HomeMy Public PortalAbout5941 AVON AVE_Building_1/23/1976_add fam room FOR APPLICANT TO�FILL IN (Print or type only)_
BISILDING • �- - . COUNTY OF LOS ANGELES
ADDRESS /� (/ _ DEPARTMENT .OF COUNTY "ENGINEER
CITY L Q(y•j �. Y 7S BUILDING' AND�-SAFETY_DIVISION
BUILDING
SIZE OF'LOT( ` 16 �( NOWO.OON LOTS. �/' ADDRESS•} � - ✓' 1/'�'""
TRACTg D BLOCK LOT NO. LOCA LIT,• ' y�
TEL.. - NEAREST.
OWNER, IhS�Ctl_p NO. CROSS ST;
ASSESSOR
ADDRESS140 O _ -�' .MAP BOOK PAGE r PARCEL
' '7- DISTRICT GROUP. TYPE FIRE SSED BY
CI TY _ G S �l. ZIP. _( 7 5 '1 wZ
OS! CONST;, -'�
ARC TECT OR- - " V - TEL. - -
ENGIN R - :. NO. -
STATISTICAL•'CLAS/SCFICA TIONEWE4M p
ADDRESS CLASS NOal__ L,UNLTS SK JPG
CONTRACTOR j60- 94D L• sVJ3q U ZONE MAP'
ADDRESS �- - . Z� � NO. '�- SPECIAL v•".- _
-P - - LIC.' .�Kv CONDITIONS
CITY �.1. . �• - .. -
-"CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES�.� NO� -
CONS UCTI.ON LENDER
NAME D-BRANCH • - - BL 'SETBACK FROM '
FR NTP
T PROP.LINE OF (STREET)
ADDRESS. CITY,. NIG WAY + YARD 1T.OTAL SETBACK.FROM TYPE OF. 1EXISTING
SQA FT.'; NO OF 'NO. OF CHECK FRONS PROP. LINE HIGHWAY WIDTH
SIZE STORIES FAMILIES •ONE' _
+ _ d
DES'C RI P.T ION OF-WORK DD F=4fif NEW - 1:1 - O
'• 'BLDG. -TBACK•FROM V
ADD. SIDE PR •LINE OF - (STREET)'. CC
ALTERHIGHWAY + - T•.OT L ETBACK FROM TYPE OF EXISTING V
REPAIR
P P.'LINE HIGHWAY WIDTH. LV
_ CL
_ N
USE OF DEMOL Q + Z
...EXISTING BLDG. - ❑
APPLIC'A T t -}�. n �� NOL ® CORNER CUTOFF YES'❑ NO
(PRI N.T) 1 V I r j._
IN OPEN SPACE. YES.�, NO
BY-(SI GNATUR E)
'IN COASTALzPER MIT ZONE YES 'NO-O'-.
VALUATION,,$.. _ S .L,O/�. .• ///�`.` y '
I HEREBY ACN NOW LEDGE'.T HAT,I HAVE READ•THIS APPLICATION
AND STATE THAT THE ABOVE'IS-CORRECT`AND AGREE TO COMPLY ��.pr✓,
WITH ALL 'ORDINANCES AND'*LAWS,,REGULATING BUILDING •CON- .�/`Q « ftp, �/%,✓� � r�.-�,,.
STRUC-TION. I CERTIF Y-THAT.-IN DOING' THE WORK AUTHORIZED'
HEREBY I.WILL NOT'EM,PLOY-ANY. PERSON IN VIOLATION OF-THE -
LABOR CODE OF THE STATE. OF- CALIFORNIA. IN RELATING-TO
WORKMEN'S COMPENSATION INSURA -
SIGNATURE'OF,
PERMITTEE -
Vh
x
ADDRESS 46. - FINAL .
J.B Y.
CITY ��'.•.� - NO.
ABY DATE
11ARE CHECKS PARABLE TO: P:C. PMT.:
FEE"$ FEE
HARVEY T. BRANDT, COUNTY ENGINEER
;PLAN'CHECK VALIDATION CK. M.o. CASH - m PERMIT VALIDATION CK; M... CASH
0e .
8'3 1 "'JAN 1 :U 8 2.5, 0 ,6 .
76A638A CE#803 5/74