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70A0864 APPLICATION FOR BUILDING PER IT
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COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGmm ADDRESS "
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENQINEER NEAREST
WILLIAM A.JENSEN SUPT OF BUILDING CROSS ST.
DISTIalpT NO. GRO TYPE P SED BY �
FOR APPLICANT TO FILL IN CONST.
BUILDING . STATISTICAL CLASSIFICATION S ER MAP
ADDRESS GE GVOO'D BK PG
CLAS.NO. DWELL:.UNITS '=
LOT NO. 1s BLOCK WATER NOT REQUIRED FVJ RECEIVED
TRACT SSS MAP IFIC�ATE: HIGHWAY
NO.OF BLDGS.
No. ff !J (CIRCLE) STATE MAJOR SECOND, C
SIZE OF LOT. 42 I N W ON LOT, ol-- USE ZONE SPECIAL
USE OF CONDITIONS
EXISTING BLDG..? �- �r
r TEL.
OWNER C 7 Z YU � N 6-10/ BUILDING EXIST.
SETBACK YARD HWY ST FEET NAME WIDTH'
ADDRESS 9.2,27Lf/POGfurooA I.1'�'IPLE Grr. FRONT
ARCHITECT OR TEL. P.L. 1
ENGINEER NO. SIDE
P.L. / �.
ADDRESS TEL
�7 /��NSPE�TI(�N RECORD \ O
CONTRACTOR / NO.
ADDRESS ., � !+%i!. `�%f��ir7�`..r,�:,,Y /1'l�f��•'� ':R� '•i.'fJ �
DESCRIPTION OF WPBK 7/�l/ �� ✓�'!rr-t�J �1�rz z_A <r/� t .
NEW ADD ALTER' REPAIR DEMOLISH V r' R ! Ind
N
SQ.FT. NO.OF /�.' '(j ; ?
IZE 1 a�. •. STORIES FAMILIES
STRUCTURE /V/A/G Z&M- dATAJ } �✓YG tK?rIt if iif�
l G 1
SIGNATURE OF � � � '
APPLICANT '
VALUATION$ Q Q d I
r ` APPROVALS DATE INSPECTOR'S SIGNATURE
�o FOUNDATION:LOCATION / ..-?
FEE $
FEE*S `� FORMS,MATERIALS </ !I G
FRAME:`•FIRESTOPS. l q g
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION - BRACING,BOLTSr �// ,r ////
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE:,LOCATION, /! C(%•/ fj""1/
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ' GAS VENT DUCTS
BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK /
AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- :L•ATH,IN,.T. i(!J r7!X Il/"✓f"•/''�!
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT-
ING TO WORKMEN'S COMPENSATION INSUR CE. '''
Ay� LATH,EXT.
SIGNATURE O.Fr HOUSE NUMBER•COR-
PERM ITTE 1 RECT AND POSTED
ADDRESS on r' c,
FINAL 1?S?
CLYDE N. DIRLAM, PRI CIPAL TRUCTURA E EFt
PLAN C13EM VALIDATION cK, M.O. cAsH PERMIT VALIDATION ' DK, N.O. cASR
i_,leo. 5 4 U :�.G APR 16 1 D 11.50-
fitDIVISION OF BUILDING AND SAFETY ® ' A n
. Department of County Engineer 14
County of Los Angeles
WM. J. FCX, COUNTY ENGINEER APPLICATION
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
BUILDING 9 tt�� ) �y � ) f DISTRIC O. PLAN CK.OR RED.No., PE MIT NO./
ADD EMS d1 / l.w�. l/1 I -1��aa'V✓V N A ice!
LOCALITY 'j` 'M Pj C
)7Y R 5 FIVE BY DAO�FA/PPL DATE ISSUED
NZAREBT �a moi. w ���� �1 - 6J7® � c•'r�����
CROSS ST. J' C )A/. ; 1 /�9 BUILDING
OWNER ti{ �l�J} N! ��f� ADDRESS
MAIL ; < LOCALITY
ADDRESS J vV G. D C9 IF W OO J) NJEAREBT
TlL. w CROSS ST.
CITY Ia1°1 DL E G 1`C �/ Na . I " le3o),.r' FIRE NO.OFT�PF-z—
ENGINEER
G AUP
ARCZONE I PLANS
ENGIiNEERT ORa6.
BLDQ9� j!_
Dr C
SETBACK LINE S
ADDRESS • USE / APPROVED v
�" TEL ZONE d'/ BY DATE
CONTRACTOR 6 g� /ANO. .. HOUSE NUMBERING
ADDRESS MAP NUMBER NO. ASSIGNED BY
LEGAL -�flej CORRECTIONS
_
DESCRIPTION �}�LOT NO. BLOCK
TRACT �J
SIZE OF LOT O x�( Sp I NO. 01 BLT
�...1
NOW ON LOT t�
USE OFr1 f NO.CF /
EXISTING BLDG. U �°/�; FAMILIES
DESCRIPTION OF WORK A
o
NEWALTERATION ADDITION Z
D
REPAIR �y DEMOLITION r
No.OF
so.
ZE . 20ROOMS STORIES
EXT.WALL OlOr
-COVERING f/fJUC. I COVERING C.O M
USE OF STRUCTURE 1
17Pb0aoj,-f l;A7 Al HAa,L A-bb
INSPECTION FOR ' APPROVALS
OCCUPANCYAS INSPECTORFBSIGNATURE DATE
FOUNDATION:LOCATION
FRAME: FIRE STOPS,
FORMS. MATERIALS
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP-
PLICATION AND STATE THAT THE INFORMATION GIVEN IS
CORRECT. BRACING.BOLTS
1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION,
AND STATE LAWS REGULATING BUILDING CON UOTION. GAN VENT,DUCTS
SIGNATURE CF lrlt . �.! LATH. INT.
PERMITTEE
ADDRESS
V PLASTER, INT.
AUTHORIZED AOT- -
PLASTER, EXT.
FEE HOUSE NUMBER COR-
��99, RECT AND POSTED
VALUATION ®� $ (Cs"®2; .CvI
FEE FINAL /
76A63BA D88 3 1-62
P989-3 z5M BETE 6-4B 1'
DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES BU
I L D I N G
WM. J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
BUILDING _ _�/
DISTRICT NO. PLAN CK. NO. PERMIT NO.
ADDRESS 117$-GCS ,r �.�-�- 75
LOCALITY _ ejCl�( ; RECEIVED BY DATE OF APPL. DATE BB ED
CROSSBT
CROSS 9T. BUILDING r A�Iii/i t
ADDRESS /9 WeE'/�
OWNER
MAIL /��p �„/ C
ADDRESS 1Y Of; / Y ''� LOCALITY
NEAREST �• t '�
TEL. ORD-98 9T. e / C�
FIRE NO.OF TYPE GROUP
ARCHITECT OR TEL. ZONE�l PLANS
ENGINEER NO.
BLDG. ORD. NO.
ADDRESS , SETSACK LINE
APPROVED
CONTRACTOR r 6 BY DATE
USE APPROVED
ADDRESS f ZONE BY DATE
DE CRIPTION I LOT NO. I BLD K CORRECTIONS
TRACT
NO. OF SLOGS.
SIZE OF LOT NOW ON LOT
USE OF I NO.OFI NO. OF
FAMILIES BLDG. FAMIsa ROOMS
DESCRIPTION OF WORK
NEW ALTERATION ADDITION D
REPAIR MOVING DEMOLISH 0
Sq. FT. NO.OF Y
SIZE ROOMS STORIES r
WALL ROOF
COVERING COVERING
USE OF NEW
BUILDING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION, INSPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE STOPS,
SIGNATURE OF
BRACING, BOLTS
OWNER [A` LATH, INT.:
AUTHORIZED AGT "�6
LATH, EXT.I
$ 't oP. C.9 PLA9TERr INT.
� 1 FEE
Q O PLASTER, EXT.
VALUATION
oaf 63 q
FEE FINAL