HomeMy WebLinkAboutNo Permit Number (1610)APPLICATION FOR COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING PERMIT BUILDING AND SAFETY DIVISION 11
BUILDING
FOR APPLICANT TO FILL IN
ADDRESS
BUILDING
19
ADDRESS
LOCALITY -/"V
NEAREST
CROSS ST.
ASSESSOR
CITY Diamond Bar ZIP
NO. OF BLDGS.
SIZE OF LOT NOW ON LOT
MAP BOOK PAGE
1PARCEL
IBLOCK
63
I
DISTRICT
GROUP
_
F
FIRE
PR9CESSED BY
TRACT 51
1
LOT NO.
ITYPE "
CONST
ol
'
_Y2F7:1�
I
fEcL
Presley of So. Cali '540-3611
STATISTICAL CLASSIFICATION
C' 2
SEWER MAP
OWNER .
P.O. Box 2200
ADDRESS
CLASS NO. _j(,N I TS
DWELLU
USE ZONE MAP
BK PG
Newport Beach, 92663
CITY -Ca. z,
I
SPECIAL
ARCHITECT <DR James J YeagerEl .979-0451
4 NO.
3
INO,
CONDITIONS
ADDRESS 17919 'Skypark Blvd.
ROAD DEPARTMENT APPROVAL REQUIRED YES F] NO ❑
CONTRACTOR Same as owner TEL..
No
BLDG. SETBACK FROM
LIC.
FRONT PROP, LINE OF
(STREET)
ADDRESS NO. 289274
HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF 1EXISTING
CITY LIC.
B-1
FRONT PROP. LINE
HIGHWAY WIDTH
CLASS
CONSTRUCTION LENDER
+
NAME AND BRANCH
BLDG. SETBACK FROM
A ADDRESS CITY
D
SIDE PROP. LINE OF
(STREET)
SQ. NO. OFS NO OF CHECK
Q
HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING
S IZE STORIES 2 FAWLIES 1 ONE
I Z E
SIDE PROP. LINE
HIGHWAY WIDTH
Gar. -4-0 sq. ':@t WEW
+
ESCRIPTION OF WORK
DE
DESCRIPTION
ADD ❑
CORNER CUTOFF YES ❑
NOE:]
Mi )/ 1)14lp Inq
ALTER
IN OPEN SPACE YES ❑
NO E]
REPAIR❑
USE OF
USE
DEMOL ❑
IN COASTAL PERMIT ZONE YES ❑
NO ❑
X I S
EXISTING BLDG,
AP
, P
APPLICANT TEL
(PRINT) NO.
(
BY (SIGNATURE)
E AD APPLICATION
S A T I
I I c
THIS P L 0 N
I HEREBY ACKNG'6LEDGE THAT I HAVE READ THIS APPLICATION
A 0 L Y
AGREE T P
AND FE C
COMPLY
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
'T AN
r BUILDING
REGULATING I NG CON-
A T N I L D N -
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON-
W
3 E WORK AUTHORIZED
T H 0 T H 0 R I ZED
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED
STRUCTION.
I T
I T 0
.0. N 0 A N 0 HE
L
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
Y
OF
F CAL fORNIA IN RELATING TO
0 RN I A IN ELATING
LABOR CODE OF THE STATE'A T I N To
WORKMEN'S COMPENSAT�l I
"I
SIGNATURE OF
FINAL BY
PERMITTEE.
/'- 4600. CamUsDrive
j
DATE
ADDRESS—
Newport Beach, Ca. 540-3611
TEL.
P.C.Fee $ Permit Fee
13
CITY 0
NO.
VALUATION $ S,
Issuance Fee
o Total Fee •7)
U
PLAN CHECK VALIDATION CK. M.O. CASH
PERMIT VALIDATION CK.
M.O. CASH
kI n P,
76A638A CE#803B 12/75