HomeMy Public PortalAbout5030ALESSANDRO AVE_Building (2) r
APPLICATION FOR-BUILDING PERMIT
FOR APPLICANT TO FILL IN (Print or type only) R s
COUNTY OF LOS ANGELES
BUILDING ND DEPARTMENT OF COUNTY ENGINEER
ADDRESS :
CITY ZIP BUI,LDING AND SAFETY DIVISION
NO OF BLDGS BUILDING
SIZE OF LOT NOW ON LOT } ADDRESS
TRACT �� BLOCK LOT NO � LOCALITY _
TEL NEAREST
OWNER OCt4 [ NO -9-ZL17 CROSS ST
ASSESSOR
ADDRESS ,(J MAP BOOK PAGE PARCEL
DISTRICTTYPE FIRE PR CE D BY
CITY G/ ZIP �'` �7 CONS ZONE
1�9
ARCHITECT OR TEL �J i(/{� x °'
ENGINEER NO STATISTICAL CLASSIFICATIONSEWER MAP
ADDRESS i CLASS NO DWELL UNITS BK PG t
TEL
CONTRACTOR 1� � NO USE ZONELIC
LIC No
_
ADDRESS C) AL� QU A-N NO SPECIAL
CONDITIONS
CITY -rLMt,1� CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO«❑
CONSTRUCTION LENDER
NAME AND BRANCH BLDG SETBACK FROM
FRONT PROP L'IN_E OF (STREET)
ADDRESS CITY TOTAL SETBACK FROM TYPE OF EXISTING
SQ FT NO OF NO OF CHECK HIGHWAY + ARD = FRONT PROP LINE HIGHWAY WIDTH
SIZE STORIES FAMILIES ONE a}
DESCRIPTION OF WORK 6 0crTNEW , + O
ADD ❑ BLDG SETBACK FROM (STREET) O
SIDE PROP LINE OF
ALTER ❑ TOTAL SETBAC ROM TYPE OF EXISTING
HIGHWAY + YARD = _ SIDE PROP LI E HIGHWAY WIDTH N
USE OF REPAIR ❑ Z
EXISTING BLDG DEMOL El + - f
APPLICANT TEL CORNER CUTOFF YES ❑ NO ❑
(PRINT)� AJC �� NO ��
IN OPEN SPACE YES ❑ NO ❑
BY(SIGNATURE(
INCOASTAL PERMIT ZONE YES ❑ NO ❑
VALUATION 1& ! V,fj l/V(j 7-ke7,ft!iCf '71'
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES D i.,,s�D U.�
AND LAWS REGULATING BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE z fir
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
PERMITTEE
ADDRESS //D� T S TEL�¢,(+�J`/
CITY �4p[,C CJ NOow'� /o`'( DATE
BY
MAKE CHECKS PAYABLE TO PC FEE $ FEET $ ?�
HARVEY BRANDT COUNTY ENGINEER
PLAN CHECK VALIDATION CK M o CASH PERMIT VALIDATION c MO CASH
A?c±
Y
1
®S 76A63BA CE#803 3 75 -
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