HomeMy Public PortalAbout9445 LAS TUNAS DR_Building_8/16/1974_install pole sign APPLICATION FOR BUILDING PERMIT .
%FOR APPLICANT TO FILL IN (Prinr or rues only)
- .
BUILDING. '• COUNTY OF LOS ANGELES
ADDRESS [� ��►-"� -t1T.�n DEPARTMENT OF COUNTY ENGINEER -
CITY 'TIz-%-�761<-�� i.r'' ziP BUILDING AND SAFETY DIVISION
NO.OF SLOGS. - BUfLDING
SIZE OF LOT NOW ON LOT ADDRESS
TRACT All- BLOCK LOT NO. LOCALIT
' TEL. NEAREST
OWNER NO. CROSS ST.
ASSESSOR
ADDRESS .75AIC�71L MAP BOOK PAGE ARCEL
DISTRICT GROUP TYPE FIRE PROC SSED Y
CITY ZIP '
ARCHITECT OR 'TEL. ��� CONS Z -
ENGINEER -� AIZIZCCC NO. _ (,b'(� _ -
2d ER STA TISTfCA'C'CC'ASSIFICATI SEW.ER,MAP
ADDRESSL141`216'rA CLASS NO. DWELL.UNITS
TEL.
CONTRACTOR AWK- 'Lirg - NO. 410 p0_je-J USE ZONE NOP D D
ADIDRESS LIC. �/
7D53 L/� �( C•`!�l NO. C+I�I�. / SPECIAL
- LIC. �r l� f CONDITIONS
CITY N' d� (�}® � I CLASS �-�7 .ROAD DEPARTMENT APPROVAL REQUIRED YES NO
CONSTRUCTION LENDER
NAME AND BRANCH BLDG.SETBACK FROM - d
FRONT PROP.LINE OF (STREET) L
ADDRESS CITY = TOTAL SETBACK FROM TYPE'OF EXISTING
HIGHWAY } YARD C
SO.-FT. -J.NO. OF NO'. OF - CHECK FRONT PROP: LINE HIGHWAY WIDTH C
SIZE STORIES FAMILIES ONE
DESCRIPTION OF WORK !/Y S NEW _ C
IaLL ADD ❑ BLDG.SETBACK FROM - - Z
SIDEPROP. LINEOF - (STREET)
1 ALTER ❑ TOTAL_SETBAC,K FROM TYPE OF EXISTING
HIGHWAY. - } YARD = HIGHWAY WIDTH
REPAIR❑ SIDEPROP. LINE
USE OF - } _
EXISTING ,BLDG. DEMOL ❑
APPLICANT TEL. CORNER CUTOFF- YES ❑ _ NO. ❑
(PRI NT) NO.
BY (SIGNATURE). _ IN OPEN SPACE YES ❑' NO ID
IN COASTAL ONE YES [] NO
VALUATION s - - I '
•• ' CATEGORICAL EXEMPTION YES NO
I, HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL
AND STATE THAT THE.ABOVE. IS CORRECT ANO,,AGREE-TO COMPLY - IMPACT EXEMPTION DECLARATION SIGNED (DATE)
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- - -
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE)
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION 'OF THE
LABOR CODE OF THE STATE OF C IFOR�NIIA IN RELATING TO
WORKMEN'S COMPE SATION INS URAN E
"R
SIGNATURE
PERMITTEE �-
ADDRESS -. .. ..
FINAL BY
TEL. DATE F
CITY NO. ig
MAKE CHECKS PAYABLE TU: FEE ' FEE
HARVEY T. BRANDT. COUNTY ENGINEER7
PLAN CHECK,VALIDATION :KK . M.O. . CASH _ PERMIT VALIDATION CK. M.O.- CASH
2 571�_JUL 3023 1 9.130
S 6":7='�AU6 6.2 3 2m7.0.0 �a
176A636A CE#803 7/73 - — 5,6 5 -AUG ,.116 '1. D•: 7 8'.0.0•_���