HomeMy Public PortalAbout9034 RANCHO REAL RD_Building_8/10/1975_wood patio :APIPLICATION FOR COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER Il
BUILDING PERMIT BUILDING AND SAFETY DIVISION
BUILDING ,�r�
FOR APPLICANT TO FILL IN ADDRESS 4 J
BUILDING
ADDRESS LOCALITY
NEAREST
CITY �/�fZ �E ZIP CROSS ST.
ev�o:;Iv 4�,ab
NO.OF BLDGS. ASSESSOR
SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL
DISTRICT GROUP TYPE FIRE RO SED BY
TRACToZ LOCK LOT NO. t� ,gyp CONST` , ZO
OWNER E A-)4Fcr, NO. ✓Z` V
STATISTICAL CLASSIFICATION V SEWER MAP
/�
ADDRESS Q 3 4- /G.,4. �O y�/
✓ �I�`-�L— CLASS NO. DWELL.UNITS �'/BK 5 4G
CITY 'T ZIP USE ZONE MAP
ARCHITECT OR TEL. NO. o
ENGINEER. -� NO• SPECIAL
CONDITIONS
ADDRESS �� ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO❑
TEL.
CONTRACTOR NO. BLDG.SETBACK FROM
LIC. FRONT PROP.LINE OF (STREET)
ADDRESS NO. TOTAL SETBACK FRO TYPE OF EXISTING
LIC HIGHWAY + YARD = FRONT PRO HIGHWAY WIDTH
CITY CLASS
CONSTRUCTION LENDER - + - a
NAME AND BRANCH O
BLDG.SETBACK FROM U
ADDRESS CITY SIDE PROP.LINE OF (STREET) (
O
SQ.FT:, ! NO.OF NO.OF CHECK HIGHWAY + YARD = TOT ' SETBACK FROM TYPE OF EXISTING rj
SIZE f STORIES FAMILIES ONE IDE PROP.LINE HIGHWAY WIDTH h
• =
DESCRIPTION OF WORK N + ZEW ❑
ADD CORNERCU FF YES ❑ NO ❑
ALTER ' ❑ IN OPEN SPACE YES ❑ NO ❑
USE OF REPAIR ❑ IN COASTAL PERMIT ZONE YES ❑ NO ❑
EXISTING BLDG. DEMOL ❑
APPLICANT TEL
(PRINT) NO.
BY(SIGNATURE)
L'E'NSAN
REBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
E ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES
WS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE
UTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF
OR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM-
PENSATION INSURANCE. t
URE OF DATE TEE � DATESS �'-� LamNO P.C.Fee$ Permit FeeIssuance Fee
TION� 4 ig V
Total
PLAN CHECK VALIDATION CK M.O. CASH PERMIT VALIDATION CK. .o. CASH
2 5 1.AUG
IRIS 76AS38A CE IF803A 8/77