HomeMy Public PortalAbout9030-9030 1/2-9032-9032 1/2 RANCHO REAL RD_Building_7/10/1978_patio _APPLICATION FOR COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
0M I LD I N G PERMIT BUILDING AND SAFETY DIVISION /J
FOR APPLICANT TO FILL IN
ADDRSSL"NG �� �0'1• r 0 Q/Yl _L�.t7 /
BUILDING Z-S
ADDRESS (7/ �Cr%. /lig'
LOCALITY
/�
NEAREST
CITY F �� CA 1 ZIP CROSSST. �J
NO.OF BLDGS. ASSESSOR
SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL
DISTRICT I GROUP TYPEFIRE PROCE ED BY
TRACT 2GP 3 � BLOCK LOT
STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS � +� CLASS NO. DWELL.UNITS
Jy)BK S SOG
CITY ZIP USE ZONENOP /
ARCHITECT OR TEL. 3 ' SPECIAL
ENGINEER NO. CONDITIONS
ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YS❑ NO❑
TEL.
CONTRACTOR NO. BLDG.SETBACK FROM ,Q n
LIC. FRONT PROP.LINE OF �` L�"^��J'^t 9r– STREET)
ADDRESS NO. I TOTAL SETBACK FROM TYPE OF EXISTING
LIC HIGHWAY + YARD = FRONT PROP.LINE HIGHWAY WIDTH
CITY CLASS
CONSTRUCTION LENDER
NAME AND BRANCH nny(} BLDG.SETBACK FROM OV
ADDRESS C.Yti CITY SIDE PROP.LINE OF (STREET) 0
SQ.FT. Q NO.OF NO.OF CHECK HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING U
SIZE L® STORIES!. FAMILIES ONE SIDE PROP.LINE HIGHWAY WIDTH. N
+ = Z
DESCRIPTION OF WORK NEW
�1 0 ADD CORNER CUTOFF YS ❑ NO ❑
ALTER IN OPEN SPACE YES ❑ NO ❑
USE OF REPAIR ❑ IN COASTAL PERMIT ZONE YS ❑ NO ❑
EXISTING BLDG. DEMOL ❑
APPLICANT TEL
(PRINT) NO.
BY(SIGNATURE)
LN 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-
ON INSURANCE.
SIGNATURE OF T FINAL/ +7 B I
TEE Q�"� ' DATE/ ��/
ADDRESS O 30� 6Z�1-
C� TEL. P.C.Fee$ Permit Fee
NO. `Issuance Fee (/TION
Total Fee �—
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
5 4 5 NJUL- 3.0. :- 1 .0 2 2.0 0 Ac'
155 76A638A CE®8a3A 8/77 `� •. I •~ -