HomeMy Public PortalAbout5317ALESSANDRO AVE_Building APPLICATION FOR BUILDING PERMIT
1-OR F�L1W4T TU5 FILL IN (Print or type only)
Bmmmm COUNTY OF LOS ANGELES
ADDRESS DEPARTMENT OF COUNTY ENGINEER
CITY ZIPBUILDING AND SAFETY DIVISION
NO OF BLD S" BUILDING
SIZE OF LOT NOW ON LOT ADDRESS ff3 17
TRACT BLOCK L NO LOCALITY
TEL NEAREST
OWNER NO LiZ1,111CROSSST � � +
ASSESSOR
ADDRESS�� �� MAP BOOK PAGE PARCEL
DISTRICT GROUP TYPE FIRE SSED BY
CITY ZIP !jj CONST ZONE
ARCHITECT OR TEL 15 O(S
ENGINEER - NO STATISTICAL CLASSIFICATION SEWER WAP
ADDRESS _ TEL CLASS NO DWELL UNITS .� B?,j PG
CONTRACTOR ZOVE MAP
LIC �/j-�i NO
�� SIAL
ADDRESSo. NO PEC
LIC CONDITIONS i
CITY CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑
CONSTRUCTION LENDER
NAME AND BRANCH BLDG SETBACK FROM
FRONT PROP LINE OF (STREET)
ADDRESS - CITY _ f TOTAL SETBACK FROM "TYPE OF EXISTING
SQ FT NO OF NO OF CHECK HIGHWAY t YARD - FRONT PROP LINE HIGHWAY WIDTH
SIZE STORIES FAMILIES ONE + y
DESCRIPTION OF WORK NEW ❑ + O
ADD BLDG SETBACK FROM Y (STREET( O
H_ SIDE PROP LINE OF -
ALTER- ❑ TOTAL SETBACK FROM TYPE OF EXISTING w
HIGHWAY + YARD = SIDE PROP LINE- HIGHWAY WIDTH N
USE OF REPAIR ❑ 4 Z
EXISTING BLDG + -
EMOL ❑
APPLICANT G L CORNER CUTOFF YES ❑ NO ❑
(FIR NT) NO
G29IN OPEN SPACE YES ❑ NO ❑
BY(SIGNATURE( Ir IN COASTAL PERMIT ZONE YES ❑ NO ❑
VALUATION $ S
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICAdNA
TATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH CES �y-y
AND LAWS REGULATING BUILDING CONSTRUCTION I CERTIFY THTHE
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IOF
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WOM 4
PENSATION INSURANCE -SIGNATURE OFPERMITTEEADDRESSFINAL BY
TELDATE �/CITY NO / � pMAKE CHECKS P ABLE TOFE $ FETHARVEY T BRANDT COUNTY ENGI {
z"
PLAN CHECK VALIDATION CK m o CASH PERMIT VALIDATIONcK m o CASH
t r
0 -MAR15 I 8 � 2 1.7 5 ,&1
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