HomeMy WebLinkAbout8878COUNTY OF LOS ANGELES1
DEPARTMENT COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN
ADIDRRESS
BUILDING
ADDRESS
LOCALITY
Diamnd Bar
NEAREST
CITY ZIP
CROSS ST.
NO. OF BLDGS.
ASSESSOR
SIZE OF LOT NOW ON LOT None
MAP BOOK
PAGE
PARCEL
DISTRICT GROUP
TYPE FIRE
PROCESSED BY
TRACT 31152-A BLOCK LOT NO. 45
CONST. ZONE
OWNER PRES= OF SO. CALIF. No: 540-0500
STATISTICAL CLASSIFICATION
SEWER MAP
ADDRESS P.O. BOX 2200
CLASS NO.
DWELL. UNITS
BK PG
CITY Newport Beach, CA. zip 92663
USE ZONE MAP
- ARCHITEC�Q[� TEL
EN GI NEEOchitectural ConcernNo979-0451
NO.
SPECIAL
CONDITIONS
ADDRESS77 Brookhollow Dr., Santa Ana, CA.
ROAD DEPARTMENT APPROVAL REQUIRED
YES ❑ NO ❑
TEL.
CONTRACTOR Same as Owner NO,
BLDG. SETBACK FROM
LIC.
FRONT PROP. LINE OF
(STREET)
ADDRESS NO, 289274
HIGHWAY + YARD =
TOTAL SETBACK FROM
TYPE OF EXISTING
LIC.
FRONT PROP. LINE
HIGHWAY WIDTH
CITY CLASS B-1
CONSTRUCTION LENDER
UnknOWn
+
NAME AND BRANCH
BLDG. SETBACK FROM
ADDRESS CITY
SIDE PROP. LINE OF
(STREET)
K
FT. 1270
HIGHWAY + YARD =
TOTAL SETBACK FROM
SIDE PROP. LINE
TYPE OF EXISTING
HIGHWAY WIDTH
SIZESSTORIES FAMILIES ONE
Z
DESCRIPTION OF WORK Plan 99-A NEW
+
Single Family Dwelling ADD ❑
CORNER CUTOFF
YES ❑
NO ❑
Gar. - 451 sq. ft. ALTER ❑
ElEXISTTIING
IN OPEN SPACE
YES ❑
NO ❑
USE REPAIR
❑
IN COASTAL PERMIT ZONE
YES ❑
NO ❑
BLDG. DEMOL
APPLICANT TEL
(PRINT) Kenneth Stark Ng540-0500
!
{/
,D.
V
BY )SIGNATURE)
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES
AND LAWS REGULATING BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF
WORK
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM.
PENSATION INSURANCE
d'
Ol
d
SIGNATURE OF
:'
FINAL
BY
PERMITTEE-icy,DATE
ADDRESS 4600 Canpus Drive
44
Newport Beach, CA. No, 540-0500
P.C. Fee $
Permit Fee
aaE
CITY
Issuance Fee
VALUATION {
Total Fee
C, t+
vA 8 87 $ 12 29 77 23
�S 76A638A CE #803A 6/76
CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
14 8.80