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MISCEItAITEOUS APPLICATION 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER �ooileii '-
BUILDING AND SAFETY DrMON
JOHN A. LAMBIE. COUNTY ENGINEER LocAurr Jh
COLHIAAN W. JENKIN■ SUPT. OF BUILDING NEAREST or
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FOR APPLICANT TO FILL IN DISTRICT NO. GROUP r ►e ROCESSHo er
• CONST.
O UILDING A3 MAP NISNWAY
AGGRESS N0. R (CIRCL[ ST AT MAJOR HCO LOCAL
LOCALITY USE ZONE SPECIAL CONDITIONS
NEAREST
CROSS ST.
LEGAL RHOUIRED YARD HWY STREET NAME !X187.
DESCRIPTION SETBACK
WIDTH
FRONT
NO. OF BLOBS. P. .
TRACT y NOW ON LOT SIGH
SIZE OF LOT O!/l Q USE TI G SLOG.
3IMort
369
OWNER _
MAIL p
ADDRESS
TEL.
CITY NO.
APPLICATION FOR
OCCUPANCY I INSPECTION SAPETY PERMIT
TRAILER USE
USE OF STRUCTURES OR DEVICES
LIMITED TIME USE
OAT[ DAT■
IROMI TOI
APPROVALS OATH INI E p'S
OCCDPANCY APPROVAL
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS SAWP OCC. LOAD
APPLICATION ANO STATE THAT THE ABOVE IS COR-
RECT AND AORBE TO COMPLY WITH ALL COUNTY TRAILER USE
ORDINANCES AND STATE A EO SUCH
WORK AS INDICATED REON.
SIONATURHOP SAFETY PERMIT IV
PERMITTEE TlMPORARY
STRUCTURE APPROVED
ADDRESS TEMPORARY
v STRUCTURE REMOVED
49
PEES pO FINAL APPROVAL ' f.
APPLICATION VALIDATIOWh JOHN F. LEWIS, PRINCIPAL STRUCTURAL ENGINEER
(NOT A PERMIT) C[. M.O. CASH PERMIT VALIDATION CS. M.O. CASH
LAr,.ald i 6t8 Ian 3 2 2 D 15-00- V