Loading...
HomeMy Public PortalAbout9210 BLACKLEY ST_Building__ APPLICATION FOR y BUILDING PERMIT BUILDING FOR APPLICANT TO FILL IN ADDRESS U ADDRESS LDING /,C�, LOCALITY + /� c NEAREST CITYr ^ZIP CROSS ST R NO OF BLDGS ASSESSOR - SIZE OF LOT D 7 O NOW ON LOT MAP BOOK PAGE PARCEL /� DISTRICT G�TY FIRE O SED BY ?RAC -/Z-13 BLOCK C LOT NiGZ� ' ,TEL / ^U� �GPFE-. OWNER ,L�L(�/S ,ot.LTOA. NO 0r-91T `J' 1 STATISTICAL CLASSIFICATION- `. SEWER MAP ADDRESS p?�D /9C/�.0 CLASS NO DWELL UNITS BK/U G CITY T�­7 L C/T ZIP &Y."O E krJP il ARCHITECT OR TEL ENGINEER NO CIAL DITIONS - ADDRESS S-. __ _ _ _ _ ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO❑ CONTRACTOR -tel' �� ��NST "ro07�D 57. � BLDG SETBACK FROMLIC - - - FRONT PROP LINE OF - (STREET) f ADDRESS 30 ,S. �� S NO d77b/3 I TOTAL SETBACK FROM TYPE OF EXISTING LIC HIGHWAY + YARD = FRONT PROP LINE HIGHWAY WIDTH CtTY'J RgAJ �� � C ASS 8`� CONSTRUCTION LENDER a} NAME AND BRANCH BLDG SETBACK FRO - 0 ADDRESS CITY SIDE PROP LINE OF (STREET) SQ FT NO OF NO OF CHECK HIGHWAY + YARD = TO TBACK FROM TYPE OF EXISTING SIZE STORIES FAMILIES _ONE SIDE P LINE HIGHWAY WIDTH ❑ t = Z DESCRIPTION OF WORK NEW - �Q ADD ❑ CORNER CUTOFF YES ❑ ❑ ALTER ❑ G41ehgN REPAIR ❑ IN OPEN SPACE YES ❑ N ) EX STOING BLDG TELr��jDEMOL ❑ IN COASTAL PERMIT ZONE YES ❑ NO ❑ APPPRNIT) -a�� 'G.e/acs NO D�S7-z BY(SIGNATURE) IHEREBY ACKNOW E THAT I HAVE READ THIS APPLICATION AND STATE J r THAT THE ABOVE IS RECT AND AGREE,TO COMPLYr WITH ALL ORDINANCES AND LAWS REGULATjRQG BUILDING CONSTRUCTION'I CERTIFY THAT IN DOINGITHEA - WORK'AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF— - THE LABOR CODE OF THE STATE OF CA RNIA IN ELATING TO WORKMEN S COM PENSATION INSURANCE - ,+ ' r a SIGNATURE OF ° r ' FINAL / ',/ BY LD__ DATE � d 'r` 't TE SP C Fee$ Permit Fee 'Issuance Fee '/ Total Fee PLAN CHECK VALIDATION ,.'K M o CASH PERMIT VALIDATION M o CASH 9,c91 0 1-3 AUG 5_ r1 1 5.0 C)-,&!,e, ®S 76A6386CE/803Br6/76- " - ' -APPLICATION FOR COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER 1. E3 U I L D I N G PERMIT BUILDING.AND SAFETY DIVISION FOR APPLICANT TO FILL IN ADIDRESS �' [� _ �?. BUILDING !Zgj C p7J�^-A/,1 r ADDRESS /� LOCALITYNEAREST CITY G�H�/'�L/i e'ry ZIP CROSS ST .�NG Y NO OF BLOGS ASSESSOR � q SIZE OF LOT © (/ 0 NOW ON LOT J MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE- FIRE P CESSED BY �` �$ T TRACT BLOCK LOT NO CONST 1, `2J TEL ZONE OWNER NO f,(L 7-0.61 NO STATISTICAL CLASSIFICATION / /SEWER MAP ADDRESS 12/j) eY Jgele L CLASS NO q / DWELL UNITS ( L- BK107PG CITY �/'n LAE 0,7- ZIP USE ZONE MAP .. _ � NO ARCHITECT OR TEL SPECIAL ENGINEER NO �.� CONDITIONS ADDRESS ,,//�� ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO R ❑ CONTACTOR ;A � r'r2 (,oNST NEL� ',��2 BLDG SETBACK FROM- ' �J/ FRONT PROP LINE OF (STREET) ADDRESS/3O G1/�bYS NO / (�� HIGHWAY YARD _ TOTAL SETBACK FROM TYPE OF EXISTING � LIC FRONT PROP LINE HIGHWAY WIDTH CITY CT�I'A2 jig, CLASS R—I _ CONSTRUCTION LENDER } NAME AND BRANCH >_p BLDG SETBACK FROM - (STREET) ADDRESS CITY SIDEPROP LINEOF SFT ^ NO OF NO OF CHECK HIGHWAY } YARD — HIGHWAY WIDTH SIZE i2S STORIES FAMTOT ETBACK FROM TYPE OF EXISTING ILIES ONE SIDE P INE DESCRIPTION OF WORK NEW } ADD ❑ CORNER CUTOFF YES ❑) NO ❑ Z ALTER IN OPEN SPACE YES ❑ NO ❑ REPAIR❑ USE OF IN COASTAL PERMIT ZONE YES ❑ NO ❑ EXISTING BLDG `- Q �` DEMOOL ❑ ,/J `� APPLICANT P R I 6'*/ 4 J os N OL�D`J �� //L 2- 470,1 BY (SIGNATURE) La 'r 7/ r //� I-HEREBY ACKNOWL THAT 1 HAVE READ THIS APPLICATION AND STATE THA TH OVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINAN ES AND LAWS REGULATING BUILDING CON- STRUCTION 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 CALI RNIA IN RELATING TO WORKMEN'S COMP TION I N ^s SIGNATURE O FINAL �--f 'QiBY PERMITTEE DATE ADDRESS if �- TE Ly q P C Fee$ Permit Fee 5� C I T Y /(lye,,. �i.J,C�JiLlF� NO�r.C.�O'J /Z- Z� Issuance Fee VALUATION Total Fee PLAN CHECK VALIDATIONCK M o CASH PERMIT VALIDATIO K M O CASH 698, EC� _ 23. © 77l.85O1 ,8-MAR ' 4 163.50A- _�) •_ ' • APPLICATION FOR BUILDING PERMIT _ FOR-APP41CANT TO FILL IN (Print or type only) BUILDING L �- COUNTY OF LOS ANGELES ADDRESS - DEPARTMENT OF COUNTY ENGINEER CIT �j / ZIP _ BUILDING AND SAFETY DIVISION !^/ Y � OF BLDGS BUILDING SIZE OF LOT G: /1 (J) NNOO W ON LOT- ADDRESS222/ O T A �AC /( � t c LOT NO LOCALITY -r' TE _ NEAREST _ OWNER � ea -NO Ej� CROSS ST ASSESSOR ADDRES5 ,2—elG _ MAP BOOK PAGE PARCEL _ DISTRICT GROUP TYPE FIRE SED BY CITY 1201C ZIP �q CONST ZONE 1' ARCHITEt TOR TEL _ ENGINEER NO STATISTICAL CLASSIFICATION SEWER MAP ADDRESS CLASS NOS/ '_DWELL UNITS / BK G CONTRACTOR NoL JU ZONE MAP LIC NO ADDRESS - _ NO _ ��, -� SPECIAL LIC CONDITIONS CITY CONSTRUCTION LENDER CLASS - ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑ NAME AND BRANCH BLDG SETBACK FROM y. FRONT PROP LINE OF (STREET) CD C ADDRESS CITY _ TOTAL SETBACK ROM TYPE OF EXISTING U SO FISO FT NO OF NO OF CHECK HIGHWAY } YARD - HIGHWAY - WIDTH SIZE STORIES _ FAMILIES - ONE - -FRONT PROP LINE c:) __ 70 c_> DESCRIPTION OF WORK - NEW } BLDG SETBACK FROM N C G ADD SIDE PROP LINE OF (STREET) z - ALTER ❑ HIGHWAY } YARD = TOTAL SETBACK FROM TYPE OF EXISTING SIDE PROP LINE HIGHWAY WIDTH REPAIR❑ USE OF } _ EXISTING BLDG - DEMOL [:1 ' APPLICANT TEL — CORNER CUTOFF YES ❑ NO E](PRINT) IfA BY (SIGNATURE) �� IN OPEN SPACE 1 _ YES ❑ NO ❑ - QQ ,t IN COASTAL ZONE YES ❑ NO ❑ VALUATION ,P / ����J CATEGORICAL EXEMPTION YES❑ NO ❑ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL, AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE) WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE) HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S$�COMPE ATION INSUaANCE SIGNATURE OF PERMITTEE ` fA J ADDRESS , -/-a--7 TY(a - ` FINAL f BY CITY N G DATE �, �t Q+]q tl 1KE (-HLC 1\S P 1) 1131-L- 10 FPC E •l / I //'FEE HARVEY T SRANDT, COUNTY ENGINEER ` Q� � 3,5- � /Q 0 0 PLAN CHECK VALIDATION -cK' M o CASH PERMIT VALIDATION M O CASH ► ` 339973 Ocf 1 z 94.15 3 5 3GC I Z 5 D 7.3 J` d f' 3 5 3 ?73 (?DT 1 5 1 D G 1 9.O 0 A 76A638A CE#803 12/72