HomeMy Public PortalAbout4830 CLOVERLY AVE_Miscellaneous__ 76M444-CE #.75 c MISCELLANEOUS APPLICATION
COUNTY OF LOS ANGELESBUIL ,{
DEPARTMENT OF COUNTY ENGINEER ADD EISS �/ 30
BUILDING AND SAFETY DIVISION
JOHN A LAMBIE COUNTY ENGINEER LOCALITY e�
COLEMAN W JENKINS SUP T OF BUILDING NEAREST
CROSS ST e` K Cl.
FOR APPLICANT TO FILL IN DISTRICT N GRO P TYPE PR SSED BY
S CONST
BUILDING eI fSO � ,`��t t AVS
V /4/ MAP HIGHWAY
ADDRESS NO p�O � (CIRCLE) STATE MAJOR SECOND LOCAL
LOCALITY '7;�JtryP,cF (7,;7' U Z�NE SPECIAL CONDITIONS
Jv NEAREST
CROSS Si �QEf/<<,��J (f L�
LEGAL REQUIRED YARD HWY STREET NAME EXIST
DESCRIPTION LOT NO BLOCK SETBACK WIDTH
FRONT
NO OF BLDGS p L
TRACT NOW ON LOT SIDE
USE OF �eS(�Q.w[ P L
SIZE OF LOT EXISTING LDV IF-A-06 AIC-Ale l s�?/1�t`(
OWNER .A 4C:n�AI FAIMAIL
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ADDRESS Apv )2k �` /
CITY NOL p[, d 3
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APPLICATION FOR CD
U
OCCUPANCY V
INSPECTION SAFETY PERMIT O
U
TRAILER USE W�
N
USE OF STRUCTURES OR DEVICES
IAIX CCT --A/ LIMITED TIME USE
DATE DATE
FROM TO
APPROVALS DATE INSPECTOR'S
SIGNATURE
OCCUPANCY APPROVAL
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS GROUP OCC LOAD
APPLICATION AND STATE THAT THE ABOVE IS COR
RECT AND AGREE T COMPLY WIMH ALL COUNTY TRAILER USE
ORDINANCES AND ATTAWS ULATING SUCH
WORK AS INDI A
SIGNATURE O /gER O
SAFETY PERMIT
PERMITTEE /x` TEMPORARY
STRUCTURE APPROVED
ADDRESS TEMPORARY
STRUCTURE REMOVED
FEES l
(`w FINAL APPROVAL - / ! j
APPLICATION VALIDATION JOHN F LEWIS, PRINCIPAL STRUCTURAL ENGINEE
(NOT A PERMIT) CK mo CASH PERMIT VALIDATION CK MO CASH
!r(j-- 1 4 a 7% AW19 2 2 D 1 5.00- IT