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APPLICATION FOR RELOCATION BUILDING P RMIT `
COUNTY OF LOS ANGELES BUILDING
OF COUNTY F.NG]N= ADDRESS r
JOHN
MIDA. I. CSAF EIMONR v ALIT I
WILLIAM A.JENSEN,BUP•T OR BUILDING CROSSEST
ST.
1ST.NO. GROUP TYPE SEWER MAP P ESSED BY
FOR APPLICANT TO EM IN coNST. K
PROPOSED •�I fe
LULL a
BUILDING
DDR •• W I NOT REQUIRED REG VED
CE
ARTIFIGATEe
LOCALITY CJS 1 MAP n a ICIRCLE)HIGHWAY
NO, STATE MAJOR SECOND: OCA
PRESENT
BUILDING USE N6 SPECIAL
ADDR ' CONDITIONS
LOCALITY
OWNER r BUILDING YARD HWY RE NAME EXIST'
MAIL SETBACK WIDTH
ADDRESS FRO
TEL-CITY NO. ( D I P
CONTRGACTOR NO• 1
/� •� WNW" DATE RECD
ADDRESS tZadILS ka Yr GOND
' , —F IL_
NTINaari NO7Q CASH DATE
SI
ADDRESS 'ILw
r , y t D - A I� APPROVALS DATE INSPECTOR'S S16NATU D W
UNDATION: LOCATION �•'
PRESENT _ IFORMS, MATERIALS
USE OF
BUILD NO S `� a"Av IreS-9A.w FRAME. FIRE STOPS,
PROPOS BRACING, BOLTS Z
USE OR 5+ ( FURNACLr'LOCATION
BUILDIN . ENTS, DUCTS
SQ. FT. NO. OF t LATH INT.
SIZE O ROOMS �It� STORIES
WALCOVE `� I COVERING a s i LATH BTT.
LEGALHOUSE NUMBER COR-
DESCRIPTION O NOi BLOCK RE6T AND POSTED
TRACT FINAL
2.6
,OF 1111-088. DISTRI G EER •ID.
SIZE OF X I 001W ON LOT I SURETY BOND
USE OF 11-- , L NO. OF RELEASED '
EXISTING BLDG.S! WV FAMILIES I I.HwEBY ACKNOWLEDGE THAT 1 HAVE READ THIS AFPLICATION•'
1 HEREBY STATE THAT THE INFO TIO GIVEN IS ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
CORRECT. WITH ALL COUNTY ORDINANCES AND STATE, LAWS REGULATING
SIGNATURE OF BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
APPLICANT Q� AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA-
TION OF THE ADDRESS V 4a�B+a INV TO WORKM`e aRCOMPENSATION INSUROF THE STATE ANCE. RELAT•
VALUATION $ FES• $ PENVI j ITT'
FEE *Q ADDRESS
VALIDATION M.o. eAsx I JOHN F. LEWIS.PRINCIPAL URAL ENGINEER
PER= VALIDATION M.O. CABN
8918Q FEB2525 D 25. 94-183Q vl%R 490. 0 -800.00-
L`'' 91800 WIR . tf. 90 D $ 00. �i184Q MAR 490 D 900.00'"� P
��RI A .1 M- - hilkR—, --- - r. � 8 5Q 1•AR 4 S D ' 15.00~ 4
18 Q..RAR 490 0 800.0ON