HomeMy Public PortalAbout5300 BALDWIN AVE_Grading__ (2) APPLICATION FOR GRADING PERMIT"
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COUNTY OF LOS ANGELES AIDDRESS ✓ LZ�� ` ✓ y
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS. SUPT. OF BUILDING NEAREST
CROSS ST.
DISTRICT NO. M A.,P NO. STATE HWY. PR SSED, BY
FOR APPLICANT TO FILL IN U� U YES p NO p
SITE
ADDRESS USE ZONE SPECIAL
L CONDITIONS
LOT
NUMBERS BLOCK
TRACT
NUMBER
SURETY $ BOND
OW NER /J� ,4 A:> f.✓//(,� BOND NO. �
MAIL SURETY
ADDRESSCOMPANY
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CITY �' NO �� C'D.
FILED BY ,
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ENGINEER zv , CASH RECD. DATE
,,��^^ DEPOSIT $ BY FILED
ADDRESS-Z Lam' NO ¢f" �/ CLEARANCE LOT NOS.
SUP'V'G.GRAD'G STATE
ENGINEER ' IXA,ORE G. NO.IeS REQ'D. FOR
ADD RES
CITYf'.�il�/I"/r �{T�E L. / - / GEOLOGY
GRADING /��/>fri ,��"//,N O_.J,7 Z`- u
CONTRACTOR
DRAINAGE
ADDRESS
PROPOSED USE OF GRADED SITE(S)
THIS IS A LIMITED TIME PERMIT
ALL WORK AUTHORIZED MUST BE COMPLETED BY
TIME LIMIT:
CHECK IF SU PERVIS RA DIN EXTENDED TO: BY:
SIGNATURE
OF APPLICANT Q //' EXTENDED TO: BY: 1
CDDR�SSL / /( DI INITIAL DAFT E, I TOR',,Si"SIGNATURE �-
NOGRD. PREP.
t
CUBIC YDS. 1C�C� �y P.C. $ COMPACTION
HANDLED: C L�' FEE b_ gEPOgT RECD.
VALUATION$ SUP. ENG R'S. ._
CER7. RECD. ! A
ROUGH GRADINGr
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVAL
APPLICATION AND STATE THAT THE ABOVE IS PLANTING AND
CORRECT AND AGREE TO COMPLY WITH ALL COUNTY IRRIGATION
ORDINANCES AND STATE LAWS REGULATING EXCA-
VATING AND GRADIN SUP. ENGR'S.
FINAL CERT.
SIGNATURE OF FINAL ,f1
PERMITTEE APPROVAL !!
n` /�//J SURETY BOND
ADDRESS ,�,� �tp� IYAr�"( ELEASED '�"' " bis r' _M T-I-NGi NEER
/��� JOHN F. LEWIS PRINCIPAL ST TURAL ENGINEER
PLAN CHECK VALIDATION /CK/ M.0. CASH PERMIT VALIDATIONCf: M.0. CASH
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APPLICATION FOR GRADING PERMIT
76A641T-CE807 4-671
COUNTY OF LOS ANGELES SITE
ADDRESS
DEPARTMENT OF COUNTY ENGINEER "
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPT. OF BUILDING NEAREST
CROSS ST.
DISTRICT NO. MAP NO. STATE HWX,, S5ED-,BY
FOR APPLICANT TO FILL IN 5_ G/ �) YES ❑ NO ` `
SITE ?'7t_'O� /` " � �.7 USE ZONE SPECIAL z'tttt-cccCCC
A D D R ESS.�.Jr! j�/CJ C- �� /v J�V CONDITIONS
LOT
NUMBERS BLOCK
TRACT v
NUMBER So--04U
SURETY $ BOND
OWNER NL`- �,%L ri�(iv On✓ ��j BOND NO.
MAIL _ SURETY
ADDRESS�`�a/'S �,�/'��NE'�411 y /�j/�' COMPANY
CITY �./ /jf ��� NOL /(r DATE RECD.
FILED BY
Tr / CASH RECD. DATE
ENGINEER`.%A 41 - /l_e_ 'ftv j �(O cJ��- DEPOSIT $ BY FILED
A DDR ESS��,� (//✓''� .ry L��O "-Y: �c CLEARANCE LOT NOS.
S U P'V'G.G R A D'G.r- STATE
ENGINEER G� L,�h/ REG. NO./�_3eo- REQ'D. FOR
ADDRESS TE L. GEOLOGY
CITY NO.
GRADING TEL.
CONTRACTOR N0.
ADDRESS DRAINAGE
PROPOSED USE OF GRADED SITE(S)
C-7/zrfr�� .7-Cl<l- J CcwG1n ,• THIS IS A LIMITED TIME PERMIT
ALL WORK AUTHORIZED MUST B COMP ET D BY
TIME LIMIT:
CHECK IF SUPERVISE RADING A EXTENDED TO: BY:
SIGNATURE
OF APPLICANT .�S !-
EXTENDED TO: B
A DDR ESS�_ TEL. INITIAL DATE INS TOR'S SIG TORE
CITY - :+ NTJ.tJ "'� ` GRD. PREP.
t
CUBIC YDS. /�/y �y COMPACTION
HANDLED: �4'G• FEP.0 $ fC) REPORT RECD.
FEE ._.J b+ t
VALUATION �.��' $ SUP. ENG S.
FEE CERT. RECD. At
ROUGH GRADING A /
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVAL �-
APPLICATION AND STATE THAT THE ABOVE IS PLANTING AND
CORRECT AND AGREE TO COMPLY WITH ALL COUNTY IRRIGATION
ORDINANCES AND STATE LAWS REGULATING EXCA-
VATING AND GRADING. SUP. ENGR'S.
FINAL CERT.
SIGNATURE OF FINAL fA
PERMITTEE IAPPROVAL
SURETY BOND
ADDRESS RELEASED DISTRICT ENGINEER t
JOHN F. LNIS, PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
4 7 19'_uGi --4 18 U
APPIICATIO All kG PERMIT J
76A641T CE807 12 73
COUNTY OF LOS ANGELES SITE \
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY '
FOR PLICANT TO FILL IN NCROSS sT
SITE K 1 DISTRICT NO MAP NO STATE HWY ROC SSED BY
ADDRESS YES ❑ NO
NUMBERS BLOCK USE ZONE SPECIAL
CONDITIONS
TRACT
NUMBER
OWNER
MAIL DATE AGENCIES REQUIRING CLEARANCE
ADDRESS
TEL
CITY NO _
STA E
ENGINEER NO r
MAIL
ADDRESS d
\ ELrj 3 c
CITY NO 7
GRATECON DTRNACTOR NOL Z
_� SURETY $ BOND
ADDRESS BOND NO
SURETY
PROPOSED USE OFA GRADE SITE(S) COMPANY 8
DATE REC D
FILED BY 0
CASH RECD DATE U
DEPOSIT $ BY FILED LV
CL
CHECK(
FSU ISED GRADING THIS IS A LIMITED TIME PERMIT Z
SIGNATURE
OF APPLICANT ALL WORK AUTHORIZED MUST BE COMPLETED BY
T / '� TIME LIMIT
O
ADDRESS
CUBIC YDS P C $
HANDLED FEE EXTENDED TO BY
i
$
FEE EXTENDED TO BY
I HEREBY ACKNOWLEDGE THAT I HAVE°'READ THIS INITIAL DATE INSPECTOR S SIGNATURE
APPLICATION AND STATE THAT THE ABOVE IS GRD PREP
CO T AND AGREE TO COMPLY WITH ALL COUNTY
OR INA NOES AND STATE LAWS (REGULATING XCA COMPACTION
yA DING REPORT RECD T
SUP ENGR S
SIGNATURE OF CERT RECD
PE RMITTE ROUGH GRADING
APPROVAL
PLANTING AND
AGENT FOR IRRIGATION
~ SUP ENGR S
FINAL CERT
ADDRESS FINAL
APPROVAL
MAKE CHECKS PAYABLE TO
SURETY BOND
[HARVEY T BRANDT COUNTY ENGINEER RELEASED
PLAN CHECK VALIDATION ''CK M D CASH PERMIT VALIDATION cK M D CASH
75 11 4 A 8500s�,c
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