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APPLICATIONf I-SS FOR U I I.:D I N G p E R.NI.I T
DIVISION 'OF BUILDING A
AND SAFETY ADDRESS S
ADDRS
NG
Deportment of County Engineer
County of Los Angeles LOCALITY
JOHN A.LAMBIE, COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST.
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I TYPE SEWER MAP
CONST..-
BUILDING MAP STATE YES O`
ADDRESS _+� (jJ� / �Y ` �J 157 NUMBER HWY
LOT NO. G(z S/ f0�� ( �D L / USE Z NE SPECIAL
CONDITIONS
TRACT 0
/ y //�.I NO.OF HLDGS.
SIZE OF LOT . (� /� G! NOW ON LOT BUILDING EXIST. .
YARD HWY STREET NAME
USE OF SETBACK WIDTH
EXISTING BLDG. RC6 j e.1VICJ5 FRONT
/ P.L.
OWNER i ]U D/I/ SIDE
MAIL
l
ADDRESS ® P// kJ OO O TRACT DWELL. I UNIT
TEL „// y a,, 5 INDUSTRIAL
CITY.: NO.%/1/��T I DWELL. I UNIT
6 PUBLIC BLDG.
ARCHITECT OR ` TEL. 2 DUPLEX 2 UNITS
ENGINEER _ZO/Ir NO. 7 ADDN:.ALT., ETC.
$' APT. UNITS
8 MISCEL.
ADDRESS 4 COMMERCIAL
TEL ��j INSPECTION RECORD
CONTRACTOR ` _'�. NO �{/t�7'i' -
ADDRESS D 6 OLX9 -gAo/'/-4I'//YO
DESCRIPTION OF WORK
NEW ADD / ALTER REPAIR DEMOLISH
S.FT.I�7 �O NO.OF NO.OF
STORIES FAMILIES B`, D U D 0,416A*”. A�*&
USE OF STRUCTURE Q /
cL !' E
SIGNATURE
APPLICANT APPROVALS
ADDRESS ! DATE INSPECTORS SIGNATURE
$ P.C.-S �GJ F FORMS.rMATERIIALS LOCATION ����� , W'9 ,
FEE FRAME: FIRE STOPS. Y
VALUATION ./,f `/ $ BRACING.BOLTS
FEE FURNACE: LOCATION,
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS GAS VENT,DUCTS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT r
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH.INT.
AND STATE LAWS REGULATING BUILDING CONSTRUC-
TION. rlell�
LATH. EXT.
SIGNATURE OR HOUSE NUMBER COR- r '
PERMITTE 'RECT AND POSTED U
ADDRES ILIAL
JOHN A.LAMBIE.COUNTY ENGINEER - AIMATION CLYDE N.DIRLAM, CHIEF BLDG. INSPECTOR
SCK! do CASH
LAAO 5 6 9 5 MAR 1 1 '6 1 9.5 0 ® �
�: 05 $ 1'3c.�, mAR 6 1 3 9.0 0 �,