HomeMy Public PortalAbout9020 RANCHO REAL RD_Building_7/3/1975_restroom and garage `2 -
--APPLICATION FOR BUILDING PERMIT
FOR APPLICANT TO FILL IN (Print or type only) C},
ADDRESS t'i'f''L' .J.La �� BUILDING r///,� f`��� //I
ADDRESS ��"'1j'—Z>,-(�'iY �I�bv���'LJ `/L.A.1:.(�SN�
;7` /'7$D
CITY ZIP LOCALITY
NO.OF BLDGS. , NEAREST
SIZE OF LOT NOW ON LOT
CROSS ST.
TRACT BLOCK LOT NO ASSESSOR
MAP BOOK PAGE PARCEL
TEL DISTRICT 1GROUPITYPE FIRE -P ESSED BY
OWNER t�� e� //i NO.��� CONS ZONE 1 /7�,
ADDRESS'."Zka" C/1 ,_f__ I G'U •�J f6LTs^�=" .
STATISTICAL CLASSIFICATION SEWER ME1P
CITY /� ZIP
CLASS NO DWELL-UNITS BFVPG
ARCHITECT TEL
ENGINEER {� NO. USE ZONE MAP rr��
ADDRESS 13z- '7+a CIS `� o! /'' r� �`3 CONDITIONS
ECIAL
Pi
CONTRACTOR �. NOLZ[r0�
ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑
ADDRESS ZJ.y) NO. / BLDG.SETBACK FROM _, I /
CITY a apt LIC' FRONT PROP.LINE OF�-� :4 "� (STREET)
Ci CLASS _ TOTAL SETBACK FROM TYPE OF EXISTING
NAME AND BRANCH
CONSTRUCTION!LENDER HIGHWAY + YARD — FRONT PROP. LINE HIGHWAY WIDTH
NAME AG! U r
ADDRESS3)j `( CITY ,+ + /~ /JL &
SQ. FT V NO. OF NO. OF CHECK B G,SETBACK FROM CD
SIZE' �/�rj STORIES Z FAMILIES ONE DE PROP,LINE OF (STREET)
ITOTAL SETBACK FROM TYPE OF EXISTING CD
DES'C'RIPTION OF WORK , �S�r�QI�`: NEW HIGHWAY + YARD =
D 10:1SIDE PROP. LINE HIGHWAY WIDTH
LLJ L-�%S IL �'� �`6f ADLTER [:] + �
REPAIR❑ CORNER CUTOFF YES ❑ NO ❑ Z
USE OF
EXISTING BLDG. DEMOL ❑ IN OPEN SPACE YES ❑ NO ❑
APPLICAN!• 9K� � 'TEL
N0. IN COASTAL ZONE YES ❑ NO ❑
(PRINT) ,, K!i •(��i
CATEGORICAL EXEMPTION YES❑ NO ❑
BY (SIGNATURE) ENVIRONMENTAL
IMPACT EXEMPTION DECLARATION SIGNED (DATE)
VALUATION 600�I �[) IMPACT REPORT PROCESSED (DATE)
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE To
COMPLY -f .2} -•�
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED �.—� iir
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA TIO OF THE Eb"� Q. 'f ?2 / V/Y -'�-�Jf� '�ffz!'_3
LABOR CODE OF THE STATE OF CALIFORNIA I R TING TO
WORKMEN'S COMPE75ATI�ONAN (,i�A/SIGNATURE OF FINALPERMITTEE: // DATE iL SQL...
ADDRESS I�'L Y P.C.
$FEE $
J GX)' FEE
CITY_
C. TEL -7/
PLAN CHECK VALIDA ION CK. M.O. CASH PERMIT. VALIDATION C M.O. ASH
, .
2.3 .n-fln-JUL 3 1 ® 7
76AG38B C E0803A 5/73