HomeMy Public PortalAbout5758 TEMPLE CITY BLVD_Miscellaneous__ 76PA444.Des 75 12.54 IRWARISCELLr NEOUS--APPLICATION
DIVISION OF BUILDING AND SAFETY OCCUPANCY-SAFETY-TRAILERS
Department of County Engineer
County of Los Angeles
WM.J. FOX. COUNTY ENGINEER ADDRESS r e /54
CASSATT D.GRIFFIN,SUPT OF BUILDING
LOCALITY
FOR AP (CANT TO FILL NEAREST
OWN Enl".' CROSS ST.
MAIL 1� • �
ADDRESS / a t DISTRICT O. I GROUP I TYPE CONST.
t TEL. '
CITYNO. MAPS
TATE/y TATE
TEL NUMBER /`Q® O HWY YES O,
CONTRACT NO. E SPECIAL �s
ADDRESS �ry CONDITbONS
LEGAL (P'D
DESCRIPTION LOT NON-! BLOCK BUILDINGEXIST.
If YARD HWY STREET NAME I
NO. OF BLDGS. SETBACK WIDTH
TRACT NOW ON LOT FRONT ®�
USE O
SIZE OF LOT . x/ b•�I EXISTING BLDG, SIDE
APPLICATION FOR P. L.
INSPECTION RECORD
OCCUPANCY y<
INSPECTION /® SAFETY PERMIT
TRAILER USE I LIMITED TIME USE
r..-...�...M .. ...................................................._.I................................
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DATE DATE
FROM: TO:
USE OF STRUCTURES OR DEVICES IS�.lai �c. 's.+ tr^s.�.-.s..............................................1..................................
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APPROVALS
INSPECTION FOR I DATE I INSPECTOR'S SIGNATURE
OCCUPANCY AS OCCUPANCY APPROVAL
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GROUP OCC.LOAD
APPLICATION AND STATE THAT THE ABOVE IS CORRECT `g 1�
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES TRAILER USE
AND STATE LAWS REGULATING BUILDING CONSTRUC-
TION.
SIGNATURE OF / SAFETY PERMIT�er1
PERMITTEE) TEMPORARY
STRUCTURE APPROVED C-0 l,Jw-4 -..Ick CC.0r-1itT1
TEMPORARY
ADDRES ti l STRUCTURE REMOVED
FINAL APPROVAL
WILLIAM J. F &OUNTY ENGINEER VALIDATION
L'�4 5 5 5 uA PSR 23 1 S 5.0 0 ••�
BY � By
DEPUTY DEPUTY