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DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES m U I L D I N G
WM. J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN - FOR OFFICE USE ONLY
BUILDING DISTRICT NO. PLAN CK. NO. PERMIT NO.
ADDRESS 3 7&/
`�� RE B. DATE OF APPL. DATE ISSUED
LOCALITY-+ -
NEAREST `
CR088 STS 7 i fi'',.. •. <+:-•`� "i•'. •, d"_ ' B D G
!✓ -- - ��, (' ADDRESS 'Lm) n � 7-
OWNER
OWNER (r f !r l ,' Y>sl,y
MAIL ti a rr:a' • LOCALITY
ADDRESS c r Ji;/ �, i ` >' NEAREST
/ r TEL. CROSS ST. Ifs:a 7—
CITY NO. FIRE NO. OF TYPE GROUP
ARCHITECT OR I TE . ZONE I PLANS a I %JI J
ENGINEER / NO. BLDG. ORD. NO.
SETBACK LINE /4f dr!!tj
ADDRESS 11
APPROVED
TEL. i BY DATE
CONTRACTOR \ NO. USE /7 APPROVED
I ZONE fq/ / BY DATE
ADDRESS \ HOUSE NUMBERING
LEGAL I LOT NO. �i BLOCK,, MAP NUMBER �� ti FIELD CHECK BY
DESCRIPTION
} � ,tom �7 D E
TRACT �' . =s / ` , �f_' NO. ASSIGNED HY, AT
t NO. OF BLDG3. CORRECTIONS
SIZE OF LOT :- �(j I NOW ON LOT
USE OF _Nt OFA'
EXISTING BLDG. FAMILIES J /
DJESCRIPTION OF WORE
NEW I��J I ALTERATION I I ADDITION
REPAIR I I DEMOLITION I I I
SQ. FT. NO. OF 1 h s A f r-P.
S1Zfi OG Q ROOMS STORIES / , (�'i�! .S i•�::i \. �, (� ,I
EXT.WALL .a e ROOF c;'-0, t
COVERING,f !;.r i ,,t`I COVERING _;ey, r
A L l I r l�i,=C. 5'C L1 R 7
USE OF STRUCTURE G
�!
INSPECCTORI'S SIGNATURE DATE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FOUNDATION: LOCATION
PLICATION AND STATE THAT THE INFORMATION GIVEN IS ' FORMS, MATERIALS •� ���� ��/�
CORRECT.
I AGREE TO COMPLY WITH THE CORRECTIONS LISTED - FRAME:FIRE STOPS,
HER
EON AND WITH ALL COUNTY ORDINANCES AND STATE BRACING, BOLTS I,k;r �2
LAWS REGULATING BUI /INGCCONN TRUCT.ION. FURNACE: LOCATION,
SIGNATURE OF �/T'� t� GAS VENT, DUCTS
PERMITTED -"e ��
LATH, INT. , / '^
A N1 d I h
ADDRESS_
yv
LATH, EXT. L/ ` U
AUTHORIZED AGT.
PLASTER, INT.
wesew• Dass so-so S���� ! FEE $ �-
_ PLASTER, EXT. A
' VALUATION d FEE $
C3 d 3 to
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'eA888A cis#8080-88 APPLICATION FOR• BUILDING PERMIT ,
COUNTY OF LOS ANGELES BUILDING S-
DEPARTMENT OF COUNTY ENGINEER ADDRESS ._ r �>✓, ,tf
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A.LAMBIE.COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN•SUPT OF BUILDING CROSS ST. '�+ r ,
" DISTRICT NO. GROUPy TyrpE• PROCESSED BY
FOR APPLICANT TO.FII.L'IN —=— I CoNST.r_ I
BUILDING f "
r ADDRESS b 2 ./_,, ,. �-C/' > SEHKR MAP
STATISTICAL CLASSIFICATION //��
i CLASS.NO. DWELL.UNITSS. _I
LOT NO. !f.0i BLOCK MAP STATE O
NUMBER D HWY. YES
TRACT USE.ZONE SPECIAL
av NO.OF BLDGS. CONDITIONS
SIZE OF LOT J^i; (.; NOW ON.LOT
USE OF f�
USE
_QIO'NG BLDG. /1 :_.Lf .C./t P7to^ i BUILDING EXIST.
y w�j`" SETBACK YARD HWY STREET NAME WIDTH
OWNER •// ., /V ,r�,(� r'
FRONT
MAIL —� ^? �� ff" P.L. C.l.
ADDRESS a, C ,.' SIDE
TEL. P.L.
CITY �!��Ie..�-�_'.a� Co.. No. INSPECTION RECORD
ARCHITECT OR ' TEL.
ENGINEER -- NO.
ADDRESS
TEL.////
CONTRACTOR /,. . !':.l s'Y Jr7 NO./'I! ' 7472
ADDRESS
DESCRIPTION OF WORE
NEW ADD ALTER REPAIR DEMOLISH
SO.FT. NO.OF / NO.OF
SIZE {�`� j f STORIES J FAMILIES
USE OF STRUCTURE
SIGNATURE OF APPROVALS
APPLICANT
DATE INSPECTOR'S SIGNATURE
ADDRESS FOUNDATION: LOCATION a
FORMS,MATERIALS
p : FIRE
$ �� FEE $ FB ACING.BOLTS STOPS. eWt
VALUATION $ �2 c) 1 FURNACE:.LOCATION.
FEE % ���.� GAS VENT.DUCTS
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH.INT.
W944S" oo
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES ANDSTATE LAWS LATH, EXT.
SIGNATURE OF-fREGULATING BUILDING�CONSTRUCTION• HOUSE NUMBER COR-
PERMITTE r �'- .-�'// +�= RECT AND POSTED
i
ADORES �f% c= f � 'v FINAL 2`~24•E �f
CLYDE N.DIRLAM.PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION,� CK..! M.O. CASH
76AG38A CE0.803 9-67 , 6f
APPLICATION-FOR BUILDIN PERMIT
r COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DMSION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS, SUPT OF BUILDING CROSS ST.
FOR APPLICANT TO FILL IN DISTRICT NO. GRO NS R ED BY
(Print or type only) ONST,
r
BUILDING Q ('1 ^ STATISTICALCLSIFICATION SEWER MAP
ADDRESS 4$ CLASS NO. DWELL.UNITS BKL PG tj e-7
LOT NO. , BLOCK USE ZONE MAP �/') 0/1 '7
NO.
TRACT SPECIAL
NO.OF BLDGS. CONDITIONS
SIZE OF LOT NOW ON LOT
USE OF
EXISTING BLDG. _BLDG.SETBACK FROM
TEL FRONT PROP.LINE OF -(STREET)
OWNERUk2NO. TYPE OF EXISTING SETBACK HIGHWAY + YARD - TOTAL
HIGHWAY WIDTH FROM C.L.
ADDRESS -Q D
CITY BLDG.SET ACK FROM
ARCHITECT OR TEL SIDE PROP.LINE OF (STREET)
ENGINEER NO, T -ZfO,Z _
TYPE OF EXISTING SETBACK HIGHWAY + YARD - TOTAL
ADDRESS HIGHWAYI WIDTH FROM C.L.
TEL. 1. + _ }
CONTRACTO O. a
. C
LIC
ADDRES LIC CORNER CUTOFF YES ❑ NO ❑ C%
LIC. �
CITY CLASS SEE REVERSE SIDE FOR SP CIAL P ROVALS
n C
DESCRIPTION OF WORK
I a
frf
z
NEW ADD ALTER REPAIR DEMOLISH
SQ. FT. NO. OF NO. OF
SIZE Coo STORIES FAMILIES
USE OF
STRUCTURE
=
SIGNATOR OF
APPLICANT
VALUATIONIIIIIIIIIS4�s,
V V APPROVALS DAY IN P TORS S G TORE
P.C. PMT. FOUNDATION: LOCATION Q
FEES FEES q FORMS, MATERIALS (J
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
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 TME ATE OF CALIFORNIA RELAT•� LATH, INT. ,
INO TO WORKMEN'S CO ATION 1 SUR C
LATH, EXT.
SIGNATURE OFHOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS 6& FINAL G
JOHN F. LEWIS. PRINCIPAL SpmtNURAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION' CK M.O. CASH
(; .4 1-.5 4 b APS- 5 1 D 2 7.7 J r