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COUNTY OF LOS ANGELES I BUILDING
WW. J. FOX. CHI[► ENGINEER
FOR APPLICANT TO FILL INN18:DDfel/
FOR OFFICE USE ONLY
BUILDING ICT NO. PLAN OK.Nd "AMIT Nd
ADDRESS 7 �� O OS
LOCALITY IV[D SY DAT[OF APPL DAT[ISSUED
NEARESTCROSS ST yNO /OWNER S C�MAIL
ADDRESS TYTOITYZ
LSTN60► TSP[ GROUP
ARCHIT[OT R TELPLANSNd dDDRESS K LIN[
APPROVED '
CONTRACTOR NO BY DAT[
W[ /f APPROVw
DR ION[ BY DATE
uoAL
D[8LEBAL QN LOT Nd BLOCK CORRECTIONS
TRACT BLOCS
SIZE OF LOT D X aO O NOW ON LCT
USE O► NO OF MO O►
BT N LDO tl
DESCRIPTION OF WORK
NEW _ ALTERATION ADDITION am
REPAIR MOVING DEMOLISH p
NO OF - F
SIZE f0 ROOMS STORIES 7F
WALL ROOF O/ "T ca
WALL NO COVERING
or NEW
BUEILDING
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I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS
APPLICATION AND STAT[ THAT THE ABOVE IB CORRECT ►OUNDATION. LOCATION INSPECTOR DAT[
AND ABREE TO COMPLY WITH ALL COUNTY ORDINANCES FORME. MATERIALS
AND STATE LAWS REOULATIN BUILDIMM CONSTq ION
FRAME FIRE STOPS.
SIGNATURE OF /..� FT, SRAOINB,BOLTS
OWNER �E� ��' 111
LATH,INT.t
AUTHORIZED ABT LATH [KT
DOD 3 23M RETS 1-47 P a.* PLASTER INT.
I'm PLABTER. CKT
VALUATION C� B —i FINAL
FE[
DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PEBMTP
COUNTY OF LOS ANGELES g U I L D i N G
WM. J. FOX. oHicr ENGINEER
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
IUILDINO DISTRICT NO PLANCK NO PERM///IyyITTNO
ADDRESS ,An .II
LOCALITY RECEIVED BY DAT[Or APPL DAT[ISSUED
NEAR[RT J
OBR
BUILDING /./.
OWNER ///I/r ADDR[SR I l�
MAIL , < LOCALITY / ILI
ADDRESS
Qln 1 -•-NO r^ �� CEST
ROSS SST �r pq0 M '
FIR[ NO OF TYPE GROUP
GNcmyrcma6 TELO N[EN T NO I „ ZONE — PLANR
4 BLOB
ADDRESS � SETBACK LINE
/ TEL r'7 � r A PROVED - DAT[
CONTRACTOR �G.4` NO 1^ /&l
useAPPROVED
ADDRESS s j ZONE BY j DAT[
LEGAL CORRECTIONS
DERCRIPr1ON LOT NO l CK
TRACT lh/�q& —/3 / - p
_SIZE or LOT Go +� /SO I NOW ON LOT 6O/ , /OO
USE Or de.�L� NO Dir
I I ROOM,,
y� "IF /
USE or RLDC rwNUIR. / aoowa {4y'•
DESCH&TION OF WORK
NEW ALTERATION ADDITION O
A
_ REPAIR MOVINBt DEMOLIRX / 0
ROOMS / STORIES / A
WALL 11 ROOF ttt r
COVERING j /uO.V COVERING
UBUILDING
E OrNG
L 7 N
IHEREBY ACKNOWLEDGE THAT I HAVE READ TRIG APPROVALS
APPLICATION AND RTATE THAT THE ABOVE IS CORRECT FOUNDATION LOCATION INSPECTOR DAT[
AND AGR[[ TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS
AND STATE LAWS REB LATINO BUILDING CONRTRUCTION
FRAME rIRE BTOPB.
RIRNATUR[OF BRACING BOLTS
PERMITTE 1�•
LATH,INTI
AUTHORIZED AOT LATH,EXT
D.e a MQIMG 7-17 $ P O S PLASTER.INT.
C..�a
FE[ / PLASTER.EXT 1
VAWATION O. 0� r[E * �O FINAL