HomeMy Public PortalAbout5164 SERENO DR_Relocation__ 76A 63" �C F'679 8-62
AIIIAPPLICATION FOR RELOCATION BUILDING PERMIT-
COUNTY OF LOS ANGELES BUILDING /
DEPARTMENT OF COUNTY ENGINES& ADDRESS G
BUILDING AND SAFETY DIVISION LOCALITY LL'
JOHN A LAMBIE COUNTY ENGINEER NEAREST
WILLIAM A JENSEN Sur T Or BUILDING CROSS ST
FOR APPLICANT TO FILL IN DIST NO GROU TYPE SEWER AP P EBBED BY
CON IrlSK
PROPOSED O
BUILDING WATER
ADDRESS / 6 CERTIFICATE NOT REQUIRED 1:1RECEIVED
LOCALITY �jf+'// �aC L MAP HIGHwgY
PRESENT NO tcIRCLE) STATE MAJOR SECOND LOCAL
BUILDINGD USE ZONE SPECIAL pUU p/
ADDRESS CON DITI ON9 t G2-I /1 Jb
LOCALITY l - G� --
OWNER /BUILDING YARD HWY ST ET NAME EXIST I
MAIL SETBACK WIDTH
ADDRESS- U FRONT ^J-,
CITY Qi4J ASF TEL
10 P L �U
SIDE
MOVINGTEL p L
CONTRACTOR NO 2/-s 4/7
f DATE PEC D
ADDRESS O.iO OA BOND SOj1 f FLL[D BY Y
BUILDING TEL CASH DATE RECO d
CONTRACTOR it/L NO ` L DEPOSIT ! FILE By O
ADDRESS
APPROVALS DATE INSPECTORS SIGNATURE V
-�
PRESENT FOUNDATION FORMSMA LOCATION O
USE OF FORMS MATERIALS '� � �
BUILDING / J FRAME FIRE STOPS
PROPOSED ' BRACING BOLTS
USE OF �� O/0 l..r y
BUILDING FURNACE LOCATION Z
GAS VENTS DUCTS
SO FT d .40140 OF LATH INT 1
SIZE A64W OMSSTORIESWALL ROOF _� X
(� 1 ,
COVERING ✓ d COVERING O LATH EXT S
LEGAL _ HOUSE NUMBER COR-
DESCRIPTION LOT NO J `�L BLOCK RECT AND POSTED
TRACT y FINAL
$=4795 11 V q c NO OF BLDGS DISTRICT ENGINEER
SIZE O LOT NOW ON LOT SURETY BOND
RELEASED
USE OF NO of
EXISTING BLDG FAMILIES I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
I HEREBY STATE THAJAWE INFORMATION EN IS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
CORRECT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
SIGNATURE OF A BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
APPLICANT 1f gUTHORI2ED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT
ADDRESS IND TO WORKMEN 6 COMP NSATION INSUNANCE
VALUATION $ FE $ AQP SIGN
EATURE OF
/) PERMITTEE_
TT FEE $ ADDRESS
VAON CK O GBH JOHN F LEWIS PRINCIPAL ST CTURAL NG[NEER
PERMIT VALIDATION
FEb X025 D 35VC1e ?—
0 4 4&MAR 4 6 D 4 8.7 5 �yG