HomeMy Public PortalAbout10554 DANBURY ST_Building_11/17/1977_swimming pool APPLICATION FOR Il
BUILDING PERMIT
BUILDING �� .Vy
FOR APPLICANT TO FILL IN ADDRESS (05S V
BUILDING
ADDRESS I LOCALITY
^- NEAREST
CITY y ZIP CROSSST.
NO.OF BLOCS. ASSESSOR
SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL
' DISTRICT G VPE FIRE SSED
TRAC Q BLOCK LOTN . /-� o ONSL Z
_ . TEL '..1. 0 (j /i _
OWNER NO.
D 1'�Ck STATISTICAL CLASSIFICATION SEWER MA
ADDRESS q --L CLASS NO.�L_DWELL.UNIi5 BK PG
CITY -` ZIP ALL 1 ONE MOAP 6
ARCHITECT OR TEL. , SPEp
ENGINEER NO. - IAL
CR CONDITIONS
ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO❑
CONTRACTOR r NO. BLDG.SETBACK FROM
�^�`` ,�,�
LIC FRONT PROP.LINE OF (STREET)
ADDRESS 0"t NO. �� TOTAL SETBACK FROM TYPEOF EXISTING
LIC HIGHWAY + YARD = FRONT PROP.LINE HIGHWAY WIDTH
CITY CLASS
CONSTRUCTION LENDER + d
NAME AND BRANCH BLDG.SETBACK FROM
ADDRESS CITY SIDE PROP.LINEOF ISTREETI p
50.FT. NO.OF IN OF CHECK HIGHWAY + YARD = TOTAL SETBACK FROM TYPE Of EXISTING w
SIZE STORIES FAMILIES �� ONE SIDE PROP.LINE HIGHWAY WIDTH n
+ = Z
DESC TION OF WORK NEW
'lrwl -� _ Q� ADD ❑ CORNER CUTOFF YES ❑ NO ❑
n 6--,3 IN 11 IN OPEN SPACE YES ❑ NO 11REPAIR ❑
EUSE XISTTIING BLDG, o2 Jo9# DEMOL ❑, IN COASTAL PERMIT ZONE VES ❑ NO ❑
APPT T
IPRNITI NO. / Z�� NOT lE
BY(SIGNATUREI
HEREBY ACKNOE THAT I HAVE READ THIS APPLICATION AND STATE
W
THAT THE ABOVE IS RECT AND AGREE TO COMPLY WITH ALL ORDINANCES
AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM.
SENSATION INSURANCE
SIGNATURE OF
1 PERMITTEE ( FINAL �.6 �O BY
DATE
ADDRESS
l•
' TEL P.C.Fee$ Pen-nit Fee
CITY NO.
_ Issuance Fee
VALUA710N M�®
Total Fee _ f, 2 )
PLAN CHECK VALIDATION cK. m.0. CASH PERMIT VALIDATION M.O. CASH
194�NVI'li 0 � 4.63A3
_ 1 9 5 NUV 17 1 U 4 8.`7 5 e'er°
tf 76A636B CE#8030 6/]6 - '