HomeMy Public PortalAbout5300 BALDWIN AVE_Building__ (2) APPLICATION FOR BUILDING PERMIT
FOR APPLICANT TO FILL IN (Print Or type only)
BUILDING BUILDING
ADDRESS
ADDRESS
ZIPNO.OF BLDGS. LOCALITY
SIZE OF LOT NOW ON LOT NEAREST
CROSS ST.
ASSESSOR
TRACT+C' `'^ BLOCK
LOT NO MAP BOOK PAGE PARCEL
TEL �..ISTRICT GROUP TYPE FIRE PROCESSED BY
OWNER ! NO.` `tet'->�- CONST. ONE
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ADDRESS ` �,....�+. "„��, ,'l ,: --•�...r,,..
STATISTICAL CLASSIFICATION SEWER MAP
CITY a:"•"'["'i C... ZIP CLASS N0. "^ , _DWELL,UNITS BK PG
ARCHITECT ,K_. TEL.
ENGINEER ---� i I'il . NO/,,, !.�� USE ZONE MAP 1
f NO.
ADDRESS °+ IC}t'r4(J .y>wp) - ! SPECIAL
L/
CONDITIONS
CONTRACTOR C1 , ��, NDLfTG�> /
ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑
//��� LIC.
ADDRESSZ~�a...•� +.+tv,�'� i{�>F1'1�j':_(.✓ NO. BLDG.SETBACK FROM
CITY riJ LIC.
CLASS FRONT PROP.LINE OF —(STREET)
HIGHWAY t YARD -_ TOTAL SETBACK FROM TYPE OF EXISTING
CONSTRUCTION LENDER
NAMFRONT PROP. LINE HIGHWAY WIDTH ate.
E AND BRANCH
O
ADDRESS CITY + - U
w
SQ. FT. NO. OF NO. OF CHECK BLDG.SETBACK FROM. __2
SIZE STORIES FAMILIES ONE SIDE PROP. LINE OF (STREET)
DESCRIPTION OF WORK NEW ❑ HIGHWAY + YARD = TUTAL SETBACK FROM TYPE OF EXISTING C=
-"� ADD F-1DE PROP. LINE HIGHWAY WIDTH
ALTER ❑
REPAIR
CORNER CUTOFF YES ElNO ❑ Hw
❑
USE OF
EXISTING BLDG. DEMOL ❑ IN OPEN SPACE YES ❑ NO ❑
APPLICANT TEL,;: ,. l IN COASTAL ZONE YES NO
(PRINT) f NO.-, IN j:: (, ❑
BY (SIGNATURE) ENVIRONMENTAL CATEGORICAL EXEMPTION YES❑ NO ❑
_ IMPACT EXEMPTION DECLARATION SIGNED (DATE)
a 7
VALUATION$ -'j f IMPACT REPORT PROCESSED (DATE)
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLIC]HE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO CO
WITH ALL ORDINANCES AND LAWS REGULATING BUILDINGSTRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHO
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION O
LABOR CODE OF THE STATE OF CALIFORNIA IN RELATIWORKMEN'S COMPENSATION INSURANCE.SIGNATURE OF FINAL BY
PERMITTEE r T` DATE
ADDRESS • P.C. PMT.FEE FEE
CITY .oiJNOL
PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION CK M 0. CASH
76A638B CEA803A 5/73
DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES 1
WM J FOX CHIEF ENGINEER BUILDING
NO OF BLDG ORD NO DISTRICT NO PLANCK NO PERMIT NO
PLANS SETBACK LINE -T
FIPE APPROVED
ZONE BY DATE RECEIVED BY DATE OF APPL DATEISSUED
USE APPROVED 'Q l I nr—1
T —�0
ZONE 2 BY ATE G
APPLICANT FILL IN HEAVILY, OUTLINED PORTION ONLY
BUILDING /� �'��' P�
p NAME ADDRESS �0 '�T"���y,L�GU��
FUW- Z ADDRESS LOCALITY ,�j�J/G,�,�^
= Z NEAREST
U yj CITY CROSS ST
Q STATE TEL
LICENSE N NO � NAME
, MAIL
0 NAME �(��� � �e/_.J DC,Q. ADDRESS
6 ADDRESS .4 CITY CITY NO
Z� J �
CITYp ,,� , ,��• g•, ,�^,� I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
O w v APPLICATION AND STATE THAT THE ABOVE 18 CORRECT
U STATE TEL AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
LICENSE NO NO AND STATE LAWS REGU TING BUILDING CONSTRUCTION r
Z0 LOT NO SIZE OF O
_ OWNER
Q ..� NO OF BLDG3— AUTHORIZED AGT
BLOCK NOW ON LOT '
U CORRECTI NS
W TRACT
W
USE OF BLDGS
NOW ON LOT
DESCRIPTION OF WORK
4
USE
OF �� �+� ojat�a
EUILDING
�r
s
J
a
a _Z
' r �
I NEW TYPE GROUP
NO OF NO OF
! ALTERATION ROOMS l FAMILIES
ADDITION SIZE
REPAIR STORKS
MOVING WALL COVERING
DEMOLISH ROOF COVERING
s P C $ FINAL APPROVAL
VJ
FEE $ A �'"4�
5 � �_ .i� INSPECTOR 6
VALUATION FEE / rr ' DATE NAME