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76M<99-CE'#875`9-P] MISCELLANE00S APPIL.I'CATION
COUNTY OF LOS ANGELES
DEPJIRTNENT OF COUNTY ENGINEER ADUDRBILDESS —
ING
BUILDING AND SAFETY DIVISION
JOHN A. LAMBIE. COUNTY ENGINEER LOCALITY L _
COLEMAN W. JENKINS, SUPT. OF BUILDING NEAREST
CROSS ST.
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP TYPE PR S BY
BUILDyy'� f {1 —(,� - CONST. '
ADDRESS �1J iL/(J /Y /`.
Map / HIGH WA♦ STATE MAJOR SECONO
21
LOCALITY / o L 7�T 11�NE SPECIAL CONDITIONS
NEAREST 1
CROSS ST. - A
P p Q ((� V a
LEGAL EOU IRED YARD HWY STREET NAME EXIST.
DESCRIPTION LOT NO. BLOCK SETBAWIDTH
FRONT
NO. OF BLDG S. /� P.L. U +S
TRACT J NOW ON LOT OF 0— �jJ SIDE
SIZE OF LOTS_ EXIS{TI�NG BLDG ARC IDI' P.L.
OWNER �� Ii D ,T['hP T.2 /
42
MAILZaL- L .-( t' XAY; '
ADDRESS
TEL.
CITY NO. CD
APPLICATION FOR v
OCCUPANCY O
INSPECTION jl— SAFETY PERMIT ^N U
W W
7 1
TRAILER USE N
USE OF STRUCTURES OR DEVICES ••// Z
L L% .� � ✓ � . ._XIS � L Ll Y'It
LIMITED TIME USE
DATE DATE
FROM: TO:
INSPECTOR'S
APPROVALS DATE SIGNATURE
OCCU PANCT APPROVAL
I EEREBY ACKNOWLEDGE THAT I HAVE READ THIS GROUP OCC. LOAD
APPLICATION AND STATE THAT THE ABOVE IS —m-
RECT AND AGREE TO COMPLY WITH ALL COUNTY TRAILER USE
ORDINANCES AND STATE LAWS �,EGULAT,N�(G S CH
WORK AS INDIC ATEA EREON. //7
SIGNATUREOF C,-a!�CC //� B SAFETY PERMIT
PERMITTEE //WWWnf TEMPORARY
ADDRESS LLCZCLG STRUCTURE APPROVED
TEMPORARY
? F7 (,F STRUCTURE REMOVED
FEES uV / �L
1 _ FINAL APPROVAL (fi 16 A t `--�
APPLICATION VALIDATION 1 JOHN F. LEWIS, PRINCIPAL STRUCTURAL ENGINEER
(NOTA PERMIT) �/I CCK. M.0. GASH PERMIT VALIDATION CR. M.D. CASH
� 4 3 4 82 RFR22 2 2 D 1 5.00-