HomeMy Public PortalAbout5625 WELLAND AVE_Building__ ....3.ACZ#80e-1-61 APPLICATION FOR BUILDING PERMIT
COUNTY' OF LOS ANGELES BUILDING
UD v
DEPARTMENT OF COUNTY ENGINEER ,
BUILDING AND SAFETY DMSION LOCALITY
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
WILLIAM A.JENSEN SUPT OF BUILDING CROSS ST.—m DI /
FOR APPLICANT TO FILL.IN __-j 9T N� CONST. R s Y
BUILDING /�/ `P STATISTICAL CLAS IFICATION . SE MAP
ADDRESS arm ,.2. (fesrII Ag!7ql !q IjE. K
CLASS.NO. DWELL.UNITS---l—
LOT NO. BLOCK -WATER NOT REQUIRED RECEIVED
CERTIFICATE:
Lj
TRACT O MAP —0 HIGHWAY STATE MAJOR SECON LOCAL
tom, / NO.OF BLDGS. NO. �� G� (CIRCLE)•
SIZE OF LOT. /Z ,�ap I NOW ON LOT USE ZONE SPECIAL
USE CONDITIONS
EXISTING BLDG.
OWNERW_- 1) A4// ' NO. BUILDING YARD HWY STREET NAME EXIST.
ADDRESS (p�� JV� V E SFRONTK WIDTH
ARCHITECT OR TEL. P.L. Q
ENGINEER NO. SIDE
ADDRESS COOL*
INSPECTION RECORD a
CONTRACTOR?j'W� d/ Cb/VS��,(;rC OL.. g
ADDRESS/LZ :&2,4 & 4 VP. fA �/� r Od
DESCRIPTION OF WORK 0
O.
NEW ADD i�ALTER REPAIR DEMOLISH y
SQZEFT. /�- NO.OF NO.OF r f D _�N. +_ s+ r` ,�"�ts '-�,' l Z
9 STORIES FAMILIES
USE OF
STRUCTURE
• 1
SIGNATURE OF
APPLICANT I
VALUATION$
APPROVALS DATE INSPECTOR'S,SIGNATURE
F.OUNDATION:,LOCATION
F E $ FEE $ I/ �x � "' ,x�p9 1p L► ?�Z' :_
FORMS.MATERIALS r
FRAME:FIRE STOPS,
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS Cly 4 `•a'/
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY FURNACE:LOCATION. j
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING - GAS-VENT DUCTS
BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK f.r
'AUTHORIZED HEREBY I WILL-NOT EMPLOY ANY PERSON IN VIOLA- 1,tArr-K,INTTION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT-
ING TO WORKMEN'S COMPENSATION INSURANCE. LATH,EXT.
SIGNATURE O HOUSE'NUMBER COR-
PERMITTE RECT AND POSTED
ADDRESS FINAL VIO,�`� /d/ ;;Z�ar.+1
CLYDE N. DIRLAM, PRINCeIPAL ST R RAL IENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERBUT VALIDATION C.
CASH
Ir 1
U",.c U d OCT 6 1 D
APPLICATION FOR BUILDING PERMIT
FOR APPLICANT TO FILL IN1 (Print or type only)
COUNTY OF LOS ANGELES
BUILDING
ADDRESS S"6- A.57- N� +Ft' DEPARTMENT OF COUNTY ENGINEER
CITYi't. )£�,� ZIP �} BUILDING AND SAF Y DIVISION
NO.OF BLDGS. BUILDING
SIZE OF LOT zC�:' NOW ON LOT „3 ADDRESS `
TRACT o,6 SGC) BLOCK LOT NO. L/, LOCALITY
q, /t TEL.�.{ NEAREST
OWNER � .112 l.c ti p NO.-')F72 77 6 33 CROSS ST.
�+ - / ASSESSOR
Z,
ADDRESS.—�$�,j� [ �:C.i` 'y I-?P MAP BOOK PAGE I PARCEL
CITY / H )G r�/!y ZIP ~Z/ ��� DISTRICT GROyI p TYPE CONST. FIRE PPLROESSED Y
ARCHITECT OR TEL. Uo _ ,1
ENGINEER NO. STATISTICAL CLASSIFICATION SEWER—KAP
ADDRESS CLASS NO. P
DWELL.UNITS �BK// G
CONTRACTOR 01-rV AIA•f Y NO..,?,ay Z/f USE ZONE �MAP
c� �} ) LIC +� O.ADDRESS F7�L/ ! N0.2 2 2l -� ECIAL
,, LIC. NDITIONS
CITY J'r�f.'e��l'/!+/��� `^ CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑
CONSTRUCTION LENDER -� }
NAME AND BRANCH f 1 � 1T , 6LDG.SETBA FROM
ADDRESS d F 3 t ,r Lcp�j��J�Y� �J�. Q_ &Z-11 FRONT PROP. INE OF [STREET)
HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING
SQ.FT. NO.OF NO.OF CHECK - FRONT PROP.LINE HIGHWAY WIDTH
SIZE �� STORIES f FAMILIES ONE }
_
DESCRIPTION OF a WORK NEW ❑ O
ADD ❑ BLDG.SETBACK NQM (STREET) O
` SIDE PROP.LINE OF
_ / ^ ALTER T AL SETBA K FROM TYPE OF EXISTING
��. ,�„ REPAIR ❑ HIGHWAY + YARD _ p LINE HIGHWAY WIDTH . h
USE OF / _ Z
DEMOL +
EXISTING BLD ,, .,
G. ,
APPLICANT , , TEL 7 f y a CORNER CUTOFF YES ❑
(PRINT) s12 /'f NO., Y7y6 J-�
IN OPEN SPACE YES ❑ NO ❑
BY(SIGNATURE) -►a-
v IN COASTAL PERMIT ZONE YES ❑ NO ❑
VALUATION$ SU D
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES
AND LAWS REGULATING BUILDING CONSTRUCTION.1 CERTIFY THAT IN DOING THE
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM-
PENSATION INSURANCE.
SIGNATURE OF
PERMITTEE
ADDRESS .3' FINA��S"-s"
CITY `= y � d NpxF/7 33
DATE `�r�� BY�� / �- e
MAKE CHECKS PAYABLE TO: FEE FET `P
HARVEY T.BRANDT.COUNTY ENGINEER L
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
6 3 5 n>t,nQ 10 l U 1 2.0 0 ,&"d
Os 76A638A CE#803 3.75' �7
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