HomeMy Public PortalAbout4833ALESSANDRO AVE_Building (2) r
AP P L I C�4T I O N FOR COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
„� ILD IMG PERMIT BUILDING"AND SAFETY DIVIISS,II.ONBUILDING
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FOR APPLICANT TO FILL IN ADDRESS i tib Vi`� o
BUILDING M0�g(/f//�fS�,/Ab�ADDRESS0
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TRACT /� BLOCK LOT NO �C p CONST ZONE
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STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS
�/ / J �C CLASS NO i DWELL UNITS BK-37 PG
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ARCHITECTOR t TEL
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SPECIAL
ENGINEER (,/j' �f
Z(9r-> CONDITIONS
ADDRESS
TEL ROAD DEPARTMENT APPROVAL REQUIRED f YES
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CONTRACTOR (( NO- BLDG SETBACK FROM
LIC FRONT PROP LINE OF (STREET)
ADDRESS NO i TOTAL SETBACK FROM TY F EXISTING
LIC HIGHWAY + I YARD - �/ FRONT PROP LINE GHWAY WIDTH
CITY < _ CLASS r }
CONSTRUCTION LENDER"116,0 �// fj� + - - a
NAME AND BRANCH
/ nv N -C� O/ �J BLDG SETBACK FROM O
ADDRESS / ((f Ihs , CITY �,4/V ABel�L SIDE PROP LINE OF __ (STREET) 0
SQ FT NO OF NO OF CHECK HIGHWAY + YARD TAL SETBACK FROM TYPE OF EXISTING u
SIZE STORIES OiY FAMILIES ONE SIDE PROP LINE HIGHWAY WIDTH a
N
DESCRIPTION OF WORK /PAl V M1 EW ❑ + ` Z
rJ) � ADD CORNER C OFF YES ❑ NO ❑
7 /,�% ALTER ❑ IN OPEN SPACE YES ❑ NO ❑
REPAIR ❑
USE OF BLDG - RE AIR IR ❑ IN COASTAL PERMIT ZONE YES ❑/ NO
❑
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APPLICANT
IPRINTI /��(A�F1 NO1. q C� r a �' fJ CVS- / /
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BY(SIGNATURE(
i
I HEREBY ACKNOWLEDGE THAT I HAVE READ 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 '
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 r
PENSATION INSURANCE
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SIGNATURE OF i FINAL BY "
PERMITTEEDATE
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ADDRESS ' G��"'�'�" �E j
�� TEL �/ QS'�Q PC Fee$ Permit Fee /7/-/ - U�
CITYdi/W% -NOY u `
Issuance Fee 7/
VALUATION$/ff a d 0 i O� a 7 Q
Total Fee
PLAN CHECK VALIDATION CK MO CASH PERMIT VALIDATION CK mo CASH
~ 27 4 t �. 0 1 7 800AS8
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®S 7SA638A CE 9803A 8/77 r 1 t t
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