Loading...
HomeMy Public PortalAbout5738AGNES AVE_Building (4) { rr- APPLICATION FOR ' r ""105-AA GELES _ DEP, 'OF COUNTY ENGINEER BUIL®INC PERMIT g( BIND SAFETY DIVISION BUILDING t FOR APPLICANT TO FILL IN ADDRcsS ,3 `)') - BUILDING(, 1 d " ADDRESS d (� N.�a� GJ f1Vte LOCAL(-i X 1�- -s� -�-�Q NEAREST _ CITY R� .� L zip ! CROSS ST. �J�i,.� a—eu.') NO.OF BLDGS. ASSESSOR ISIZEOFCOT 150& IO NOW ON LOT I MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE PROCESSE BY ' } TRACTS �' BLOCK L 0 T NO. '-•f > CONST., r ZONE / 'o TEL.//�^� �� • 1'�_- �/ r.l„z.__z-G OWNER:f,�l•If S �'IVf�_ NO. 1G l Z ` y STATISTICAL CLASSIFICATION SEWER MAP ADDRESS .�� CLASS NO. �/ DWELL.UNITS BK, JJ PG . CITY " ZIP (3e0 USE ZONE MAP ARCHITECTOR 11 pi � 2 TEL. GG�� / 'I NO. ENGINEER Wt N NO '�fJ�' rr CONDITIONS ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ 1' TEL 1 CONTRACTOR (C NO. BLDG.SETBACK FROM ) LIC. FRONT PROP:LINE OF "n 2 (STREET) ADDRESS NO. HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING LIC: - FRONT-PROP.LINE HIGHWAY WIDTH CITY-- `"'' CLASS CONSTRUCTION LENDER + L L �.6� �'U` a NAME AND.BRANCH G C BLDG.SETBACK FROM •- c-. SIDE PROP.LINE OF (STREET) ADDRESS CITY c NO.OF +r CHECK HIGHWAY + YARD __ TOTAL SETBACK FROM TYPE OF EXISTING SQ.FT. NO.OF SIZE I STORIES FAMILIES l ONE SIDE PROP.LINE HIGHWAY WIDTH , a ❑ + = Z DESCRIPTION OF WORK NEW ADD ❑ CORNER CUTOFF YES ❑ NO ❑. M, ALTER -❑ _ w�'W ❑ IN OPEN SPACE YES [:1 NO / REPAIRUSE F EXISTTIING BLDG.'r7 W0LV_ •-IRM DEMOL ElIN COASTAL PERMIT ZONE YES ❑ NO ❑ APPLICANT- (( `` ��QQ TEL. ! { (PRINT( (V n NO. 7. �" r !:•ice Gri "r . � Nil°'""�C' /�.al%"'� /�� ►. - BY(SIGNATUR ` I HEREBY`ACKNOWLEDGE THAT 1 HA4E REA IS 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 ' 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. SIGNATURE OF FINAL BY PERMITTEE` '" DATE ADDRESS a �✓ CITY. �-!L 1 '! TEL. . P.C. Fee$ Permit Fee; NO: Issuance Fee VALUATION$ ' j-� Total Fee PLAN CHECK VALIDATION CK. M.O. CASH eERMIT'VALIDATION CK. O. CASH - G, 32 ©S' 76A638A CE#603A 6/76