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Home My Public Portal About5527 WELLAND AVE_Building__ 76A638A CE#803 1/71 APPLICATION FOR BUILD G PER �.r COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF-COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION BUILDING ADDRESS SOC COLEMAN W. JENKINS. SUPT OF BUILDING LOCALITY L FOR APPLICANT TO FILL IN NEAREST Print or tVDe onl CROSS ST. BUILDINGDISTRIC G TYPE R E ED BY ADDRESS .� tV. II�Aal Ue,A S i CONST. LOT NO. BLOCK STATISTICAL CLASSIFICATION SEWER MAP �� CLASS NO.,z4DWELI UNITS BK r FIG113 TRACT tt USE ZONE MANo.P SIZE OF LOT ( � NOW ON LOTNO.OF BLDGS SPECIAL 06 USE OFy� CONDITIONS EXISTING BLDG, p L '{! �j OWNER ki 'Q IV AJ e f `e NOL'i ` _73r($ BLDG.SETBACK FROM ADDRESS �j e a e If& o/d AV S FRONT PROP.LINE OF (STREET) � ,,...- TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL CITY I C� �.'� J�'1 J ��/� HIGHWAY WIDTH FROM C.L. ARCHITECT OR TEL. + _ ENGINEER NO. BLDG.SETBACK FROM I . ADDRESS SIDE PROP: OF (STREET) TEL. TYPE OF EXISTING SETS GHWAY + YARD = TOTAL d CONTRACTOR Jjill @0 NO. HIGHWAY WIDTH FROM C.L. L ADDRESS - Np + C LIC. F CITY CLASS CORNER CUTOFF YES ❑ NO ❑ 1`i CONSTRUCTION LENDER 0- NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS z ADDRESS SQ. SIZE �'y!'�FT. '�'/ �r -3 NO OF NO S DRIES I FAMIOLFES NEW ❑ �L �� USE OF r ADD r STRUCTURE li ALTER ❑ t'' /\ EPAIR❑ v SIGNATURE O - /�. APPLICANT 11Dd ° DEMOL ❑ VALUATION S APPROVALS DATE INSPECTOR'S SIGNATURE P,C. PMT. C� �O' FOUNDATION: LOCATION FEE 5 FEE$ r FORMS, MATERIALS FRAME: FIRE STOPS, ry /{ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS Lei / AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS STRUCTION. IC THAT IN DOING THE WORK AUTHORIZED HEREBY i WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT. LABOR CODE OF THE STATE OF -CALIFORNIA IN RELATING TO WORKMEN.'S OF INSURANCFJ, LATH, EXT, SIGNATURE OF ,� �� I , HOUSE NUMBER COR- ��9 ' '� PERMITTEE RECT AND POSTED ADDRESS • t 1 I' , e Iir� FINAL �"' 'o JOHN F. LEWIS. PR1 G Al-STRUCTURAL(,'ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT Vl!ltuTION CK. M.O. CASH L 6508N JUN12. -.,,1 D, 28.50x' Q azt�_ 76&-z'"A CE 1!603 3-69 APPLICATION FOR BUILDIN`'G PERM 'COUNT( OF LOS ANGELES ADDRESS J -2 UILDING / Lvi �/Q(V v DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION LOCALITY e pi Gl F JOHN A. LAMBIE, COUNTY ENGINEER a COLEMAN W. JENKINS, SUPT OF BUILDING CROSS ST. If IU FOR APPLICANT TO FILL IN DIISLTRRIICT6�l0 ' IGRO TYPE CONST . PRO E Y (PRINT OR TYPE ONLY) ✓ V BUILDING fv� STATISTICAL CL S (CATION SEW R MAP ADDRESS �� -L7 (i Q�L CLASS N0. DWELL.UNITS SK PG LOT NO. BLOCK USE ZONE MAP NO. V TRACT p O IQ( CSPECIAL ONDITIONS NO. OF BLDGS. SIZE OF LOT �� NOW ON LOT USE OF EXISTING BLDG. BLDG. SETBACK FROM TEL. FRONT PROP. LINE OF (STREET) OWNER j N0. � S` _ TYPE OF EXISTING SETBACK HIGHWAY + YARD - TOTAL ADDRESS ' �,et/ V HIGHWAY WIDTH FROM C.L. `^ ^� CITY tP �_ 4 � + �v= o«� ARCHITECT OR TEL. BLDG.SETBACK FROM (STREET) ENGINEER N0. SIDE PROP. LINE OF TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C.L. TEL. + -_ CONTRACTOR NO. F ADDRESS NO.. CORNER CUTOFF YES ❑ NO ❑ CITY CLASS SEE REVERSE SIDE FOR SPECIAL APPROVALS CONSTRUCTION LENDER NAME AND BRANCH t ADDRESS SQ. FT. N0. OF NO. OF - SIZE STORIES FAMILIES NEW ❑ USE OF DD STRUCTURE - - PIZ ALTER REPAIR ❑ GNATURE 0 P. DEMOL ❑ ff/PPLICANT VALUATION$ 10011, APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. FOUNDATION: LOCATION FEE$ FEE$ �� FORMS MATERIALS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION FRAME: FIRE STOPS, BRACING BOLTS04 AND STATE THAT THE ABOVE IS CORRECTAND AGREE TO COMPLY FURNACE: LOCATION, ��• WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUC- GAS VENT DUCTS TION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA Ok OF THE LABOR CODE LATH, INT. OF THE STATE OF CA ORNIA IN REL G T�WORK EN'S COM- PENSATION INSURAN. �r// LATH, EXT. SIGNATURE OF HOUSE NUMBER CORRECT PERMITTEE _ AND POSTED ADDRESSs� ic FINAL JOHN F. LEWIS, PRIN IPA ST eTiRAL ENGINEER PLAN CHECK VALIDATION CK. M.G. CASH - PERMIT VALIDATION CK. ' M.O. CASH Ar,-3 9 5 a9 �AR 5 1 � 9.0 O N =aASSBA tE#809 9-67 C:T Y ��' �'c/'T. (�i 7r' APPLICATION FOR BUILDING PERMIT �,�COTINTY' OF•LOS 14NGELES BUILDING DEPARTMI I T OF COUNTY ENGINEER ADDRESS �� BUILDING AND SAFETY DIVISION LOCALITY'��f�pC.E JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPT OF BUILDING NEAREST CROSS ST. �J DISTRICT NO. GROUP TYPE C SED BY FOR APPLICANT TO FILL IN CONS . (Print or type only) BUILDING _. n I STATISTICAL CLASS[FICATIO SEWER MAP ADDRESS �rj -.� /I�, L/( f/L (i, CLASS NO._&C!�_313WELL.UNITS BKr- PG LOT NO. 13 LOCK S C'O USE ZONE MAP NO. G TRACT �� ) SPECIAL NO.OF SLOGS. CONDITIONS SIZE OF LOT 5 v� NOW ON LOT USE OF EXISTING BLDG. I 0 0 U GL �C1�C' BLDG.SETBACK FROM TEL FRONT PROP.LINE OF (STREET) OWNER (�/U (� I Q NO. i2 3S TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS11.4,vct HIGHWAY WIDTH FROM G.L. CITY F 1jle C BLDG.SETBM TREET) ARCHITECT OR TEL. SIDE PRP. NE ENGINEER NO. OUN _ TYP F NG SETBACK HIGH YARD - TOTAL ADDRESS HIGHW WIDTH I FROM C.L TEL. + = a CONTRACTOR ) NO. ADDRESS NO. CORNER CUTOFF YES [jNO ❑ c..7 CD CITY CLASS SEE REVERSE SIDE FOR SPECIAL APPROVALS •DESCRIPTION OF WORK a NEW ADD_ ALTER REPAIR DEMOLISH SQ. FT. NO. OF NO. OF r L SIZE37.1 STORIES FAMILI USE OF Q STRUCTURE 7 SIGNATURE OF-.02/ APPLICANT VALUATION S r� //�� r APPROVALS DATE 1 ECTOR'S SIGNA uRE FOUNDATION: LOCATION � FORMS, MATERIALS FEES FEES FRAME: RE FISTOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE- LOCATION, WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANYeERSON IN VIOLA- LATH, INT. TION OF THE LABOR CODE F THE STATE O dALIFORNIA RELAT- ING TO WORKMEN'S CO ATION INSU A � LATH, EXT. SIGNATURE HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS �2 `G! FINAL JOHN F. I EWIS. PRI CI AL S!:C.:) RAL ENGINEER LI PLAN CHECK VALIDATION CK. M.D. CASH _ PERMIT VADATIO M.O. CASH X11;0 6 8 2 900 OCT 14 ID 27.75- 76A698A CE#808 9-67 ` APPLICATION FOR BUILDI G PERM COUNTY. OF..LOS ANGELES- BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS o� , BUILDING AND SAFETY DIVISION •LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST COLEMAN W. JENKINS, SUPT OF BUILDING CROSS ST. FOR APPLICANT TO FILL IN DIS NO. GROU T PE P �D Byli (Print or type only) `� , CONST. Q BUILDING / � � STATISTI L CLA SIFICATION SEWER MAP ADDRESS A CLASS NO. glE DWELL.UNITS BK PG LOT NO. I BLOCK USE ZONErNECIAL MA P TRACT r 6 NO.OFBLDGS. ONDITIONS SIZE OF LOT NOW ON LOT USE OF EXISTING BLDG. .S BLDG.SETBACK FROM �� NOEL. �� pD FRONT PROP.LINE OF -(STREET). OWNER c7 TYPE OF EXISTING SETBACK HIGHWAY } YARD - TOTAL ADDRESS 57.-Ea 2.0 op e ��J Ad� HIGHWAY WIDTH FROM C.L. CITY `��'� !� i_.1 { � = o�N BLDG. TRACK FROM ARCHITECT OR I) EL. SIDE PROP.LINE OF (STREET) ENGINEER u NO. TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C.L. TEL. } CONTRACTOR C2U ) NO. CD ADDRESS NO. CORNER CUTOFF YES ❑ NO ❑, v CITY CLDd ASS SEE REVERE SIDE FOR SPECIAL PROVALS t3 DESCRIPTION OF WORK wi a N da-6 Mfx Z NEW'. ADD ALTER REPAIR DEMOLISH SQ�FT. NO. OF p NO. OF SIZE STORIES P FAMILIES USE STRUCTURE � z 3 SIGNATURE OF APPLICANT VALUATION S APPROVALS DATE INI ECTOR;f SIGNATURE P.C. PMT. FOUNDATION: LOCATION FEE$ FEE$ 71 FORMS, MATERIALS D FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING, BOLTS AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY FURNACE' LOCATION, ' WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL EMPLOY ANY PERSON IN VIOLA- LATH, INT. TION OF THE LABOR CODE OF THE STATE OF�! LIFORNIA RELAT-ING TO WORKMEN'S COMP SATION INSURANC LATH, EXT. SIGNATURE OF r ZAO HOUSE NUMBER COR- PERMITTEE c� -f RECTAND POSTED ADDRESS -� Z ° P/ ''v • ° FINAL JOHN F. LEWIS. PRINCIPAL ST RAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION SO M.O. CASH I ti 76AG33A CE#1309. 1-G, APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING . f. DEPARTMENT OF COUNTY ENGINEER ADDRESS j,2 % Ay L BUILDING AND SAFETY DIVISION LOCALITY Q P C 17V » ' JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. FOR APPLICANT TO FILL IN DIS`ICT O. mi TYPE P SSED BY '� CONST. BUILDING STATISTICALC SIFICATION -- I SE ER MAP ADDRESS �� C 11 4 �V K CLASS. NO DWELL. UNITS PG LOT NO. BLOCK WATER NOT REQUIRED ® RECEIVED CERTIFICATE: TRACT MAP HIGHWAY STATE MAJOR SECOND, OCA NO.OF BLDGS. NO. �� (CIRCLE) SIZE OF LOT I NOW ON LOT USE ZONE SPECIAL / USE CONDITIONS EXISTITI NG BLDG. TEL 1, ) OWNER f l �L,j ,NO. BUILDING EXIST. / SETBACK YARD HWY STR ET NAME WIDTH _ ADDRESS sl'F Wf� /� Ip FRONT ARCH ITECTORTEL.N��— P. L. - ENGINEER 'v It NO. /Q7�+ / SIDE P. L. ADDRESSCL TEL. INSPECTION RECORD O CONTRACTOR NO. U ADDRESS O DESCRIPTION OF WORK � W CL NEW ADD ALTER REPAIR DEMOLISH h SQ. FT. NO.OF NO.OF Z CZE STORIES FAMILIES USE OF STRUCTURE SIGNATURE O APPLICANT v c.� I VALUATION$ , APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. O a FOUNDATION: LOCATION FEE FEE $ FORMS, MATERIALS FRAME: FIRE STOPS, 1HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING, BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ArtY PERSON IN VIOLA- LATH,INT. TION OF THE LABOR CODE OF THE STATE,-Of fLFORNIA RELAT. ING TO WORKMEN'S C PENSATION INSU. N LATH,EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTE RECT AND POSTED ADDRESS_3 •�•��1 — FINAL CLYDE N. DIRLAM, PRINCIPAL STRI).CTURAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION cK. M.O. CASH DEPARTMENT OF BUILDING AND SAFETY Arra.i%wa L LVM r va rassma L COUNTY OF LOS ANGELES O ® e WM. J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY n DISTRICT NO. PLAN CK.NO. PERMIT NO. BUILDING ADDRESS LOCALI RECEIVED BY DATEorAPPL. DATE ISSUED NEAREST ` -,d CROSS ST. - BUILDING OWNER ADDRESS MAIL /„ „Q LOCALITY • ADDRESS NEAREST TEL. CROSS ST. CIT NO. FIRE NO.OF TYPE ARCHITECT IIR TEL. ZONE I /tel�� ENGINEER NO. - 5x6-&J -� BLDG. ORD.NO. ADDRESS SETBACK LINE APPROVED CONTRALTO T BY DATE USE APPROVED ADDRESS ZONE BY DATE LEGAL �, -� �;1 CORRECTIONS DESCRIPTION LOT NO. BLOCK TRACT NO.OF BLDGB. L4�211 SIZE OF LOT I NOW ON LOT y UBE OF I NO.OF I NO.OF EXISTING BLDG. FAMILIES ROOMS tP S f�,Ij DESCRIPTION OF WORK NEW ALTERATION ADDITION / O A REPAIR MOVING DEMOLISH 0 Sq.FT. NO.OF Z SIZE ROOMS STORIES D WALL I ROOF t' COVERING COVERING USE OF NEW BUILDING ic 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION:LOCATION INSPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS AND STATE LAWS-REGULATING BUILDING CONSTRUCTION. FRAME: G,E GTOPS, BOLTS SIGNATURE:OF �Jv_ � /1�_ N � BRACING,BOLTS PERMITTEE, PXiC.F%Ll` LATH,INT.:, AUTHORIZED AMT. I LATH,EXT.: DBS-3 SOM SETS 1-48 $ - P.C.* PLASTER,INT. FEE PLASTER,EXT. VALUATION '��Lj Z FEE 18�J FINAL r _ DEPARTMENTOF BUILDING O5 AAN LES SAFETY JL '1'L1GA 17 VJ.V r Ull__k% VJLi7K COUNT NG WM. J. FOX. CHIEF ENGINEER � ' L DI FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY 'LD'NO �DISTRICT1IO. PLAN CK.NO. PERMIT NO. BE � ADDRESS. r n .0 A �// y r. LOCALITY / /sem.!✓ ' RECEI & AY DATE OFAPPL. DATEISSUED NEAREST / �. BUILDING 2 ��v ADDRESSMAIL J L ADDRE59 4g/r �1/�J��C ��sf �1sVs��l1�7� . LOCALITY ! y'IN /'� �^�/ /� / N,EAREBT CITY/ r�T G"(F NOL .f// 41 .4":�2 [!ROBS 5T. FIRE NO.OF TYPE jf l¢ROUP Imo^ ARCHITElffOR � / TEL. ZONE, �- PLANS v �J ENGINEER i NO. BLDG. ORD.NO. ADDRESS SETBACK LINE APPROVED TEL 9Y NATE CONTRACTOR NO. U5EAPPROVED ADDRESS ZONE BY DATE LEGAL / / � >(� CORRECTIONS DEfiCRIAL ON �LO3T NN1O. ' BLOCK TRACT 0 NO.OF BLDGS. �� SIZE OF LOT NOW ON LOT 0 L- �— USE OF NO.OFNO.OF ' EXISTING BLDG. 7 i FAMILIEe I ROOMS /,A-e erc 7-«. DESCRIPTION OF WORK NEW ALTERATION I ADDITION O REPAIR P�MOVING DEMOLISH 8 ZE � , ROOMS STORIES / y WALLRoard �// r COVERING )ityC I COVERINB6 e.✓ - ,J . USE BUILDING vt w 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE 19 CORRECT FOUNDATIOIt:LOCATION INSPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FGRMS,MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION. y;) ��r FRAME: FI RE STOPS, SIGNATURE DIP— .//4• BRACING.BOLTS PERM ITTEG , �--W, LATH, INT. AUTHORIZED AMT LATH, EXT. 76AS38A 9-48 n DES-3 SOM SETS $ �� _sIF PLASTER,INT. (!�T►`�� C yrt PLASTER,EXT. /�G VALUATION v 1 FINAL `( �� srr.reinlmr.n 1 Vr J3Uli vil4Ci al4li -�Arzj Y COUNTY OF LOS ANGELES ® ' WM- J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING DISTRICT NO. PLAN CK. NO. PERMIT NO. ADDRESS d1 h. LOCALITY RECEIVED BY DATE OF APPL. OA E ISSUED 1 NEAREST CROSS ST. BUILDING ADD ESS vv .� -lty<[�' ) OWNER --� MAIL ADDRESS LOCALITY �.``� NEAREST CITY TEL. CROSS ST. 7T-L, f NO. FIRE NO. I TYPE_,1.. I OgQIJP^' ARCHITECT OR TEL. ZONE PLANS NS ENGINEER NO. BLDG. ORD.NO. ADDRESS SETBACK LINE /�z TEL. APPROVED CONTRACTOR /'� J NO. BY DATE rTt - USE APPROVED ADDRESS - ZONE BY DATE LEGAL CORRECTIONS DESCRIPTION I LOT NO. I BLOCK - TRACT r b SIZE OF LOT �/1 S I NOW ON LOTS / USE OFN nn� O.OF NO.OF EXISTING BLDG. dW.i S�tl-' I FAMILIES ROOMS A DESCRIPTION OF WORK NEW x ALTERATION ADDITION O A REPAIR MOVING DEMOLISH M SQ.FT. NO.OF Z SIZE ROOMS STORIES D WALL1 I h 36f-�Y .t!OOF COVERING COVERING USE OF NEW --- -- - ------ BUILDING ..y I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS _APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION INSPECTDR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS l - AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE STOPS, SIGNATURE OF BRACING,BOLTS OWNER LATH,INT.: AUTHORIZED AO LATH,EXT.: DBS-3 25M SETS 1-47 $ P C.S PLASTER. INT. - FEE PLASTER, EXT. VALUATION /4r FEE FINAL r`- .. � ,u tr F 1 �OIC PERMIT DEPARTIMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES BUIL WM. J. FOX, CHIEF ENGINEER NO.OF BLDG. ORD:NO. DISTRICT NO. PLAN CK. NO. PERMIT NO. PLANS SETBACK LINE - FIRE APPROVED ZONE BY DATE RECEIVED BY DATE OF APPL. DATE ISSUED USE f APPROVED ZONE BY DATE APPLICANT.' FILL IN HEAVILY OUTLINED PORTION ONLY BUILDING �/ !_ '60 K NAME ADDRESS / L LU �— /r'w/ - /T OUI z ADDRESS _ LOCALITY / /o 1- 5 NEAREST .x__30 y !,q U w CITY CROSS ST. Q STATE TEL. /?A LICENSE NO. NO, � NAME W MAIL a: NAME z Z ADDRESS. 0 - 0 U TEL. U Q ADDRESS CITY NO. C F Z CITY I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS 0 - APPLICATION AND STATE THAT THE ABOVE IS CORRECT U STATE TEL. AND AGREE 70 COMPLY WITH ALL COUNTY ORDINANCES LICENSE NO. NO, AND STATE LAWS REGULATING BUILDING CONSTRUCTION. Z SIGNATURE OF / LQT NO. SIZE OF LOT r OWNER 4 a .� ^[[[��NO. OF BLDGS. gUTiiOR ZED AGT 4 r )."t 17 _ BLOCK NOW ON LOT W tX SNI TRACT ' CORRECTIONS ❑ USE OF BLDGS. NOW ON LOT DESCRIPTION OF WORK USE OF �j '7 ` BUILDING IN. COLTS! V481541mig a' War Prr-' 3. You are _ 0 Caution if local War ;p —. C) ir . t'- snkk, z D NEW TYPE GROUP r NO.OF NO.OF ` ALTERATION ROOMS FAMILIES ADDITION SIZE - .r REPAIR STORIES MOVING WALL COVERING DEMOLISH ROOF COVERING P.c.s FINAL APPROVAL FEE / I s INSPECTOl 'S / 'VALUATION FEE ��` DAME I NAME -�