HomeMy Public PortalAbout9445 LAS TUNAS DR_Building_7/7/1974_demo APPLICATION FOR. BUILDING- PERMIT
FOR APPLICANT TO FILL IN (Print or type only) ".
BUI LDI NGL _ COUNTY OF LOS ANGELES
ADDRESS 7 i' DEPARTMENT OF.COUNTY ENGINEER
CITYLs L Cy z,P BUILDING AND SAFETY DIVISION
NO.OF BLDGS. BUILDING- �-•^
SIZE OF LOT NOW ON,LOT - ADDRESS J
TRACTBLOCK LOT NO, LOCALIT
TEL. NEAREST
OWNE NO. CROSS ST.
ASSESSOR
ADDRES �- MAP BOOK PAGE PARCEL
- DISTRICT GROUP, TYPE FIRE ESSED BY
CITY ZIP. '" CONST . 'ZONE
ARCHITECT OR TEL.
ENGINEER NO.
STATISTICAL CLASSIFICATION /SEWER MAP
ADDRESS 'CLASS NO� _DWELL.UNITS 2 BF�� G/'
CONT C TEL. `/�NO. USE ZONE MAP-
7J G /
Ic NO.
ADDRE •Il NO. Q `� / SPECIAL
_ LIC. CONDITIONS
CIT / S CLASS
Y/
��vv _ ROAD DEPARTMENT APPROVAL REQUIRED YES NO
CONSTRUCTION LENDER
NAME AND BRANCH BLDG.SETBACK FROM d
FRONT PROP.LINE OF -- (STREET) C
ADDRESS CITY. C_ TOTAL SETBACK FROM TYPE OF EXISTING
HIGHWAY } YARD - 0:
SQ. FT. NO. OF • NO. OF CHECK •FRONT PROP. LINE HIGHWAY WIDTH C
SIZ_EDC, STORIES FAMILIES ONE
NEW
DE IPTION OF WORK ❑ + -=1
❑ BLDG.SETBACK FROM
P ADD SIDE PROP. LINE OF (STREET)
ALTER ❑ - TOTAL SETBACK FROM TYPE OF EXISTING
HIGHWAY' } YARD =
REPA IR 0, 1 SIDE 'PROP. LINE HIGHWAY WIDTH
USE OF DEMOL }
EXISTING BLDG. _
APPLICANTTEL CORNER CUTOFF YES-❑ NO ❑
(PRINT) .
BY (SIGNATCR2 A IN OPEN SPACE. YES NO E]
Q ` IN COASTAL ZONE YES ❑ NO ❑
VALUATION$ �- 1 - CATE•GORI CAL EXEMPTION YES❑ NO
I HEREBY OWLEDG THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL
-AND STATE AT THE ABOVE IS CORRECT AND.AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE)
W ITN A - ORDINANCES ANDI LAWS REGULATING BUILDING CON-
STRUf7 ON. I CERTIFY THA7 IN DOING THE WORK AUTHORIZED`- IMPACT REPORT PROCESSED (DATE)
HEREB I WILL NOT EMPLOY ANY PERS .I.li�%IO LATION OF THE
LA BO CODE OF THE STATE IFORNIA 7IN RELATING TO
WORK EN'S C PE NSATION INS ANCFj.
TI /
SIGNA RE F
PERMITTEE -
ADDRESS
FINAL BY "q
TEL.
.DATE
CITY NO.O. 7 7P/ YY�. P/,
MAKE CHECKS PAYABLE TO: P.C. $ PMT.$
HARVEY T. BFEE FEERANDT. COUNTY ENGINEER
PLAN CHECK VALIDATION CK. M.O. . -CASH _ PERMIT VALIDATION CK. M.O. CASH
r I
15.00A98
76A638A CE#803 7/73