HomeMy Public PortalAbout9030-9030 1/2-9032-9032 1/2 RANCHO REAL RD_Building_7/3/1975_garage and addition to residence I
APPLICATION FOR BUIL NG PERMIT
FOR APPLICANT TO FILL IN (Print or type only)
BUILDING BUILDI G
ADDRESS ADDR 3 3 g L ���t/•c�C/K.7
CITY & ZIPF17 V
LOCALIT
NO.OF BLDGS. � NEAREST
SIZE OF LOT NOW ON LOT �(/
GROSS ST.
TRACT Z BLOCK LOT NO ASSESSOR
R MAP BOOK PAGE PARCEL
OWNER J,8- 1 G L�� Ur iNOL��Q ZF �,ti`O�DISTRICTGN P CONSTy„ ZONE TYPE FIRE
P EE `SSED BY
ADDRESS �10'--' f�LOH Ie l:� EJ !1
/`�D STATISTICAL CLASSIFICATION SEWER MAP
CITY�WI / ZIP --77 7 pp CLASS NO.�RRDWELL.LIN ITS '4 BKPG
ARCHITECT Oh+.i No.23-4 3031 USE ZONE MAP L/
ETEL
NGINEER }A1��i a ..fir n
ADDRESS `I{3l -LAS T MIS QI--' tpiC' l�-� SPECIAL
CONTRACTOR
�b f/ � NOL;z 6Z MOA` CONDITIONS
_ ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑
ADDRESSS 'L4,— Z1a1 Lf 7 111=4
NO. BLDG.SETBACK FROM
LIC. FRONT PROP.LINE OF f.3 ISTREETI
CITY wpm �J'� CLASS
CONSTRUCTI N LENDER / r HFRONT PROP. LINE
IGHWAY + YARD = TOTAL SETBACK FROM HIGHWOF AY E ISD IHG
NAME AND BRANCH GI U/�l
ADDRESS IS= �/ CITY / + A;
SQ. FT NO. OF NO. OF CHECK B G.SETBACK FROM v
SIZE Z STORIES-e--- FAMILIES ONE ftfDE PROP.LINE OF (STREET)
IGS 7Z NEW HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING CD
DESCRIPTION OF WORK �r� aVr ❑ SIDE PROP. LINE HIGHWAY WIDTH W
ADD + _ a..
rn
ALTER ❑ z
ETE R❑ CORNER CUTOFF YES ❑ NO ❑
USE OF EMOL
EXISTING BLDG. d� f� 7ppL7Q/❑ IN OPEN SPACE YES ❑ NO ❑.
AP PRINT NT���r� 6/eUr NO,
NO IN COASTAL ZONE YES ❑ NO ❑
CATEGORICAL EXEMPTION YES[] NO ❑
BY (SIGNATURE) ENVIRONMENTAL
10.9 9.70 IMPACT EXEMPTION DECLARATION SIGNED (DATE)
VALUATION Y 7 ♦a0 IMPACT REPORT PROCESSED (DATE)
I HEREBY ACKNOW EDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY �'� G
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING COSTRUCTN-
HEREBYION.
WILLCERTIFY THAT IN DNG NOT EMPLOY ANY PERSON THE
VOLATIONHOFITHE /��'7� /_`1 f �� (PO U!1, /r e''J r'7!'�l.1/✓ r
LABOR CODE OF THE STATE OF CALIFRNI IN RELAT)G TO
WORKMEN'S COMPENSATIAVNSU AN
FINAL I �,/ BY ��,
SIGNATURE OF
PERMITTEE _ DATE �-
ADDRESS 6� -RiLi%
FEE $ FEE $ _ _
77��77/�
`' /
CITY NOLd+Uh�i �� 3. 7_ ��� /
7
PLAN CHECK VALIDATI N CK. O. CASH PERMIT VALIDATION CK. M.O. CASH
0 3 7 Lu-'l-AT 623 . '� ?.4 5 A t^A'j'�
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