HomeMy Public PortalAbout5954ALESSANDRO AVE_Building APPLICATION F06"
BUILDING PERMIT
BUILDING
FOR APPLICANT TO FILL IN ADDRESS 9�
BUILDING j�
ADDRESS sL4 � 1 LOCALITY
NEAREST
CITY E✓ C\ ZIP y CROSS ST
NO OF BLDGS ASSESSOR
SIZE OF LOTaS JU X <S NOW ON LOT MAP BOOK PAGE PARCEL
DISTRICT GROUP TYPE FIREPROC SED BY
TRACT Ci Co BLOCK LOT NO J� ��D .� CONST E
TEL
OWNER _ NO 1/
tt STATISTICAL CLASSIFICATION SEWER MAP `
ADDRESS Yv, CLASS NO �'/ DWELL UNITS ^ BK PG `
CITY ZIP USE ZONE I OP a O O
ARCHITECT TEL SPECIAL
ENGINEER NC CONDITIONS
ADDRESS a ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑
TEL
CONTRACTOR NO BLDG SETBACK FROM d n e
FRONT PROP LINE OF ay"-a�eY1 A.A2 (STREET)
ADDRESS HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING
FRONT PROP LINE HIGHWAY WIDTH
LIC
CLASS C—b 1
CONSTRUCTION LENDER
NAME AND BRANCH O
BLDG SETBACK FROM U
ADDRESS CITY SIDE PROP LINE Of (STREET) Ce
O
SO Fz NO OF NO OF CHECK HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING
SIZE/6 O I STORIES I FAMILIES ONE SIDE PROP LINE HIGHWAY WIDTH N
DESC PTION OF WORK NEW ❑ O OVA
z
" ADD CORNER CUTOFF YES t❑ NO ❑
' ALTER ❑ IN OPEN SPACE YES ❑ NO ❑
REPAIR ❑
USEOF- BLDG DEMOL ❑ IN COASTAL PERMIT ZONE YES ❑ NOEXISTIN ❑
APPLICANT TEL
(PRINT) A oo
BY(SIGNATURE)
1HEREBY 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
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN CO
PENSATION INSURANCE
SIGNATURE OF y � AL S� BY
PERMITTEE DA E
ADDRESS _
TEL PC Fee$ 13 Permit Fee 1 �5
CITY, NO
Issuance Fee
VALUATION$ i p20 0 Total Fee :;-/ -)3
PLAN CHECK VALIDATION CK M o CASH _ PERMIT VALIDATION CK Mo CASH
9 4 4 N NOV '5 2'3 U 1 .S 0 5
945�NOV 3 -1. D 21 `75 ®7-)
C�5 76A6388 CE NBa3B 6/76 -- ...
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