HomeMy WebLinkAboutNo Permit Number (1669)� N 64 0 —
0 U 21 ri kv, I BE
COUNTY OF LOS. ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
BUILDING
FOR APPLICANT TO FILL IN
ADDRESS
BUILDING
ADDRESS
LOCALITY
Diamond Bar
NEARESTCROSS
CITY ZIP
ST.
NO. OF BLOGS.
ASSESSOR
SIZE OF LOT NOW ON LOT
MAP BOOK PAGE
PARCEL
DISTRICT GROUP TYPE FIRE
P OCESSED By
TRACT 31151 IBLOCK LOT No. 22
I -
CONS,T_ ZONE
'K_' 14 N 7
' IT—
TEL -540-3611
PRESLEY OF SO. CALIFNO.
OWNER
STATISTICAL CLASSIFICATION
SEW E.'R' MAP
ADDRESS P.O, Box 2200
CLASS NO, 0 DWELLN I TS
,U
BK PG
Newport Beach, CAz,, 92663
USE ZONE MAP
CITY
NO.
ARCHITECT 7,7 / '��'TEL.
-'T;--e'a/ger 9790 451
SPECIAL
4RI49"Weftwgames�—J. NO.
CONDITIONS
ADDRESS 17915 Skypark Blvd.
ROAD DEPARTMENT APPROVAL REQUIRED
YESE] NO ❑
CONTRACTOR Same as owner T NEL -540-3611
BLDG. SETBACK FROM
LIC.
FRONT PROP, LINE OF
(STREET)
ADDRESS NO. 289274
HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING
CITY LIC.
FRONT PROP. LINE
HIGHWAY WIDTH
CLASS
CONSTRUCTION LENDER
+
NAME AND BRANCH
BLDG, SETBACK FROM
ADDRESS CITY
SIDE PROP. LINE OF
(STREET)
SQ. FT,'t 'I NO, OF NO OF CHECK
I
HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING
SIZE -2-2-1-14STORIES 2 FAWLIESI_ ONE
SIDE PROP. LINE
HIGHWAY! WIDTH
RIP 0N 4Gar. 460 sq.ft*4EW
+
DESC OF ORK
Single Family Dwelling ADD
CORNER CUTOFF YES E]
NO ❑
c- —ALTER ❑
IN OPEN SPACE YES D
NO ❑
plan R'I—Q REPAIREI
USE OF *9
DEMOL ❑
IN COASTAL PERMIT ZONE YES ❑
NO ❑
EXISTING BLDG.
APPLICANT TEL
(PRINT) NO. J
BY (SIGNATURE)
I HEREBY ACeNOWLEDGE 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
OLATION OF THE
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION
LABOR CODE OF THE STATEOF CALIFORNIA Itt RELATING TO
C
WORKMEN'S COMPENS I �11 r�su 14C
VN
SIGNATURE = -
0 F -
FINAL BY
PERMITTEE
DATE
ADDRESS 4600 Campus 'Orivp
Newport Beach, CA T EO.L'
6�J'
P.C. Fee $ 1
Permit Fee
CITY N540-3611
VALUATION $
Issuance Fee
Total Fee
It
PLAN CHECK VALIDATION
CK. M.O. CASH
PERMIT VALIDATION CK. M.O. CASH
11
76A638A CE*8038 12/75