HomeMy Public PortalAbout9020-9022-9022 1/2-9024-9026-9028 RANCHO REAL RD_Building_8/30/1978_patio -IvtPP L I CATION FOR COUNTY OF LOS ANGELES
OF COUNTY
B U ILD ING PERMIT DEPARTMENT
BUILDING AND SAFETY DIVISION ENGINEER
BUILDING
FOR APPLICANT TO FILL IN-. . ADDRESS Q
ADIDRESS Q a T LOCALITY
U_ NEAREST
CITY L✓'✓ �-•. L ZIP CROSS ST.
IqO.OF BLDGS. ASSESSOR
SIZE OF LOT NOW ON LOT -MAP BOOK PAGE PARCEL
DISTRICT GROUP TYPE FIRE �;rED BY
TRACT'A-3 9 dti BLOCK. LOT NO. 6.JU CONST. t / Z�E
TEL. V
OWNER NO. STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS �O p �C//.�� CLASS NO. DWELL.UNITS m BK 5'4G
CITY of ZIP U--SSEnE ZONE NOP a O
ARCHITECT OR TEL. SPECIAL
ENGINEER NO. CONDITIONS
ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑
CONTRACTOR ���1/'Cl�� NO. BLDG.SETBACK FROM
LIC. FRONT.PROP.LINE OF (STREET)
ADDRESS NO. TOTALSETBACK•FROM TYPEOF EXISTING
LIC. HIGHWAY. + YARD = FRONT PROP.LINE HIGHWAY WIDTH
CITY CLASS
CONSTRUCTION LENDER + a
NAME AND'BRANCH BLDG.SETBACK FROM 8
ADDRESS CITY SIDE PROP.LINE OF' ISTREED 0
SQ.FT. NO.OF NO.'OF CHECK HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF 'EXISTING
SIZE 0 STORIES FAMILIES ONE SIDE PROP.LINE HIGHWAY WIDTH . CL
DESCRIPTION OF WORK NEW
ADD ❑ CORNER CUTOFF '. YES 0 NO ❑
ALTER ❑ IN OPEN SPACE YES ❑ NO ❑
REPAIR [:1USE OF BLDG. DEMOL ❑ IN COASTAL PERMIT ZONE YES ❑ a�•ANOEXI ❑
APPLICANT TEL ns -
(PRINTI p(-�7-� ��- .NO.. p� - •
BY(SIGNATURE) f
I HEREBY ACKNOWLEDGE THAT I HAVED THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE T 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 : _ FINAL / 'i BY
PERMITTEE . 0DATE C1 .,;,
ADDRESS
TEL. = � P.C.Fee$ Permit Fee J
CITY NO.
Issuance Fee
VALUATION
Total Fee
,PLAN'CHECK VALIDATION cK 'M.o. cAsH PERMIT VALIDATION clt. o. CASH
iDS 76AG38A GE 0803A 8/77 5` ON*AUG 10 1.. D 1 no