HomeMy Public PortalAbout4942 CLOVERLY AVE_Miscellaneous__ �
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MISCELLANEOUS APPLI ATIO '
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISIONjV
LOCALITY `
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JEN KINS SUP T OF BUILDING NEAREST
CROSS ST
FOR APPLICANT TO FILL IN DISTRICT No G_r I TYPE S BY
. CONST
BUILDING MAP HIGHWAY
ADDRESS eeL '�� NO (CIRCLE) STATE MAJOR SECOND LOCAL
LOCALITY USE Z /NE SPECIAL CONDITIONS
NEAREST /
,Ross Si
LEGALRE UIRED YARD HWY STREET NAME EXIST
DESCRIPTION TLOT NO J BLOCK SETBACK WIDTH
FRONT l
NO OF BLDGS P L
TRACT NOW ON LOT SIDE i
USE OF P
SIZE OF LOT J EXISTING BLDG
OWNER VA JJ
MAIL
ADDRESS 16 /•�
TE
CITY
NOL �3 ,
APP CATIA FOR
CD
OCCUPANCY e • G
INSPECTION SAFETY PERMIT
TRAILER USE " - �r� ^^^�7/^�'�i /�/ � W
GO
USE OF STRUCTURES OR DEVICES = -' � '!^ v i3 F`_6diP / Z
LIMITED TIME USE
DATE OAT
FROM TO
INSPECTOR'S
� ' s
APPROVALS DATE SIGNATURE
OCCUPANCY APPROVAL
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS GROUP OCC LOAD
APPLICATION AND STATE THAT THE ABOVE IS COR
RECT AND AGREE TO COMPLY WITH ALL COUNTY TRAILER USE
ORDINANCES AND STATE LAWS R ULATING SUCH
WORK AS INDIC AT ER N
SIGNATURE OF SAFETY PERMIT
PERMITTEE
TEMPORARY
STRUCTURE APPROVED
ADDRESS ` TEMPORARY
STRUCTURE REMOVED
1
FEE rj /� V , FINAL APPROVAL �, ld 7d
/ C I
APPLICATION VALIDATION 'JOHN F LEWIS, PRINCIPAL STRUCTURAL ENGINEER
(NOT A PERMIT) CKM O CASH I PERMIT VALIDATION CK M G CASH
R
I,Af - 3 6 0 1.1cm— FEB, 5 2 2 D 1 5.0 0 `ss