HomeMy Public PortalAbout5625 1/2 WELLAND AVE_Relocation__ I6A639-.•CE 879�B-62
APPLICATION FOR REL CATdO.N'BUILDING PE;R:N4I
COUNTY OF LOS ANGELES BUILDING S
DEPARTMENT OF' COUNTY ENGINEER:
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBI:E, COUNTY ENGINEER NEAREST
WILLIAM A.•JENSEN;SUPT.OF BUILDING CROSS ST. 4�/V E
FOR APPLICANT TO FILL IN DIST.NO. GROUP TYPECON . SEWER MAP O ESS BY
11
K
PROPOSED ,
BUILDING S*�ZS WATER
ADDRESS ..CE.RTI.FICATE<• NOT REQUIRED ❑ RECEIVED
LOCALITY 4kMAP HIGHWAY
NO: (CIRCLE)
PRESENT STATE MAJOR SECOND;LOCAL
BUILDING US ZONE SPECIAL..
ADDRESS— US
CONDITIONS'
LOCALITY /. ,'.
//y�
OWNER 49 f ` !✓.I� BUILDING YARD HWY STREET NAME EXIST.
MAIL
_ SETBACK WIDTH
ADDRESS: :FRONT
�• TEL. �• P. L.
CITY NO. 2�7/� . SIDE
MOVING TEL.37 2jj� P: L.
CONTRACTOR NO. ff_.._
''•�� l
SURETY DATE REC•:D
ADDRESS' V J �,�✓ Ply .. BOND $ FILED pY'
BUILDING T.L. CASH DATE RECD IL
'L� NO... ��
CONTRACTORDEPOSIT $ FILED BY O
P' F APPROVALS DATE INSPECTOR'S SIGNA7l1RE 41
ADDRESS
' 7
PRESENT FOUNDATION: .LOCATION 'z_2!r_
USE E FORMS; .MATE.RIALS �.a•� 0,
BUILDING ' U
FRAME: FIRE.SLOPS, ) �
PROPOSED BRACING•„BOLTS . 11.71 _ �.,. a
USE,OF
BUILDIN FURNACE.: LOCATION v Z
GAS-VENTS, DUCTS
SQ. FT. NO. OF LATH, INT,.
SIZE - 7i 2� ROOMS STORIES
WALL. r•y�--- ROOF '
COVERING �L C:aCt I COVERING r.
LATH, EXT.
LEGAL / n 1-100$8 NUMBER COR=
DESCRIPTION LOT IVO. (� BLOCK RECT AND POSTED
TRACT FINAL
/� N.O. OF BLDGS.. - DISTRICT ENGINEER
S.12E OF LOT �b.P. I NOW ON LOT J SURETY BOND
RELEASED
USE OFNO. OF
EXISTING SLOG. ,_ — a• •. r FAMILIES •1 HEREBY PCKNOWLEDGE THAT I HAVE READ THIS APP.L1C.ATION-
I HEREBY STATE THAT THE INFORMATION GIVEN IS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO:COMFLY
•
CORRECT. WITH. ALL COUNTY ORDINANCES AND STATE :LAWS RECtU.LATING
SIGNATURE OF BUILDING CONSTRUCTION.. I CERTIFY THAT IN, DOING THE WORK
APPL.ICA T AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA-
TION!OF tHE'LABOR CODE OF THE STATE OF LA.LIFORNIA RE(.AT-
ADDR'ESS J 4 :� o /• INC TO WORK.AIEN'S COMPENSATION.INSURANCE.
VA ATION. $ FEE' fi=� PERKITT1EE OF
P. v
A.
FEE $ k.7J ADDRESS -� .
VALIDATION .f_C'A M.D. CASK JOHN. F. LEWIS, PRINCIPAL STRUCTURAL ENGINEER
(L, PERMIT VAIIDATION CK. M.O. CASH