HomeMy Public PortalAbout6311 ENCINITA AVE_Relocation__ I
70AE99-CE 979•2-90 /�n7 d/C ✓i �j
APPLICATION FOR RELOCATION BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDREss .
BUILDING AND SAFETY DIVISION LOCALITY " ^�
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. d A/
DIST.NO. GR UP TYP SEWER MAP PR CESSED BY
FOR APPLICANT TO FILL IN C s . BK PG
PROPOSED —
BUILDING q YY
ADDRESS / AIEi NUMBER / 6 0 J HWY. YES NO
LOCALITY 21 i USE ZONE SPECIAL .T�
PRESENT R CONDITIONS 4 J P /C%(//..
ADDRESUILDISS L' i /(_ I _ _ / mo
i BUILDING EXIST.
LOCALITY SETBACK YARD HWY STREET NAME WIDTH
OWNER / FRONT
P. L.
MAIL
ADDRESS SIDE
T-V�— TEL. P. L.
49
NO.
77
URETY
M OTVING TEL. Sv,,,,D $ 2 S—AFI EE / BEC'D
4 CONTRACTOR NO. KJ-
ADDRESS DER IT 3�P r Y
BUILDING qq TEL. 9 APPROVALS DATE INSPECTO SSI GNAT RE �..,
CONTRACTOR yV E No. g7-^ 3O FOUNDATION: LOCATION ..¢ R'
FORMS, MATERIALSOin-/I/` EU
ADDRESS FRAME: FIRE STOPS, U
PRESENT BRACING. BOLTS al
USE OF r
BUILDING G FURNACE: LOCATION Q
PROPOSED GAS VENTS, DUCTS U
USE OF
_. r I✓a
BUILDING - LATH, INT. R.
II SO. FT. NO. OF LATH, EXT. J—G /Jii-gwvt.(y�/ R
SIZE ROOMS STORIES
WALL ROOF
HOUSE RECT AND POSTEDR
COVER IN ® COVERING
LEGAL
DESCRIPTION I LOT NO. FINAL BLOCK _
..` V � 15TRICT ENGINEER
TRAC
WORK COMPLETED
/ �I
3
NO. OF SLOGS. Q SURETY BOND �/ ( e I
SIZE OF LOT/06'X NOW ON LOT C� RELEASED !, Y
USE OF No. OF 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
EXISTING BLDG. ✓ I rAnU LIED APPLICATION AND STATE THAT THE ABOVE IS CORRECT
I HEREBY STATE THA TH NF MATZO ,GIVEN IS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
CORRECT, yy� AND STATE LAWS REGULATING BUILDING CONSTRUC-
SIGNATURE OF J TION.
APPLICAN/T� !�`` - I CERTIFY THAT IN DOING THE WORK AUTHORIZED 1
ADDRESS (G�� /iiiGL;C (�.. WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
WORKMEN'S COMP NSATION S O CALIFORNIA.
VALUATION $ 7 0-0 FEE $ SIGNATURE OF
PERMITTE l
/ FEE S I ADDRESS
VALIDATION CK M.O. CA9H CLYDE N. DIRLAM, PRINCIPAL STRUCTURALGINE fZ
PERMIT VALIDATION — M.O. CASH ®r
LriLo 9 1 9 2 JAS! 7 2 5 D 2 5.0 0- Q
L&I O 9 3 2 6�2 J0118 6 D �/1 1 .5 0