HomeMy Public PortalAbout9052 ACASO DR_Building_5/5/1976 APPLICATION FOR BUILDING PERMIT
Fjl APPLICANT TO FILL IN (Print or type only)
BUILDING COUNTY OF LOS ANGELES
ADDRESS 'q�D� SU DEPARTMENT OF COUNTY ENGINEER
CITY z I P 17BUILDING AND SAFETY DIVISIO
NO.OF BLDGS. BUILDING
S �E OF LOT NOW ON LOT ADDRESS '
T CT ��1-) BLOCK
f� LO�i NO. Z- LOCALITY
NEAREST
OWNER 61h,P o/ d<S AFL �L� fQpF - CROSS ST.
ASSESSOR
ADDRESS MAP BOOK PAGE CEL
DISTRICT IGROUPITYPE FIRE PROC SE BY
CITY ZIP CONST. ZONE
ARCHITECT OR TEL. _ '09 Z, 1� fr
ENGINEER NO.
STATISTICAL CLAS{/SI FICA TION SEWER MAP
ADDRESS CLASS NO.�CLry� DWELL.UNITS BK PG
CONTRACTOR v 44-, T 1111(33-' � USE ZONE NO. /�
ADDRES ��„2 ,s ff NO1C -36�2.l9 J �L SPECIAL
LIC. CONDITIONS
CITY J'10 .Cv CLASS
ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑
CONSTRUCTION LENDER
NAME AND BRANCH BLDG.SETBACK FROM
FRONT PROP.LINE OF (STREET)
ADDRESS CITY HIGHWY + YARD TOTAL SETBACK FROM TYPE OF EXISTING
SQ. FT. NO. OF NO. OF CHECK FRONT PROP. LINE HIGHWAY WIDTH
SIZE Iu STORIES FAMILIES 'ONE
�a,�.I� p� + a
DESCRIPTION OF WORK NEW ❑��.?/A�/ �.L V
BLDG SETBAC<FROM
019�/�` ��� ADD SIDE OP.LINE OF (STREET) o
`-J / ALTER ❑ HIGHWAY YARD = TOTAL SETBACK FROM TYPE OF EXISTING V
REPAIR❑ E HIGHWAY WIDTH W�
USE
EXISTING BLDG, f.L�� J1ty DD�EMJO�sL ❑ + Z
APPRINT)NT $f/Pi'//L�/lf?/A NOLVFa.7 CORNER CUTOFF YES ❑ NO ❑
BY (SIGNATURE) s'_,t� IN OPEN SPACE YES ❑ NO ❑
•�v�l IN COASTAL PERMIT ZONE YES ❑ NO ❑
VALUATION,$
I HEREBY.ACKNOWLEDGE THATI HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION. I CERTIFY ,THAT-'IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT EMPLOY ANY PERSON VIOLATION OF THELABOR CODEOFTHE TATEOF ALI NIA IN RELATING TO
WORKMEN'S COMPENSAT N INSR E
SIGNATURE OF
PERMITTEE �—//
4,4
ADDREOS\SS 9z -�G
CITY � �/ �`!`E�+ NO.L {N� DATE
111f�E CNECI�S Pl]'At3LE 70: P.C. PMT.;$
FEE' FEE $
HARVEY T. BRANDY, COUNTY ENGINEER / SUS C--?;, /,
PLAN'CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIO cK. M.o. CASH
J5 7 2 `i r'm.AY 5 D 2 1.7 5 ,k
t;
� 25� nY 5 � 1 3.
76A638A CE#803 574
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