HomeMy Public PortalAbout5042ALESSANDRO AVE_Building (2) APPLICATION ORB ILDING PERMIT
FOR APPI ICANT,TO FILL IN (Print or type only)
COUNTY OF LOS ANGELES
BUILDING
ADDRESS DEPARTMENT OF COUNTY ENGINEER
CITY ZIP o_ BUILDING AND SAFETY DIVISION
NO OF BLDGS BUILDING
SlZEOFLOTfjQ xuol NOW ON LOT on e, ADDRESS Q P 5,
TRACT �(Q�17� BLOCK LOT NO Q� LOCALITY
TEL NEAREST
OWNER Tpranj1p 6N ,
NO CROSS ST
ASSESSOR
ADDRESS MAP BOOK 9'CAJ PAGE 3'' 3 / PARCEL 25
i DISTRICT GROUP TYPE FIRE y ESS BY
CITY - _ ZIP J O Q CONST'/ ZONE'
ARCHITECT OR TEL C/ �/
ENGINEER -NO STATISTICAL CLASSIFICATION (-*'SEWER MpAP
TEL )l
ADDRESS CLASS NO DWELL UNITS J,_BK✓CJPG
CONTRACTOR NO USE ZONE NOP C11-0
LIC
ADDRESS NO '^ SPECIAL -
LIC 7a7 NDITIONS
CITY CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑
CONSTRUCTION LENDER y
NAME AND BRANCH0 no BLDG SETBACK FROM
FRONT PROP LINEOF (STREET)
ADDRESS- CITY HIGHWAY + YARD __ TOTAL SETBACK FROM TYPE OF EXISTING
SIZE_
�� SNO TORIES ` NO OF CHECK FRONT PROP LINE HIGHWAY WIDTH
FAMILIES ONE f
1 _ G a
DESCRIPTION OF WORK NEW [I ,+ `�'v ii b 0
ADD BLDG SETBACK FROM '(STREET( O
SIDE PROP LINE OF H
TER ❑ TOTAL SETBACK FROM TYPE OF` EXISTING w
HIGHWAY + YARD = f SIDE PROP LINE HIGHWAY`WIDTH N
USE OF ` - -ld� EPAIR ❑ k Z
EXISTING BLDG S DEMOL ❑ +
APPLICANT TEL CORNER CUTOFF YES ❑ NO ❑
(PRINT( NO I
IN OPEN SPACE S YES'❑ NO
BY(SIGNATURE( IN COASTAL PERMIT ZONE YEST❑- NO>:❑
VALUATION 1300OD
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES `.-/!„�V //-�,p�/`�
AND LAWS REGULATING BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE '/
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF - j4 _
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN S COM j31
PENSATION INSURANCE
tt I Q fi
SIGNATURE OF
- r
PERMITTEE T
t t
ADDRESS adr"O
FINAL / l BYTEL
t
CITY ' NO DATE 0
MAKE CHECKS PAYABLE TO FEE ``�� FET
HARVEY BRANDT COUNTY ENGINEER
i
PLAN CHECK VALIDATION CK M o cASH PERMIT VALIDATION CK r MO CASH
2 1 3 JAN' 23 1 D 4%
f
®i 76A638A CE 4803 3 75