HomeMy Public PortalAbout5717 PRIMROSE AVE_Building_10/29/1974_2 CAR GARAGE AND WORKSHOP APPLICATION FOR BUILDING PERMIT
FOR APPL-ICANTATO FILL IN (Print or type only)
BUILDING COUN3717 F'rimro" Ave, DEPARTMENT ANGELESY OF LOS
DDRESS T OF COUNTYENGINEER
A
CITY Temj:le !Cit , CA. zip 91780 BBUILDING AND SAFETY
/DIVISION
SIZE OF LOT 75x185 NOW OONBLOT S ,� BUILDING
n1[ aok 72 ,� // .r G /
TRACT VA/61 BLOCK LOT NO 63d LOCALITY � "�. �' T
TEL NEAREST �,. K
OWNER • . Van Cleve NO. CROSS ST.
7 ASSESSOR
ADDRESS 5717 Primrokie MAP BOOK PAGE PARCEL
jZ
CITY �' ':le 41t t DISTRICT GROUP TYPE FIRE PROCESSED BY
Cae ZIP :)1760 CONS ZONE ))
ARCHITECT OR TEL.
ENGINEER NO.
STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS CLASS NO.I�. _DWELL.UNITS BK PG
TEL.
CONTRACTOR NO USE ZONE MAP 9
• LIC. NO. i(
ADDRESS 1 LNO.IC /� / SPECIAL
LIC. j CONDITIONS
CITY CLASS
ROAD DEPARTMENT APPROVAL REQUIRED YES NO
CONSTRUCTION LENDER
NAME AND BRANCH BLDG.SETBACK FROM
FRONT PROP.LINE OF f 1 G r, Ai AWREET)
ADDRESS CITY HIGHWAY t YARD —_ TOTAL SETBACK FROM TYPE OF EXISTING
SQ. FI• ' NO. OF NO. OF CHECK FRONT PROP. LINE HIGHWAY WIDTH 0
SIZE�:QX.�3Ci STORIES 1 FAMILIES ONE ''77 ,/� C
DESCRIPTION OF WORK NEW ® `174 is
BLDG.SETBACK FROM �+
i2-Car ,-arage plus workoho (STREET)ADD SIDE PROP. LINE OF -
ALTER ❑ TOTAL SETBACK FROM TYPE OF EXISTING p
❑ HIGHWAY t YARD =
REPAIR SIDE PROP."LINE HIGHWAY WIDTH O
USE OF t = C❑
EXISTING BLDG. Ll DEMOL ❑
APPLICANT t`..,, 77�� �/ t TEL �i_ �[(� CORNER CUTOFF YES ❑ r NO H
(PRINT) p. N. Van—CleV � E �:A.7J��JV
IN OPEN SPACE YES NO
BY (SIGNATURE)
IN COASTAL PERMIT ZONE YES NO
VALUATION $ 28C)o.00
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO
WORKMEN'S COMPENSATION INSURANCE.
SIGNATURE OFA
PERMITTEE )
ADDRESS
FINAL BY
TEL _ : ' DATE
CITY_, �" NO. -
1LIKE CH ChS PA}'ABLE TO: FEE W PEE
HARVEY T. BRANDT, COUNTY ENGINEER
PLAN'CHECK VALIDATION CK. M O. CASH _ PERMIT VALIDATION CK. M O. CASH
:� S ,.o li.� W:Ali 3; • c", iJ.:.J v ---
76A630A CE*803 5/74