HomeMy WebLinkAbout1345A (7) � .�t 76A636A - - _ I
CE/8031REV.8/78i . �
APPLiCATION FQR BUILDtNG PERM[T
COUNTY OF LOS ANGELES BWtDING AND SAF£fY
FOR APPLICANT TO FILL IN ADDRESS 3JYU S. Cotter Rim Lane �
ADDRESS .3��#6 S. C ttel� R�CI) IQCACITY
cirr Diamond Bar zEP 9i 165 c"osss. �
NO.OF BLDGS. ASSESSOR
SIZE OF LQT NOW ON LOT MAp gQpK PAGE PARCEL
TRACT 2�Qrj3 BLOCK LOT NO. DISTRICT GROUP CONST. Z�E PR $SED 8Y
TE�. ia -� �t. wall IV ��
OWNER NQ.
n STATIST{CAL CLASSIFICATfdN SEWER MAP.
ADDRESS ZOU N. Tustin A e. 2 � CLASSNQ. L� DWElLUN1T5 BK PG
CITY ZIP _
ARCHItECTOR fiE�� YALUATION $ 35Q.00
ENGINEER Nd.
ADDRESS BIDG.SETBACK FROM
TEL. fRQN1'PRbP.IiNE OF ISTREETI
CONTRACTQR Diamond Rid e No., 5 � �{�q�yyAY + YARD - TOTAl5ET8ACKFRpM TYPEQF EXISTING
LIC. FRONT PRpP.EINE HIGHWAY WfOTH
ADDRESS Np.
LIC. -
- CtTY tLASS
CONSTRUCTVON LENDER BLDG SEfBAGK FROtUV
NAME AND BRANCH SIDE PROP.LINE OF (STREESI
HIGHWAY + YARD = TOTAL SETBACK FROAA 7YP EXISTING �'
ADDRESS CITY SIDE PROP.UNF HIGHWAY IDTH O
SQ.FT. •NQ.OF NQ.OF CHKK + - y
SIZE STORIES FAMILfES ONE p�
DESCRIPTtON dF WpRK NEW � P-C-Fee$ ��� Permit Fee �[f � �
ADp ❑ �I /j-ff d
Q Issuance Fee � !• e" '� y�y
ALTER / �
REPAIR ❑ Totol Fee j J , �
USE OF DEMOL ❑
EXIS7WG BLDG. Z
APPtICANT TEL Q
IPRINT! NO. �
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BY tSiGNATUREi <
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1 HEREBV ACKNQWLEDGE-THAT I HAVE READ THIS APPUCATION AND STATE Y
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES -
AND LAWS REGULATING BUILDING CQNSTRUCTION.1 CERTIfY THAT IN DOING FHE - _
V.`ORK AUTHOR4ZED HEREBY i WILL NOT EMPIOY ANY PERSON IN VIOiATiON pP - N
TNE LABpR CODE HE STATE OF CALIFORNIA IN RftATING TO WORKMEN�S COM� Z -
PENSATION iN5 E. - - . � � � ����
SIGNATURE O �'
� . . . . . 1
PERMITTEE
ADDRE55 � �I • • � a O G
TEL �
c�T„ Santa Ana No 953-0932 Q • a • 1 u C G�
0
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