HomeMy Public PortalAbout4941ALESSANDRO AVE_Building (4) I
APPLICATION FOR COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
,BUILDING PERMIT BUILDING AND SAFETY DIVISION
BUILDING �7 /
FORNAPPL,I+CANTTO FILL IN ADDRESS 7
ADDSSG
4941 . ALcsSANU9t0 LOCALITYNEAREST
4 T
CITY TEmPLC- C it'Y ZIP `I-1C7o CROSS ST
NO
SIZE OF LOT G5)(I 10 NOWOON LOTS 2r MAPESSOR BOOK PAGE PARCEL
��qq DISTRICT GROUP TYPE FIRE ESSED BY
TRACT 164'-7S BLOCK I LOT NO 3C- D (/ CONST. ZONE 1
TEL
OWNER Kew r-t + STV615C NO 257-4v3y STATISTICAL CLASSIFICATION SEWER�MAP
ADDRESS- 4Ct41 IJ ALE%ANORd CLASS NO --1 DWELL UNITS BK PG
CITY TEMPLE CITY ZIP 9176 O USE ZONE MAP .P,, / - s
7
NO
ARCHITECT OR TEL yp _ SPECIAL
ENGINEER of 6NIU rN NO CONDITIONS
41
ADDRESS 41 Ne / LeMANM-0 ROAD DEPARTMENT APPROVAL REQUIRED YES[] NOj❑
CONTRACTOR TEL BLDG SETBACK FROM
NO FRONT PROP LI NE OF (STREET)
LIC _
ADDRESS NO HIGHWAY + YARD = TOTAL SETBACK FROM TYPEOF EXISTING
LIC
FRONT PROP LINE HIGHWAY WIDTH
CITY CLASS _
CONSTRUCTION LENDER +
a�
NAME AND BRANCH BLDG SETBACK FROM - CD
LINEOF (STREET) CD
ADDRESS CITY
SQ FT// NO OF �7 NO OF CHECK HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING OC
SIZE �pIO STORIES G� FAMILIES ONE SIDE PROP LINE HIGHWAY WIDTH t3
AL Lu
DESCRIPTION OF WORK /.►DD 2/FLOOJL. NEW ❑ + N
BEUR00�'+ PAT14 CLOS" REMODEL ADD CORNER CUTOFF YES ❑ NO ❑ rZ
L LTER ❑
KITC.14E" REPAIR 11IN OPEN SPACE YES ❑ NO El
USE
EXISOT NG BLDG RCSIDE•AJG%= DEMOL [IIN COASTAL PERMIT ZONE YES ❑ NO ❑
APPLICANT TEL Q-7 l
(PRINT) KENNETH �Tv pjPjL NO ZS/^4b
BY (SIGNATURE) /
I HEREBY ACKN LEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THA TME ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL OR INANCES AND LAWS REGULATING BUILDING CON
STRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED 7 U ✓ -
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE „
LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO
WORKMEN S COMPENSATION INSURANCE I
SIGNATURE FhO�
����r/tL FINAL BY-
PERMITTEE DATE
ADDRESS 10Y,71 A/ ALESlA/v0�0
CITY
TEmPL e C/Ty NOL 297"039 P C Fee$ � �,f Permit Fee
Issuance Fee
VALUATION$ 1 200-0
Total Fee '
PLAN CHECK VALIDATIO CK M o CASH PERMIT VALIDATION CK M O CASH
21 6t'-'MAY I1 23 0 5 3-5 5 a __
76AG38A CE 0803B 12/75
t./ I