HomeMy Public PortalAbout4916 MCCLINTOCK AVE_Relocation__ NT OF BUILDING AND SAFETY APPLICATION FOR BUILDING
-` CLIAM
TY OF LOS AP.:-:..LES
J. FOX, CHIE IGINEER _� E Lo. ALT-I-0-N. -
i; :s -
FOR APPLICANT TO FILL 1N FOR OFFICE USE ONLY
PR POSED /�/ RELOCATION APPLICATION.
BUILDING ��}�/ /P� p ljG Ls `�Cr4�" -
ADDRESS L fC !Y me - -
DISTRICT NO. . RECEIVED BY DATE RECD RECEIPT NO.
LOCALITY
PRESENT ✓ I fa °� r�� �/Z�Eg
BUILDING r:/AtA-� At(�
ADDRESS a Iv _ I BUILDING APPLICATION
LOCALITY yy yy A {S�4 IbC-AJ PLAN CK.NO. PERMIT NO.
OWNER @i! d`Q (�®��! r 70 �7- 4
MAIL q®. ��� RECEIVED BY DATE OF ADPL. DATE ISSUED
ADDRESS 94i
TEL.
CITY �l V/ NO. FIRE NO.OF TYPE GROUP
ZONE I PLANS I y Ir
MOVING TEL.
CONTRACTOR NO. BLDG. ORD.NO.
SETBACK LINE 2-C
ADDRESS APPROVED
BUILDING .� TEL. BY DATE
CONTRACTOR �j NO.
USE APPROVED
�y �o ZONE q BY DATE
ADDRESS.. l HOUSE NUMBERING
USE OF', (�'[�9/J: � Map Number..Zd.�.�----- Field Check By--------------------_---
BUILDING
PROPOSED NO.Assigned -----:_ Date-------------------------------
USE OF ]� y
BUILDING
SQ.FT. �. V NO. OF V
SIZE A ROOMS STORIES
COVERING �C C-0 I COVERINGWALL ROOF
LEGAL
DESCRIPTION LOT NO. ;'BLOCK
TRACT
av NO. OF BLDGS.
SIZE OF LOT NOW ON LOT
USE OF NO.OF NO.OF
EXISTING BLDG. FZ.OLF S. ROOMS
1 HEREBY STATE,THAT THE-INFORMATION'GIVEN AND• /.� J
�•ZfJ v
THE PLOT PLAN SUEMITTED'ARE CORRECT:
///J APPROVALS
SIGNATURE OR //
Imo►
APPLICAN /✓ . ! R FOUNDATION: LOCATION SPECTOR DATE
FORMS, MATERIALS
® FRAME:FIRE STOPS,
ADDRESS -/ � ��t® BRACING,BOLTS \
y I`
LATH, INT.:
RELOCATION
APPLICATION .S 0.00:: LATH, EXT.:
-FEE
P.C.4, PLASTER, INT.
�pOr FEE [ PLASTER, EXT. A
VALUATION FEE, FINAL
L76AS39 8-49