HomeMy Public PortalAbout9058 ACASO DR_Building_4/19/1978 APPLICATION FOR -
;,/OUILDING PERMIT
BUILDING
FOR APPLIQANT TO FILL IN ADDRESS
BUILDINGQ ! r�
ADDRESS 1 GELAIrLOCALITY
,y� � NEAREST
CITY C i `Y ZIP CROSS ST - I'
NO OF BLDGS ASSESSO _ _
SIZE OF LOT NOW ON LOT I MAP BOOK PAGE PARCEL ` '-
i Q DISTRICT GROUP. ,TYPE FIRE PROCESSED
-TRACT-' RS:--11151 BL�C1P� LOT NO (� �O^r/ �J'a, CONST:
TEL fT .o J' `
OWNER ' _NO
STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS �*
CLASS NO DWELL UNITS+ BK��• PG,
CITY ZIP USE ZONE MAP NO ,
ARCHITECT OR- TEL SPECIAL
ENGINEER C.. NO CONDITIONS '
ADDRESS 11 " , ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NOTEL
❑'
CONTRACTOR L' �JL7 NO 3�~ _ BLDG SETBACK FROM -
LIC FRONT PROP LINE OF r ' (STREET)
ADDRESS O _ TOTAL SETBACK FROM TYPE OF EXISTING
LIC. t HIGHWAY + YARD - FRONT PROP LINE HIGHWAY•WIDTH
CITY E✓ CLASSC✓� __
CONSTRUCTION LENDER +' • -
NAME AND BRANCH - BLDG SETBACK FROM - V
ADDRESS CITY ' SIDE PROP LINE OF ' (STREET)
SQ F NO OF NO OF CHECK HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING U
SIZE STORIES I FAMILIES ONE SIDE PROP LINE_ HIGHWAY WIDTH_ wa
_ V)
DESCRIPTION OF WORK z-tzn NEW ❑ + Z
- J ADD CORNER CUTOFF YES O NO ❑
ALTER
REPAIR./❑ IN OPEN SPACE - YES ❑ NO ❑ - _
USE OF BLDG W��r DEAAOL ❑ IN COASTAL PERMIT ZONE YES "❑ NO- ❑
EXIAPPLICANT_ TEL
(PRINT)
LB,
NATURE( • ' «6 �'�� '
EREBY-ACKNOWLEDGE•THAT I HAVE READ THIS APPLICATION AND STATE
HE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES -
WS REGULATING BUILDING CONSTRUCTION 1 CERTIFY THAT IN DOING�THE ,
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION F "
BOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKIN S CO
ION INSURANCE ,
TURE OF + � � FINA ! 7 y BY
PERMITTEE ATE
ESS
" TEL P C Fee$ Dl1. Permlt Fee-NO
�� Issuance Fee O
ATION$
Total Fee b� '
PLAN-CHECK VALIDATION CK Wo CASH PERMIT VALIDATION (SK,) Mo -CASH
t•
APR 19 ji,g D" '' 0 0 7,-AR- «19 -1 V •.1 .0 0
_ ; s.00A _ -
®S 76A638B GE'/8038 6/76