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T••••�a+N•P•I APPLICATION FOR BUILDING PE IT
COUNTY OF LOS "mm
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DEPARTMENT OF COUNTY ENGUq= ADDRE88 6
BUIIADQG AND SAFETY' DrMON LOCALrrY
JOHN A LAMBIE. COUNTY ENGINEER NEAREST
WI 1 A JENSENorl a CROSS ST
FOR APPLICANT TO FILL RJ DISTRICT NCO' CONST
GR LAP TYPE P HD BY
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BUILDING �E--- STATISTICAL CLASSIFICATION SEW MAP
ADDREHB /
CLASS NO A1DWELL UNITS — [i
LOT NO BLOCK WATER NOT REQUIRED RECEIVED
CERTIFICATE _
MAP ( IGHWAY STA+E MAJOR SECOND CAL
NO OF SLOGS NO ICIRCLEI
SIZE OF LOT NOW ON LOT USE ZONE SPECIAL
USE OF CONDITIONS
EXISTING BLDG /
TEL
OWNER NO BUILDING EXIST
SETBACK YARD HWY STREET NAME WIDTH
ADDRESS FRONT
ARCHITECT OR TEL P L
ENGINEER NO SIDE
L �
ADDRESS TEL / INSPECTION RECORD0_
CONTRACTOR NO Q
ADDRES
DESCRIPTION OF WORK r
NEW DO ALTER REPAIR DEMOLISH I Z
SO FT NO OF NO OF
IZE STORIES FAMILIES /
USE OF
STRUCTURE O
`SIGNATURE OF
APPLICANT
VALUATION S
APPROVALS DATE ' INSPECTOR l SIGNATSRE
PC PMT FOUNDATION LOCATION
FEE FE! FORMS MATERIALS
FRAME FIRE STOPS
1 HER[CY 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 ORDINANC ME AND STATE LAWS REGULATING GAS VENT DUCfB
BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
AUTHORIIED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT I
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT _
ING TO WORKMEN S COMPENSATION I URANCE LATH.EXT e /
SIGNATURE O �J� ���///_ HOUSE NUMBER COR-
PERMITTEE � �/5 ' ,! REMAND POST D
ADDRESS FINAL
CLYDE N DIRLAM. P INCIPAL STRUCTURAL
PLAN CH= VALIDATION a no CASH PERMIT VALIDATION o«. no
LAW" 3 0 8 1- APR 2 2 1 D
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DEPA9TMENT OF'BUILDING AND' SAFETY" APPLICATION FOR PERMTf
COUNTY OF LOS ANGELES'
• - WM J FOX. CHIEF ENGINEER ,..1�'LLQ�Y r BUILDING Y
_ + FOR APPLICANT TO FILL M_ , FOH OFFICE USE ONLY
'BUILDING -•..S _ D18TR1(�NO PLAN K/NOO PQR T NOF1
ADDRESS+ • , 1-J + a "J( G
LOCALITY 1 1LJ ' )' w4RQ IVSD BY DATE OF APPL DATA IB /6D
NEAREST 11r �+�
•- CROSS ST
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OWNER` —>
MAIC '+ ' + ••' + ,., ,V LOCALITY
ADDRESS _ iCROSBY
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CITY ' .0 - TE PIRQ-, NO OF�j TY GROt7—
f ARCHITECTO TEL.I'D .,•" ZONE PLANE )
HNOINESL NO BLDG /
-'- -, SETBACK LIN[ C.^
ADDRHBD' <� , APPROVED
f., TEL ` ^ BY DATE
CONTRACTOR`- NO ' ' �� US[ APPROVED
• 1 / < + • •, v J ,, _ ;ZON6 BY DAT[
ADDRESS.. HOUSE NUMBERING
LEGAL
P'D[BCRIPTION / LOT NO _ _ I BLOCK _ �; MAP,NUMB 18LD CHECK BY
NO .ASSIGNED AT
_TRACT
• �• ' INO OF SLOGS CORRECTIONS —
BIZ[OF LOT NOW ON LAT r
Uee OF- :f i NO OF
EtISTINOB�- q '!A •Perluu -" r14
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`L 1• DESCFXMON OF WORE'
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NEW ` ALTERATION ADDITION,
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REPAIR I I-L DEMOLITION } �, 1• 1 ?
SO FT . ;. !. NO OF i Ar
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Slzr ROOMS STORIES
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ECT-WALL OF'
COVERING , ERING I
r
USE OF BTRU [
_ . .,_ ., .- APPR ,, ,,,u
t l INBPE SIGNATURE DAT['
ITA[R[BY ACKNOWLEDGE THAT 1 HAVE READ THIB_AR FOUNDATION LOCATION, G r
PLICATION AND STAT[ THAT THE INFORMATION GIVEN IS FORMS, MATERIALS
CORRECT ' +. .�i•7... r 1 (` •1 _
1 AGRQ[ TO COMPLY WITH THE CORRECTIONS LISTCD FORMS,FIR BOLTS RAME u }g JZ
X[RGON AND WITH•ALL' COUNTY ORDINANCES AND STATE ,
LAWS REGULATING BUILDING CO BTRUCTION 8 FURNACE LOCATION._ 1
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SIGNATURE OF ) GAS V[NT, DUCTS
PEIMITT �.d�r LATH. INT
ADDRESS�.7� �Y �� LATH. EX
AUTHORIZED AOT r
PLASTER. INT Q
)MNM om TPN f P E B _
® 3L�V P� B / PLASTER. EXT
VALUATION v
FEe ` FINAL Q^�
-TEMPLE CBTY
>••n�a+•e•I�l APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES ABUILDNO
DORESIS S -
DEPARYMENT OF COUNTY ENGWEER
MUDING AND SAFETY DrMON LOCALITY
JOHN A LAMBIE. COUNTY ENGINum NEAREST
WI AM A JKNSEN. QUIPT of Bu CROSS ST
FOR APPLIC TO FILL IN DISTRICT NO G �P PROCESSED BY
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BUILDING BTATIbTTICAl CLASSIFICATION SEWER MAP
ADDRESS BK♦♦'' PG
r� CLA89 NO WeLL UNITE ^ -7Z1
LOT NO G(1 BL K WATER NOT REQUIRED RECEIVEDLi
Z —�3 CERTIFICATE
TRACT
NO OF BLDGS NO o' A IICIIRCYL
ZE' STATE MAJOROC
SECON
SIZEOFLOAY
1J NOW ON LOT USEZONE SPECIAL
USE OPCONDITIONS
EXISTING BL TE I
OWNS NO. l BUILDING EXIST
SETBACK YARD HWY STREET NAME WIDTH
ADDRESS FRONT
ARCHITECTOR TEL P L 70 S ARE ASV- Q
ENGINEER NO HIDE
ADDRESS
TEL ON RECORD p
CONTRACTOR NO � V
n m,
ADDRESS i� �'� �T
DESCRIPTION OF WORK � 1 �
ADD ALTER REPAIR DEMOLISH w�
SO FT NO OF NO OF ?
IZE STORIES FAMILIES '
USE OF
STRUCTURE E
2-71 14
8I0NATUR!O `
APPLICANT
VALUATIONS 6o -
APPROVALS DATE INSPECTOR 5 SIGNATURE
PC pM — A YomFOUNDATION LOCATION
FEE F!E K� ,• FORMS MATERIALS
FRAME FIRE STOPS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITH ALL COUNTY ORDINANCEY 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 LATH INT
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT
INO TO WORKMEN S COMPKNGAT109 INSURANCE LATH EXT
BIGNATUREOE%% ��� HOUSE NUMBER COR-
PERMITTEE RISCT AND POSTED
ADDRESS FINAL,
CLYDE N DIRLAM. PRINCIPAL STRUCTURAL EN
PLAN CE= VALIDATION cE. M G cABH PEBM T VALIDATION cm. M G
L PCo 5 2 9 6'- ;AAY <7 1 D 4 0 0
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7a.636A CIE 4;803 6.e2APPLICATION FOR BUILDING PE MIT '
COUNTY OF LOS ANGELES ADORES G Q
DEPARTMENT-OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY _ /
If
JOHN A LAMBIE COUNTY ENGINEER NEAREST '
WILLIAM A JENBEN SUP T Or BUILDING CROSS ST
DIST T O GROUP TYPE ROC SED BY
FOR APPLICANT
rT(O� FILL IN el CONST
FINIINEER
SS 5ZV SGR6No P{2_ STATISTICAL CLASSIFICATION SEWER MA
T Q CLASS NO DWELL UNITS
LO WATER NOT REgUIRED RECEIVED
CERTIFICATE
/ - Z— MAP HICHwAr
LOT O f + NNO OF OW ON LOTS NO I"HWAt STATE MAJOR SECOND OCAL
USEZONE SPECIAL
r prO �S CONDITIONS
G BLDG _ 1 L '`Ct
TAI {_iON TEL -b16�1 BUILD NG YARD HWV STREET NAME EXIST
SETBACK WIDTH
SS �t• FRONAR, T ♦
ER'TET OR rA FER'Rt L,. NO SIDE
P L d
SS T 1 O
CTOpRR Cpp RL1 F. POOL"',
ADDRESS 88 V L-PVC�JVNPSS.G
O
DESCRIPTION OF WORE
NEW AD i ALTER REPAIR DEMOLISH
Sq FTp NO OF NO OF
S
SIZE C301•AA STO/rR�IES FAMILIES
E �
CTURE U3ft v I
STOPL—
0
SIGNATURE OF
APPLICANT
VALUATION E 4�QQ OG
APPROVALS DATE INSPECTOR Y SIGNATURE
PC PMT FOUNDATION LOCATIO ) /
FEE FEE S FORMS MATERIALS 1.2 V16 •,
FRAME FIRE STOPS
1 HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS t
AND 6T T[ THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION
WITH ALL CO UNtY ORDINANCES AND STAT[ LAWS REGULATING GAS VENT DUCTS
BUILDING CON6TRU ION 1 CERTIFY THAT IN DOING TH[ WORK
AUTHORIZED E.
WILL NOT ENP Y ANYZAL
VIOLA LATH INT
TION OF THE LASO ODE OF THE Bt O R£LAT
IND TO WORKMEN S JP[NSATION IN U N LATH EXT `
SIGNATURE OF HOUSE NUMBER CORPERMITTEE 0./MA/J RECT AND POSTED
ADDRESS FINAL /
JOHN F LEWIS I, NCIPAL ST RAL ENGINEER
I PLAN CHECK VALIDATION CK M O GASH _ PERMIT VA ATION' CK NO CASH
r
LtILo 1 8 1 6.d r hR 8 z 3 D 5.5 0
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APPLICATION FOR Il
BUILDING` PERMIT
FOR APPLICANT TO FILL IN noon
BUILDING
ADDRESS O r r LOCALI
NEAREST
CITY ZIP CROSSST
NO OF BLDGS _ ASSESSOR
SIZEOFLOT O NOW ON LOT p3 MAP BOOK PAGE PARCEL
TRACT BLOCK LOT NO )"�y DISTRICT GROUP TYPE FIRE P ED
r CONST ZONE
OWNER Li TEL J
NO :1143 IkAl
STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS rt OASS NO DWELL UNITS /N`BK71-fl.
GTV .Q ZIP ONE MAP
ARCHITECTOR TEL F NO
ENGINEER NO SPECIAL _
CCRJDITIONS
ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED - VES ❑ NO❑
fl
CONTRACTOR DIV-J'/,Q NO BLDG SETBACKOM
LIC FRONT PROP LINE OF -ISTREET)
ADDRESS - NO
LIC HIGHWAY _+ YARD FRONT PROP LINE HIGHWAY WIDTH
CITY - -- - CLASS ---• -
CONSTRUCTION LENDER + a
NAME AND BRANCH - - BLDG SETBACK FROM + S
ADDRESS CITY SIDE PROP LINE OF ISTREETI
50 FT-/ p NO OF NO OF CHECK HIGHWAY + YARD T051DE PRBACK OP INEOM HIGHWAPE Y EWSDTHG G
SIZE / STORIES FAMILIES ONE a
+ Z
DESCRIPTION OF WORK NEW ❑ -
ADD CORNER CUTOFF YES ❑ NO ❑
ALTER IN OPEN SPACE YES ❑ NO ❑
REPAIR
LISE OF 'y�(• _ _ IN COASTAL PERMIT ZONE YES ❑ NO ❑
EXISTING BLDG /1 lJ DEMOL
APPIPRRIINTIS4µ7" HI LI No.19
T TEL ,
BY ISIGNATUR _
I P
I HEREBY ACKNOWLEDGE THAT VE READ THIS APPIIUTION AND SPATE` `
THAT THE ABOVE a CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES
AND LAWS REGULATING BLAMING CONSTRUCTK)N I CERTIFY THAT IN DOING THE
WOW AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF
THE LABOR CODE OF THE STATE OF ULIFORNIA IN RELATING TO WORKMEN S COM
PENSATION INSURANCE
SIGNATURE 4DATE
2 BY
PERMITTEE ADDRESS C N .PAID Di
CITY �.Q TNSee S Permit Fee ~. �-
Issuance Fee
VALUATION$ LO d
CJ ` Z
' Total Fee
PLAN CHECK VALIDATION cIc 'mo cAsH PERNUT VALIDATION w o c"H
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