HomeMy WebLinkAboutN/A (1364)plan D20" Elevation B BUILDINGI J�
APPLICATION FOR
COUNTY OF LOS ANGELES
FOR APPLICANT TO FILL IN IPrint or type only) DEPARTMENT OF COUNTY ENGINEER
BUILDING < �� ��� 13UIL®ING AN® SAFETY DIVISION
I ADDRESS Di
ZIP BUILDING
CITY NO. OF BLDGS. ADDRESS
a NOW ON LOT
SIZE OF LOT LOCALITY
NO
BLOCK LOT .
r. TRACT 37�062 NEAREST
c® 0��®1I N99-849�' A O S OR PAGE PARCEL
OWNER pn Blvd -MAP BOOK TYPE FIRE PROCESSED BY
ADDRESS 629 �®��"��' DISTRICT GROUP CONST. ZONE
Dimass ZIP �177
rt' -CITY TEL SEWER MAP
ARCHITECT41� ROs� ®�°9J0.52�®�3� STATISTICAL CLASSIFICATION
ENGINEER/ BK PG
uite 230, $rem DWELL. UNITS
CLASS NO. -----
ADDRESS 770 S® 33O
NLL-5�9-849 USE ZONE NAP
CONTRACTOR Amen ®
Covina ���®
LIC.
N0.31942U
SPECIAL
CONDITIONS
YES ❑ NO ❑
ADDRES629
��
LIC. B-1
CLASS
ROAD DEPARTMENT APPROVAL REQUIRED
�iTi1��
CITY
BLDG. SETBACK FROM
(STREET)
CONSTRUCTION LENDEIllinoisFRONT
NAME AND BRANCH Oj1�Y1�11� �^
NAM
PROP. LINE OF
TOTAL SETBACK FROM
TYPE OF EXISTING
HIGHWAY WIDTH
5 ®Ids ���.�ITY
chic O
CHECK
HIGHWAY + YARD =
FRONT PROP. LINE
E5�3�
NO.OF
SQ. FT NO OF FAMILIES
157 STORIES
�- ONE
RT
+ =
U
O
SIZE
DESCRIPTION OF WORK
NEW
ADD ❑
BLDG. SETBACK FROM
SIDE PROP. LINEOF
SETBACK FROM
(STREET)
TYPE OF EXISTING
I `
a
�� it residenCe
le f ALTER ❑
HIGHWAY + YARD =
TOTAL
SIDE PROP. LINE
HIGHWAY WIDTH
Z
REPAIR ❑
+
USE OF
EXISTING BLDG. N/A
DEMOL ❑
CORNER CUTOFF
YES ❑
NO
TEL
APPLICANT oral .OrNO.599
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IN OPEN SPACE
YES ❑
NO ❑
(PRINT)
YES ❑
NO ❑
IN COASTAL PERMIT ZONE
BY (SIGNAT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE AlAND LAWS REOGULATING BUILDING CONSTRUCOTIONO.MCERTPLY IFY THAT IN ITH ALL BOOING THE
TN IN VI
HELA OR CODE OF THE STATE OIF CALIFORNIA IN RELL NOT EMPLOY ILATING TOO WORKMEN'S O OM
PENSATION I RANCE.
SIGNATURE OF 629 ����� PERMITTEE 10N g
ADORES � ® FINAL
TEL.599�849 DATE
as $ CA NO.
(CITY � P.C.
MAKE CHECKS PAYABLE TO:
FEE
HARVEY T. BRANDT, COUNTY ENGINEER
"1 CHECK VALIDATION
CK. M.O. CASH
� � •f-j
2
BY
d I
PERMIT VALI®ATION
PMT.
FEE
CK. M.O. CASH