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HomeMy WebLinkAbout0900A f �`s 76A63BA _._ .'._' . . ._. . . . . . _. . _- ��— �j , CE A803(REV.11/78) . . LS APPLICATION FOR BUILDING PERMIT COUNTY OP LOS ANGELES BUILDING A Q SA ETY FOR APPLICANT TO FILL IN _ sunow� n I ADDRESS � J � �� BUILOING ADORESS ���� LOCALITV /�'L,/ . L NEAREST CITY Q 21P CROS55T. �L.f�L/ . NO.OFBLDGS. ASSESSOR ' � S�ZE OF LOT NOW ON LOT � MAP BOOK ' PAGE� - PARCEL . DISTRICT GROUP TYPE FIRE PRpCE55ED BY TRACT 6LOCK LOT NO. �J CO��y1ST,�. / �f }'�n/ OWNER �L L NO. .. ._ . .�IO J��� �.1�-�/ ' J^ � 1 GU�.C�/, STAi15TICALCLA5�51F/IC�y,TION �/ SEWERf+1P,P ADDRESS CLASSNO.,_,:{-J?—�WELLUNiTS BK . PG CITY ZIP ' "' . . ' AftCHITECTOR ' TE�,�D VAW.4110N $ �pO O� ENGINEER 'rS i [��L �I NO ADDRESS �� I E /G�f BLUG.SEIBAIXFHOM /�7 p FRONT FROP.UNEOF ISTREETI CONTRACip . [ L� E T/NbNO d�Q� HIGHWAV + YARD � T�TA�SETBACKFROM TYPEOF EXISTING ADDRESS / �� / ST�JL NO G7.L3 FRONTPROP.LINE HIGHWAY WIDTH IIC. } ��,� A «Ass e .� CON TRUC710N LENDER .. Bl�G.SETBACK FROM NAh1E AND BRANCM SIDE PROP.LINE OF �STREETi � HIGHWAY + VARD T�TALSETBAIXFROM TYPEOF E%ISTING 0. ADDRESS CI7V SIDE PROP.LINE HIGHWAY WIDTH O v SQ.FT. NO.OF NO.OF CHECR + - - � � • SIZE STORIES� FAMILIES `�ONE � l)$E N� MAP (_' �,� �,,, OESCRIPTION OF WORK - NFW -❑ ���" N�' � W , SFECIAL d �SC �S T/N�SC/✓ nDD ❑ --'- CONDITIONS - ' y ' AITER FINAI 8Y ? REPAIR DATE � ' �- ' USEOF � V C Ti9T/DN . DEMOI � � EXISTINGBLDG. tl� I P � � . , . �Z _ APPUCANT� TEl �/�. � �O 9 O.O A IPRINTIJA•�AL�,�6 /�(1�T' N0.�3(Jdn� ` ' /� �.p o �;. . . .2 3. BY ISIGNATUREI- ` � K! /� � � �� I HEREeY ACKNOWLEDGE T I HAVE READ THIS APPLICATION AND STATE y/;/ � uY f,� � ��O O TNAi iHE ABOVE I$CORRECi �0 AG0.EE TO COMPLY WI7H All ORDINANCE$ / /(J �u = AND LAWS NEGULPTING BUILDiNG CONSiRUC710N 1 CERTIFY THAT IN OOING THE �(fi� � 2 •�• r •8 O Q L WORK AUIHOR12E0 NEREBY I WI��NOi EMPIOY ANY FERSON IN VIOIAfION OF V � THE LABOR�ODE OF THE SiATE OF�AI,IFOANINN RELAiING IO WORKMEN 5 CO.N�_ _ GENSAiION INSIIAANCE.' . { 0�,0 9=8 0 .� SIGNATURE OF � s . GERMITTEE . ADDRESS S H�I" '.� ✓G ' O � TEL. ' cin ' No. 30� c � P.C.Fee S Permit Fee ' > � , Issuance Fee � - -- 6 . TotolFee PLANSTOAPPLICANT INSPECTOR'S NOTES � 70: . RETURNED_ . . . . .. . APPROVED NO OATE NO. DATE REQUikED DATE RECEIVED� APPROVAL$ YES NO ORAPPROVED � WATERCERTIFICATE , , , . HEALTH DEPARTMENT • fIRF DEPARTN�FNT . _ . � GRADING . � , . . . GEOLOGICAL � � PEOESTRIAN FROiECT10N � � IFENCEI ICANOPYI - ' �, . � ,� � - ' ' SPECIAUNSPECTION � '� ' � � I ICOyC.I IMASNRV.I I W ELDG.1 . LOi ORAINAGE . _ . PARK�NG - - APPROVALS DATE INSPECTOR'SSIGNATURE � . LOCATION�;i�i'�1 N.i ,� . �SEfBACK&YAR�SI � FOUNDATIONS� � '� � . FRAME ���J.; . •.. � , . , � IATH/�RYWALL� " ' - INTERIOR LATH�E7(?ERIOR� ~ '� �� � HOUSE NUhiBER� � CORRECTBGOSTED �� ' - � � ENERGYINSULATION - � � - � � ' ' � ' � ( FINAL. ' � ' • .. ,. ' ENTER ON FFONt I