HomeMy Public PortalAbout10228, 10224 DAINES DR_Relocation__ 76A•639 - CE 879 - 8-62 {, ,
APPLICATION FOR RELOCATION BUILDING PERMIT . -
COUNTY
ERMIT . .'.COUNTY OF LOS ANGELES BUILDING
ADDRESS •O22'¢ �g
J� DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY �P/-46 ` T
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST /�
WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST V
DIST NO �GROUP�TYPE SEWER MAP P-
SSED BY
FOR APPLICANT TO FILL IN- o CON T.` BKj -7G ,
PROPOSED I
BUILDING a WATER
ADDRESS CERTIFICATE NOT REQUIRED ` RECEIVED ❑
LOCALITY f/c liL A'l 4 51 (CIRCLE)HIGHWAY
NO STATE MAJOR SECOND LOCAL
C1 � 'go
PRESENT
ABUILDINGDDRESS �✓% USE ZONE SPECIAL
CONDITIONS
LOCALITY
I 1
OWNER BUILDING IST
SETBACK YARD HW Y IDTH
MAIL _
ADDRESS FRONT
L
TEL. aV
CITY NO SIDE
MOVING TEL P L
CONTRACTOR , (. V' O G /
� SURETY DATE REG'D
ADDRESS BOND $ - FILED BY >(L-
CASH
-
CASH /49 -� DATE RECD
BUILDING TEL' DEPOSITS__ _
_ FILED BY
CONTRACTOR NO - 0
APPROVALS DATE INSPECTOR'S SIGNATURE
ADDRESS FOUNDATION LOCATION O
PRESENT • FORMS,'MATERIALS - �Gr1 U
USE OF
BUILDING FRAME FIRE STOPS, W
CL
PROPOSED BRACING, BOLTS N
USOF
BUILD NG FURNACE LOCATION z
GAS VENTS, DUCTS
SQ FT. qqNO OF LATH, INT
SIZE ei1 0/� ROOMS STORIES
WALL /� ROOF LATH, EXT
COVERING 1/ COVERING
LEGAL HOUSE NUMBER COR-
DESCRIPTION
LOT NO BLOCK RECT AND POSTED
TRACT O t7 a FINAL
NO OF BLDGS_ _ DISTRICT ENGINEER
SIZE OF LOT I NOW ON LOT SURETY BOND
USE OF NO OF USE
EXISTING BLDG I FAMILIESI HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
I ��AT7HEREBYSTATEGIVEN IS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
CORRECT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
SIGNATURE OF BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
APPLICANT AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY P RSON IN VIOLA
TION OF THE L OR CODC-OF THE STATE OF IFORNIA�RELAT
ADDRESS ING TO WORKMENRSATION IN URAN
VALUATION $ SIGNATURE OF
�5 , i,,�� FEE -j , ✓ PERMITTEE
3JU d ADDRESS
tiVALIDATION' CK. Mo. CASH JOHN F LEWIS, PRINCIPAL STRUCTURAL E INE R
(�1 PERNIIT VALIDATION CK. M O. ASH
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