HomeMy Public PortalAbout5709ALESSANDRO AVE_Building (2) APPLICATION FOR BUILDING PERMIT
FOR APPLICANT TO FILL IN (Print or type only)
BUILDING COUNTY OF LOS ANGELES
ADDRESS Q DEPARTMENT OF COUNTY ENGINEER
CITY j ZIP BUILDING AND SAFETY DIVISION
NO OF BLDGS / BUILDING
SIZE OFLOT
�+ NOW ON LOT ( ADDRESS
TRACT ( BLOCK LOT NO y LOCALITY
NEAREST
OWNER 'LL N L CROSS ST .P
ASSESSOR
ADDRESS d MAP BOOK PAGE PARCEL
DISTRICT GROUP TYPE FIRE CESSED BY
CITY �� (�/ ZIP Q -y^ CONST ZONE
ARCHITECT OR TEL s ��J ti{� "`7T
ENGINEER NO STATISTICAL CLASSIFICATION SEWER AP
ADDRESS EL CLASS NO DWELL UNITS BK PG
CONTRACTOR O US ONE N
MA
o O
LIC- I?
ADDRESS LIC CIALLIC NDITIONS
CITY CLASS C
CONSTRUCTION LENDER ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑
NAME AND BRANCH BLDG SET CK FROM
FRONT PR P LINE OF (STREET)
ADDRESS CITY I TOTAL SETBACK FROM TYPE OF EXISTING
SQ FT NO OF NO OF CHECK HIGHWA + YARD = FRONT PROP LINE HIGHWAY WIDTH
SIZE STORIES FAMILIES ONE
DESCRIPTION OF WORK NEW ❑ O
ADD ❑ BLDG SETBACK FROM
werm-
w SIDE PROP LINE OF (STREET) O
ALTER TOTAL SETBACK FROM NYPE OF EXISTING
❑ HIGHWAY + YARD = SIDE PROP LINE HI WAY WIDTH N
USE OF REPAIR Z
EXISTING BLDG DEMOL ❑ +
APPLICANT TELO CORNER CUTOFF YES ❑ NO ❑
(PRINT) NO
� l N OPEN SPACE YES ❑ NO ❑
BY(SIGNATURE) 9v IN COASTAL PERMIT ZONE YES ❑ NO 1:1VALUATION $
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES
AND LAWS REGULATING BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE
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 '
PERMITTEE
ADDRESS
FINAL BY
TEL DATE
CIT NPC
MAKE CHECKS PAYABLE TO FEE $ FET
HARVEY BRANDT COUNTY ENGINEER y+�
PLAN CHECK VALIDATION CK M o CASH PERMIT VALIDATION cK M o CASH
S 3 c"O. 27 1 P 2 8.5 0 Abb
Os 76A638A CE#803 3 75 x a