HomeMy Public PortalAbout5412 BALDWIN AVE_Building__ APPLICATION FOR BUILDING PERMIT
FOR AP,q!ICANT TO FILL IN (Print or type only)
BUI,ttWG COUNTY OF LOS ANGELES
ADDRESS 3s-- �12 ,BSG 0/r1/ `� DEPARTMENT OF COUNTY ENGINEER
CITY �— ZIP gl7C1 O BUILDING AND SAFETY DIVISION
C, NO OF BLDGS BUILDING
SIZE OF LOTj�/ ✓Q NOW ON LOT ADDRESS
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TRA Q BftOEICiiCJ LOT Nd"Q a �Q2 LOCALITY Cy
OWNER r/ NEAREST
/�/� �/'�N�f��,�JJ� CROSSST /
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ADDRESS.?f 9Q/ N, 0� �v" MAP BOOK PAGE PARCEL
CITY ZIP DISTRICT GROUP TYPE FIRE OC ED BY
'/�/n J I P �� O q y� f CONST V/ ZON�
ENGIiNEER+OR_�//ITEC 0 Ulc V✓ iC N� �7� (J •',
iq t STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS -
CLASS NO DWELL UNITS 7-2BK6 J JZ
TEL
CONTRACTOR NO USE ZONEkS
OP - O D
LIC
ADDRESS NO PE IALCLIC 7 ONDITIONS
CITY CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑
CONSTRUCTION LENDER
NAME AND BRANCH BLDG SETBACK FROM
FRONT PROP LINE OF t a l[L��" - (STREET)
ADDRESS - CITY TOTAL SETBACK FROM TYPE OF EXISTING
SQ FT NO OF NO OF CHECK HIGHWAY + YARD = FRONT PROP LINE HIGHWAY WIDTH
SIZE ., STORIES FAMILIES ONE /�J r
DESCRIPTION OF WORK NEW ❑ + - � O v O
U
ADD ❑ BLDG SETBACK FROM
f SIDE PROP LINE OF (STREET) 0 O
ALTER ❑ TOTAL SETBACK FROMTYPE OF EXISTING w
HIGHWAY + YARD = SIDE PROP LINE HIGHWAY WIDTH N
USE OF REPAIR Z
EXISTING BLDG) r ,/ 1 DEMOL ❑ +
APPLICANT �ILC�KC' I/,/�j ��G TEL CORNER CUTOFF YES ❑ � NO ❑
' IN OPEN SPACE 'YES ❑ NO ❑
BY(SIGNATURE(
Q ,.^} IN COASTAL PERMIT ZONE YES E] NO ❑
VALUATION$ v O
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE 15 CORRECT AND AGREE TO 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 WORKM OM
PENSATION INSURANCE
SIGNATURE OF
PERMITTEE
ADDRESS
�JIMI a `V�!
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CITY / - TEL
�� DATEFINA ^' ��j� BY ��►�(/4`G��"�' v �y
MAKE CHECKS PAYABLE TO FEE $ FET $� Yo3
HARVEYT BRANDT COUNTY ENGINEER
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PLAN CHECK VALIDATION CK M o CASH PERMIT VALI AT®N CK MO CASH
1 0 7 APR 2a 1 0' 31 C1 U A%
®f 76A638A CE#803 3 75