HomeMy Public PortalAbout4800 BALDWIN AVE_Building_5/13/1971_Pole for signh APPLICATION FOR BUit9lNG -Wd1-
FOR Ar"LICANT TO FILL IN (Print or type only)
ADDSS
COUNTY OF L
DEPARTMENT
OS ANGELES
RTMENT OF COUNTY ENGINEER
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ZIP
BUILDING AND SAFETY DIVISION
N OF BLDGS BUILDING e
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C'SIZE OF LOT NOW ON LOT ADDRESS IV
TRACT BLOCK LOT NO LOCALITY
OWNER
TEL NEAREST r
NO CROSSST a
ASSESSOR
ADDRESS MAP BOOK PAGE RCEL
DISTRICT GROUP TYPE FIRE P ESSED BY
CITY ZIP
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ENGINEER N2::2 STATISTICAL CLASSIFICATION ` SEWER MAP
ADDRESS CLASS NO DWELL UNITS BK 015G
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LIC
ADDRESS NO z SPECIAL
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CONDITIONS G/S -/
COCITY
RU TION LEND>
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CLAS ROAD+DEPARTMENT APPROVAL REQUIRED YES NO
NAME AND BRANCH Fi BLDG SETBACK FROM
FRONT PROP LINE OF STREET)
ADDRESS - CITY
TOTAL SETBACK FROM TYPE OF EXISTING
SQ FT NO OF NO OF CHECK HIGHWAY ±, $YARD = FRONT PROP LINE HIGHWAY WIDTHL
SIZ STORIES FAMILIES ONE r
DESCRIPTION OF WORK NEW O
ADD BLDG SETBACK FROM
SIDE PROP LINE OF STREET) O
ALTER TOTAL SETBACK FROM TYPE OF EXISTING w
HIGHWAY + YARD = SIDE PROP LINE HIGHWAY WIDTH N
USE OF
b -K REPAIR Z
EXISTING BLDG DEMOL
APPLICANT TEL CORNER CUTOFF YES NO
PRINT) 7
IN OPEN SPACE YES NO
BY(SIGNATURE) 42 IN COASTAL PERMIT ZONE r YES NO
VALUATION p I
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES s
AND LAWS REGULATING BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE'
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PEWN IN VIOLATION OF
THE LABOR CODE OF THE TA OF CALF
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E p(fI TOW MEN 5 COM
PENSATION INSURAN 4
SIGNATURE
n
PERMITTEE F
ADDRESS T
FINAL 79' 1 BY
CITY N Y
DATE 1
Ta, MAKE CHECKS PAYABLE TOW
FEE
s
FE
HARVEYT BRANDT COUNTYENGINEER 3 &-D
PLAN CHECK VALIDATION cK M o CASE, t PERMIT VALIDATION cK mo CASH
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