HomeMy WebLinkAbout0829A (4) ��� �
CE#803�,�V.11/76J
APPLiCAT10N F�R BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL �N BUILDING
ADDRESS O O Q � Q/��
ADDRESS � N�"'V'f/ /C���
LOCALITY
CITY
I' •oil� /.s�/�ZIP CROSSST. ,
NO.OF BLDGS. ASSESSOR �
SIZE OF LOT NOW ON LOT I MAP 800K PAGE PARCE�
TRACT ��� BLOCK LOT NO. � DISTRICT GROUP TYPE FIRE PROCESSED BY
El. � 'C'� CONS� Z—` �
� OWNER � C O.
l� ,r,,, STATISTICAL CLASSIFICATION SEWER MAP
ACDRESS� G✓ �O�T�/C �/�I CLASSNO. '�� DWE�I.UNITS BK PG
CITY � • ZIP ��� �
AiiCHIiECT QR TEL. VALUATION $ �
ENGINEER NO. �
ADDRESS BLDG.SETBACK FRpM
^�' TE� FRONT PROP.LINE OF � �� Ra� rSTREEi1
CONTRACTO��LE�rG�idn L CNO. }{4^vFiWAY + YARD - TOTALSETBACKFRpM TYPEOF EXISTING
ADDRE55 `
7 (/�/- �/v'� NO� [�i J� fRONT PROP.IINE HIGHWAY WIDTH
UC. + _
- GTY Q/1� CLASS
CONSi RUCTIO ENDER BLDG.SETBACK FROM
NAME AND BR NCH SIDE PROP.LINE OF i$TREETI
TOTAL SETBACK FROM TYPE OF EXISTING �
HIGHWAY + YARD SIDEPROP.LINE H�GHWAY WIDTH
ADDRESS CI7Y �
SQ.FT NO.OF NO.OF CHECK + _ �
SIZE �p STORIES FAMILIES ONE
USE ZONE MAP D �n+•� � �� �
DESCRICTION OF WORK NEW NO. ..7
�LJ�Q'�xI � v��(-f�'fJ'Q�J ADD ❑ CO �ATIO 5 �'
N
3/ � A�TER ❑ FINAt BY a
�� Fo�ri�• p oATE
REPAIR
USE OF DEMOI
EXISTING BLDG. � � Z •
APPLICANT 1EL 0
iPRINT� NO. �
C
BY i51GNATUR ' � r= C �� -' r'
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND$TATE W 7.i • • s • ! 1
THAT THE ABOVE IS CORREC�AND AGREE TO COMP�Y WITH ALL ORDINANCES .
AND LAWS REGULAiING BU�I�ING CONSTRUCTION.I CERTIFY THAT IN DOiNG THE ' _ ' . • � �
VVORK AU?HORIZED HEREBY I WILI NOT EMPLOY ANY PERSON IN VIOLATION OF V ���'`
THE LABOR CODE OF THE STATE OF CALIFORNIA IN REIAiING TO WORKMEN�S COM� Z �
PENSATION INSURANCE.' g s ` L y; 1,; .,. C
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SIGNATURE OF x ;'. ,<. � �:..`r� !'
PERMITTEE
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