HomeMy Public PortalAbout9157 JAYLEE DR_Building_8/15/1978_bdrm, bath ' 'A _ fl ��1'fl® II I FOR COUNTY OF LOS ANGELES
� �fl fl�. DEPARTMENT OF COUNTY ENGINEER
BUILDING AND.SAFETY DIVISION
BUILDING
FOR APPLICANT TO FILL IN • ADDRESS l
BUILDING /
ADDRESS' LOCALITY
NEST
CITY'-.7—,C--.--1 '(_ C + ZIP J��G CROSS ST.
NO.-OF BLDGS. ASSESSOR
SIZEOF LOT S.SS'X J If NOW ON LOT_ MAP BOOKPAGE: PARCEL
TRACT) '/ BLOCK ' LOT NO. I ' DISTRICT' GROUP TYPE- FIRE 4;C ED BY
TEL. > '(J CONST`, ' ZE
OWNER -R
STATISTICAL CD JV%iS NO.
STATISTICAL CLASSIFICATION SEWECR''MAP---
ADDRESS
- T13 y C C `D tZ CLASS NO.. DWELL. ��
UNITS •�' .BK / /PG
CITY Tf-0.� PCF C , T ZIP / 7�� USE ZONE NOP
ARCHITECT OR TEL. .`,
ENGINEER NO. -7 SPECIAL
./�L C DITIONS.'
ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO❑
< ,TEL. _
CONTRACTOR C--/, 6 zag 'BLDG.SETBACK FROM
LIC. FRONT PROP.LINE OF (STREET)
ADDRESS J.z U NG A N ^ No'.3 G O b z7 HIGHWAY +. YARD' TOTAL SETBACK FROM TYPE OF EXISTING
LIC. (� FRONT PROP.LINE HIGHWAY WIDTH
CITY-76;'i PC C C 14-Y, CLASS J __
CONSTRUCTION LENDER +
NAME AND BRANCH BLDG.SETBACK FROM U
SIDE PROP.LINE OF- (STREET)
ADDRESS ,CITY - O
SQ.FT., NO.OF- NO.OF CHECK HIGHWAY + YARD - TOTAL SETBACK FROM TYPE OF EXISTING
SIZE STORIES- FAMILIES J . ONE SIDE PROP.LINE HIGHWAY WIDTH . N
DESCRIPTION OF WORK-IS A.R f- $'A'T NEW
ADD.' CORNER CUTOFF YES''"❑ NO: ❑
ALTER ❑ IN,OPENSPACE YES ❑ 'NO
REPAIR ❑
EUSE
X STOING BLDG. DEMOL ❑ IN COASTAL.PERMIT ZONE YES ❑• NO -❑
APPLICANT TEL
IPRINT) NO.
BY(SIGNATURE(
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS-CORRECT•AND�AGREE"TO COMPLY WITH ALL ORDINANCES -
AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOINGJHE -
WORK'AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF -
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM'
PENSATION INSURANCE. '!•/ pp
SIGNATURE OF FINAL �� BY
PERMITTEE - DATE' a�
ADDRESS' / L A" A-V C,
�r ' ' TEL.' P.C.'Fee$ Permit Fee
CITY NO.
Q � Issuance Fee
y
[VALUATION
of I Fee
PLAN{IiECK'VALIDATION CK.- M.O. CASH PERMIT VA4IDAT(�} CK. M.O. CASH
`3 o s�ni � �i o 1 0 b:J vU
®S 76A638A CE 1803A 8/77