HomeMy Public PortalAbout9161 JAYLEE DR_Building_4/20/1978_add 2nd flr,4bdrm 1 bath Q CA r o®N FOR COUNTY OF LOS ANGELES
®� DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAF TY DIVISION
FOR APPLICANT TO FILL IN ADIDRESS
BUILDING , �A -
ADDRESS /� LOCALITY
�l NEAREST
CITY � � `�r ZIP' � ��, CROSS ST. .
N0.OF BLDGS. ASSESSOR
SIZE OF.LOT �-�—J�/ NOW ON LOT MAP BOOK PAGE PARCEL
DISTRICT GROUP TYPE FIRE ESSED Y '
TRACT5�3 C BLOCK LOT NO. � CONS ZON '
TEL. ®Q 1
OWNER STATISTICAL-CLASSIFICATION SEWER MAP
t
ADDRESSSEE
CLASS NO.�DWELL.UNITS K h PG
CITY jE? /I` ZIP 9 f� ,Fo US ONE MAP O
ARCHITECT 09 TEL. / SPECIAL
ENGINEER NO. CONDITIONS
ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ -'.NO ❑
TEL.
CONTRACTOR A NO. BLDG.SETBACK FROM
i) LIC. FRONT FfOP.LINE OF (STREET)
ADDRESS / NO. TOTAL SETBACK ROM TYPE OF I EXISTING
LIC. HIGH Y + YARD = FRONT PROP.LINE HIGHWAYI WIDTH
CITY CLASS _
CONSTRUCTION LENDER +
NAME AND BRANCHfl
BLDG.S ACK FROM
ADDRESS CITY SIDE PROP. E OF (STREET) U
SQ.FT. NO.OF NO.OF CHECK HIGHWAY + = TOTAL SETBACK FROM TYPE OF EXISTING
SIZE STORIES FAMILIES ONE DE PROP.LINE HIGHWAY WIDTH . O
DESCRIPTION OF WORKP,4,oa NEW ❑ + C�
ADD 2 CORNER CUTOFF YES ❑ NOEla-
LTER El IN
Gt ., ZO L• ,rtn 7 CQ,.1 �C<. ! NOPENSPACEZ`
YES ❑ NO ❑
REPAIR ❑
USE OF IN COASTAL PERMIT ZONE YES ❑ NO ❑
EXISTING BLDG. 12tr DEMOL
APPLICANT TEL < D AVIe-
(PRINT(
4`J 13k
BY(SIGNATURE( 'f
/
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE 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 ST OF CALIFORNIA IN RELATING TO WORKMEN'S COM-
PENSATION
OM- t `PENSATIONINSURANCE. .. ,4 p..{ q,�
SIGNATURE OFlie FINAL y 1 BY. �d V I J
. DATE g /
ADDRESS c
TEL a2 _ ;j P.C. Fee$ , Permit Fee
CITY NO.
�f E74
„-^'1Issuance Fee 7.VALUATION �(/ (� _
/ Tot ee ' U
PLAN CHECK VALIDATIONM.O. CASH PERMIT VALIDATIO cK. M.O. CASH
9 7 8 MAR D 3 5.9 5 ►`
0 3 2-r'-�;APR' 2,0 2.3 0 3 1.G � `'
76A638A CE A803A 6/76 - 6 ®”
0 3 3"OTtPR� 20 ,l ® �- �,� •_