HomeMy Public PortalAbout5329 ZADELL AVE_Building_4/7/1976_ APPLICATIO FOR BUILDING PERMIT
FOR APPLICANT TO FILL IN (Print or type only)
BUILDING 5], _ t' Imo+ t� BUILDING �y
ADDRESS e'�. 7% '7 ADDRESS
CITY I ZIP /;? kj LOCALITY
'NO.OF BLDGS. �.
SIZE OF LOT fr7Y I r-g NOW ON LOT L NEAREST
CROSS ST. j vL
TRACT BLO K LOT NO ASSESSOR
MAP BOOK PAGE PARCEL
1 TEL. DISTRICT" GROUP TYPE FIREqPRC )SSED BOWNER NO. CONST. ZONE
ADDRESS .� � � a L/. /9L l/r~
STATISTICAL CLASSIFICATIONSEWER MAP
CITY ZIP CLASS NO. .DWELL•UNITS BIM PG
ARCHITECT OR TEL.
� E ZONE MAP
ADDRESS Cy SPECIAL
TEL.
EL.
CONDITIONS
0.L C. , ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO'❑
ADDRESS 1 , NO.
BLDG SETBACK FROM
LIC. FROiW PROP.LINE OF (STREET)
CITY �-
CONSTRUCTION LENDER CLASS HIGHAY } YARD _ TOTAL SETBACK,FROM TYPE OF EXISTING'
n —
NAME AND BRANCH
FRONT,PROP. .LI'NE HIGHWA.Y WIDTH
ADDRESS CITY }
SQ. FT. NO. OF NO. OF I CHECK BLDGS BACK FROM.
SIZE STORIES FAMILIES ONE SIDE PROP. OF d (STREET) v
NEW HIGHWAY } YARD - rarxL:�'�'�, �CK FROM TYPE OF EXISTING •�
DESCRIPTION OF WORK^r. SIDEE PROP.'L-'NS, HIGHWAY' WIDTH CF
r 067 N\ ES�a I O ADD } = w
Cu-
ALTER
LALTER ❑ C/7
yam. CORNER CUTOFF YES ❑ NO
R ❑ Z
e - EPAIR❑
USE-OFi
EXIS-TINq BLDG. f�+ S DEMOL E] IN OPEN SPACE YES ❑ NO ❑ ,
AP(PR_fNAN ,� 'T� J1(S QJ'I N01. IN COASTAL ZONE Yes ❑, , NO ❑
�� - CATEGORICAL EXEMPTION r YES❑ NO ❑
BY (SIGNATURE ENVIRONMENTAL
IMPACT EXEMPTION DECLARATION SIGNED (DATE)
Ute
VALUATION$ `JL IMPACT REPORT PROCESSED (DATE)
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- s
STRUC TI ON. IC
THAT IN DOING THE WORK AUTHORIZED
,HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE � � ''•r��"i x`
LABOR CODE OF THE`STATE OF CALIFORNIA IN RELATING TO
WORKMEN'S COMPTIO NCE.
a
SIGNATURE OF
FINAL BY 1
PERMITTEE_ '�'a' DATE �
ADDRESS P.C. $ PMT.Q 55 ^
I+ P r
FEE FEE
TEL.
+w.. '
CITY .': NO. �.•- r
PLAN CHECK VALIDA'T'ION CK. M, r CASH PERMIT VALIDATIO cK. M.O. CASH
4 $c- 7.2-3 U a,�
440"Afrt 123 .'1t� a,i;
F-4. n lm
78p638B CE9803p 5/73