HomeMy Public PortalAbout10014 GREEN ST_Relocation__ APPLICATION FOR RELOCATION BUILDING_ PERMIT ],
DIVISION OF BUILDING AND SAFETY BUILDING
Department of County Engineer ADDRESS )
County of Los Angeles
DBS,79 WM•J. FOX, COUNTY ENGINEER LOCALITY C- r
12.54 CASSATT D.GRIFFIN, SUPT OF BUILDING NEAREST
CROSS ST. -L{_yV -- •[.
FOR APPLICANT TO FILL IN DISTRICT NO. rl GROUP I TYPE CONST.
PROPOSED ,./ r s/
ADD EISS /0D/,vCr8 LSC./� -4 /�/' MAP STATEi
NUMBER HWY. YES O
LOCALITY / e./y ►�� / y USE ZONE SPECIAL
PRESENT / CONDITIONS
BUILDING O
ADDRESS
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_LOCALITY -'/- i /O,OV7'' YARD HWY 5'�REET NAME I
BUILDING EXIST.
SETBACK WIDTH
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OWNER /7' R. A//C �1p0�n1SO ,V Q P. L.MA'L � ���•
ADDRESS 99.5 ' .�[7 1'✓�/� �7 Z�U�Ig /fin j9rV SIDE
CITYTE .CL M�iN7�P NOL(..'^�' `l
v SURETY DO DATE C'D
MOVING /' /� TEL./i/, R7/73 BOND$ �Q FILED'j Y
CONTRACTOR ELr4�✓ (-.RRIVf'i�NO. CASH DATE r el
I A� DEPOSIT$ FILED BY
ADDRESS,2i il.Ce oS Ve L RDAd A�IYCA':,'
BUILDING TEL
/ APPROVALS
CONTRACTOR D W >✓ .O.Gl
ADDRESS W y v DATE INSPECTORS SIGNATURE
PRESENT FOUNDATION: LOCATION
USE OF FORMS, MATERIALS /-
_BUILDING yD Al-c- FRAME: FI
AME: I BSTOOPS.
P ROP O S E D -
USE OF /,O M FURNACE: LOCATION p
BUILDING �7 GAS VENT, DUCTS Z7
LATH. INT.
SO. FT. /� NO. OF
SIZE f/C(/ ROOMS STORIES j
LATH. EXT. 7 /�-�� �/ Sd-WALL r
RING -STiyt'c''_0 I COVOERING�f1J T/'-7�' r� HOUSE NUMBER COR-
COV C --ff�`//
- RECT AND POSTED •�` J per{',. ,
LEGAL i
DESCRIPTION I LOT.NO.. I BLOCK FINAL
TRACT Se-C. 44?2f s7C. Ae(2� DISTRICT ENGIN�ER
WORK COMPLETEDNO. OF BLDGS.
SIZE OF LOT _ I NOW ON LOT -` -` SURETY BOND
USE OF NO.OF RELEASED
EXISTING BLDG. _C "" FAMILIES
■ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
I HEREBY STATE THAT THE,t FORMATION GIVEN IS COR- APPLICATION AND STATE THAT THE ABOVE IS CORRECT
RECT. _�. AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
SIGNATURE OF - TAND ION. LAWS REGULATING BUILDING CONSTRUC-
APPLICANT -
ADDRESS �` SIGNATURE QF.
PERMITTEE- /"
VALUATION ,�--�
P.C. $
Z L -0 FEE ADDRESS
FEE S i
WILLIAM J. FOX, COUNTY ENGINEER VALIDATION
BY / ill n n BY
DEPUTY ,-1 DEPUTY
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