HomeMy Public PortalAbout5623 PAL MAL AVE_Relocation__ APPLICATION FOR RELOCATION BUILDING PERMIT ],
DMSION OF BUILDING AND SAFETY BUILDING %
Department o4 County Engineer ADDRESS 46
County of Los Angeles
76A633 WM. J. FOX. COUNTY ENGINEER LOCALITY
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t2-s4 CASSATT D. GRIFFIN, SUPT of 8111LDIND NEAREST '
CROSS ST.
FOR APPLICANT TO FILL IN DISTRICT NO. GROUT✓ TYPE CONST.
PROPOSED -T �— I -�'�
BUILDING �� (
ADDRESS v MAP J1 /I HTE YES NO
NUMBER �'C V
LOCALITY USE ZONE SPECIAL
PRESENT /7 _ CONDITIONS
BUILDING /1
ADDRESS
LOCALITY SETBABUILDIN YARD HWY STREET 14AMEE/I WIDSTTH.
OWNER / T 2N / FP. LT O C �//CMCJ
MAIL SIDE
ADDRESS 2 Ivy P L
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TEL-
CITY
ELCITY /C &I NO. / BURLTY U DAT[ REC'
MOVING TEL sonDt �— FILE - LS- sY '
CONTRACTOR IV44NO. OAsn DATE RECD
DEPOSIT S AILED Y
ADDRESS �yL JY
1 _L�
BAPPROVALSUILDING r TEL
CONTRACTOR �P�.£ NO.
ADDRESS DATE INSPECTOR'S SIGNATUR
PRESENT FOUNDATION: LOCATION
USE OF p� t FORMS. MATERIALS
BUILDING C..1 Ur FRAME: FIRE STOPS,
PROPOSED BRACING. BOLTS
BU
IL� GAS VENT. DUCTS
ING S I FURNACE: LOCATION
LATH. INT.
SO. FT. O. OF - _ I
SIZE - d ROOMS STORIES / LATH. EXT.
WALL /7,� _^r'� I ROOF �DMiDd HOUSE NUMBER
AND POSTED � �
COVERING Yljdk � COVERING
LEGAL
DESCRIPTION I LOT NO. / I BLOCK ? FINAL
SSp
TRAZ;T gD a Nom/d�O may/ #�-T/� �p�'j' S ICT NGI EER
N OF BLDG WORK COMPLETED
SIZE OF LOT O �� NOW ON LOT SURETY BOND 6 /
USE OF /` 10.OF RELEASED
EXISTING BLDG. lr-� FAMILIEs 1 HEREBY ACKNOWLED E THAT 1 HAVE READ THIS
I ,STATE AT THE I FOR T Nt IVEN IS COR. APPLICATION AND STATE THAT THE ABOVE 15 CORRECT
RECT. ° AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
SIGNATURE OF AND STATE LAWS REGULATING BUILDING CONSTRUC-
APPLICANT TION.
ADDRESS SIGNATURE OF
VALUATION S PERMITTEE
^ V U P. C. S
FEE / U ADDRESS
is FEE S
WILLIAM J. FOX. COUNTY ENGINEER VALIDATION
BY I.11 04 7 5 9 FEB 4 17 1 0.O ore (� E7
DEPUTY 1.4 _ 1 0.0 DEPUTY
BY
By
® �'� DF17UTY '' � `7` 4 DEPUTY