HomeMy Public PortalAbout5022 DOREEN AVE_Relocation__ APPLICATION FOR RELOCATION BUILDING PERMIT 1 1
DFI/ISION OF BUILDING AND SAFETY BUILDING i
Department of County Engineer ADDRESS V { ) /1/ s
County of Los Angeles /1
7EA039 WM. J. FOX. COUNTY ENGINEER LOCALITY �r ` 1
'0x79
13.94 CASSATT D. GRIFFIN. SUPT OF BUILDING NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN DISTRIX O.. ( GROUP I TYPE CONST.
PROPOSED
BUILDING �O z
ADDRESS,1 ; MAP STATE
f NUMBER ✓ 0 HWY.
LOCALITY USEZONE SPECIAL
PRESENT 'T 1 CONDITIONS
BUILDIN
ADDRESS I
LOCALITY SU LDING SETBACK YARD HWY STREET NAME Wj1DTH
OWNE FRONT 43 /
7/
MAIL I SIDE
ADDRE24 P L
T�L. /
CITY / N SURETY ��-Q-DATE �/pEC'n
MOVING TE BONDS /OT PILEa�7�•�l ^Y
CONTRACTOR Cl CASH DATE RECD
DEPOSIT j FILED ^Y
ADDRESS
BUILDING TEL. APPROVALS
CONTRACTOR NO. r�ee..
ADDRESS eJ//h DATE INSPECTOR'S SIGNATURE
PRESENT ♦ FOUNDATION: LOCATIO 3/f 'f I f •W�.r
USEOF � f -'O_���� FORMS. MATERIALS I/
BUILDING _ _ FRAME: FIRE STOPS. //�if+ ♦V'P�l
PROPOSED 1 BRACING. BOLTS
USE OF �4 �l FURNACE: LOCATION 'J / // ,�1a /�/'
BUILDING ��� »���"'� GAS VENT. DUCTS - M., A / _�"'-'-`.''�'/'t'_
LATH, INT.
SIZE T
S ROOMS STORIESLATH. EXT
.
WALL - ROOF J HOUSE NUMBER COR-
COVERING COVERING RECT AND POSTED
LEGAL
DESCRIPTI LOT NO. O K&J FINAL ,
1
� TRACT Oil STRICT�ENGINEER
NO. OF SLOGS. WORK COMPLETED �1��'J x 'yl.�•i0i r�
SIZE OF LOT NOW ON LOT SURETY BOND / �I
USE OF A A sem. NO.OF
RELEASED /rJ�I<_ JGuI�w'A
EXISTING BLDG.-J IAiO/. pert/[' X -FAMwes 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
1 HEREBY STATE THAT THE INFORMATION GIV N IS COR. APPLICATION AND STATE THAT THE ABOVE IS CORRECT/
RECT. - f AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
SIGNATURE OF A AND STATE LAWS REGULATING BUILDING CONSTRUC-
APPLICANTTION.
ADORES SIGNATURE OF
PERMITTEE
VALUATION $ P. C. S
!'J� FEE ADDRESS(� 1 FEE S le,
WILLIAM J. FOX.COUNTY ENGINEER VALIDATION
NO483S Fm 14 , 6 10.00 + o _ ;:,WO8OS -m 3 6 1-0,00
9EPUT� \ /I_ ^__ ♦ -- - QEPUTY-
D.(',,,r'
BY BY //
m DEPUTY A DEPUTY