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APPLICATION FOR BUILDING ERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FBUILM .
R APPLICANT TO FILL IN BUILDING
ADOR�SS
a LOCALITYZIPNCROSS ST..OF BLDGS. ASSESSOR
NOW ON LOT PAGE P RC$
DISTRICT GROUP TYPE FIRE PROCESSED BY
TRACT a . BLOCK LOT NO. CONSTE
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OWNER I 61i Z.
STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS \ CLASS NO. ��DWELL UNITS BK PG
CITY ZIP
ARCHITECT OR TEL- VALUATION ✓ 3 .
ENGINEER NO.
ADDRESS BLDG.SCMAFROM
FROTJ`F PROP.LINE OF
TEL (STREET
CONTRACTOR V NO.. TOTAL SETBACK FROM TYPE OF EXISTING
LIC HIGHWAY + YARD FRONT PROP.LINE HIGHWAY WIDTH
ADDRESS NO.
LIC +
CITY' CLA55
CONSTRUCTION LENDER BLDG.SETBACK FROM:
TI
NAME AND BRANCH SIDE PROP.LINE OF ($TREE
HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTINGrL
ADDRESS CITY SIDE PROP.LINE HIGHWAY WIDTH O
SO.FT NO.OF NO:OF CHECK } * V
SIZE STORIES FAMILIES ONE
DESCRIPTIbN OF WORK NEW P.C. Fee$ Permit Fee
ADD.
Issuance Fee _
ALTER ` _
REPAIR Total Fee V
USE OF
EXISTING BLDG. DEMOL —V 1w/�
APPLICANT TEL
(MNT) NO.
BY LSIGNATURD > t
IH6"Y ACU40WLBDGE THAT I HIS AVE READ THIS APPLICATION AND STATE _
THATTHE ABOVE II$$CCCXJRRECT AND AGREE TO COMPLY WITH ALL ORDINANCES
AND LAWS REGlA.A111JG BULDI NG CONSRUCTION.I CSM FY THAT IN D01 NG THE
WORK AUTHORIZED HEREBY I WELL NOT EMPLOY ANY PERSON IN VIOLAPON OF -
THELABOR CODE OF THESTATE OF CALIFORNIA IN RELATING TO WORKMEN--CAM .. 1 2 A
NNSAT}ON INSURANCE
SIGIN ATLIRE0F ;# ° 0 0 0 0 1
PERMITTEE
ADDRESS 2 ° ° 5200
CrTY o. o o a 5 2 0 0 .
USE=ZONE
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SP EG A-L
CONDITIONS.
FINAL BY
DATE
NG AND
DSP COUNTY OF S ANGELES n SAFETY BUILDING 1
WM. J. FOX, CHIEF ENGINEER J•� Ld APPLICATION
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
DIOTRI D.
T / P C REO.NO. PERMIT NO.
OS / /6,ADDR
LODALITY
�
61V oY DATZ OF APPLL DAT[ MOULD
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OWNER �A U L ! 1 �� /� ADDREEE
MAIL LOOALITY • T
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f� TEL O OR M ST. • G,r
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T[L ZONE E■Y DATE
CONTRAOTOR a w h-P1� MEL HOUSE NUMBCRIND
ADDRESIa MAP NUMBER— NO. AMMIONED 17Y !�
LE"L CORRECTIONS
DESORIPTION LOT NO. BLOOK
TRADT
/ NO. OF ■LD
NOW L
Or�
SIZE OF LOT S NOON
UBE OF Nd OF
EX1wrIN BLD FrA"M I LI ES
DZ9C7lfl5TION OF WORK °
NEW ALTERATION J_�tRD[71.31
REPAIR DEMOLITION
SQ. FT. NO. OF
■IZE ROOM■ STORIES
EXT.WALL ROOF ,
OOVERINO tl _e ODV[RINO
USE OF OTUR
INSPEOTION FOR APPROVALS
C OOUPAN OY AS I NCPEOTOR'S BIONATURE DATE
FOUNDATIONI LO°ATION
FORM4 MATERIALS
I K
HEREBY AONOWLEDOHV
E THAT 1 HAVE READ THIS AP-
PLICATION AND STATE THAT THE INFORMATION GIVEN 1■ FRAM[i FIR[STUPE, L-
I
.��r,.r y _ y r-•��
OORR[DT. ■RAOIN[1, BOLT?
I AOR[[ TU COMPLY WITH ALL COUNTY R INANDES FURNAD[1 LO DATION,
AND STAT[ LA�RTINEI BUILDING OOti UOTION, ORNL4M VENT DUOTB�fJ 1
■IONATURE OF TH, INT.
P[RMITTI[
D !� •fit LATH. [](T. G y L
ADR rJ 21
PLASTM INT.
AUTHORIZED ALT
PLABT714 EXT.
B� rK[ HOUSE
R[OT AND PEOST[D
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vALUATI FEE * FINAL
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APPLICATION FOR. BUILDING PERMIT `
COUNTY OF LOS ANGELES BUILDING 57
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALIT
.JOHN A. LA.MBIE, COUNTY ENGINEER NEAREST. -
WIWAM A. JPNSEN, SUPT OF ]BUILDING CROSS ST.
DIICT :r
TYPE O 6S BY-.
FOR APPLICANT TOFILL IN CONST.
ADDRESS 51015 Double Drive. L W
NG STATISTICAC IFICATION SEER MAPPG
CLASS. NO. DWELL UNITS
LOT NO LQt 7 BLOCK B WATER NOT REQUIRED RECEIVED
CERTIFICATE:
TRACT MAPD He RCL[)IGHWAY STATE AJO SECOND, LOCAL
NO.OF SLOGS. 2
SIZE OF LOT /' NOW ON LOT USE ZONE SPECIAL
USE OFl f8m. ell CONDITIONS '
EXISTING BLDG. 1 .
443 OWNER kf3 NO. -l�2 BUILDING EXIST..
7y,,.�riSETBACK YARD HWY STREET NAME WIDTH
ADDRESS O DO ublQ Drive FRONT
ARCHITECT OR TEL. P. L.
ENGINEER None NO. SIDE
P. L. y
ADDRESS n-
G
CONTRACTOR United Tani ldere rTioL£1. 2107 Ov
ADDRES6 J �Ii10 Trace v,
0
O
DESCRIPTION OF WORK
NEW ADD X ALTER REPAIR DEMOLISH - N
Z
SQ FT. 1�
.1,E
.353 TS, . ft. STORIES l FAMILIESUSE OF
l -
STRUCTURE Family Room
SIGNATURE OF
APPLICANT
VALUATION S
3500-00
APPROVAL$ DATE IM •210 NATU RI
P.Q. - - PM T Q�S`�I FOUNDATION: LOCATION
_ •
FEE-S-- FEE $ FORMS, MATERIALS
FRAME: FIRE STOPS,
1 HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS
AND STATK,THAT THE ADOVK 16 CORRICT,AND AGREE TO COMPLY FURNACE: LOCATION.
WITH ALL COUNTY ORDINANCES AND STATE LAWS MKOULATINO GAS VENT. DUCTS
■UI{.DI NO CONSTRUCTION. I CIATIFY THAT IN DOING -fH[ WORK
AVTHORIZED H6tIEY I WILL NOT EIAPLOY ANY PERSON IN L
'VIOA- LATH. INT.
TION OF THE LABOR CODE OF THE STATE OF CALIFOIRNIA RKLAT-
ING,TO WQRKMEN.v5 C PZNSATION INSURANC11
. _ LATH, EXT.
SIGNATURE OF HOUSE NUMBER Cqq R- '
PERMI.TTRECT AND POSTED
ADDRESS oo6FINAL '
._ JOHN F. LEWIS. PRINCIPAL STR URAL ENG EEFj
PLAN CIIDCg VALIDATION cK CAWH _ PERMIT VALIDATION K. M.O. CASH
. 1 .
1
8''7 9 'S Lak- .JM1 8:5 ON Q
F
DA-3 F1-43-'SM SET£ ti.PPLICATION FOR FEWMI1•
DEPARTMENT OF I3LTILDING AND SAFETY BUILDING
COUNTY OF LOS ANGELES
WM. .J. FOX, CHIEF ENGINEER
NO.OF BLDG. ORD.NO. DISTRICT NO. PLAN CK. NO. PERMIT NO.
PLANS SETBACK LINE
FIRE APPROVED _
ZONE BY DATE RECEIVED BY DATE OF APPL. DATE ISSUED
USE APPROVED
ZONE BY DATE
APPLICANT FILA. IN HEAVILY OUTLINED PORTION ONLY
Ix BUILDING
O NAME ADDRESS C
W Z ADDRESS J .� _ LOCALITY ° r
U' NEAREST ,.,,,.:.•'t
U W CITY CROSS ST.
4
Q STATE TEL.
LICENSE NO. NAME /
, MAIL
NAME /i, 1J°) ADDRESS ---
0O
U TEL.
ADDRESS �` CITY NO.
OCITY /! p!•.. 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
U APPLICATION AND STATE THAT THE ABOVE IS CORRECT
STATE TEL. AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
LICENSE NO. NO. AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
Z
LOT NOX 3V SIGNATURE OF
, O . SIZE OF LOT
10-12 OWNER �C w
P SINO. OF BLDGS.W 0. AUTHORIZED AST. +
BLOCK NOW ON LOT
" CORRECTIONS
y� TRACT
USE OF BLDGS.
NOW ON LOT
DESCRIPTION OF VOR -------- --- -- -USE OF - - --- ------------------------
BUILDING t
This conGtntc-tinn mai be in 3iol3tina., i _
War Production Board orders. You are
Way — O
P n r a �J
-�,� ^a- �ars mmmerr- �
1 t_ :s cyarmit. Z
- — D
NEW TYPE GROUP r
NO.OF NO.OF 4i
ALTERATION ROOMS FAMILIES
ADDITION SIZE
REPAIR STORIES
MOVING WALL COVERING
DEMOLISH ROOF COVERING
FEE FINAL APPROVAL
/i
INSPECT'OR'S
'I EVALUATION FEE �� DATE I NAME - -
DR-3 11-43 SSM SETS APPLICATION FOR PRIfiMIT
DEPARTMENT OF BUILDING AND SAFETY g�, �j
COUNTY OF LOS ANGELES BUILDING
WM. J. FOX, CHIEF ENGINEER
NO.OF ` BLDG. (/ ORD.NO. DISTRICT NO. PLAN CK. NO. (PERMIT NO.
PLANS SETBACK LINE
FIRE APPROVED /J
ZONE BY DATE R'SCEIVED BY DATF,,OF APPL. DATA: ISSUED
USE APPROVED
ZONE BY DATE �'''
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
y BUILDING
p NAME • ADDRESS '
r"1
W Z ADDRESS LOCALITY
r
U
NEAREST
IZ CITY _ CROSST.
tC
B STATE TEL. NAME
LICENSE NO. NO.
MAIL
NAME $ ADDRESS
0
TEL.
ADDRESS CITY NO.
7 CITYrC/?-Wit-�. �. 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
v STATE TEL. APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
LICENSE NO. NO. AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
ZSIGNATURE OF
LOT NO. SIZE OF LOT ) r..
J O �-T OWNER
a /� NO. OF BLDGS. AUTHORIZED AGT. "` a/
W BLOCK /a(, G NOW ON LOT
J TRACT / 6 O CORRECTIONS 1
USE OF BLDGS.
NOW ON LOT --" -
DESCRIPTION OF WORK
USE OF
BUILDING .e /G i
WARNINGI
construction may be in violation of
War Production Roam] arrier
cautioned to consultwith your local War 2!
ora commerce G)
ha Wo-k a,.z h-,r'z^ Z
D
NEW TYPE � GROUP r
NO.OF NO.OF
ALTERATION ROOMS FAMILIES
ADDITION SIZE __ S
REPAIR ✓_ STORIES /1
+C ---
MOVING WALL COVERING
DEMOLISH ROOF COVERING
$ / 0 FEE s FINAL APPROVAL
(-� $ / O INSPECTOR'S
-VALUATION FEE � DATE NAME
DA-3 E1.43 23M SETS APPLICATION FOR PERMIT
DEPAFTiAUXT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES BUILDING
WM. J. FOX, CHIEF ENGINEER
NO.OF BLDG. ORD.NO. DISTRICT NO, PLAN CK. NO. PERMIT NO.
PLANS SETBACK LINE
FIRE APPROVED
ZONE BY DATE RECEIVED BY DATE OF APPL. DATE ISSUED
USE APPROVED
ZONFt i BY DATE
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
E BUILDING
p NAME ADDRESS J
K
!- W
U Z ADDRESS LOCALITY
h 6 N EAR EST -
U CITY _ CROSS ST. `
E
4 STATE TEL. NAME /3.r
LICENSE NO. NO
Z
MAIL
x I NAME ADDRESS
a ��/�, Td' peg G r4��. TEL
ADDRESS lO �`� (✓7/ C f ...LM4ro'�1L « d � �- CITY S NO.
cc
7 CITY I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
STATE TEL. AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
LICENSE NO. NO. AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
Z LOT NO. SIZE OF L T SIGNATURE OF L
® OWNER
< d NO. OF BLDGS / AUTHORIZED AGT.
W K BLOCK NOW ON LOT
�s
A W TRACTQ '` CORRECTIONS
D USE OF BLDGS. -
NOW ON LOT 6 2 -- l
DESCRIPTION OF WORK.
USE OF —
BUILDING
0
r
NEW TYPE r.,: a GROUP `
NO.OF OF
FA — —_
ALTERATION ROOMS FAMILIES
ADDITION SIZE I
REPAIR STORIES
t �
MOVING WALL COVERING A
DEMOLISH ROOF COVERINGTl
P'C.$ FINAL APPROVAL
FEE
INSPECTOR'S
.._ _
,VALUATION FEE BATE NAME
T
I
78A838A E 1803-10.56
APPLICATION FOR BUILDING PERMIT
BUILDING AND SAFETY DIVISION BUILDING
ADDRESS �
Department of County Engineer e
County of Los Angeles LOCALITY
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN, SUPT OF BUILDING CROSS ST.
DISTRICT NO. GROUP TYPE SEWER MAP
FOR APPLICANT TO FILL IN J� K PG_
J�' �'']�� ]� � CONST.X�
ADDREISS�,-J��S �/[*U` f 1/17 ?> STATISTICAL CLASSIFICATION I
LOT NO. BLOCK V CUSS. N DWELL. UNITS
MAP STATE YES O
(' NUMBER HWY
TRACT a USEZQNE SPECIAL
NO. OF SIZE OF LOT �/ 'X I ov/ I NOW ON LOTS CONDITIONS
y -----
USE OFp tv
EXISTING BLDG. Mous" 4 6/w' 4"w- BUILDING YARD HWY STREET NAME EXIST.
SETBACK WIDTH
OWNER FRONT
MAIL ,qq� _ �/ 'j� ( P. L.
ADDRESS 5 04 ��/ 1J(J1J�J t SIDE
'I TEL. F. L.
CITY "O• INSPECTION RECORD
ARCHITECT OFe TEL. —
ENGINEER /'9GuJV'�'I NO.
I _
ADDRESS
TEL. —
CONTRACTOR Ow fvdc,-'L NO.
ADDRESS
DESCRIPTION OF WORK -
NEW ADD ALTER REPAIR DEMOLISH
SCI. FT. J �^' NO. OF f NO.OF
SIZE 3 6,G STORIES FAMILIES
USE OF STRUCTURE
APPROVALS
SIGNATURE OF
APPLICANT q� DATE INSPECTOR'S SIGNATURE
ADDRESS {iy � FC UNDATION: LOCATION
i'ORMS. MATERIALS L' C-
$ M� p $ FRAME: FIRE STOPS.�— BRACING, BOLTS
FEEE
VALUATION tl FURNACE:
GAS VENT. DUCTS
N
FEE
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH. INT.
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WIT ALL COUNTY DINANCES AND LATH. EXT. f
STATE LAWS REG G _$U 'DI CONSTRUCTION.
SIGNATURE OF .�--(/f(�/(��' I HOUSE NUMBER COR-
PERMITTEE � RECT AND POSTED
ADDRESS 1 FINAL
JOHN A. LAMBIE, COUNTY ENGINEER, CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION K M.O. CASH
O 1 U 1 5AUG 1 2 1 6,p 0 0
1
COUNTY OF LOS ANGEL
APPLICATION FOR ES 4
„ DEPARTMENT OF COUNTY ENGINEER
B U I L D I N G. PERMIT BUILDING AND SAFETY DIMI ON
BUILDING L,
FOR�fAPPLICANT TO FILL IN ADDRESSBUILDING
ADDRESS •`OZ�itLOCAj-ITY' � �//�/! Q��i L/
CLTY `'C ZtPNEAREST
b CROSS ST, �1/Y� LJ�t
Q NO.Off' BLDGS. ASSES$QR
SIZE OF LOT V NOW ON LOT MAP BOOK PAGE PARCEL
DISTRICT GROUP TYPE FIRE ED BY
/n� LOT NO. CONS ZO E
::4
TRACT " BLOC
• T L.
N� O. TATIS ICAL QLA$SIFICA TION ,SEWER MAP
ADDRESS CLASS NO DWELL,UNIT$ BK PG
11S Z QN E MAP
CITY �— ZIP NO. l7v
ARCHITECT OR TEL SPECIAL
ENGINEER NO. _� CONDITIONS
ADDRESS ROAD QEPARTMENT APPROVAL REQUIRED YES❑ NOF] .
CONTRACTOR
-TEL BL G.SETBACK FROM
_ LIC.0.
FRONT PROP.LINE OF (STREET)
ADDRESS - NO. HIGHWAY + YARD = TOTAL SETCACK FROM TYPE OF EXISTING ..
LIC, FRONT PROP. LINE HIGHWAY WIDTH
CITY _ _ CLASS ,
CONSTRUCTION LEN-DER + -
NAmE.AND BRANCH BLDG.SETBACK FROM 0
ADDRESS CITY SIDE PROP.LINE OF (STREET) C.0
SQ FT. NO.QF NO. OFT CHECK HIGHWAY + YARD = OTAL_ SETBACK FROM TYPEDF EXISTING
SIE In STORIES FAMILIES ONE SIDE PROP. LINE HIGHWAY WIDTH
D'ES'CRIFTTION OF WORK EW +
DD . CORNER CUTOFF YES ❑ NO ❑
L7ER 1:1 "
_ L-tEREPA I EllIN OPEN �pACE YES E] NO ❑
USE OF IN COASTAL PERMIT ZOF{E YES ❑ NO ❑
EXISTING BLDG, ENOL [:]
APPLICANT ��� TEL
"( "
Pn1KT) VN " 4�
'RY (SIGNATURE)-, -
•1 HEREBY ACK14OWLFDGE SHAT I HAVE READ IS APPLIgATION
N .
AM STATt THAT THE ABOVE 1/ CORRECT AMD AGRff TO COMPLY
WI ALL ORDINANCES AND LAWS REYULATFNG BUILDING COR- -
STRYOTION. F CERTIFY THAT IN DOING THE WORK AUTHORIZED -
RtRESY I WILL NOT EMPLOY ANY PERSON IN YIOLATI ON OF THE
LABOR CODE OF THE STATE OF CALIFORNIA rN RELAYING TO
WORKMEN'S COM PJ< SA.TION INSURANCE. - -
SIGNATURE' OF FINA-L IS -
PERMI'rTIIE DATE ..
ADDRESS
CITY - NEO. p Fee$ Permit Fee s
t /y ` Assuancb Fee
VALUATION$
Total Fee
-PI" CHECK VAIJOATION CK. M.O. CASH PERMIT VALIDATION cK- M.O. cwsH
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PPLICATION FO'k COUNTY OFILOS ANGII.
1 PERMIT- DEPARTMENT OF COUNTY ENGINEER
L I N C7 BUILDING AND SAFETY DIVISION
BUILDING /
FOR APPLICANT TO FILL IN ADDRESS N
BUILDING ��yy c"' �`
ADDRESS V S A - �` LOCALITY
CITY IL '� ZIP O NEAREST
CROSS ST. �
NO.OF BLDGS. ASSESSOR
SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL
DISTRICT IGROUP TYPE FIRE P OCESSED BY
T .RAC ONSTZON
BLOCK LOT NO. � D
/� ] TEL. ,
OWNER y /ld NO. STATISTICAL CLASSIFICATION
„ $EWER MAP
ADDRESS V� Q L/\ Dt CLASS NO-��DWELL,UNIT3 BK PG
US Z E MA P
CITY 0012 & r i ZI NO.
ARCHITEC OR TEL SPE AL
ENGINEER ` NO. 0� CONDITIONS
ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED-, YES[] NO ❑
CONTRACTOR TEL. BLDG.SETBACK FROM
LIC. FRONT PROP.LINE OF .(STREET)
ADDRESS ! NO. _ TOTAL SETBACK FROM TYPE OF EXISTING
NIGHwA } YARD
CITY LIC.
FRONT PROP. LINE HIGHWAY WIDTH
cLASS _
CONSTRUCTION LENDER +
NAME AND BRANCH BLDG,SETBACK FROM o
ADDRESS CITY SIDE PROP.LINE OF (STREET) C�
SQ. FT. NO. OF NO. OF CHECK HIGHWAY + YA RD = TOTAL 9 K FROM TYPE OF, EXISTING
SIZE STbRIES FAMILIES ONE SIDE PROP. E HIGHWAY WIDTH
DESCRIPTION OF WORK
NEW ❑ + _ I W_
DD CORNER CUTOFF ' YES ❑ NO
` ALTER
IN OPEN SPACE YES ❑ ANO ❑
-REPAIR
USE OFIN COASTAL PERMIT ZONE YES �.,., N'O ❑
EXISTING BLDG. I=MOL
APPLICANT TEL -
(PRINT) NO.
BY (SIGNATURE) '
I HEREBY ACKNOWLEDS[ THAT I HAVE READ THIS APPLICATION
AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION. IC
THAT IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
LABOR CODE OF TME STAT[ OF CALIFORNIA IN RELATING TO
WORKMEN'S CO M P[NSATION INSURANC[. /
SIGNATURE OF FINAL BY
PERMITTEE DATE
ADDRESS 0
TEL. PC_ Fee$ Permit Fee Q
CITY NO. a�
Inuance Fee n
VALUATION$ J1 if 4Total Fee Q TJ
PLAN CHECK VALIDATION cIL M.o. cAsH PERMIT VALIDATION CK. M.o. CASH
4.' 3��It}V 1'J 1 U 69-0 O
?GAGGaA CIE 00030 11/75 l GA S
7GA688A CE#803 10-68 APPLICATION FOR BUILDING PERMIT n 1
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY '
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
CASSATT D. GRIFFIN, SUPT OF BUILDING CROSS ST.
DISTRICT NO. GROUP I TYPE PRO -D
FOR APPLICANT TO FILL IN CONST. _
BUILDINGSTATISTICAL CL SIFICATION I SEWER MAP
ADDRESS '' CLASS.NO. DWELL.UNITS GS
LOT NO. BLOCKMAP STATE YES NO
NUMBER o 0 HWY.
TRACT USEZONE SPECIAL
NO.OF.BLDGS CONDITIONS
SIZE OF LOT I NOW ON LOT
USE OF
EXISTING
EXISTING BLDG. " a BUILDING YARD HWY STREET NAME EXIST.
SETBACK WIDTH
OWNER FRONT /
AILP.L.
ADDRESS ,,�C�p� 7),Ls'Q,Q, �L.� SIDE
TEL. P.L•
CITY 11,: NO. INSPECTION RECORD
ARCH ITECT OFt, TEL. _
ENGINEER NO. -
ADDRESS
TEL. `
CONTRACTOR NO.
ADDRESSL'5,X.)
DESCRIPTION OF WORK
NEW ADD ALTER REPAIR DEMOLISH
SQ.FT. NO.OF NO.OF
SIZE STORIES FAMILIES
USE OF
STRUCTURE
SIGNATURE F
APPLICANT
APPROVALS DATE INSPECTOR'S SIGNATURE
ADDRESS t'S , FOUNDATION:LOCATION
FORMS,MATERIALS
VALUATION$ QOO. FRAME: FIRE STOPS,
BRACING,BOLTS �� ` `
FURNACE:LOCATION,
FEE $ I FEE $ _GAS VENT,DUCTS -
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP-
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND LATH.INT.
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATE LAWS R ING 1 CO STRUCTION. LATH.EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTE RECT AND POSTED
ADDRESS t• FINAL
CLYDE N. DIRLAM, PRINCIPAL ST URAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK, i M.O. CASH
M [JC 5 3 9 4 ,TAN 1 9 1 A 6.00
not,
T
76AG38A OBS-3 3.55
APPLICATION FOR BUILDING PERMIT 1
DIVISION OF BUILDING AND SAFETY ADDRESS 4-
Department of County Engineer V '
County of Los Angeles LOCALITY
WM.J. FOX, COUNTY ENGINEER NEAREST
CASSATT D. GRIFFIN, SUPT OF BUILDING CROSS ST.
DISTRICT NO. GROUP � SEWER MAP '
FOR APPLICANT TO' FILL IN h t NST. ..- I BK PG}�
ADP STATE
DRESS v '7 L'S •'�1`S D✓ /{c'War rib _NUMBER � O��1i HWY ��ifj)
n i�Gi
LOT NO. / BLOCK US SPECIAL
CONDITIONS
TRACT V
Q i NO. OF BLDGS. y BUILDING EXIST.
SIZE OF LOTI?/ X 3�-.�' NOW ON LOT SETBACK YARD HWY STREET NAME n WIDTH
USEOFr` �. FRONT
EXISTING BLDG. c '•'� P. L. •LE// �L_(L_
OWNER /'�V L /i_!"ICI�w.,,/ SIDE
,,11 lt ']� P. L.
ADDRESS VV aryl{ Pf' O TRACT DWELL. I UNIT
5 INDUSTRIAL
CIT;� TEL._ 1 DWELL. I UNIT
(F Lf _ f�7 NO.R) 9�(A 6 PUBLIC BLDG.
2 DUPLEX I UNIT
ARCHITECT OR TEL. 1,7 ADDN.,ALT.. ETC.
_ENGINEER OLV N�FIy' NO. 3 APT. UNITS
$ MISCEL.
ADDRESS 4 COMMERCIAL
TELCONTRACTOR OW N f i- NO.' INSPECTION/RECORD
AdpDRESS ,(
DESCRIPTION OF WORK
NEW ADIK ALTER REPAIR DEMOLISH
Cl. FT. / j NO. OF NO.
SjF
SQ. STORJE$ _ FIMILIES/
USE r- RE -
�lxG
SIGNATURE O APPROVALS
APPLICANT
ADDRESS � tI Ir ✓ Fi'� %. DATE INSPECTOR'S SIGNATURE
P. C. ffi FOUNDATION:
FORMS. MATERIALS LOCATION
�- e— d�� FEE FRAME: FIRE STOPS,
5 6
VALUATION ffi e1Q. BRACING.BOLTS
FEE U FURNACE: LOCATION.
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GAS VENT.DUCTS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL CQJAVY ORDINANCES LATH, INT.
AND STATE L EGULA ING B L NG CONSTRUC-
TION.
LATH, EXT.
SIGNATUR60F]&_1 HOUSE NUMBER COR-
PERMITRECT AND POSTED
aDDREs `/`g "�1 f FINAL
WM.J.FOX,COUNTY ENGINEER -"'VALIDATION C. N. DIRLAM, CHIEF BLDG. INSPECTOR
CO3 4 8 ?'" F'ER 2 7 1 1 0.0 0 n