-L IAV O TRACT DWELL 1 UNIT
D INDUSTRIAL
Td I DWELL ,3 1 UNIT 6 PUBLIC BLDG
•ARCHITECT OR Td �('� 2 Cum" 1 UNIT 7 ADDN.ALT ETC.
[NGINQR NO I $ APT 1{_UNITS
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p 0Lu 4 COMMERCIAL
CONTRACTOR 10C NO 1 INSPECTION RECO
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DESCRIPTION OF WORK.
NEW ADD ALTER REPAIR DEMOLISH _
SG PT NO OF NO OF
BIZH STORIES FAMILIES 4
USE OF STRUCTURE
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SIGNATURE OF c'on.iS otic.
APPLICANT APPROVALS
ADDRESS OS D TQ ECTOR S SJSNATURE
/ ION
P C B Ci FOU FORMpTMATERIALpTION i
O nd FEH FRAME FIRE STOPS
VALUATION • Q BRACING BOLTS fH Z O..
FEE FURNACE LOCATION,
II
ACKNOWLEDGE THAT 1 HAVE READ THIS GAD VENT DUCTS
APPLICATION AND STATE THAT THE ABOVE IB CORRECT S-1
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH INT
AND STAT[ LAWS REGULATING BUILDING CONSTRUC-
TION LATH EXT V V
SIGNATURE OR (�. f�(J"Y-c..0 HOUSE NUMBER COR.
PERMITTHE R[CT AND POSTED
ADDRESS FINAL D
WM J FOX,COUNTY ENGINEER VALIDATION C N DIRLAM CHIEF BLDG INSPECTOR
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APPLICATIO FOR BU DING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS SSI
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUPT OF BUILDING NEAREST
CROSS ST
FOR APPLICANT TO FILL IN U15T$ICT No GROUP TYPE CONST SSED BY
(PRINT O PE ONLY) S O /w
BUIL0I NG STATISTICAL CLASSIFICATION SEWER MAP
ADDRESSIr
CLASS NO DWELL UNITS BK PG
LOT NO _ BLOCK USE ZONE MAP
TRACT #7 NO zoo
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,oSPECIAL
NO OF BLOGS CONDITIONS
SIZE OF LOT NOW ON LOT
USE OF
EXISTING BLDG BLDG SETBACK FROM
TEL _ �� FRONT PROP LINE OF y -(STREET)
OWNER NO TYPE OF EXISTING SETBACK HIGHWAY YARD - TOTAL
XIGHWA, WIDTH FROM C L
ADDRESS
CITY
ARCHITECT OR TEL BLDG SETBACK FROM
ENGINEER NO SIDE PROP LINE OF (STREET)
TYPE OF EX6TK SETBACK HIGHWAY + YARD = TOTAL
ADDRESS XIGXWAY WIDTH FROM C L
CONTRALTO TELO LIC
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NO CORNER CUTOFF YES ❑ NO ❑ C
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clivLASS SD SEE REVERSE SIDE FOR SPECIAL APPROVALS y
CONSTRUCTION'LENDER
NAME AND BRANCH
ADDRESS
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SO FT NO OF NO ❑ Z
SIZE STORIES FAMILIES NEW
US E OF
STRUCTURE ADLTER 0
REPAIR
SIGNATURE OF DEMOL ❑
APPLICANT
VALUATION $ tl,41 l'of APPROVALS DATE INSPECTOR'S *IGNATURE
P C PMT (J O FOUNOAT ION LOCATION
FEES FEE § '� F R T RIA
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION FRAME FIRE STOPS,
LT
AN STAT! TNAT TXE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION,
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUC-
TION I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I GAS VENT, DUCTS
WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR COD! LATH INT
OF THE STATE OF CALIFO IIA IN RE LATIN TO WORKMEN'S OM•
PENSATION INSURANCE LATH, EXT n
SIGNATURE OF
PERMITTEE HOUSE NUMBER CORRECT /
AND POSTED ^ p'
ADDRESS FINAL
JOHN F LEWIS, PRIN (PAL STR URAL ENGINEER
PLAN CHECK VALIDATION CR M 0 CASH - , PERMIT VALIDATION CR M 0 CASH
lAr,65-969 SEP 2 1 D 12.00^' PJ
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Ilse 1. APPLICATION FOR BUILDING PERMIT 1
/ � •
ON�OF`BLt ING AND SAFETY BUILDING
OI County nghimer ADDRESS OSCYYJ C`S�
Comfy of A
LO/ BgdG: C C Ge LOCALITY •(
JOHN A LAMBIE. COUNTY ENGINEER NEARESTA
CABBATT D GRIFFIN. SUP T OF BUILDING CRO 68 BT O Q �
FOR APPLICANT TO FILL IN DIET 1 T NO Gir TYPE SEWER MAP G
CONST t
BU ILD INO MAP �Y�/�.T�� STATE
ADDRESS l8 C'V�• N MBER Ot{%VI� HWY YEB NO
LOT NO V BLOCK�" U6 ONE SPECIAL
GOND TIONS 146'90
TRACT 7V Y 1�`� E. s6
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SIZE OF LOT Z`�L7 SO NOW ON LOTTNO 0 B BUILDING EJIIBT
USE OF SETBACK YARD HWY STREET NAME WIDTH
EXISTING BLDG A C FRONT
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MAIL S�� OS CMC LIN+
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DRESS O TRACT DWELL 1 UNIT
D INDUSTRIAL
CITY �g „1 i Np 1 DWELL1 UNIT
ARCHITECT OR TEL 2 DUPLEX Z UNITS 8 PUBLIC BLDG
ENGINEER NO 7 ADDN ALT ETC
9 APT �UNITS
8 MIBCEL
ADDRESS 4 COMMERTEL
CIAL
CONTRACTOR
C ^' NO 4tr-7q(a9j INSPECTION RECORD
ADDRESS SlQ OS LVA. 13C W�LLT 1..5.
DESCRIPTION OF WORK
NEW ADD ALTER REPAIR DEMOLISH I CA
v$
SO FT NO OF NO OF
SIZE ZO STO IES FAMILIES
USE OF STRUCT p 1 d2.4 C
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SIGNATURE OF
APPLIGNTll ✓+^^ APPROVALS
ADDRESS "C�I M�f_ I'f� L VDD ATH INSPECT)DR S SIGNATURE
[�I.�) FOUNDATION LOCATION
$ O v/ O —� P C S m FORMS MATERIALS �I L
FEE FRAME FIRE STOPS C-�
VALUATION )1 / C BRACING. BOLTS I 10 3�
��
FURNACE LOCATION
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS GAS VENT DUCTS N 4
APPLICATION AND STATE THAT THE ABOVE 8 Co ECT
AND AGREE TO COMPLY WITH ALL COU CES LATH INT e, .� n li._
AND STATE LAW RE LATINO BUI ON
TION l LI
LATH EXT
81 ONATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED L
ADDREB d E �- FINAL 7
JOHN A.LAMBIE.COUNTY ENGINEER CK No ATIGAllm D
ON CLYDE N DIRLAM. CHIEF BLDG. INSPECTOR
690 AW 5 16 900A997u, �L'9 g 1 1800 m
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