HomeMy Public PortalAbout9101 HERMOSA DR_Relocation__ APPLICA:TJON FOR RELOCATION BUILDING-PERMIT
DIVISION OF BUILDING AND SAFETY Bu ILDING
Departinent of County Engineer ADDRESS
9
County of Los Angeles
OSS n - -
7a WM. J. FOX. COUNTY ENGIN EER' LOCALITY
Des
12.54 CASSATT D. GRIFFIN, SUPT OF BVILDIND NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN` DISTRICT GROU I TYPE CONS
PROPOSED '.
BUILDING 9/61 A v�,
ADDRESS MAP STATE YES do
_ /� NUMBER HWY.
LOCALITY IEMpL/- e! 117-1, CALIF - USEZONE SPECIAL
PRESENT ,/ /' p /•' AVE /��J CONDITIONSBUILD .
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ADD EISS ' Z I((6 12A/C V6 7 AV
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ADORESS �. ,c,.�ivJJSA /C. SIDE
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CITY f�C� / NO. T �S SURETY .DATE REC-D
MOVING _ TEL. T BOND$ FILED BY
CONTRACTOR A ,�A,P p NO.ATO//z27 CASH D ATE ` EO'D 1� /
O '7 E4,V GAQ.�. DEPOSIT$ FILED Y
ADDRESS `7'T/ Lc S"14 '6 �q�J�,,
BUILDING TEL
l/ Q�yq�g..{/i+'APpROVALS f
CONTRACTOR SEL NO. - 1 - „ -�J
DATE INSPECTOR'S SIGNATURE
ADDRESS
PRESENT �AF VG F OCATION
FORMS. MATERIALS ��
BUILDINGS�2A&4C
-FRAME: FIRE STOPS.
PROPOSED 9 BRACING. BOLTS
USE OF .vn
BFURNACE:T.LOCATION
VENUINGQT ��O'•` GAS DUCTS
o 0c1411196&!CiAL =.
LATH. INT.
SOFT. NO. OF d i --
'SIZE 11' rr77 ROOMS TSTORIES LATH, EXT. S"WALL '
ROOF
COVERING WALL &A" I .COVERING K' PAP Ems( HOUSE NUMBER COR-
RECT AND POSTED —�
LEGAL / t�
DESCRIPTIONr ..LOT NO 31577 BLOCK FINAL
TRACT J /Q�- _ ('S� ICT F/�QGI/yEER
pC NO. OF BLDGS. WORK COMPLETED S`I �(� !//:Lwy'1'G J�
SIZE OF LOT-�:Y-r x �SO NOW ON LOT / SURETY BOND
.USE OF I ND.OF RELEASED '
EXISTING BLDG; - NOME J FAMILIES I HEREBY ACKNOWLEDGE THAT IHAVE READ THIS
1 HEREBY STATE T AT THE INFORMATION G N IS COR- APPLICATION AND STATE THAT THE ABOVE IS CORRECT
RECT. AND AGREE TO COMPLY WITH ALL COUNTY'OROfNANCES
'SIGNATURE OF �y/�y/ AND STATE LAWS REGULATING .BUILDING CONSTRUC-
APPLICANT /f / . TION.
ADDRESS E nOlA - old 66,66 SIGNATURE OF lNWfv�
PERMITTEE
VALUATION $ pO FEE $
ADDRESS / �^ �-""^' —'�—
FEE$ J ��'
WILLIAM J. FOX, COUNTY ENGINEER VALIDATION '
BY iD&O 2;S`2m JAN 1.p 1..7. A 1.0 004,2 BY
%7 1
JAN 16 74 �
A 8 E®I�'O3 0 DEPUTY
4.2:- JAIL 16- 6 A. 6.0 0
!0 � /� "�g�/PJUTY }��y('' /� /DA _- DEPUTY
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