HomeMy Public PortalAbout4970 LOMA AVE_Relocation__ 76A899-CE 879-2-80 _
APPLICATION FOR RELOCATION UILDING PERMIT
COUNTY OF LOS ANGELES BUILDING `' 74
DEPARTMENT OF COUNTY ENGINEER ADDRESS ,-
BUILDING AND SAFETY DMSION LOCALITY r
JOHN A. LAMBIE. COUNTY ENGINEER
WILLIAM A. JENSEN,SUPNEARESTT OF BUILDING CROSS ST �
DIST NO 1GROUPITYPE SEWER MAP PR SSED BY
FOR APPLIC T TO FILL IN co P
PROPOSED ✓/ �� �+ ^/'
BUILDING MAP ATE
ADDRESS NUMBER HWY YES O
LOCALITYUSE ZONE SPECIAL
PRESENT ... a S CONDITIONS
- BUILDING YA��
ADDRESS
LOCALITY C/ SETBACK HWY ST ET NAME EXIST
C /o _ SETBACK WIDTH
OWNER S -` V/q Al C JI Lrj FRONT ,
MAIL
//�� P L
ADDRESS�C�sd� A- F SIDE
TX NE I P L
'= CITY t 9s SURETY DATE RECD
MOVING TEL. 7 BOND $ FILED-
"
ILED BY
CONTRACTOR NO. d
cc /►I ,. ` CASH DATE REC',
ADDRESS 3 dDi -S,4[/ QAi 9r-FF DEPOSIT $ FILED BY
APPROVALS DATE INS T R'S' I NATURE
BUILDING E 1, ,y+
CONTRACTOR /� N 57 FOUNDATION* LOCATION ATERIALS O
"� a''
FORMS,-M
ADDRESS F_ `/ (�
FRAME- FIRE STOPS,
USE OFT Ll(N/7`4_ �� Z 3 li BRACING, BOLTS �..�
BUILDING �V FURNACE LOCATION 0
PROPOSED /�/� .►� A(.'jr GAS VENTS, DUCTSUSE OF / U
-70
BUILDING �' '` -5- O ��
LATH, INT
SQ FT. N10
OFS / LATH, EXT
SIZE ROOMSTORIES
WALL ROOF HOUSE NUMBER C -
COVERIN COVERING RECT AND P S
LEGAL ��I FINAL
DESCRIPTION LOT NO. BLOCK wvXy 11
/ DISTRICT ENGINEER
TRACT WORK COMPLETE
NO OF BLDGS.. ` SURETY BOND
SIZE OF NOW ON LOT / RELEASED
USE OF I No OF 1 HEREB A NO LE GE THAT 1 HAVE READ THIS
EXISTING BLDG FAMILIES APPLICATIO A D S AT THAT THE ABOVE IS CORRECT
I HEREBY STAT4T 'THE INFOR TIOI`[GIVEN IS AND AGREE O OMPIrY ITH ALL COUNTY ORDINANCES
CORRECT jl AND STATE I
LATING BUILDING CONSTRUC-
SIGNATURE OF TION.
APPLICANT 1 CERTIFY T AT NG THE WORK AUTHORIZED I
ADDRESS �� • /e �7 WILL NOT E PLOPERSON IN VIOLATION OF THE
_ WORKMEN' COMION LAWS OF CALIFORNIA.
VALUATION $ P C. $ ti SIGNATURE OF
FEE I PERMITTEE
w
FEE $ ADDRESS
VALIDATION cK M.o. CASH CLYDE N DIRLAM, PRINCIPAL STRUCTURAL ENGINEER
PERMIT VALIDATION CK. M.O. CASH ®P
L11L;o�8 '1 8 0:"D-I DEC 10 2) 5 a 25-00
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