HomeMy WebLinkAbout0906A 0907A I :o s 76A638A \�
CE N803(REV.11/78) ,
� APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUIL ING D AFETY �
BUIlOING ' �
LI I �N ADDRE55
BUILDING
ADDRE55 LOCALITY
NEAREST OL
, CITY ZI CROSS ST.
NO.OF BLDGS. A$SESSOR
SIZE OF lOT NOW ON LOT MAP BOOK PAGE PARCEL
D15TRICT GROUP TYPE FIRE PROCESSEDBY
TRACT BLOCK LOT NO. ^ /OrIVST. ZONE
EL. p� tT
OWNER L � NO.
STATISTICAL CLASSIFICATION SEW MAP
ADDRESS CLASS NO. DWELL.UNITS BK PG
CITY ZIP �
ARCHITECT OR r, TEL. LUATION �
ENGINEER , NO. -
ADURE55 BLDC,.SETBACK FROM
E� T PROP.LINE OF • ISTREEiI
CONTRACi NO. � (',f{yyAY + YARD TpTAL SETBACK FROM TYPE OF EXISTING
��_ — fRONT PROP.LINE HIGHWAY WIDTH
ADDRESS � I
LIC. t
CITY CLASS �
CONSTRUC ION LEND R BLDG.SETBACK FROM
NAME AND BRANCH SIDE PROP.LINE OF �STREET� �
HIGHWAY + VARD = TOTAL SETBACK FROM TYPE OF EXISTING O.
AUDRES CITY SIDE PROP.LINE IGHWAY WIDTH Q
SQ.FT. NO.OF NO.Of CHECK + = V
SIZE STORIES FAMILIES ONE �
�E�1�E MAP •/� 0
DFSCRIPTION OF WORK NEW ���y N�' < �
�` �1 � �� SPECIAL �
ADD ❑ CONDITIONS J K H
ALTER ❑ FINAL �
REPAtR ❑ DATE /� +� �� '
�SE C DEMOL � . f�X��r'�`� � " 1
EXISTI� 6LDG. � C Z
APPLIC . TEL / ` 0 TM • • %� i !��,
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BY�SIGNAT'1REi `
I HEREBY '�CKNOWLEDGE THAT I HAVE READ THI PPLfGA N AND STATE u � �� � � ���� G U
THAT THE ABGVE IS CORRECT AND AGREE TO COM WITH L OROINANCES W �
AND LAWS RE ��ATING BUIIDING CONSTRUCTION.I RTIFY T T IN DOING THE _ ' G ��1 7 L�G
WORK AUTHOQ ZEO HEREBY I WILL NOT EMPIOY ANY PERSON IN VIOLATION OF V �
PENSATBIONClNSURANCEE STATE OF CALIFORNIA IN RELATING TO WORKMEN 5 COM� ` � O 7 O� I �
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SIGNATUR;-�F � � • � � • 1
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Issuance Fee w
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Total Fee /
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