HomeMy Public PortalAbout9022 JAYLEE DR_Building_6/6/1978_1 + 3/4 bath, family room A P P L ICAT OO N.F®R _ s. COUNTY OF LOS ANGELES ,
DEPARTMENT OF COUNTY ENGINEER
B U OLD O N G P E R M OT . ' `: BUILDING AND SAFETY D ISION
BUILDING
FOR APPLICANT TOc FILL IN ADDRESS, Zy
ADILDIN C J L�'C DR='. c LOCALITY" f
NEAREST
CITY 5Aiv G,AAtzIfL .- ZIP, -Gj(71S,. CROSS ST.
1'
NO.'OF BLDGS.. ASSESSOR
SIZE OF LOT '_ ,3L'- NOW ON LOT,-, MAP BOOK PAGE PARCEL.
/0,/(�/ DISTRICT GROUP [TYPE FIRE ESSED BY
TRA T 7 O K LkS Q �y�i CONST. ZONE
OWNER Cy ST ' TEL
tRPfl?14 NO '?
STATISTICAL CLASSIFICATION SEW�^ AP
ADDRESS c!d Z2 F, 1A j4-FF UI'- CLASS NO. DWELL.UNITS BK]"' PG
CITY SA'A/ CN,3tzia ZIP: �I.` 7,S7
. U E ZONE MAP
ARCHITECT OR TEL. _'I NO.
ENGINEER NO. ���CCC SPECIAL
j CONDITIONS
ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑
:TEL.
CONTRACTOR., aA NO. BLDG.SETBACK FROM '
LIC. FRONT PROP;LINE OF (STREET_)
ADDRESS NO. HIGHWAY +. YARD = •TOTAL SETBACK'F-ROM TYPE OF EXISTING
LIG. FRONT PROP.LINE HIGHWAY WIDTH
CITY U CLASS
CONSTRUCTION DER �^ + c,26.. O
NAME AND BRANCH BLDG.SETBACK FROM U
ADDRESS CITY SIDE.PROP.LINE OF ` (STREET) m
SQ.FT.1t.3J NO.OF- NO.OF• CHECK HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING U
i SIDE PROP.LINE HIGHWAY WIDTH . w
SIZE STORIES FAMILIES / ONE N
DESpCRIPTION OF WORK j3FA(�a M 5 NEW: ❑
/J.V aAl 14- FAA4k ADD .. ® CORNER CUTOFF YES ❑ NO ❑
ALTER ❑ IN OPEN SPACE YES ❑ NO [:1
REPAIR ❑
USEOF BLDG. DEMOL E] IN COASTAL PERMIT-ZONE. YES :❑ NOEXISTIN ❑
APPLICANT SS TEL 1
(PRINT)C•96I/FS 1 .I f/�'(I�Zfj1-j4 NO.
BY(SIGNATURE)
IHEREBY ACKNOWLEDGE THAVI HAVE'READ THIS APPLICATION AND STATE - -
THAT THE ABOVE IS CORRECT.SAND 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 N'
THE LABOR.CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM - '
PENSATION INSURANCE: '
SIGNATURE OF FINAL BY
PERMITTEE DATE
ADDRESS
TEL. P.C. Fee$ 6, Permit Fee
CITYNO.
Issuance Fee.
VALUATION$ tl/nC G r✓
Total Fee
:..PLAN CHECK VALIDATION CK M:O:' 'CASH PERPMIT•VALIDATION CK. M.O. CASH
T 7 5.02 JUN' 6 2 o 1 3 6.8 0 998
(PS 76A638A CE#803A 8/77 -