HomeMy Public PortalAbout5019 ENCINITA AVE_Relocation__ APPLICATION FOR--RELOCATION BUILDING PERMIT 1
DIVISION OF-BUILDING AND-SAFETY BUILDING
Department of County Engineer ADDRESS > -
County of Los Angeles a
DBS-70 WM. J. FOX, COUNTY ENGINEER LOCALITY
12.54 CASSATT D. GRIFFIN,,SUP•T OF BUILDING NEAREST �i
CROSS ST. + ,� -L�i'Z• / '
FOUR APPLICANT TO FILL IN 'DISTRICT NO.' � GROUP I TYPE CON
PROPOSED
BUILDING
ADDRESS MAP �- � STATE YES NO j
e,, NUMBER HWY. J
LOCALITY/ �,v�/-� /� / USE ZONE SPECIAL
PRESENT CONDITIONS
BUILDING ,�] jf ��L y
ADDRESS-7f,3 �� �
LOCALITY BUILDING YARD HY STREET NAME EXIST.
W
SETBACK WIDTH
FRONT
OWNER _ P. L.
MAIL o SIDE
'ADDRES P. L.
TEL.
CITY NO. SURETY DATE RECD
MOVING /� TEL. BOND$ FILED RY
CONTRACTOR(r NO CASH DATE RIC'j
0 F DEPOSIT$ AILED_ _ "Y
ADORES
BUILDING TEL. APPROVA S
CONTRACTOR NO. 14
rPA E NSPECTOR'S SIGNATURE
ADDRESS '
PRESENT
FOUNDATION:-LOCATION '
USE OF de/� /�ly��(y/° FORMS, MATERIALS—
BUILDING If// i( : FRAME: FIRE TO
PROPOSED /� ,! l BRACING,/BOLT¢SI J
BUILDING ` //�!Z AO FGAS VEN URNACI,OD
UACJfSN/ N r�
SQ. FT; LATH,it NT..
SQ. FT, ` O. OF -
SIZE �/�' ROOMS t? STORIES LATH,
WALL T. I ROOF /jam [� HOUSE NUMBER
COR—/
COVERING COVERING RECT AND POSTED
LEGAL I i�t�y e I S FINAL
DESCRIPTION .L,OAT OF BLOCK
, �a. C'- `� 1 DISTRICT ENGINEER
TRACT
NO. OF BLDGS. WORK COMPLETED
-SIZE OF LOELEASE
T O I NOW ON LOT vL. SURETY BOND I
USE OF NO.oF RD
EXISTING BLDG. FAMILIES e
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
I HEREBY STATE THAT THE INFORMATION GIVEN IS COR- APPLICATION AND STfATE THAT THE ABOVE IS CORRECT
RECT. -AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
SIGNATURE OF ,,QQ)),, A ,� AND STATE LAWS REGULATING BUILDING CONSTRUC-
APPLICANT 0IA,` - l TION.
ADDRESS S01 I SIGNATURE OF
PERMITTEE
VALUATION $ P. C. $
FEE ADDRESS
FEE$
WILLIAM J. FOX, COUNTY ENGINEER VALIDATION
BY 5 9 S G °j-'312 17 1 U.0 TJ A M
DEPUTY DEPUTY ;
BY ( BY
® �1.0 DEPUTY DEPUTY