HomeMy Public PortalAbout10936 DAINES DR_Building__ APPLICATION FOR BUILDING PERMIT
FOR APPLICANT TO FILL IN (Prim or type nIV)
BUILCIINGCOUNTY OF LOS ANGELES
ADORss I J�J • DEPARTMENT OF COUNTY ENGINEER -•
CITY. ru 6 ZIP BUILDING-AND SA TY DIVISION
BUILDING
'.R �/ NO.OF BLDGS. Gj
SIZE O/F,LOT "/ /4 � NOW ON LOT ADDRESS. 93,6
44,47—r1-tBLIO/C(K�� } / L( N`0. ,�1 j LOCALITY'
ST
OWNER . W • VA 1"Vr6. NOL` [J'1��. CRO SNE EST.
a p ASSESSOR; '�- -
ADDRESS •l/ 1 f1e5 MAP BOOK PAGE PARCEL
•���(�� (� DISTRICT GROUP TYPE FIRE SSED BY
CITY 1'V( 1If�W GC ZIP ��r'"� T CONST. .ZONE
ARCHITECT-OR _ - TEL, l../•0cq /
ENGINEER NO.
STATISTICAL C�LAJSSIFICATION SEWER MAP
ADDRESS, () V1 �A CLASS NO.SX{�OWELL.UNITS _ -BH /(/PG
CONTRACTOR 1` C)E W ? U �J ZONE MAP
/�:�, � ,,��••�� LIC, ,,,,{{,�/ ((//45�5 Z I NO.
ADDRESS - . E�-- Av NO. YY V/ SPECIAL
LIC. CONDITIONS
CITYwHCLASS '
CONSTRUCTION LENDER ROAD DEPARTMENT APPROVAL REQUIRED YESEl NO
NAME AND BRANCH BL G.SETBACK-FROM'
- -' - FR NT PROP.LI NE OF (STREET)-
ADDRESS • CITY `
NIG WAY + YARD TOTAL SETBACK FROM TYPEOF EXISTING
SQ. FT. NO. OF_- -NO. OF CHECK FRONT PROP. LINE HIGHWAY WIDTH
SIZE �/ STORIES FAMILIES 'ONE
CL.
DESCRIPTION OF WORK - NEW ❑ + CD
r 1:1
BLDG.SE CK FROM ... _ _ .
RIM
ADD SIDE PROP. L IS TREETI
CD
ATTER ❑ T K FROM TYPE OF EXISTING U
HIGHWAY -+' YARD = TYPE OF
WIDTH W
REPAIRED
OE P .11N 1
_ N
EXIOF ST NG BLDG. � J/J� - /�DEMOL ❑ + ❑ Z
A PIPRIN INT /-L` �/ • NOL{yry�" Ff CORNER CUTOFF , YES ❑f NO
BY (SIGNATOR 1 IN OPEN.SPACE YES.❑ NO ❑
C _ IN COASTAL PERMIT ZONE YES _ NO ❑
17-3
I HEREBY ACKNOWLEDGE TNAT HAyE RE1D TNIS APPLICATION / !�Z �Or S` / ` ` /
AND STATE THAT THE ABOVE:1
CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- /✓s•`y '-� �rl')��„ Nrl7� Ti)M�'
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED _
HEREBY-'I WILL NOT-EMPLOY ANY-PERSON IN VIOLATION OF THE
LABOR CODE O H TATE OF 'CALIF NIA IN RELA,PING TO -
WORKMEN'S C PENBAI NINSURPN E.
SIGNA TURWOF /� - - �� Y
PERMITTE
AOORESSto
CITY (�Y � NOLyIF`f� DATE BY
' C.
JUKE CHECKS PAYABLE TO: FEE' $ _ •F FEE p II
HARVEY T. BRANDT, COUNTY ENGINEER - Y
PLAN CHECK VALIDATION CN. M_o. CASH _ ! u 2RMIT VALIDATION (:,.)... __CASH.
3-2 . 7 1 0 3 52 5 A90
76A638A CM*003 5/74