HomeMy WebLinkAbout1343A ` (�y 76A838A �� �
CE i803 tREV.6/78) +
APPLICATI4N FOR� BUILDING PERMIT
COUNTY OF LOS ANGELES - BUILDING AND SAFETY
BUILDING
FOR APPLICANT TO FILL IN ADDRESS 11 5 . R Bra h d �
BUILDING
ADDRE55 21195 E. Runnin Branch Rd. LOCALIiY Qiamond Bar
arr d B Z1P 9176 c"a�`oss sT.
tVO.OF BLDGS. ASSESSOR
SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL
C DISTRICT GROUP TYPE FIRE P ESSED BY
TRACT 29 a3 BIOCK LOT NO. �O n�3 �e�sT. Wa�� �NE
TEL R '`'L�
OWNER i d i d e No 953- 932
STATISTICAL CLASSIFICATION SEWER MAV
AD4RES5 ZOO N. Tusti n Ave. �ZO� ��qs$NO. 2� DWELL.UNITS BK PG
CITY Santa Ana Z�p 427uJ
ARCHITECT OR TEL. VALUATIpN $ 350.OO
ENGINEER NO.
ADDRESS BLDG.SETBACK FROM
TEL. FRpNT PROP.IWEOf �STREETI
CONTRACTOR NO. � HIGHW.AY + YARp TOTAL SETBACK FRQM TYPE OF EXISTING
ADORE55 2 O . Tusti No. 323640 fRONT PROP.LINE HIGHWAY WIDTH
uc. + _
C�TY Santa Ana C1A55 BLDG.SEiBACK FROM
CON57RUCTION IENDER SIOE PROP.LINE OF 1STREET�
NAME AND BRANCH TOTAL SETBACK FROM TYPE O EXISTING �'
n �p HIGHWAY + YARD = a.
ADDRESS . BOX 7H0 CITY Santa Ana SIPE PROP.LtNE HiGHWAY WI�TH �
SQ.FT. NO.OF NO.OF CHECK + — V
SIZE STORIES FAMILIES �NE �
DESCRIPTION OF WORK NEW � P.C.Fee$ Permif Fee < <'li� �
W
Reta i n i n wa 11 a round ADD Q Issuonce Fee 7 � �
AITER
i �
REPAIR ❑ Totol Fee ��i . �
USE OF DEMOL
EXISTING BLDG. �
APPLICANT TEl
IPRINT; NO. Q
�
BY ISIGNATUREI < '
�
I HEREBY ACKNOWIE�C'iE THAT 1 HAVE READ THIS APPlICA710N AND STATE �
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WIiH ALL ORDINANCES uVi
AND lAWS REGUTATING BUILDIN6 CONSTRUCTION.I CERTIFY THAT IN DOING THE u
WORK AUiMORfZED HEREBV f W L NOT EMPLOY ANY PERSON IN VIOLATION OF
iHE LABOR CODE E STATE CALIFORNIA IN RELATING TO WORKMEN'S COM� Z
4ENSATION INSU N E. �
. � 13t�3A
SIGNATUREOF� �,� � �,� � '�
PERMITTEE
ADDRESS 2 ' TuS i n Ave. 20� Q f • • 1 �U� ;
c�T,, Santa Ana No 953-0932 0 .• • • 1 5,0 0�
use zoNE nnAP y 0 7,0 1 —8 G
NO.
SPECIAL ;� r
CONDITIONS �
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