HomeMy Public PortalAbout4857 HELEO AVE_Building_2/22/1978_MUTUAL BLOCK WALL FOR APPLICANT TO FILL IN (Print or type only)
COUNTY-OF LOS ANGELES:
B±) REss ,• e DEPARTMENT OF COUNTY ENGINEER
ADDRESS `t8 He1�o �r�
c1rY Temple .Cit Calif IP BUILDING AND SAFETY DIVISION .
NO.OF BLDGS. BUILDING
SIZE OF LOT 53 . 4 X 2 2 NOW ON LOT 2 ADDRESS
TRACT 13329 BLOCK 252 LOTNO. .12,. LOCALITY L
NEAREST
OWNER Helmut & Joan Rickio. CROSS ST.
ASSESSOR - -
ADDRESS ` MAP BOOK PAGE -PARCEL
-CITY ZIP DISTRICT GROUP- TYPE FIRE PR ESSED BY
<<
CONS
T ZO
ARCHITECT OR TEL. d+O� , /
ENGINEER _ NO. STATISTICAL CLASSIFICATION' SEWER MAP
ADDRESS .TEL. CLASS NO. DWELL.UNITS BK PG
CONTRACTOR NO. USE ZONE MAP
LIC. / n NO.
ADDRESS /7 � CONDITIONS
SPECIAL
LIC.IC.
CITY CLASS
CONSTRUCTION LENDER ROAD DEPARTMENT APPROVAL REQUIRED " YES ❑. NO ❑'
,
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 YARD - FRONT,PROP..LINE HIGHWAY WIDTH
SIZE STORIES 1 FAMILIES 1 , ONE
DESCRIPTION OF WORK mutual.-blOck NEW ❑ + Ov
`. ADD. ❑ BLDG.SETBACK FROM �
wall fence t}+L1 hl h SIDE PROP.LINE OF - (STREET) O
8o t longALTER ❑ _ TOTAL SETBACK FROM. TYPE OF EXISTING
❑ HIGHWAY .+,. .YARD SIDE PROP.LINE HIGHWAY WIDTH_ a
USE OF REPAIR Z
EXISTING BLDG. DEMOL_._❑ +
APPLICANTEL CORNER CUTOFF YES NO ❑
(PRINT)'ft C3ut Rick N62865138
IN OPEN SPACE - YES NO
BY)SIGNATURE)
QQ IN COASTAL'PERMIT ZONE YES NN/OJ �
VALUATION P /Z ��f j� GZJ7,.
IHEREBY ACKNOWLEDGE THAT I HAVE.READ THIS APPLICATION AND STATE - -
THAT THE ABOVE 15 CORRECT AND AGREE TC 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 OF
PERMITTEE
'ADDRESS
FINAL
CITY _. `. .. TEL.NO. DA E
MAKE CHECKS PAYABLE TO: ' FEE'$ t FEET
HARVEYT.BRANDT,COUNTY ENGINEER /
s
PLAN CHECK VALIDATION ``'\ SCK. -.,M.O CASH a�: PERMIT VALIDATION CK. ' CASH
_� o � z 1 1 5.0 Q
Os 76A63BA CE#803 3-75'' -