HomeMy Public PortalAbout5438 PAL MAL AVE_Relocation__ � ` r
APPLICATION FOR RELOCATIO 1 ING PERMIT
DIVISION OF BUILDING AND SAFETY, BUILD
Department of County Engbum ADDR
County of Lw Angelosl
76X439 JOHN A LAMBIE.COUNTY ENGINEER _ LD AZA
Dee 79 H e9 CASHATT D GRIFFIN SUP T OF BUILDING NEAR
CRO
FOR AFFLICANT TO FILL IN DIST uPTYPE SEWER MAP
K
PROPOSED SitCONfrr
BUILDING
ADOR M STATE
L LITY r 1%4 I CI NUM HWY YES O
USE NL AL
P /� 1'
a I I G 6304 / `I IL-1 Vbf -,rL D IO 8 /—
CITY Y4 BUILDING YARD R IST
SETBACK WIDTH
LADDRFSS
ER (/O A kH !h {{� FRONT
M MAIL
etie 5 r /�R I / PI /'1 L, SIDE
l+l C Np-1s / Z's �GURIITYJ
ING TEL [� eOX�J ��� DATE
TRACTOR UKfO ( t f NO
(� CAeX DAT! 116C D
T O ✓ y DEPO3R PP m �Y
BUILDINGTEL APPROVALS
CONTRACTOR V NO TIL INSPECTOR S SIGNATUR
ADDRESS
FEF
OUNDATION LOCATIONS
PpRESENT J1 FORM MATERIALS
BUIILDIING FA 6, f A -� FRAME FIRE STOPS.
BRACING BOLTS
PROPOSED �
u8E OF 4. FURNACE LOCATION
BUILDIN 1"a GAS VENTS.DUCTS
LATH.INT
HO PT 1306 NO OF L
SIZE ROOMS v STORIES
WALL S CCG 00
COVERING
LATH B)(T OV! N VE IN O HOUSE NUMBER COR-
LEGAL ReCT AND POSTED i
DESCRIPTION LOT N BLOCK
TRACT N
R ENGIN
O X I/� NNO OW F BLDGS WORK COMPLETED
''T� LOT SURETY BOND
UH�FG BLDG
VU-" 4- NO OF ELEA ED
1 HEREBY STATE THAT THE INFORMATION GIVEN 18 I HEREBY ACKNOWLEDGE THAT HAVE D THIS
CORRECT F APPLICATION AND STATE THAT THE ABOVE IS CORRECT
RDINANCES
S APPLICANT F �Q • ���'; AND STATE LAWS D AGREE TO MRE REGULATING BPLY WITH ALL`U L NOUNTY GCONSTRUC-
lION
ADDRESS 3 L L.V I J f (� �� 8 ONATURE OP a
PERMITTE! Ae
VALUATION
S
PER ADDRESS
FEES i
JOHN A LAMBIE.COUNTY ENGINEERCLYDE N DIRLAM.CHIEF BLDG INSPECTOR
ro C H
(A(,01 47 0 4 "� APR 19 2 5 D 2 5 0 0 A
lJ o3 d 1 8 � I`AY2y 6 D 1 0 .50