HomeMy WebLinkAboutNo Permit Number (1666)AmPPLICATI N FOR COUNTY OF LOS ANGELEs
DEPARTMENT OF COUNTY ENGINEER
BUILDING I BUILDING AND SAFETY TNVTRMN
FOR APPLICANT TO FILL IN
BUILDING
ADDRESS
BUILDING
ADDRESS
LOCALITY
CITY Diamond Bar
NEAREST
ZIP
CROSS ST.
ASSESSOR
NO. OF BLOGS.
SIZE OF LOT NOW ON LOT NONE;
MAP BOOK PAGE
PARCEL
DISTRICT GROUP TYPE FIRE
PROCESSED BY
TRACT 31151
BLOCK
LOT No. 67
CONST,,r° ZoN
STATISTICAL CLASSIFICATION
�DWELL,UNITS � �
,
SEWER MAP
OWNER PRESLEY OF 50. CALIF EL' 540-3611
P•Q• BOX 2200
ADDRESS
CLASS NO.
BK PG
CITY Newport Beach, CA. 92663
USE ZONE MAP
ZIP
NO.
ARCHITECT - y'' TEL
JameeJe Yea e/ NO.979-1451
SPECIAL
CONDITIONS
ADDRESS 17915 Skvpark Blvd.
ROAD DEPARTMENT APPROVAL REQUIRED
YES ❑ NO ❑
EL.
CONTRACTOR .Same as OmerNO
BLDG. SETBACK FROM
LIc•289274
FRONT PROP. LINE OF
(STREET)
ADDRESS NO.
HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING
CITY LIC, B-1
FRONT PROP, LINE
HIGHWAY WIDTH
CLASS
CONSTRUCTION LENDER
+ -
NAME AND BRANCH
BLDG. SETBACK FROM
ADDRESS , CITY
SIDE PROP. LINE OF
(STREET)
SQ. FT, NO OF NO OF CHECK
2 1— 2
HIGHWAY + YARD - TOTAL SETBACK FROM
TYPE OF EXISTING
SIZE STORIES FAMILIES 1 ONE
SIDE PROP. LINE
HIGHWAY WIDTH
� 460 sq.ft. NEW
1-L4JdC-A1L CarDESCRTION
+ -
OFWORK
Single Family Dwelling ADD ❑
CORNER CUTOFF YES ❑
NO ❑
ALTER ❑
Plan 83-8 ,,
REPAIR ❑
IN OPEN SPACE YES ❑
NO ❑
USE OF
EXISTING BLDG, DEMOL ❑
IN COASTAL PERMIT ZONE YES ❑
NO ❑
APPLICANT TEL
(PRINT) NO. f
BY (SIGNATURE)
I HEREBY ACK4 6WLEDGE THAT I HAVE READ THIS APPLICATION
AND 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 R ATING TO
AWORKMEN'S COMPENS0 N if'
SIGNATURE OF
FINAL BY
PERMITTEE
ADDRESS 4600 Camus Dr1Ve
DATE
TE L. 540-3611
Newport Beach, CA.
CA.
P.C. Fee $ � t , Permit Fee
4 ty
CITY —NO.
°`i � `Z C Issuance Fee
Q /j{/ _
t1 �J i,?
VALUATION a F / -` Y A �A
/
F
cE Total Fee
•�� "
PLAN CHECK VALIDATION CK. M.O. CASH ®
PERMIT VALIDATION CK.
M.O. CASH
76A638A CB#803B 12/75