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DEPARTMENT OF COUNTY ENGINEER MISCELLANEOUSDIVISION OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES OCCUPANCY SAFETY TRAILERS
WILLIAM J. FOX, COUNTY ENGINEER
CASSATT D. GRIFFIN, SUPT OF BUILDING APPLICATION
FOR APPLIC NT TQ FILL IN BUILDING
BUILDING AT_ Q ^ n ADDRESS D
ADDRESS - "V {/ Lm -4 cWa
LOCALITY
LOCALITY J NEAREST f
NEAREST CROSS ST.
CROSS ST. DISTRICT NO. PUN CK. DR REe.No,
PERMIT NO.
OWNER
MAIL /� 6�/ RECEIVED BY DATE OFAPI DATEISSUED
_ADDRESS {% G k,/ <:�z- :7
CITY gj!!� Y TEL U//S 11E ZONE MAP NO. TYPE 1 /G�R� UP FIRE ZONE
CONTRACTOR TEL / PPItI OV
ZONING GATED
ADDRESS APPROVED BY_
LEGAL BUILDING
ORD. No
DESCRIPTION LOT NO. BLOCK SETBACK LINE:
DATE
APPROVED
NO. OF BLOBS. By;
TRACT NOW ON LOT
USE OF
HOUSE NO. DATE
A9gIGNED BY
SIZE OF LOT "STING BLDG. CORRECTIONS
APPLICATION FOR
OCCUPANCY DATE INSPECTOR
INSPECTION I SAFETY PERMIT --------------_I-....._....-------.......... .........................._...........-_1..._I................
M 19CELLANEOUS I ./ i.�F.�a - f_�„��/,!--*/- .� �Y._��...-...�--.
............... T
TRAILER USE I LIMITED TIME USE -----.�...__. _._...._.._..... _�_I.............._------__.
DATE DATE
FROM: TO: ............. ..... ....-......................................I-------------- _......
USE OF STRUCTURES OR DEVICES
_...-..... .... _-0..........5..........�......._..-s- --i........__...... --
LAge / eoc. 4,. ,e� i.----........._.__.... rt- --.........._
........................_...._..__......_....._. =1---- __
... ------
ev
1 ..
INSPECTION 40R ---------------_-. ..._......................
I-......_...._........_...
OCCUPANCY AS
........_._._ ......................._._............................_.....__...
.I_................_.__.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP-
PLICATION AND STATE THAT THE IN
GIVEN IS .-_--.___------------------------------------------------------------------------------
CORRECT.
IAGREE TO COMPLY WITH ALL COUNTY ORDINANCES
ANO STATE LAWS REGULATING BUILDING CONSTRUCTION. ..----..........L.....---..---...-..---.-.-.---..------..-----
..._.---
---.-------I-_.----.---_......._...
` APPROVALS
SIGNATURE OF //// INSPECTOR'S SIGNATU DATE
PERMITTEE �fiG ��i OCCUPANCY APPROVAL
N /1^ ,[ GROUP DCC.LOAD
I,
ADDRESS -'-`/-E" `� 713'ei /T�Q "j�
N ^- >-„-r- TRAILER USE
m AUTHORIZED AST. SAFETY PERMIT
ff1��
m
D O STRUCTURE APPROVED
TEMPORAR
MISCELLANEOUS FEE I TEMPORARY
d STRUCTURE REMOVED
PERMIT FEE I s FINALAPPROVAL V ��