HomeMy Public PortalAbout9941 LOWER AZUSA RD_Miscellaneous__ 76M444 D"731234 MISCELLANEOUS APPLICATION 1
DIVISION OF BUMMIG AND SAFETY OCCUPANCY-SAFIG-Y.TRAUMS
Depaatment of County Engineer
County of Loa Angeles BUILDING
WM.J. FOX. COUNTY ENGINEER ADDRESS
CAISSATT D GRIFFIN.Sup T or Bummma
NEAREST
17 FOR APP AN T 1 LIN
NEAREST
OWNERP et CROSSST
► MAIL
ADDRESS PJjz • DISTRIC�10 I GROUP I
CITY
TEL
TYPE C�"ST
O 2 5 'I,�! /
MAP STATE YES
TEL NUMBER HWY
CONTRA OR NO USE ZONE SPECIAL
ADDRESS CONDITIONS
LEGAL • f�L'1•
DESCRIPTION L T / BLOCK
BUILDING YARDHWY STREET NAME EXIST
NO OF SLOGS SETBACK WIDTH
TRACT NOW ON LOT
FRONT Q
P L
SIZE L / USE ON SIDE
APPLICATION FOR P L
OCCUPANCY INSPECTION RECORD
INSPECTION I SAFETY PERMIT
TRAILER USE LIMITED TIME USE
DATE DATE
FROM TO
USE OF STRUCTURES OR DEVICES -----
V»_»
APPROVALS
INSPECTION FOR DATE I INSPECTORS SIGNATURE
OCCUPANCY AS OCCUPANCY APPROVAL
I HEREBY ACKNOWLEDGE THAT t HAVE READ THIS GROUP OCC LOAD
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WIThL ALL COUNTY ORDINANCES TRAILER USE
AND STATE LAWS REGULATING BUILDIN, L NSTRUC-
TION
SAFETY PERMIT
SIGNATURE OF J l TEMPORARY
PERM ITTTTEEE�(,ESTRUCTURE APPROVED
`� .1f z TEMPORARY
ADDRES
d� STRUCTURE REMOVED
FINAL APPROVAL
WILLIAM J.FOX.COUNTY ENGINEER VALIDATION
3592A MC21 13 5.0014
BY BY
DEPUTY DEPUTY