HomeMy Public PortalAbout9549BISBY ST_Building P P L I C AT I O N FOR COUNTY OF LOS ANGELES
OF COUNTY E U I L D I N G PERMIT DEPARTMENT BUILD NG AND SAFETY DIVISION ENGINEER
BU
FOR APPLICANT TO FILL IN ADILDINGDRESS J s
BUILDING LOCALIT -j " `
NEAREST
ADDRESS
CITY L ZIP C OSS ST. _ CC
O.OF BLDGS. ASSESSOR
SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL
C-G
DISTRICT G UP TYPE FIRE PRO SS D BY
TRACT BLOCK LOT NO. `S d CONST. ZOt
TEL. a (J :�� ��! a.z -c
OWNER �//W 7,A NO.
STATISTICAL CLASSIFICATION SEWER WAP
ADDRESS ` r/ CLASS NO. DWELL.UNITS BK PG
CITY pL� C 1 T ZIP }J3�ZONE NO. r
ARCHITECT ORTEL �/ SPECIAL
ENGINEER Nt'o NO. Z ` CONDITIONS
ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑
TEL.
CONTRACTOR NO. BLD .SETBACK FROM
LIC. FRO T PROP.LINE OF (STREET)
ADDRESS HIG WAY + YARD NO. = TOTAL SETBACK FROM TYPE OF EXISTING
LIC. FRONT PROP.LINE HIGHWAY WIDTH
CITY CLASS
CONSTRUCTION LENDER + a
Ov
NAME AND BRANCH BLDG.SET FROM
SIDE PROP.
ADDRESS CITY LINE (STREET) 0
AL SETBACK FRO E OF EXISTING
SQ.FT. NO.OF NO.OF CHECK HIGHWAY + YA = SIDE PROP.LINE HIGH WIDTH w
SIZE STORIES FAMILIES ONE N
+ = Z
DESCRIPTION OF WORK NEW ❑
tT^ ADD CORNER CUTOFF YES ❑ NO ❑
C/1vC— ALTER ❑ IN OPEN SPACE YES ❑ NO ❑
REPAIR ❑ IN COASTAL PERMIT ZONE YES ❑ NO
EXISTING BLDG. ❑
USE DEMOL ❑
APPLICANT TEL
(PRINT) NO.
r,A
BY(SIGNATURE)
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES ff��
AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE V Ui/ x5 W�A /Ar c'614,4 x
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF / KK �V 'vJ L/ 'P
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM
P E NS A T I�O NINSURANCE,
NZyN S UURR AA NNCCjE,
ATURNIEOF�� FINAL /'— BY
PERMITTEE A DATE
DRESS
t EL. P.C. Fee$ Permit Fee
CITY -:zZ'� NO. 3 ��
Q Issuance Fee
VALUATION$ /}
L� Total Fee
PLAN CHECK VALIDATION CK. m.o. CASH PERMIT VALIDATIO cK. m.o. CASH
G :� .f -J 1 1 J �.iJ 11 e1
PSS 76A638A CE 0803A 6/76 ,—