HomeMy Public PortalAbout4846 AGNES AVE_Building_7/24/1975_Expired ADD FAMILY ROOM AND BATHROOMAPPLICATION FOR BUILDING PERMIT
FOR XPPLICANT TO FILL IN—(P , r o rra o Iv)
BUILDING COUNTY OF LOS ANGELES
ADDRESS E DEPARTMENT OF COUNTY ENGINEER
c I T z I P i^BUILDING AND SAFETY DIVISION
NO OF BLDGS BUILDING
SIZE OF LOT13,6-:'NOW ON LOT " ADDRESS
p d
TRACT Q B CK LO LOCALITY
TEL NEAREST
OWNER NO CROSS ST
ASSESSOR F K
ADD SS ii
rte' MAP BOOK PAGE PARCEL_* t-
e DISTRICT GROUP TYPE FIRE PR ESfED BY
CITY a ZIP 7 CONST
r
Z ry 4
ARCHITECT OW TEL lag
ENGINEER NO
STATISTICAL CLASSIFICATION SEWERM.P
ADDRESS
4
CLASS NO DWELL UNITS
I.
PG
CONTRACTOR o r NOL22-S30.) USE ZONEMAP
NO
ADDRESS 0 Xi NO
L 1C
z2.J SV p SPECIAL
LIC ff
CONDITIONS
CITY
CONSTRUCTION LENDER
CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES NO
NAME AND BRANCH BLDG SETBACK FROM
FRONTPROP LINEOF STREET)
ADDRESS CITY
HIGHWAY `+ YARD = NOTAL SETBACK FROM TYPE OF EXISTING
SQ FT NO OF NO OF CHECK FRONT PROP LINE HIGHWAY WIDTH
SIZE I STORIES FAMILIES ONE
d
DESCRIPTION OF WOR
0
NEW "
ADD BLDG SETBACK FROM
4.— SIDE PROP LINE OF STREET)
LTER
HIGHWAY + YARD =
TOTAL SETBACK FROM TYPE OF EXISTING
C
CD
EPAIR SIDE PROP LINE HIGHWAY WIDTH
Cl-w
EX SOT NG BLDG EMOL
r•
APPLICAN STEL S,.2'
CORNER CUTOFF YES NO _
PRINT) e'(ed, NO
1 +
IN OPEN SPACE YES,[]NO „ ,
BY (SIGNATURE)
IN COASTAL PERMIT ZONE S YES NO
J
VALUATION
drIHEREBYACKNOWLEDGETHATIHAVEREATISAPPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY C
AAAWITHALLORDINANCESANDLAWSREGULATINGBUILDINGCONA
STRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT EMPLOYVANY PERSON IN VIOLATION OF THE
LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO
WORKMEN S COMPENSATION INSURANCE ti T v
9.SIGNATURE
PERMITTEE
OF
4
d
y
ADDRESS
TEL
FINAL BY
CITY NO DATE
y Q 7
L
HAKE CHECKS PAIABLL 10 FEE J v
FEE $ (
HARVEY T BRANDT COUNTY GINEER]
qt5F- I
PLAN CHECK VALIDATION CK M 0 C SH PERMIT VALIDATION Cy mo c sH
6 4 3 JUL L24 2 3 U - 4 9.5 O oyo 64 5 ,jUL 24 ib 8 2.5 0 ,&w
s
78A838A CE#808_5174
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