HomeMy Public PortalAbout5531 WELLAND AVE_Building__ ;- _�3
r BUILDING ADDRESS /N.
APPLICATION LOCALITY `
DIVISION OF BUILDING AND SAFETY NEAREST
CROSS 9T.
Department of County Engineer DISTRICT NO. RECEIPT NO. PERMIT NO.
County of Los Angeles 15 R"7 f¢e / 04c'7
WM. J. FOX, COUNTY ENGINEER GROUP DATE RECEIVED DATE ISSUED
CABBATT D. GRIFFIN, 9UPIT of Bu1LDING
FOR APPLICANT TO FILL IN �� IS
�N�i �j��I TYPE ONST. �ECEIVED JY ISSUED BY
OWNER 'ice -� t �i/4LU MAP /^� �/ e{(/JIYES
AMAIL DDRESS �3 � NUMBER V O STATE YES l�
G G p rUSE ZONE SPECIAL
CITY NOL. p CONDITIONS
ARCHITECT OR TEL.
ENGINEER NO.
BUILDING YARD HWY STREET NAME EXIST.
SETBACK WIDTH
ADDRESS I
TEL. / PONT of
CONTRACTOR d)�� �¢j)� �N/O. F.P. �y � BIDE
ADDRES8011BGDWg /e df910T P.L.
BUILDING t- +� L DATE CORRECTIONS INSPECTOR
ADDRESS V�7. G�lK.C. co) t
LOT NO. BLOCK
TRACT 119 12 v
NO.OF SLOGS. '
SIZE OF LOT 71 f-,,r NOW ON LOT f
USEDF
EXISTING BLDG. S lr,:" `�-
DESCRIPTION OF WORK SO
0
NEW ADD ALTER REPAIR DEMOLISH Z
B0.FT. N13 OF NO.OF r
SIZE 7P,4, STORIES or
USE OF STRUCTURE slN�1e , �
19klD / iy z .
NO.OF
EMPLOYEES
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ TH19 AP-
PLICATION AND STATE THAT THE INFORMATION GIVEN IS APPROVALS INSPECTORPB SIGNATURE DATE
CORRECT.
IAGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION: LOCATION
AND STATE LAWS REGULATING BUILDINp�r,ON UCTION. FORMS,MATERIALS C/ /fis✓�_ �L ' �/
of f��Y FRAME: FIRE STOPS,
SIGNATURE OF BRACING,BOLTS
PERMITTE URNACE: LOCATION, /!
GAS VENT,DUCTS /k
ADDRESS � I �
LATH, INT: � J/Y
AUTHORIZED ADT. p
LATH, EXT. ," 2-
$ 7�oQ EE
—_O F •S �� "R CT AND POSTED � p ly7� �y�rry
VALUATION 11
FEE S D'��
�- FINAL
76AS38A OBS 3 12-53
APPLICATION FOR BUILDING PERMIT
FOR APPLICANT TO FILL IN (Print or type only)
BUILDING COUNTY OF LOS ANGELES
ADDRESS DEPARTMENT OF COUNTY ENGINEER
CITY ZIP BUILDING AND SAFETY DIVISION
NO,OF BLDGS. BUILDING
SIZE OF LOT ..��� e?" NOW ON LOT ADDRESS 3/
TRACT Q�0 BLOCK LOT NO. LOCA LI -e-�
TEL. NEAREST
OWNER U j NO. CROSS
ASSESSOR
ADDRESS MAP BOOK PAGE RCEL
DISTRICT ROUP TYPE FIRE PROC tSED BY
CITY ,7J k ZIP CONST JN
ARCHITECT OR TEL. �re G
ENGINEER NO.
STATISTICAL CLASSIFICATION SEWER M P
ADDRESS CLASS NOf.?Y—DWELL.UNITS B/, PG
CONTRACTOR NoL' `' ��(J USE ZONE MAP67
LIC. No. ,, `J
ADDRESS j�' �j� y NO, ! 3 SPECIAL
LIC. CONDITIONS
CITY 0/ CLASS
ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑
CONSTRUCT) N LENDER
NAME AND BRANCH BLDG. ETBACK FROM
FRONTPROP.LINE OF (STREET)
ADDRESS CITY HIGHW Y + YARD - 'TOTAL SETBACK FROM TYPE OF EXISTING
SQ. FT. NO. OF NO. OF CHECK FRONT PROP. LINE HIGHWAY WIDTH
SIZE I STORIES FAMILIES ONE
DESCRIPTION OF WORK NEW ❑ G
❑ BLDG.SETBAC C.
ADD SIDE PROP.LINE OF (STREET)
ALTER ❑
HIGHWAY + YARD TOjALJ§ETBtCWFRqM F EXISTING v
�! REPAI SIDE PROP. LINE HIGHWA )DTH LL
USE� _ d
CA
EXISOT NG BLDG. DEMOL El +
APPLICANT TEL CORNER CUTOFF YES ❑ NO ❑
(PRINT) NO.
BY (SIGNATURE)
IN OPEN SPACE YES ❑ NO ❑
_ IN COASTAL PERMIT ZONE YES ❑ NO ❑
VALUATION$ [l � ,If C
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION N"/-
•+' S'.t'f/�. A-1f�-0+✓� ?�/.�+f"� •R F"+�• _r
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- •f lye
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
LABOR CODE OFTHE STPT OF •CALIFOR IN RELATING TO Pte. a•7!� fT,G� /.1// .ec.!/fe%�. 1•`J ••C��=.
WORKMEN'S COMPENSATI N URANCE. 7
or
SIGNATURE OF /}. � ,lllr_+-1-
PERMITTEE-
TELy�
ADDRESS .moi (}- "/`(.k)) BY S7 /04-7� (-
DIA T E / _ //�,� B Y�_
. _
CITY �iy NO. ��
MAKE CHECKS PAYABLE TO: P.C. $ v PMT.,Q
FEE' FEE,
HARVEY T. BRANDY, COUNTY ENGINEER �Jt
PLAN'CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. 'o. CASH
U
6 3 4rtiWOV 6 1 D 2 8.5 0 ,&-,,6
7fiA696A CE q?B09 5/74 ,_ � -