HomeMy Public PortalAbout5926ALESSANDRO AVE_Building f �
' x* APPLICATION FOR BUILDING PERICIT
FOR'APPLI CANT TO FILL IN` (Print or type only) C �T� OF _ -remPLE I-ry
BUILDING /(' DEPARTMENT OF COUNTY ENGINEER
ADDRESS Ip A� D O
CITYZIP BUILDING AND SAFETY DIVISION
NO OF BLDGS ^' BUILDING
SIZE OF LOT NOW ON LOT ADDRESS r
w
TRACT (a 516 BLOCK LOT NO -3572 LOCALIT
OWNER L U N S EST
NO -2Gb CROL 287 SS ST
ASSESSOR -
ADDRESS , MAP BOOK PAGE CEL
DISTRICT ROUP TYPE FIRE PROC SED BY
CITY ZIP T �
ARCHITECT ORr, TEL
ENGINEER NO STATISTICAL CLASSIFICATION SEWER MA
ADDRESS CLASS NO DWELL UNITS BK PG
TE
CONTRACTOR ! r NO7 1 ONE MAP
LICADDRESS S2 6 G 0 F�� a NOG.(OC) 0 _ NO Q -
SPECIAL
LIC / CONDITIONS
CITY r CLASS C-(v ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑
CONSTRUCTION LENDER
NAME AND BRANCH BLDG SETBACK FROM
FRONT PROP LINE OF (STREET)
ADDRESS - CITY 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 r
DESCRIPTION OF WORK CL
kj NEW ❑ + O
ADD SIDE P OP LBLDG INE OF FROM (STREET) O
ALTER ❑ TOTAL SETBACK FROM TYPE OF EXISTING w
HIGHWAY + YARD = SIDE PROP LINE HIGHWAY WIDTH N
USE OF __z - REPAIR ❑ Z
EXISTING BLD 14c, DEMOL ❑ +
APPLICANT TEL CORNER CUTOFF YES ❑ NO ❑
(PRINT) NO
IN OPEN SPACE YES ❑ NO ❑
BY(SIGNATURE) /� IN COASTAL PERMIT ZONE YES ❑ NO E]VALUATION$ 1300
1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES I l
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 I
PENSATION INSURANCE - -
i
SIGNATUR119
PERMITTE
f
ADDRESS
CITY L A TEL7
NO - .' DATE FINAL /, /7 BY '
MAKE CHECKS PAYABLE FEE 1�' a_ FEET
HARVEYT BRANDY COUNTY E ENGINEER /
' PLAN CHECK VALIDATION x CK M 0 CASH - PERMIT VALIDATION M 0' CASH
0 5 3 N14AR j a,2. 3 - 1� 3 (;`5 ♦�
®s 76A638A CE#803 3 75 ~ p
054rMAR 8 1 ® 21.755 ®