HomeMy Public PortalAbout10871 GRAND AVE_Relocation__ APPLICATION FOR RELOCATION PUILDINC PERMIT 1
" DIVffiION OF BUILDING AMID SAFETY BUILDING
Depmimmt of C--tv End ADDRESS
7eweara
Coantp of Los Angel"
0µ70 ".J. FOX, COUNTY ENGINIMR LOCALITY
11-04 CASSATT D. GRIFFIN, Sur,T OF BUILDIna NEAREST
CROSS ST.
FOB APPLICANT TO FILL IN DISTRICT NO. GROUP TYPE CONST.
PROPOSED.
BUILDING
ADDRE MAP STATS Yap NO
LOCALITY NUMBER HWYUSE ZONE SPECIAL
PRESENT CONDITIONS
-BUILDING
ADDRESS
LOCALITY UILDINO YARDy-R_9KT NAME - 'EXIST.QTBACK WIDTH
W
ONER 1 ROM
. L
MAIL IDE
ADDRESS L
TEL
CITY NO. • R1TY DA "r RIC'D
MOVING TEL ND Y
CONTRACTOR NO. RicC•D .
R S Y
ADDRESS
BUILDING TE APPROVALS
CONTRACTOR NO
DATE INSPECTOR'S SIGNATURE
AD D R E6Jz
PRESENT F LOCATION
USE OF R IALV
BUILDING - E: FIRE STOPS.
PROPOSED CINE BOLTS
UGE OF
RNACE: LOCATION
BUILDING. OAS VENTDUCTS
LATH 1 M.
SO. PT. NO: OR
SIZE ROOMD I LATH IEXT
WALL ROOF HOUSE NUMBER C
COVERING COV RI RECT AND POST
LEGAL
DEliCRIPTION LOT NO. OCK FINAL
TRAM DISTRICT HNGINEER
NO, OF BLDOf. WORK COMPLETED
SIZE OF LOT NOW ON LOT. SURETY BOND
USEOF -
or RELEASED
EXISTING BLDG. NAY1L1[l I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
1 HEREBY STATE THAT THE INFORMATION GIVEN IS COR- APPLICATION AND STAT�E�VVTHAT THS ABOVE IS CORRECT
RFCTSIGNATURE
IGN AND ➢TAT[AND AGREE TLAWSCOMPLY
RROULATINOITH LCOUNTY BUILDINGOCOINSTRU�CG .
Jz1ONA APPLICANT
OF TION.
APPLICANT
rVALUAT107N
BIONATURE OF
P[ 1TTEE
SP c-
ADDRESS
FEE f
WIL J"J. FOX, CouNTY ENaIN[>ot VALIDATION
BY BY
DEPUTY DEPUTY
BY ■Y
Jm DEPUTY DEPUTY
APPLICATION FOR RELOCATION BUILDING PERMIT ],
DNISION OF BUILDING AND SAFETY
DUILDING
DeP�� of ��Y Eal7laKr ADDRHSS
County of Los Angeles
76AS39
Def-72 WM.J. FOX. COUNTY ENGINXI R LOCALITY f
D -7•
12-84 CASSATT D. GRIFFIN, Sur,T of DUILDINO NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP. TYPO
PROPOSED
DU11"ING
AD MAP STATE YEf NO
NUMBER HWY.
LOCALITY UB NE SPECIAL
PRESENT CONDITIONS
BUILDING
ADDRESS
LOCALITY BUILDING YARD I HWY T BI'NAME EXIST.
D9.TBACK WIDTH
OWN FRONT sf
MAIL
y. P. L
ADDREbSJ } SIDE
P. L
T
CI N ■URITY DAT[ Yt='D
MOVING TSL *0HD= rllrp aY
CONTRACTOR NO CMH �J DAT[ IIXC'D
DQDerT SV rILI Y
ADDRESS
BUILDING TEL APPROVALS
CONTRACTOR NO.
DAT[ INSPECTOR'S SIGNATURE
ADDRESPRESS
FOUNDATION: LOCATION _
USE OFF FORMS MATERIALS
CUILDING FRAME: FIRE STOPS.
PROPOSED BRACING BOLTS
USE OF FURNACE: LOCATION
BUILDIN GAS VENT DUCTS
LATH INT.
SQ. FT. - NO. OF r�
SIZE ROOMS STORIES LATH EXT.
WALL ROOF HOUSE NUMBER COR-
_COVERIN COVKRING06Jlr;&j2& RECT AND POSTED
LEGAL
DESCRIPTION I LOT NO. FLOCK FINAL
TRACT RIOT 1 EER
NO. OF BLD-GS. WORK COMPLETED
SIZE OF LOT D NOW ON LOT SURETY FOND
USE OF HO.OF RELI A.SED
EXISTING BLDG. rAMILi[e I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
I HEREBY STATE THAT THE INFOR-MATION GIVEN 1 OR- APPLICATION AND STATE THAT THE ABOVE IS CORRECT
RECT. AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
SIGNATURE OF l,�' AND STAT[ LAWS REGULATING BUILDING CONSTRUC-
APPLICAF `- TION.
ADDRESS SIGNATURE OF
PF.RMITT
VALUATION 5 P
�D .r FEE ADDRESS ezz
WILLIAM J. FOX, CouNTY SNGINX13t VAIMATION
BY L&O97o�RWT .4 17 10.0crA, d
- DEPUTY DIEP
4051 JM10 7 0 5. 0.004 1 .00 1°
BY BY G ��t1 6 ,
m DEPUTY } � 0 Q .J E •ItI� DKPUTY