HomeMy Public PortalAbout9156 JAYLEE DR_Building_8/8/1978_conv 3/4 ba & hall AP P L O CA Q O N FOR COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY-ENGINEER
B U Q LD O N G P E R M OT BUILDING AND SAFETY VISION
FORAPPLICAN^T*TO FILL.IN ADIDRESS lJf /!••
ADIDRESS / J tJA-,/L C G i7'I� LOCALITY L
•—p+ NEAREST
CITY / G/'1 Z C 1 ZIP �'. J CROSS ST.
NO.OF BLDGS. ASSESSOR
,SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL
DISTRICT G OUP TYPE' FIRE OCE¢ ED Be
TRACT %'7 3 C� BLOCK LOT NO. t` 3 ` p CONST. ZONE
.. .� �.
OWNER STATISTICAL CLASSIFICATION y--- S WER P
ADD R�ES-S�%S'� L., SA� L6 1�IZ CLASS NO. �1 DWELL.UNITS �K / PG
CITY / /[f'LC C r t ZIP (7 'Sri USE ZONE MAP
NO.
ARCHITECT OR TEL. SPECIAL
ENGINEER NO. 6e— CONDITIONS .
ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES.[:] NO❑
TEL.
CONTRACTOR C 1.V ct ZAP u/✓.1}fL NO. �l 7^1 3 7 BLDG.SETBACK FROM
LIC. FRONT PROP.LINE OF (STREET)
ADDRESS % i. Lc�AlG DEN N0.3G GSU Z TOTAL SETBACK FROM TYPE OF EXISTING
HIG WAY + YARD. =
LIC. FRONT PROP.LINE. HIGHWAY WIDTH.
.
CITY%7 iI P[ ...0 /.r CLASS
CONSTRUCTION LENDER + r
NAME AND BRANCH BLDG,SETBAC M OU
SIDE PROP.CINE OF (STREET)
ADDRESS CITY O
SQ.FT:•/ NO.OF NO.OF CHECK HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING
SIZE �(� STORIES FAMILIES ONE SIDE PROP.LINE HIGHWAY WIDTH . N
DESCRIPTION OF WORK FA 1"t 1 C y NEW
ADD Y CORNER CUTOFF' -YES NO..is
ALTER
3 SA `I- LL 'WG-C ALTER .El OPEN SPACE YES ❑ NO ❑
REPAIR ❑
USE OF�I� DEN10L ❑ IN COASTAL.PERMIT,ZONE ' YES ❑ NO
EXISTING BL U (/
APPLICANT TEL
(PRINT(. NO.
BY(SIGNATURE(
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 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 - •
'PENSATION INSURANCE.
SIGNATURE OF ` FINAL.•., ` 2 7
MI ,BY
PER ' DATE
ADDRESS
TEL. P.C. Fee.$. Permit Fee
CITY. ` NO.
Q' Issuance Fee- 4
VALUATION� �V d t• r, .
Total Fee
PLAN CHECK VALIDATION j ^�L EKE M.O. cA H m PERMIT VALIDATION CK: M.O. GASH
8€ R:. : -to- - _�.�.�-L 1-9 8 8: } G
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