HomeMy WebLinkAbout3327AOs 76A638A
P
CE #803 (REV. 11 / 78)
APPLICATION FOR
BUILDING PERMIT
COUNTY` F LOS ANGELES
BUILDING AND SAFETY
FOR APPLICANT TO FILL IN
ADIDRESS
BUILDING
ADDRESS
LOCALITY b
CITY I _'0'°1D Bt..211. ZIP 91765
NEAREST
CROSSST.
NO. OF BLDGS. e 0-
ASSESSOR
SIZE OF LOT NOW ON LOT
MAP BOOK
PAGE _
PARCEL
DISTRICT GROUP
TYPE FIRE PROCESSED BY
TRACT r BLOCK LOT NO.
CONST. ,.- <-" ZONE
OWNER T,i�/ . e Aar ')ON0. r 61
D x,D i Z TT $,�
C- 0. (,
STATISTICAL CLASSIFICATION
SEWER MAP
0 .ES.� ,�
ADDRESS 3Z d3.:�,EE a.
J
CLASS NO. s
DWELL. UNITS .X BK
PG
CITY r ZIP
T a n
ARC E`I= R " �:� sLa
,�,
VALUATION �j
�1
ENGINEER � ,� � �� s �. NO t` a-�_9;�,1
Tl (a7 ly_1'I } 1 I\ll `, 9 11 2DDRES
�`
BLDG. SETBACK FROM
I FUU I.R.1Tk TEL T f g
)FRONT PROP. LINE
(STREET)
CONTRACTOR NO
TOTAL SETBACK FROM TYPE OF
EXISTING
LIC.
HIGHWAY + YARD
= FRONT PROP. LINE HIGHWAY
WIDTH
ADDRESS '32? NO.-O.
__ LI(-
CITY A� 0ND BA- CLASS B-'1
+
_
CONSTRUCTION LENDER
BLDG. SETBACK FROM
SIDE PROP. LINE OF
(STREET)
NAME AND BRANCH
HIGHWAY + YARD
= TOTAL SETBACK FROM I TYPEOF 1EXISTING
y„
aI
ADDRESS_- CITY
SIDE PROP. LINE IHIGHWAY
WIDTH
SQ.FT. NO, OF NO.OF CHECK
+
_
S e' , 5T0RIFSS FAMILIES ONE
USE ZONE MAP-,
NO.
ESCRIPTION OF WORK NEW
SPECIAL
ADD ®
CONDITIONS
F� E
_71! v ALTER ® FINAL
BY
REPAIR
DATE
USE OF DEMOL
EXISTING BLDG.
APPLICANT TEL
PRINT) 4 .L h .' € NO. 9Zs: i
_,
BY (SIGNATURE)
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
5U
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES:
AND LAWS REGULATING BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE.
,<.
- W
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM-
Z
PENSATION INSURANCE.'
SIGNATURE OF
PERMITTEE
ADDRES32 9 ?,r'TZZ 711." p sEntP
_
Z
I 0:° 30 BARTEL 5`9 e- —2n61
CITY NO.
�!P.C.
>
Fee $ Permit Fee
Issuance Fee
LU
Total Fee