HomeMy WebLinkAboutNo Permit Number (1668)APPLICATION FOR COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING E I BUILDING AND RAFFTY DTVTSTOTJ
FOR APPLICANT TO FILL IN
BUILDING
ADDRESS
_ e
BUILDING
ADDRESS
LOCALITY�d
CITYDiamondZIP
NEAREST
CROSS ST.
NO. OF SLOG�f
ASSESSOR
SIZE OF LOT NOW ON LOTS
MAP BOOK PAGE
PARCEL
DISTRICT GROUP TYPE FIRE
PROCESSED BY
TRAC BLOCK TE NO. 6
} �_.. CONST'Y
y
OWNER Pres1e of So. Calif.No4Q-3611
Y
STATISTICAL CLASSIFICATION
SEWER MAP
ADDRESS PO, Box 2200
CLASS NO. `(r` DWELL,UNITS .. .,
BK PG
CITY Newport Beach. Ca21P 92663
USE ZONE MAP
NO,
ARCHITECT TEL
SPECIAL
., .. NO.
CONDITIONS
ADDRESS17915 Sky ark B1Vd.
ROAD DEPARTMENT APPROVAL REQUIRED
YES❑ NO❑
CONTRACTOR Same as owner
BLDG. SETBACK FROM
NOL
LIC.
FRONT PROP. LINE OF
(STREET)
ADDRESS NO,
HIGHWAY + YARD -_ TOTAL SETBACK FROM TYPE OF EXISTING
CITY LIC.
FRONT PROP, LINE
HIGHWAY WIDTH
CLASS B-1
CONSTRUCTION LENDER
+
NAME AND BRANCH
BLDG,SETBACK FROM
ADDRESS CITY
SIDE PROP. LINE OF
(STREET)
SQ, FT. NO. OF NO. OF CHECK
HIGHWAY + YARD - TOTAL SETBACK FROM TYPE OF EXISTING
SIZE STORIES 2 FAMILIES 1 ONE
SIDE PROP, LINE
HIGHWAY WIDTH
DESCRIPTION OF WORK raaY.rJ70 Sq.f. NEW
+
Single Family Dwelling ADD
CORNER CUTOFF YES ❑
NO ❑
3 Car) )3dr2--,f ALTER ❑
Plan
OPEN SPACE YES ❑
NO ❑
An= AL REPAIR[]IN
USE OF Z",`-
❑
IN COASTAL PERMIT ZONE YES ❑
No ❑
EXISTING BLDG. DEMOL
APPLICANT TEL
(PRINT) NO.
BY (SIGNATURE)
I HEREBY ACK 0 LEDGE 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 TATE OF CALIFORNIA I '-RELATING TO
WORKMEN'S COMPENS l NSU N
SIGNATURE OF -
FINAL BY
PERMITTEE �
DATE
ADDRESS 4600 C
Newport Beach, Ca. TEL. 540-361
P.C. Fee$p a Permit Fee
CITY NO.
cl Issuance Fee
VALUATION J ro� r
INS
,r« Total Fee
,
PLAN CHECK VALIDATION CK. M.O. CASH
PERMIT VALIDATION CK.
M.O. CASH
_ `7 9!).
76A638A CE#803B 12/75