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APPLICATION-FOR iC LDING PERMIT
COUNTY OF LOS ANGELES__ _ _ - BUILDING AND SAFETY
FOR APPLICANT TO FILL IN EE
NG ` �lSS C� vLDINGADDRESS ITY Y ST CITY S ZIP STNO OF BLDGS ORSIZE OF LOi 65 ZF GF NOW ON lOT GLrm4r OOK ` �- T PAGE PARCEL
RICT GROUP TYPE FIRE P ESSED BY
TRACT BLOCK LOT NO G CONST - ZONEJ 3 3TICAL CLAS�SsIFICATION '-- SEWER MAPADDRESS SS NO C/� DWELL UNITS BK7/PGSTY zlP �3 Ty,2�ARCH) OR TEL TIONENGINEER - - - NO-
ADDRf ETBACK FROM
TEL FRONTPROP UNEOF (STREET) '
CONTRACTOR NO tHIGHWAY
Y + YARD TOTAL SETBACK FROM TYPE OF EXISTING f
IC FRONT PROP LINE' HIGHWAY /WIDTH
ADDRESS CITY CCONSTRUCTION LENDER - — - - _ _ _ BACK fROMNAME AND BRANCH LINE OF ISTREETI
+ YARD -TOTAL SETBACK FROM TYPEOF EXISTING
ADDRESS CITV SIDEPROP LINE I HIGHWAY WIDTH Q
SO Fi NO OF _ NO OF _ _CHECK +
SIZE / STORIES FAMILIES I V ONE O
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DESCRIPTION 6F WO -— -' NEW ,(,/J OSPECIAL 1(L�
ADD „ CONDITIONS
ALTER FINAL -7 q BY
REPAIR DATE a `
USE OFs
EXISTING BLDG - DEMOL r _ _
APPLICANT NEL
IPRINT C NO / -
G3 • .
BY ISIGNATUREI _ . _ —_ t
I HEREBY ACKNOWLEDGE THAT I HAVE READ TKXN AND SLATE _ m
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH Alt ORDINANCES ,_ -) - ,.. __ _ -_ • Ell r V 1-7; gf�-, ,1• ,
AND LAW$REGULATING BUILDING CON$TRuCTION I CERTIFY THAT IN DOING THE _
WORK AUTHORIZED HEREBY WILL NOT EAWOY ANY PERSON IN VIOLATION OF 1 V
THE LABOR CODE OF THESTATE OF CALIFORNIA IN RELATING TO WORKMEN SCOM _ _ _ _ __ _ _ __ � •„� �—,��
PENSATION INSURANCE • '
SIGNATURE OF - - _ - - -_ _- -- _ - _ �� �•
PERMITTEE
ADDRESS n F• T• }
R G
CITY / K 0 22 .3 •GV _
PC Fee$ Permit Fee > 3'(r -60
Issuance Fee
_ Total Fee-- ^a ,J _ , ,
451
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APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES - BUILDING AND SAFETY 3_O,Z-O.ZBUILD ' L
NG
FOR APID A TO FILL IN ADDRESS L6�-rpt'
BUILDING
ADDRESS LOCALITY f
NEAREST
Cli P CROSSST
NOOFBLDGS ASSESSOR
SIZE OF LOT D NOW ON LOT �7� MAP BOOK PAGE PARCEL
DISTRICT GROUP TYPE FIRE P ESSEp BY
I PACT BLOCK LOT NO QQ �� CONST
TIL �� JJ
OWNER NO
STATISTICAL CLASSIF TION SEWER MAP
ADDR 0 ,lZ CLASS NO O DWELL UNITS � BK'/ PG
CITY ZIP V
ENG NEER ARCHKIECT OR NO TEL VALUATION $ /aQ�Q,
ADDRESS BL ETBACK FROM
TEL FRONTPROP LINE OF ISTREETI
CONTRACTOR NO HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING
LIC FRONT PROP LINE HIGHWAY WIDTH
ADDRESS NO �7
U O + 1Q - �O r /
CITY' CL's BLDG SETBACK FROM
CONSTRUCTION LENDER SIDE PROP LINE OF ISTREETI
NAME AND BRANCH
HIGHWAY + YARD TOTALSETBACK FROM TYPE E%ISTING
ADDRESS CITY SIDE PROP-TINE HIGHWAY WIDTH
SOF NO OF NO OF CHECK +
SIZE O STORIES FAMILIES-1- ONE a
DESCRIPTION OF WOR 00 Z6jNEW P C Fee E Permit Fee741SO
W ADD T77 2 0
Issuance Fee
ALTER _ 7 /
REPAIR ❑ Total Fee
USE OF
BLDG DEMOL �. �. X�S( Z
APPLICANT TEL ' V N ^
(PRINT) Q,# NO —2,a ]�OC
BY ISIGNA 450 iR '7 O
HEREBY AC WLEDG HAi HAVE READ i 5 APPLI ON AND STATE /
THAT THE ABOVE CORREQ ND AGREE i0 COMPLY WITH A ORDINANCES
AND LAWS REG IAA G CONSTRUCTION I CERTIFY THAT MING THE '
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF '
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN 5COM _ �9256A
PE TION INSU
SIGNATUR
PERMITTEE 2 - 72850
JADDRESS
TEL � • • 72850
CITY NO - 0 0 3 0'6'-8 0
USE ZONEMAP O
1 SPECIAL
!!!/// CONDITIONS
FINAL V BY /
DATE
T.wuu P..s a.. 5 del _
APPLICATION FOR BUILDING PERMIT 1
DIVISION OF BUILDING AND SAFETY BUILDING
�
DSan1 of County Fn♦� ADDR2HG S
COnwT of Los Angel" LOCALITY
WM J FOX, COUNTY ENGINEER NEAREST
CASBATT O GRIFFIN SUP T OF BUILnING C S BT
O SBN'�e 4 ef
DISTRICT NO GROUP I TYP[ SEW K MAP
FOR APPLICANT TO FILL UT 9soBUILDN
ADDRLQS 16 MAP 0} STATE
NUMBEA VL HIVYTAT YtS NO
LOT NOS " 0P LDT-0:// BLOCK US ZONZI SP IAL
CONDITIONS P I OT' PLA
TRACT
L� �j 1 NO OF BLOOM 01 BUILDING QIBT
512E OP L �7 1 NOW ON LOT S^I S¢fBACK YARD NWT BTNEET NMS WIDTH
UB¢OF ` I ONT /LD
1
OWNERooe
Ai A G BIDE
MAIL - �e r,e O TRACT DWELL I UNIT
ADORES! 8 INDUSTRIAL
TEL• 1DWELL. 1 UNIT
CI O B PUBLIC BLDG
ARCHITECT OR Ta I$ DUPLEX 1 UNIT 7 ADDN ,ALT ETC.
ENGINEER NO 9 APT _UNITS
8 MIBCBt.
R 4 COMMERCIAL
TEL INSPECTION RECORD
CONTRACTOR NO
ADDRESS /
DESCRIPTION OF WORN legs 7.4s
NEW ADD ALTER REPAIR DEMOLISH
NO OF
y=Q Q 0 STORIES FAMILIES
USi OF STRUCTURE 4r 1 hC L ^_ ar
e F =P lA Tt
SIONAT RE OF V
APPLICANT APPROVALS
ADDRESS ATi INSPJCTOR S SIGNATURE
�r FOUNDATION LOCATION C-
S r /0) y O O P C. 0/y 0 FORMS, MATERIALS
J
I Q REE /m— FORAGING BOLTS
E FIRE STOPS.
VALUATION O B �Q
FURNACE LOCATION
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ "IS GAB VENT DUCTS
APPLICATION AND STATE THAT THE ABOVE IB CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH INT ^
AND STATE LAWS REGULATING BUILDING CONSTRUC. `/'
TION LATH EXT IS 5r.
SIGNATUREOP HOUSE NUMBER COR-
PERMITTH RQCdr
T ANO POSTED �-� G.
ADDRESS-2P INAL u
WM J FOX.Cou NTY ENGINmm VALIVATION C N DIRLAM CHIEF EILDo INSPECTOR
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