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IA99BAC6 19"6O APPLICATION FOR BUILDING PERMIT .
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COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS /
BUILDING AND SAFETY DIVISION LOCALITY /
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST.
DISTRICT NO. GROU TYPE ..� O SED BY
FOR APPLICANT TO FILL IN -51 CONST.
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r STATISTICAL CLASSIFICATION I S ER MAP
ADDRESS 1�J / S t• lw BK SPGCLASS.NO. DWELL.UNITS-
L TN OCK MAP p STATE
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YES NO
NUMBER �(� HWY.
TRA USE ZONE SPECIAL
` O.OFBLDGS. CONDITIONS
SIZE OF COT ?NOW ON LOT /�
USE OF 1/ J
EXISTING BLDG. vo 'g- "'- BUILDING EXIST.
E N
YARD HWY STR E
TEL. SETBACK � WIDTH
OWNER Y (-? "-P ZG? O. FRONT ol /J
ADDRESS . + J _tiL- SIDE T
ARCHITECT OR TEL. P.L.
ENGINEER NO. INSPECTION RECORD
ADDRESS �j a
/J TEL. - 7/-41 i'� 0
CONTRACTOR G"A�' p f • ( P'I'1NO.
ADDRESS lf�o�: S� Aa."?l�Va 7>D�' �1.�. J /y �/VCU' I•� � O
DESCRIPTION OF WORK 0
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D ALTER REPAIR DEMOLISH Z
L Y NO.OF ] NO.OF (]7'LSFE /7-
SIZE fIY
) STORIES / FAMILIESJ� C�OFC \/ _ ,29" •`-='�- f-������w`��.x �+ ry / _$ r V A� L`� t7��fV / �N�O �(�i'1 �`II�`�
APPROVALS DATE INSPECTOR'S SIGNATUREP C% PMT —�
d FOUNDATION: LOCATION +� 9 / y'/� /'f
FEE $ I I FEE $ FORMS,MATERIALS qI/ f:�IIIUJ
FRAME:FIRE STOPS, 7
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS ,1S -A -6) /:=7�'l-;l1��1! '?/I
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 THE PERFORMANCE cI
OF THE WORK FOR WHICH THIS PERMIT IS ISSUED I SHALL NOT LATH,INT,
EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBUECT
TO THE WORKMEN'S COMPENSATION LAWS OF CALIFORNIA. R
e LATH,EXT.
SIGNATURE(OF HOUSE NUMBER COR-
PERMITTM RECT AND POSTED 2
ADDR SS FINAL
CLYDE N. DIRLAM, PRINCIPAL STRU RAL ENGINEER
PLAN CHECK VALIDATION. CK, M.O. CASH PERNUT VALIDATION M.O.M.O. CARR
-.11-10 4 2 0 1 ? I 0 15.0