HomeMy Public PortalAbout9177 WOOLLEY ST_Building__ 16A638A CE #803 3-69 �al�
APPLICATION FOR BUILDIPdG PERMIIT
Ii -
COUNTY OF LOS ANGELES ADDREit
SS
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPT OF BUILDING CROSS ST.
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FOR APPLICANT TO FILL IN DIsv�Ta_ICT�. cao TYPE-0e r. :PROCnE!;�&_
(PRINT OR TYPE ONLY)
BUILDING f� '�j a STATISTICAL CLASS FICATION SE R MAP
ADDRESS J 141,v fl
CLASS N0. DWELL.UNITS BK PG
LOT No. f�L) BLOCK USE ZONE MAP D�
/ N0.
TRACT SPECIAL
NO. OF BLDGS. I CONDITIONS
SIZE OF LOT NOW ON LOT
USE OF
EXISTING BLDG. BLDG. SETBACK FROM
TEL / FRONT PROP. LINE OF (STREET)
OWNER v me, NO. ! TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS O dft,
IGHWAY WIDTH FROM C.L.
CITY
ARCHITECT TEL. SI LI DG.SET. F (STREET)
ENGINEER NO. SDE PROP. LINE OF
TYPE OF EXISTING SETBACKHIGHWA + YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROM G.L.
TEL. +
CONTRACTOR 0 lye� NO.
ADDRESS NO CORNER CUTOFF YES ❑ NO ❑ f
CITY CLASS SEE REVERSE SIDE FOR SPECIAL APPROVALS
t
CONSTRUCTION LENDER
NAME AND BRANCH ^
ADDRESS '
SQ. FT. N0. OF N0. OF ❑ '
SIZE STORIES FA MILIES NEW
USE ADD
STRUCTURE +ate Q
ALTER
EPAIR
SIGNATURE 0 DEMOL ❑
APPLICANT l
`i1/r Iti
VALUATIO $ OO APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. PMT. FOUNDATION: LOCATION
FEE$ FEE $ FORMS MATERIALS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION FRAME: FIRE STOPS,
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY BRACING BOLTS
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUC- FURNACE: LOCATION,
TION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I GAS VENT DUCTS
WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE LATH, INT.
OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM-
PENSATION INSURANC
LATH, EXT.HOR CORRECT
SIGNATURE OF
PERMITTEE 1^ "y��J/✓ AND POSTEDp+
ADDRES FINAL J U
JOHN F. LEWIS, PRI CIPAL STRUCTURAL E NE
PLAN CHECK VALIDATION CK. M.G. CASH - PERMIT VALIDATION CK. M.O. CASH
I Af'l,4 1 6 9 R MAIR2 0 1 D �.0ON a.