HomeMy Public PortalAbout10134 LYNROSE ST_Miscellaneous__ 76M444-CE.S8764-67 WSCELLANEO�1 S APPUCA u�ON
COUNTY OF LOS ANGELES u [�
DEPARTMENT OF COUNTY ENGINEER ADD BUI EI S S
BUILDING'AND SAFETY DIVISION LOCALITY
JOHN A LAMBIE, COUNTY ENGINEER
_ COLEMAN W. JENKINS. SUP'T. OF BUILDING NEAREST j��� �J�/•
CROSS ST .L.'17 ��0
FOR APPLICANT TO FILL IN DISTRICT NO GROUP TYPE �PoR/O�CESSED BY
o .r CONST ~&
BUILDING �jHIGHWAY
ADDRESS Q _ NO CiO-/ (C RCLE) STATE MAJOR SECOND LOCAL
LOCALITY USE ZONE SPECIAL CONDITIONS
NEAREST
C R O S S S f
REQUIRED EXIST
LEGAL SETBACK YARD HWY STREET NAME WIDTH
DESCRIPTION LOT NO BLOCK
FRONT
NO OF BLDGS P L
TRACT NOW ON LOT SIDE
USE OF P L
SIZE OF LOT S.S / EXISTING BLDG
'i -' C.,t PfI7 / Lii6S I�f
OWNER
MAIL
ADDRESS
CITY r �.. . NOL C
APPLICATION FOR v
OCCUPANCY O
INSPECTIONSAFETY PERMIT G7
LII
TRAILER USE
N
Z
USE OF STRUCTURES OR DEVICES
'9 12-
LIMITED TIME USE
DATE DATE
FROM TO
-INSPE C T OR'S
APPROVALS DATE SIGNATURE
OCCUPANCY APPROVAL
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS GROUP OCC LOAD
APPLICATION AND STATE THAT THE ABOVE IS COR-
RECT AND AGREE TO COMPLY WITH ALL COUNTY TRAILER USE
ORDINANCES AND STATE LAWS REGULATING SUCH
WORK AS INDICATED REON
SIGNATURE OF "�//• SAFETY PERMIT
PERMITTEE
TEMPORARY
_ STRUCTURE APPROVED
ADDRESS TEMPORARY
STRUCTURE REMOVED
FEE Pjci
FINAL APPROVAL
APPLICATION VALIDATIOJOHN F. LEWIS, PRINCIPAL STRUCTURAL ENGINEER
(NOT A PERMIT) cK M o CASH PERMIT VALIDATION CK mo CASH
s 0 3%-Z FE$20 2 2 D 15.0 0