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APPLICATION FOR BUILDING PERMIT Z
COUNTY OF LOS ANGELES ABUILDING
DDRESS /G
DEPARTMENT OF COUNTY ENGINEER
BUMNG AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE, COUNTY ENGIN[HR NEAREST
WILLI JENSE T BULOINO CR0888
DISTRICT NO GROUP I TYPE PR H88ED BY
FOR APPLICANT TO F=IN CO'ST
BUILDING �j BTATISTICALQC CLASSIFICATION SEWER MAP
ADDRESS
CLASS NO DWELL UNI O MK PO
LOT NO BLOCK MAP STATEBER YES NO
�.Z��3 U8 ZON�O / HWY
TRACT �.y� SPECIAL
SIZE OF LOT
J' ;P•3� ? NOWOF ON LSLOGS CONDITIONS
USE OF
EXISTING BLRgx&.Sb BUILDING
TEL SETBACK YARD HWY STREET NAME EXIST
OWNER E NO D a FRONT
P L o�
41,
ADDRESS // SID
ARCH g
ENO NIEER OR Ir a NO L
INSPECTION RECORD
ADDRESS
TE
CONTRACTOR OL ^
ADDRESS 8
DESCEnMON OF WOES /° �e (` ` .ter �C % �a�/ %�O 0
p P is
NEW ADD TER REPAIR DEMOLISH r—
SIZE
H SEO NO OF NO OF II o /
(O STORIES FAMILIES / P ! ,��I
USE OF
STRUCTURE IV #
I /
J
APPLSIGNATURE
ICANT -
VALUATION
APPROVALS ItATH INSPEC40R 99 GNATURE
PC PMT -0-0FOUNDATION LOCATION -�
FEE PEH _ FORMS MATERIALS D
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FRAMBRAE P , STOPS
CINGGBOLTS
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND FURNACE LOCATION,
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND GAS VENT DUCTS
STATE LAWS REGULATING BUILDING CONSTRUCTION
I CERTIFYTHAT IN DOING THE WORK AUTHORIZED I LATH INT
WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
WORKMEN S COMPHNS ON WS OF CALIFORNIA LATH EXT
SIGNATURE OPHOUSE NUMBER COR-
PHRMITT RECT AND STED
DDR FINAL
CLYDE N DIRLAM PRINCIPAL STRUCTURAL E �
PLAN CHEM VALIDATION « No cA.H PERM VALIDATION CK NO �
LACO 3 3 7 8 2 JUL 11 10 5.0 U 0,
£c
ZO `°-
A ROAD DEPT f`_R"d'T 13 OR WORK
FOR ANY MATERIAL ST-,A'
} DONE IN THE ROAD RIGHT OF WAY.
APPLICATION FOR BUILDING PERMIT 1
COUNTY OF LOS ANGELES BUILDING
DEPABTMENTI OF COUNTY ENGINEER
DRESS
BUILDING AND SAFETY DIVISION LOaALITY
JOHN A LAMBIE. COUNTY ENGINEER NEAREST
CA88AT7 D GRIFFIN SUP TOE BUILDING CROSS ST
DISTRICT NO I GROUP TYPE P HD BY
FOR APPLICANT TO FILL IN CONST
BUILDING STATISTICAL CLASSIFICATION SEWER MAPpppOOG
ADDRESS K 0
CLASS NO WELL UNITS C.
LOT NO ee BLOCK MAP STATE YES O
NUMBER HWV
TRACT USE ZONE SPECIAL
NO OF SLOGS CONDITIONS
SIZE OF LOT-355( ,Z .� NOW ON LOT n A
USE OF
EXI9TIN0 BLDG BUILDING YARD HWY REST NAME EXIST
SETBACK WIDTH
OWNER FRONT
MAIL /, L/ P L
ADDRESS TI D D A61I-4i sr y SIDE
C NOL / P L
CITY INSPECTION RECORD
ARCHITECT OR �� TEL
ENGINEER NO
ADDR IF
(A-�( T
CONTRACTOR TE Q O F /LL
ADDRESS 7 f e' LC /�k ulli e
AST iJo A /l OO c/a/
DESCRIPTION OF WORK /�r 4io s
'GO
NE& 3
ADD ALTER REPAIR DEMOLISH -
SO FT �/ NO OF NO OF Q. („ A
SIZE 6 5 STORIES FAMILIES
USE OF J
STRUCTURE 0�((
lhl
SIGNATURE OF
APPLICANT
APPROVALS DATE INSPECAOR 991GNATURE
ADDRESS Z E. dfC C l FOUNDATION LOCATION
FORMS A.
VALUATION f Q10-0 FRAME F RESTOPS I/, �^
BRACING BOLTS
PC SU MT FURNACE LOCATION
P
FEE
t FEE ` GAS VENT DUCTS 7/
1 H REBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH INT
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATE LAWS RE TING BUIL CO STRUCTION LATH EXT ll
SIGNATURE OF r HOUSE NUMBER COR-
PERMITTE RECT AND POSTED
ADDRE FINAL
CLYDE N DIRLAM PRINCIPAL STR URAL EN INlHR
PLAN CHECK VALIDATION .IL NO O H PERNIIT VALIDATION (cK) M G CAGH
L,1G,0 7 0 7Q ilAY 12 2 3 A 13 .5 0 1 r;
m.
n U&2 1 2 0 2 JdfJ 13 1 D 2700