HomeMy WebLinkAbout8876COUNTY ENGINEER
COUNTY OF LOS ANGELES
BUILDING AND SAFETY DIVISION
11
FOR APPLICANT TO FILL IN
BUILDING
ADDRESS
BUILDING
ADDRESS
LOCALITY
CITY Diamond Bar ZIP
NEAREST
CROSS ST.
NO. OF BLDGS.
SIZE OF LOT NOW ON LOT N011e
ASSESSOR
MAP BOOK
PAGE
PARCEL
IBLOCK I
DISTRICT GROUP TYPE FIRE
PROCESSED BY
TRACT 31152-A LOT NO. 7
CONST. ZONE
OWNERPREST,F'y OF SO. CALIF. No.540-0500
STATISTICAL CLASSIFICATION
SEWER MAP
P.O. 2200
ADDRESS .BOX
CLASS NO. DWELL. UNITS
BK PG
CITY NeWport Beach, CA. ZIP 92663
USE ZONE MAP
ARCHITECT OR TEL.
ENGINEERArohlteCtUral On rnNQ• -
NO.
SPECIAL
CONDITIONS
ADDRESS 77 BrookholloW Dr. Santa, Ana CA.
ROAD DEPARTMENT APPROVAL REQUIRED
YES ❑ NO ❑
TEL.
CONTRACTOR Same as Owner NO.
BLDG, SETBACK FROM
LIC.
FRONT PROP. LINE OF
(STREET)
ADDRESS NO.289274
+ = TOTAL SETBACK FROM
TYPE OF EXISTING
LIC.
HIGHWAY YARD FRONT PROP. LINE
HIGHWAY WIDTH
CITY CLASS B-1
CONSTRUCTION LENDER
Unknown
_
+
NAME AND BRANCH
BLDG. SETBACK FROM
SIDE PROP. LINE OF
(STREET)
ADDRESS CITY
SQ. FT NO OF NO OF CHECK
HIGHWAY + YARD = TOTAL SETBACK FROM
SIDE PROP. LINE
TYPE OF EXISTING
HIGHWAY WIDTH
SIZE 1388 STORIES 1 FAMILIES 1 ONE
DESCRIPTION OF WORKPlan 97-AR NEW
Single Family Dwelling ADD ❑
CORNER CUTOFF YES ❑
NO ❑
Gar. - 470 S . ft. ALTER ❑
❑
IN OPEN SPACE YES ElNO
El
REPAIR
USE OF Porch - 42 sq. ft.
❑
IN COASTAL PERMIT ZONE Y S ❑
NO ❑
EXISTING BLDG. DEMOL
y
APPLICANT TEL
(PRINT) Kenneth . Stark N0.5 -0500
JV
BY (SIGNATURE)
I HEREBY ACK40WLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES
AND LAWS REGULATING BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE
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-
PENSATION INSURANCE.p�
i
SIGNATURE OF ��
FINAL BY
PERMITTEE
DATE
ADDRESS 4600 Canpus Drive
P.C. Fee $ /e iU ^
ermit Fee
CITY Newport Beach, CA. NO,j 54 —
Issuance Fee
VALUATION'
Total Fee
PLAN CHECK VALIDATION
� 5. it3l8AGCE#RZ9,77 2.3
CK. M.O. CASH
6.8 0
YtKMII VALIL7AIIVN CK• M.O. CASH
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O
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