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Home My Public Portal About5940 AGNES AVE_Building__ APPLICATION FOR BUILDING PERMIT -1 ' FOR APPLICANT TO FILL IN (Print o. type only) � U COUNTY OF LOS ANGELES AtDRESS 0 Aanes . DEPARTMENT OF COUNTY ENGINEER v, CITY zIP BUILDING AND SAFETY DIVISION NO OF BL BUILDING 4o —.k? ; SIZE OF LOT NOW ON LOTT ADDRESS `� � TRACT&S CO / BLOCK LOT NO LOCALITY ` OWNER Allan Shinn NO 8 CROSS ST QA,_ tA ASSESSOR ADDRESS C) Q AgneS MAP BOOK PAGE PARCEL DISTRICT I GROUP TYPE FIRE PROCrED BY CITY Temple City ZIP 5- ,6 &q - O&q � CONS Z E ARCHITECT OR TEL V � ENGINEER NO r STATISTICAL CLASSIFICATION - EWER MAP ADDRESS CLASS NO /DWELL UNITS Bd aPC(C CONTRA CTO - NEE USE ZONE MAP ^ NO off--O O ADDRESS 12 S•S`' ta, Anita, 26 �v SPECIAL t y LIC CONDITIONS CITYArcadia CLASS B1 ROAD DEPARTMENT APPROVAL REQUIRED YES NO E] CONSTRUCTION LENDER NAME AND BRANCH Downey Savings BLDG SETBACK FROM 1 a FRONT PROP LINE OF (STREET) V ADDRESS Foothill BlvdTy Arca is _ TOTAL SETBACK FROM XISTING SO FT- NO OF NO OF CHECK HIGHWAY } YARD - HIGHWAY WIDTH CD FRONT PROP L O SIZE STORIES FAMILIES ONE V + LLJ DESCRIPTION OF WORK J NEW 11 y SETBACK 0' x 16' Addition ADD ® SSI EGPROP L NEOFOM (STREET) z IrL_ �^ / n` _ - ALTER ❑ HIGHWAY } YARD _ TOTAL SETBACK FROM TYPE OF EXISTING CL�O�I-r[iL GcJZdIC/w-Q-lv) REPAIR❑ SIDE PROP LINE HIGHWAY WIDTH USE OF EXISTING BLDG Residence DEMOL ❑ APPLICANT TEL CORN CUTOFF YES ❑ NO (PRINT) NO BY (SIGNATURE) IN OP SPACE YES ❑ NO ❑ Q JGN NICOASTAL ZONE YES NO ❑ VALUATION X12 000.QQCATEGORICAL EXEMPTION YES❑ NO I HEREBY ACKNOWLEDGE THAT I HAVE READ THCATION ENVIRONMENTAL AND STATE THAT THE ABOVE IS CORRECT AND AGOMPLY IMPACT EXEMPTION DECLARATION SIGNED' (DATE) WITH ALL ORDINANCES AND LAWS REGULATING CON , ST�RUC TI ON I CERTIFY THAT IN DOING THE WOORIZED IMPACT REPORT PROCESSED (DATE) HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOOF THE v`//� LABOR CODE OF THE STATE OF CALIFORNIA IING TO /xj WORKMEN S COMPENSATION INSURA /"I SIGNATURE �� G0 v 7" �,jPERMITTEEADDRESS �� =NAL BY`CITY TEDATE G�MAKI CIILCKS I'AYABLC 7UFEE E HARVEY T BRANDT COUNTY ER S g 'PLAN CHECK VALIDATION CK M O CASH _ PERMIT VALIDAT Df CK m. CASH r 1_ � � , ✓r t 1U by -bes3 3 1 �Ub �G b� � 76A638A CE#803 7/73 DEPARTMENT OF 13'CiILDING AND SAFETY APPLICATION` FOR rJERMIT COUNTY OF LOS ANGELES I L WM. J. FOk. CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTRICT NO: PLAN CK.NO. �yJPERMIT NO. ADD BUILDNG E18B 0 LOCALITY { RECEIVED VED BY DATE OF APPL. DATE ISSUED NEAREST IVf en et'— _E ROSS omoCROSS ST. - �, f BUILDING O WNER ADDRESS MAIL / OL�CALITY C ADDRESS J e (� �Gd'✓L. �' HE REST /_ DO_�i1 TEL. CRO SST. `Kim d CI NO. FIRE % NU.OF TYPE ®ROUP ARCHITECT OR TEL. ZONE PLANE ENGINEER NO. BLDG. ORD.NO. ADORES SETBACK LINE\t �� APPROVED CONT RACTO �� :� �� BY DATE USE __APP VED ADDREBB S- 4? (D' L2 0 � ZONE BY ��+ DATE LEGAL 0RREC a•ON8 DESCRIPTION LOT NO. BLOCK acv TRACT G' i NO.OF BLDOB. SIZE OF LOT I NAW ON LOT USE OF I NO.!-OFI NO.OF EXISTING BLDG. FwMIL.rg ROOMS _3 DESCRIPTION OF WORK NEW ALTERATION AlDbiTION O REPAIR MOVINP;�. DEMOLISH U Sq.FT. NO.OF ��qq i = SIZE ROOMS STORIES {�F ( A,PC 1) r WALL ROOF COVERING I COVERING USE OF NEW BUILDING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION INSPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMB.'MATERIALB AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE STOP& SIGNATURE OFl„ _ /) BRACING.BOLTS PERMITTEE.< LG/� LATH, INT. AUTHORIZED AGT-f LATH, EXT. 7-6A63BA-3 2-50 $ 06 P.C.!i3 PLASTER.INT. FEE PLASTER.EXT. cq !$ Q VALUATION FEE FINAL APPLICATION FOR BUILDfNG PERMIT FOR APPLICANT TO FILL IN (Print or type only) BUILDINGa� COUNTY OF LOS ANGELES ADDRESS � .�/v //' /� f � -� DEPARTMENT OF COUNTY ENGINEER CITY ZIP 'M.y i,(f t3 BUILDING AND SAFETY DIVISION .,� NO.OF SLOGS. BUILDING SIZE OF LOT�.�,. ) / ��j NOW ON LOT ADDRESS,_ TRACTBLOCK L T LOCALITY4_` TEL. > NEAREST OWNER r .t'e ,y .��1 da''�b'd NO. + CROSS ST. ASSESSOR ADDRESS f//�,57 y/�[E �;,/.-e'L� MAP BOOK .PAG PARCEL DISTRICT GROUP TYPE FIRE P CESSED BY CITY '�- � ZIP G/, /� CONST ZONE ZONE ! '� ARCHITECT OR TEL. a. I—- --'S ENGINEER NO, STATISTICAL CLASSIFICATION SEWER MAP ADDRESS TEL. CLASS N _DWELL.UNITS f � BK G CONTRACTOR / NO USE ZONE MAP / LIC. NO. __q C3 ADDRESS / NO. SPECIAL LIC. CONDITIONS CITY CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑ CONSTRUCTICA4 LENDER NAME AND BRANCH BLDG.SETBACK FROM Gi FRONT PROP.LINE OF - (STREET) C ADDRESS CITY HIGHWAY + YARD TOTAIFSETBACK FROM TYPE OF EXISTING CY SQ. FT. NO. OF NO. OF CHECK FRONT PROP. LINE HIqyWAYj WIDTH C SIZE STORIES FAMILIES ONE 4 NEW t �+ - 1:1 �� Q. C/ DES R PTION OF WORK z ADD ❑ BLDG. M SI LINEOF (STREET) SIDE PROP. LINE OF ALTER ❑ TOTAL SETBACK FROM TYPE OF EXISTING IGHWAY + YARD REPAIR SIDE PROP. LINE HIGHWAY WIDTH USE OF + _ EXISTING BLDG. DEMOL ❑ APPLICANT// TEL `-� CORNER CUTOFF YES ❑ NO ❑ (PRINT) rCi .��ftJ F,lAv f+, A) N0.�J(�4.. k IN OPEN SPACE YES ❑ NO ❑ BY (SIGNATURE) - _ � �-,K., Q, IN COASTAL ZONE YES ❑ NO ❑ VALUATION •Y CATEGORICAL EXEMPTION YES❑ NO ❑ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE) WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE) HEREBY I WILL NOT EMPLOY- ANY PERSON IN VIOLA kON OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN ELATING TO WORKMEN'S CO MPE NSATIO_ NSURANC SIGNATURE PERMITTEE W,+I- — IrcA 1 .-��'"'` '"' f;i:a.� ,. . ADDRESS OI I"'h_— "O®fpr FINAL8Y4, CITY NOTE L DATE IA:57- -7 MAKE CIIECKS F'AYA6LE TO: FEE FEE HARVEY T. BRANDT. COUNTY ENGINEER 1 2 PLAN CHECK VALIDATION CK. M'0 CASH _ PERMIT VALIDATION CK.' CASH U'4 4 i;11111 v1 j U 1 2.00An,d i 76A638A CEN803 7/73