HomeMy Public PortalAbout4833, 4825AGNES AVE_Building (4) Irt,138A _
CE 11803(REV 11%78)
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APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES f-. BUILDING AND SAFETY z -_ L
LDING
,,FOR APPLICANT TO FILL IN ADDRESS /4,/62,4—
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ADDRESS O v LOCALITY /
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CITY NEAREST
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NO OF BLDGSASSESSOR µ i
SIZE OF LOT O NOW ON LOT MAP BOOK + t a PAGE PARCEL E
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STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS Z,.6-�e� CLASS NO D U DWELL UNITS 1121=5 BK 'PG r f
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CITY / r ZIP i s
ARCHITECT OR TEL VALUATION 7056
ENGINEER �—• NO
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ADDRESS _ BLDG SETBACK FROM
TEL FRONT PROP LINE OF (STREET)
CONTRAQ99_ t� NO 7�� .7 TOTAL SETBACK FROM TYPE OF EXISTING
LIC HIGHWAY t YARD = FROIJT PROP LINE HIGHWAY WIDTH
ADDRESS S E NO
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CITY CLASS
CONSTRUCT( NDER _ BLDG SETBACK FROM
,/ SIDE PROP LINE OF (STREET)
NAME AND ,y� L „O s'�L - TOTAL SMACK FROM TYPE OF EXISTING Off.
HIGHWAY + YARD =ySIDE PROP LINE HIGHWAY WIDTH
ADdRO �� Who YJ� y
SOF OF NOOF CHECK J + _
SIZ STORIES ' FAMILIES ONE
USE ZONE MAP / ,00
DESCRIPTION OF WORK //`� NEW ��(� O NOECIAL
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foxY ALTER ❑ FINAL -�I-�S } BY ZDATE
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REPAIR ❑
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APPLICA r TEL 3 �f 7
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BY(SIGNAT
I HEREBY ACKN DGE THAT I ERE T PLICATION AND STATE /7�� y�.-y uY f
THAT THE ABOVE I ORRECT AND REE T OM WITH ALL ORDINANCES ;
AND LAWS REGULATING BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE Z
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF �����*'� u
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN S COM O
PENSATION INSURANCE 29
9 3.4 A
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SIGNATURE OF
0 0 0 0 0
PERMITTEE M� _
ADDRESS r. Z 2 o 5 5 V Q
CITY NO r I �, o 055451pE r
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PC Fee$ Op, l b-80 "
3 Permit Fee 570 >
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Issuance Fee y arc
Total Fee sy!i
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