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HomeMy WebLinkAbout2932A©5 96A638A CE#803(REV. 6/78) . APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN ADIDR SSCQ J. BUILDING j /� ' I di ADDRESS V CJ (� cd LOCALITY � � NEAREST !� � CITY . ZIP l � J CROSS ST. /� NO. OF BLDGS. ASSESSOR SIZE OF LOT ¢-!tc-u, NOW ON LOT MAP BOOK PAGE PARCEL ® DISTRICT GROUP TYPE FIRE PROCESSED BY TRACT CJ / BLOCK LOT NO. !jo CONS oal- TEL(7, OWNER ONa- STATISTICAL CLASSIFICATION SEWER MAP ADDRESS : ,^ : r CLASS NO. FIaDWELL. UNITS BK PG CITY `/Llazip o ' VALUATION ARCH ITECTTEL( "' ���E'zIOC)m� ENGINEER d7F c NO. a, ADDRESS E4 Rd BLDG. SETBACK FROM FRONT PROP. LINE OF (STREET) TEL.Esi HIGHWAY + YARD _ TOTAL SETBACK FROM TYPEOF EXISTING CONTRACTOR + N.O. � 6-q11. ADDRESS LIC. L� Id, ` PP,, NO. FRONT PROP. LINE HIGHWAY WIDTH _ + LIC. CITY ; CLASS BLDG. SETBACK FROM SIDE PROP. LINE OF (STREET) CONSTRUCTION LENDER _ NAME AND BRANCH — �?,� HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING ADDRESS CITY SIDE PROP. LINE HIGHWAY WIDTH SQ. FT. NO. OF NO. OF CHECK + _ SIZE STORIES FAMILIES ONE DESCRIPTION OF WORK t s'i NEW P.C. Fee $ F/f�} ' / Permit Fee ` ' - ADD El❑ ALTER REPAIR ❑ USE OF DEMOL ❑ Issuance Total Fee Fee _' 1, d 2 9,5.2 A BLDG. EXISTINAPPLICANT TEL ® . 2 3) (PRINT) NO. ( i BY (SIGNATURE) > I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE tie t _L THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES w AND LAWS REGULATING BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE U !; :@, f 0- 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. Q 51 f i SIGNATURE OF PERMITTEE`''" (� ! ADDRESS 0 66 rr�� n s i 1� t„7 t.} TEL. R CITY NO. ® USE ZONE NO. Q T: 8 -- 7 C) SPECIAL r CONDITIONS FINAL BY 09 DATE PLANS TO APPLICANT ? INSPECTOR'S NOTES TO: RETURNED - APPROVED NO DATE NO. DATE APPROVALS REQUIRED GATE RECEIVED OR APPROVED YE5 NO WATER CERTIFICATE HEALTH DEPARTMENT FIRE DEPARTMENT GRADING . GEOLOGICAL PEDESTRIAN PROTECTION I FENCE) (CANOPY) SPECIAL INSPECTION FCONC.I I MASNRY, 14W ELDG. ! LOT DRAINAGE PARKING INSPECTORS SIGNATUR�E APPROVALS DATE LOCATION - (SETBACK & YARDSI FOUNDATIONS FRAME LATH/DRYWALL INTERIOR LATH• EXTERI OR HOUSE NUMBER - CORRECT & POSTED ENERGY INSULATION FINAL - ENTER ON FRONT