HomeMy Public PortalAbout6241 HART AVE_Relocation__ T T �
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7d.098-CE 979-2-60
APPLICATION FOR RELOCATIO BUILDING PE IT 1
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS 7� /�
BUILDING AND SAFETY DIVISION _LOCALITY / /�J/ /�jJ,4 � V r-
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. "' `" 101F �c
DIST NO GROUP TYPE SEWER MAP PR CES BY
FOR APPLICANT TO FILL IN I coN K- P
PROPOSED
BUILDINGMAP '- STATE
ADDRESS u NUMBER C� C/.�� HWY. YES NO
LOCALITY J/ USE ZONE SPECIAL
PRESENT CONDITIONS
BUILDINGa .r,
LOCALITY / rSS/ �GS BUILD NG EXIST
L
� tt SETBACK YARD STREET NAME WIDTH
OWNER / �L S FRONT
P. L.
MAIL //__ // `' ,/
ADDRESS (p v{„ TA Ah v SIDE
CITY 4F C/ W� NO.TE CV3;;gj6 P L l
MOVING TEL. SURETY \ DATE
11ATE RECD t
CONTRACTOR p� J NO. SA)V I�4 $�C �+i—�-- � b
9efR' $ -
ADDRESS DE?
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BUILDING TEL. APPROVAL DAT 9V INS CTOR'S SIGftXMlk& �..�
CONTRACTOR NO. FOUNDATION: LOCATION Q'
FORMS, MATERIALS 0
ADDRESS FRAME: FIRE STOPS, 0
PRESENTBRACING, BOLTS
USE OF
�V V/'14A/7.�,_ D k/� � 0 e
IBUILDING FURNACE: LOCATION
H
PROPOSED GAS VENTS, DUCTS W
USE
BUILDING LATH, INT. 11,
Z7�
SCI. FT. NO. OF LATH, EXT, a
SIZE OQA J�ROOMS STORIES
COVERING PLgsr�/1 ROOF HOUSE NUMBER
COR-
COVERING RECT AND(POSTEDED
LEGAL 2 'O� 2D ANO / ZZ FfNAL / +';
DESCRIPTION LOT O.
DISTRICT EER
TRACT �CD WORK COMPLETED
7I NO. OF SLOGS. S' SURETY BOND
SIZE OF LOT
NOW ON LOT 0 RELEASED
USE OFNo. Df I HEREBY ACKNOWLEDGE THAT 1 HA E EAD THIS
EXISTING BLDG. - FAMILIES APPLICATION AND STATE THAT THE ABOVE IS CORRECT
I HEREBY STATE THAT THE INFORMATION GI EN IS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
CORRECT. AND STATE LAWS REGULATING BUILDING CONSTRUC-
SIGNATURE OF TION.
APPLICANT 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED I
ADDRESS SIP4 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
WORKMEN'S COMPENSATION LAWS OF CALIFORNIA.
VALUATION $ P. C. $ SIGNATURE OF y
�) FEE PERMITTE
r S
E $ ADDRESS 14 �
VALIDATION CK. M.O. casH CLYDE N. DIRLAM. PRINCIPALS UC URAL ENGINEER
PERMIT VALIDATION GK. M.O. CASH ®F
Il
7 4 7 9 JNA :?6 5 D 15 .- a Y;
1 4 QJ ILD 1 6 D 15.Ci n Y
16�41�