HomeMy Public PortalAbout4908ALESSANDRO AVE_Building (3) APPLICATION FOR COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
B U I L D I N G PERMIT BUILDING
/AND SAFETY DIIVISIOON
FOR APPLICANT TO FILL IN ADDRESS
BUILDING o^ ' A
ADDRESS fff c �� LOCALITY l{/f
CITY y ?sf 4 � Cl7 ZIP NEAREST � n/�►�/) y1/ESA
CROSS ST,
NO.IOF BLDGS. ASSESSOR
SIZE OF LOT ��D NOW ON LOT MAP BOOK PAGE- PARCEL
DISTRICT GROUP TYPE FIRE PROCESSED BY
-o ,Oj CONST. ZONE
TRACT BLOCK—"" LOT NO. '�- Z w"} -YVT-
TEL.q
OWNER �' NO. / 6sTATISTICAL CLASSIFICATTON SEWER MAP
ADDRESS 9 �•r j c>.,e�' �► CLASS NO. W _OWELL,UNITS ' BK PG
CITY USE ZONE MAP Jn
•.(��Lt J' (•,", ZIP N O. 9;
ARCHITECT TEL. SPECIAL
ENGINEER NO. CONDITIONS
ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑
CONTRACTOR - TEL. BLDG.SETBACK FROM
LIGI FRONT PROP.LINE OF (STREET)
L
ADDRESS NO. HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING
LIC.
_ FRONT PROP. LINE HIGHWAY WIDTH
CITY CLASS
CONSTRUCTION LENDER +
NAME AND BRANCH BLDG.SETBACK FROM
d
ADDRESS CITY SIDE PROP.LINE OF (STREET) O
C-)
SQ. FT. NO. OF NO. OF CHECK HIGHWAY + YARD - TOTAL SETBACK FROM TYPE OF EXISTING O
SIZE STORIES FAMILIES ONE - SIDE PROP. LINE HIGHWAY WIDTH
W
DESCRIPTION OF WORK �.to ft< NEW El '} N
f ADD ❑ CORNER CUTOFF YES ❑ NO ❑
ALTER
REPAIR❑ IN OPEN SPACE YES ❑ NO ❑
EXISTINGUSE BLDG. .p I .l>t/` DEMOL ❑ IN COASTAL PERMIT ZONE YES ❑ NO ❑
APPLICANT ( TEL ��
(PRINT) NO. Qry
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 AN LAWS REGULATING BUILDING CON-
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT EMPLOY ANY PERSON -
LABOR CODE OF THE STATE OF CALIFORNIAI VIOLATION OF THE IN RELATING TO
WORKMEN'S COMPENSATION INSURANCE.
SIGNATUREOF, � � _ _.,/ FINAL
PERMITTEE ' "--`-a- DATE
ADDRESS
//�� TEL n,�j P.C. Fee$ Permit Fee
CITY "s/ l.-�/ N O.
Issuance Fee fO
VALUATION$ _ G P
�� Total Fee A v `�
PLAN CHECK VALIDATION CK. M.O. CASH s PERMIT VALIDATION CK. M.O. CASH
25 4 MAY 22 1 ® 7.5 0 A�`b
76A638A CE0803B 12/75