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76M444D8S 75 12-54 -IMM' SCELL® NEOUv -APPLICATION
DIVISION OF BUILDING AND SAFETY OCC �i�T��+ FETY-TRAILERS i
Deportment of County Engineer L7
County of Los Angeles t
WM.J. FOX, COUNTY ENGINEER BUILDNG
ADDRESS J19CASSATT D.GRIFFIN, SUPT OF BUILDING y � J�
FOR APPLICANT TO FILL IN' LOCALITY 0�� 7
NEARE
OWNER J!%.�%� v/OLS /YIL�� .a-.� CROSS ST
T. 6.�
MAIL
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ADDRESS 1T�j DISTRICT NO. GR
fOI •-7 TYPE CONST.
_ TEL. �/ ..�--
CITY.///D/Y% /� Y �/� �1 NO. h/-T_��1 aj
MAPSTATE
CONTRACTOR NO. yES",2 NO
TEL. NUMBER - Z:+. HWY I
U E ZONE SPECIAL a
ADDRE S CONDITIONS
LEGAL
DESCRIPTION I LOT N • � / BLOCK BUILDINGEXIST.
WIDTH
SETBACK YARD HWY' STREET NAME
TRACT �7�7��� I NOW ON LATS �.
�y FRONT.
USE OFC P. L.
SIZE OF LOTl4
am�'6 X ��D I EXISTING BLDG. c=O' SIDE
APPLICATION FOR ' ° L.
---- INSPECTION'RECORD
OCCUPANCY
_ INSPECTION Jt I SAFETY PERMIT
.........................._.................:.................................................................................................................
TRAILER USE I LIMITED TIME USE -
.................:....:.I............:......................:......................:....................................... ....................................
.....................I...................................................................................................I.....................................
DATE DATE
........................i...................................................................................................I.....................................
FROM: TO: '
USEOF STRUCTURES OR DEVICES ........................I..................................................................................................I.....................................
................_.....I..................................................................................................I.....................................
KA0154?(AA-'. C2eK__ca Pyr Jt y ...................................................................i.....................................
.......................I.....................:............................................................................i....................................
........:..:........... ............:...................................................................................L....................................
{-PAID A5e_ck,0 c pz t(eicA-TG,- t�; ........................:.................................................................................................I....................................
Ole APPROVALS
INSPECTION FOR - I DATE I INSPECTOR'S SIGNATURE
OCCUPANCY AS OCCUPANCY APPROVAL
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS` GROUP OCC. LOAD-
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES TRAILER USE
AND' STATE LAWS- REG ULATING BUILDING CONSTRUC-
TION. SAFETY PERMIT
SIGNATURE OF - 'TEMPORARY
PERMITTEE_-- - STRUCTURE APPROVED.
ADDRESS TEMPORARY
.. STRUCTURE REMOVED
FINAL APPROVAL
WILLIAM J. FOX, COUNTY ENGINEER VALIDATION
o,1 8 G.P, PAY 18 18 5 .0 1 � r�
BBY
DEPUTY' - - DEPUTY