HomeMy WebLinkAboutNo Permit Number (1677)APPLICATION FOR COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING PERMIT BUILDING AND SAFETY DIVISION fl
FOR
FOR APPLICANT TO FILL
BUILDING
ADDRESS
BU I LO I NG
BUILDING
DO
LOCALITY
CITY Diamond Bar ZIP
NEAREST
CROSS ST.
ASSESSOR
NO. OF BLOGS.
SIZE OF LOT NOW ON LOT NONE
MAP BOOK AGE
PARCEL
T T C
RAC31 151
BLOCK
I LOT NO. - 47
DISTRICT
jev
I GROUP
ITYPE
CONST
FIRE
PROCESSED BY
"JG1
-)
of S.' Calif.TEL
� 540-3611
STATISTICAL CLASSIFICATION
SEWER MAP
OWNERresley NO,
P.O. Box 2200
ADDRESS
CLASS NO, DWELL, UNITV'/
USE ZONE MA
SK PG
CITY t Beach, Ca- zip 92663
NO.
ARCHIIFE&T - ' TEL
"hr4ps NO. 979-0451
SPECIAL
EM0440E4V _j _YQ_aq_ex
CONDITIONS
ADDRESS I Zg]5 Skypark Blvd.
ROAD DEPARTMENT APPROVAL REQUIRED YES E] NO ❑
TEL.
CONTRACTOR Same as owner NO.
BLDG. SETBACK FROM
LIC.
PROP.FRONT LINE OF
(STREET)
ADDRESS NO, 2,qc)274
HIGHWAY + YARD TOTALSETBACK FROM TYPE OF EXISTING
LIC I
CITY
FRONT PROP. LINE.
HIGHWAY WIDTH
CLASS B-1
—
CONSTRUCTION LENDER
+
NAME AND BRANCH
'
I �)
BLDG. SETBACK FROM
SIDE PROP, LINE OF
(STREET)
A 1) 1) R ESS I TY
SQ. FT, NO. OF NO OF CHECK
HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING
SIZE 18281 STORIES 11 FAMILIES 1 ONE
SIDE PROP. LINE
HIGHWAY WIDTH
DESCRIPTION OF WORK Gar. 524 sq. ftNEW [X]
+
Single Family Dwellinc ADD ❑
CORNER CUTOFF YES ❑
NO ❑
ALTER ❑[j
Plan 91-B _e J'&
_7,f
REPAIR ❑
IN OPEN SPACE YES E]
-
NO
USE OF F
IN COASTAL PERMIT ZONE YES ❑
NO ❑
EXISTING BLDG, DEMOL
APPLICANT TEL
(PRINT) NO.
BY (SIGNATURE)
I HEREBY ACKWAV—LEDGE THAT I HAVE Rt—AD 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 CALI",RNIA IN LATI NG TO
WORKMEN'S COMPENSATI URAN %i
SIGNATURE OF
FINAL BY
PERMITTEE 1
DATE
ADDRESS— A 600 Camn t'
Newport BEach, Ca. TE540-361 I
P.C. Fee $ fPermit Fee
CITY NO.
$ +0/ o
Issuance Fee
LVALUATION
Total Fee
PLAN CHECK VALIDATION CK. M.O. CASH
PERMIT VALIDATION CK.
M.O. CASH
p
76A638A CE*803B 12/75