HomeMy WebLinkAboutNo Permit Number (1625)APPLICATION FOR COUNTY OF LOS ANGEIXS
DEPARTMENT OF COUNTY ENGINEER
BUILDING PERMIT BUILDING AND SAFETY DIVISION 11
FOR APPLICANT TO FILL IN
BUILDING
ADDRESS
BUILDING
ADDRESS
LOCALITY L-/
NEARESTCROSS
CITY f) i amund Ra, r ZIP
ST.
ASSESSOR
NO. OF BLDGS.
SIZE OF LOT NOW ON LOT
MAP BOOK PAGE
PARCEL
DISTRICT GROUP FIRE
PROCESSED By
TRACT
BLOCK
LOT No. 64
�TYPE
CONST 7-
/ 6 9 7.
TEL
OWNER Presley of Sn- Cal NO.
o .840-.1611
,f
STATISTICAL CLASSIFICATION
CLASS NO. - DWELL,UNITS
USE ZONE MAP
SEWER MAP
BK PG
ADDRESS P.O. Box 2200
Newport Beach, Ca. 926
66
63
CITY ZIP
NO,
SPECIAL
ARCHITECT eft TEL
-zy,s"*m" James beag6r NO.
CONDITIONS
ADDRESS 17915 Sky ark blvd.
ROAD DEPARTMENT APPROVAL REQUIRED
YES ❑ NOE]
EL.
CONTRACTOR Same as owner T 0
BLDG. SETBACK FROM
.
LI c.289274
FRONT PROP, LINE OF
--(STREET)
ADDRESS No.
HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF 1EXISTING
LIC
CITY
FRONT PROP. LINE
HIGHWAY WIDTH
CLASS R_
CONSTRUCTION LENDER
+
NAME AND BRANCH
BLDG, SETBACK FROM
ADDRESS CITY
SIDE PROP, LINE OF
(STREET)
SQ. FT ff7t—I.N0. OF I NO. OF CHECK
HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING
SIZE lSTORIES 2 FAMILIES 1 ONE
SIDE PROP, LINE
HIGHWAY WIDTH
Gar. 460 sq.ftNEW
+
DESCRIPTION OF WORK
Single Family Dwelli.ng — ADD ❑
CORNER CUTOFF YES
NO ❑
❑
!PALTER --I
—REPAIR[I
IN OPEN SPACE Y ES E]
NO ❑
USE OF F7
DEMOL
IN COASTAL PERMIT ZONE YES
NO ❑
EXISTING BLDG,
APPLICANT TEL
(PRINT) NO.
BY (SIGNATURE)
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
A N D STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION. 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 COMPENSA
SIGNATURE OF
: ��4
FINAL BY
PERMITTEE. 4;;:
DATE
ADDRESS 4 00 Campiid-Drive
TEL
Beach, Ca.
P.C. Fee $ Permit Fee
CITYNewport NO.
4- Issuance Fee
VALUATION $
Total Fee
PLAN CHECK VALIDATION CK. M.O. CASH
PERMIT VALIDATION CK.
M.O. CASH
0
76A638A CE08038 12/75