HomeMy Public PortalAbout9078ACASO DR_Building (4) APPLICATION FOR BUIL•DING` PERMIT . .
COUNTY OF-LOS ANGELES. _ BUILDING
aAND.SAFETY
FOR APPLICANT-TO FILL INBUILDING
ADDRESS
_ 5
BUILDING '
ADDRESS cxso Diz LOCALITY_NEAREST -
Z �'
CITY Pt G ZIP 1717 90 CROSS ST
r O OFBLDGS ASSESSOR
SIZE OF LOT J 3 X cW r NOW ON LOT 02^ MAP BOOK t • PAGE r� PARCEL t
DISTRICT GROUP TYPEyl•, i 'FIRE PR CESSEDBY
TRACT BLOCK , LOT NO
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STATISTICAL CLASSIFICATION ""' SEWER MAP
ADDRESS *0 s ?` ". �� f. `,p' - 14"
6•, r 'G',
CLASS NO DWELL UNITS�� " BK P,G
CITY LF ZIP'' • , 0.-.,
ARCHITECT OR TEL VALUATION
ENGINEER•; - - NO _
ADDRESS _ , BLDG SETBACK FRO ^
TEL FRONT PROP LINE Of (STREET)
CONTRACTOR NO OTAL SETBACK FROM TYPE OF EXISTING
LIC HIGHWAY t YARDx> _ 'r RONT PROP LINE HIGHWAY ,WIDTH -
ADDRESS NO
" LIC, ., +
CITY CLASS
BLDG'SETBACK FROM
CONSTRUCTION LE E - ---,* ,- . - +
NAME AND BRANCH , - SIDE PROP LINE OF - (STREET) �=
HIGHWAY +YARD = Al SETBACK NOM TYPE OF 1EXISTING
ADDRESS ^ CITY , SIDE PROP LINE HIGHWAY WIDTH , O
SO FT » NO OF NO OF CHECK i + ' _ ` 'o - 29
SIZE / STORIES FAMILIES 'ONE" USE,ZONE MAP
DESCRIPTION OF WORK.- _ L NEW - - NO"
SPECIAL 117711
r ADD ❑ �� CONDITIONS
ALTER Cl FINALBY ' Z
- REPAIR- Q DATE
USE OF „ ❑ r s '�
DEMOL
EXISTING BLDG Z -
APPLICANT rTEL 0 i "t
(PRINT) NOp��� Q • + .�,'
BY(SIGNATURE)
> .c.
I HEREBY ACKNOWLEDGE THAT I HARCEAD 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 ^• ,r = • '
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF
THELCODE O THE STATE OF CALIFORNIA IN RELATING TO WORKMEN rS COM _ ,
ATONt 0-21,
O A' '
SIGNATURE OF
PERMITTEE '
0 0 790
ADDRESS w - Z , r
.+ , TEL w.- ...a i-_.. „ 0 0.0 o `7 9 0 d v
CITY NO A.
'05,,0-5-8 0"-.
PC Fee-$ Permit Fee
Issuance Fee Y W
I IL
Total Fee • r _.+ _ ___