HomeMy Public PortalAbout5622 ENCINITA AVE_Building__ DIVISION OF BUILDING AND SAFET p
Department of County EnTeer BU
[� OL
., County of Los Angeles l• _
I'^ WM. J. FOX. COUNTY ENGINEER �� - APPLICATION
FOR APPLICANT TO FILL IN q FOR OFFICE USE ONLY
BUILDING �{ J 4 /�/��p DIB I/C�TNO. PLAN C[. DLR,REc.No. /PER/,MIT NO.
ADDRESS .) !O !r{.- iYl.r•��n.c.'/�J /-lls'�+ - J � �T�� V '1-3 O
RECEIVED BY DATE OFAPPL. DATE IBBUED
LOCALITY
NEAREST BUILDING / -{
CROBB BT. _ ADDRESS 2
OWNER
MAIL LOCALITY
ADDREHS NEAREST
CR099 B'r. J�tJ•"l� lJ TJ��1(•
Cl NO. FIRE NO.OF E I TYPI GROUP
;ZONE / PLANS
ARCHITyB TEL
ENGINE NO. SET
Is
LINE NO.
ADDRESS 104
USE
TEL y ZONE 1�-/ BYPROVED DATE
CONTRACT ia;?"ym NO. O I ,/ -2 a HOUSE NUMBERING
ADD BB V U ` !i (f MAP NUMBER D O �+ NO. ASSIGNED BY
LEGAL wu . s - .�j,(�,:,.,��{1 /off CORRECTIONS -
DESCRIPTIO�N LOT NO. yip BLOCK __"
TRACT �T �� Lf,IQ 6 �• •_ 2�
,I NO. BLDG _
SIZE OF LOTJ .� '��Pl� NOW IFN LOT
USE OF
EXISTING BLDG. I F MIL6�
DESCRIPTION OF WORK
0
NEW ALTERATION T ADDITION _
` REPAIR DEMOLITION
NO or
M.F. ROOMS STORIES
EXT.WALL I ROOF
COVERING COVERING
USE OF STRUCTURE
INSPECTION FOR / APPROVALS
OCCUPANCY AS INSPECTOR'S SIGNATURE DATE
FOUNDATION: LOCATION
FORMS. MATERIALS
I HERESY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FRAME: FIREBTOPS.
PLICATION AND STATE THAT THE INFORMATION GIVEN IS
CORRECT. BRACING.BOLTS iE
1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FURNACE: LOCATION,
GAS VENT,DUCTS
SIGNATURE Cl - Vim. g LATH. INT.
PERMITTE
ADDRES O D LATH. EXT.
/ PLASTER. IMT. r JI P y6 f3
AUTHORIZED AST.
D
O P.C.O HOUSE NUMR EBE
6 COR-
-/
FEE /L�� RECT AND PORTED
VALUATION FINAL
v, FEE
7s Ws Dass 1-52