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Home My Public Portal About9802 DAINES DR_Building__ APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN (Print or type only) ' -BUILDING -Q COUNTY OF LOS ANGELES ADDRESS DEPARTMENT OF COUNTY ENGINEER CITY ]" zip BUILDING AND SA DIVISION N4 OF BLDGS BUILDING SIZE OFLOT NOW ON LOT ADDRESS P TRACT BLOCK LOT NO LOCALITY TEL NEAREST OWNER ��'- - NO CROSS ST ADDRESS 8D lVeS ASSESSOR MAP BOOK PAGE CEL i-- DISTRICT JGR�OUPIIRE(FPPROCSSED BY CITY L� IP O T ZONEARCHITECT OR TEL / ENGINEER NO STATISTICAL CL AS �SI /FICATION SEWER P ADDRESS CLASS NOL_DWELL UNITS BK PG TELT US ONE MAP CONTRACT N j-36 NO ADDRES4 y /� SoeOe'r NO r ! - 5/3 SPECIAL CONDITIONS CITY /x,'411-,--, LIC CLASS "I ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑ CONSTRUCTION LENDEA NAME AND BRANCH % BL SETBACK FROM FRjbNTPROP LINE OF (STREET) in- HI HI WAY } YARD ADDRESS CITY _ TOTAL SETBACK FROM TYPE OF EXISTING U SO FT-1 NO OF NO-OF CHECK H — HIGHWAY WIDTH FRONT PROP LINE SIZE STORIES FAMILIES ONE —_ O DESCRIPTION OF WORK NEW ❑ C.3 ILLI ADD LDG SETBACK FIR (STREET) N SIDEPROP LINEOF Z TER ❑ HIGHWAY + YARD _ TOTAL SEfTBACK FROM TYPE OF ISTING _ REPAIR❑ SIDE PROP LINE HIGHWAY TH USE OFG + = EXISTING BLDG — •/ EMOL ❑ APPLICAN TEL CORNER CUTOFF- YES ❑ NO ❑ (PR NT) _ NO 3�� BY (SIGNATUR �+ IN OPEN SPACE YES ❑ NO ❑ _ /� Q , IN COASTAL ZONE YES ❑ NO ❑ VALUATIONY _ fP 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 I CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE) HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOL TION OF THE LABWORD ME NOS ECO MP NS T I S`URANCOF A IA I RELATING TO `/�� `R+�A�c� �H ../C 97,0', SIGNATURE O j 71 �/ PERMITTEE ADDRESS FINAL BY C I T / ~ TEL C.V� DATE 1l 11\L (.IIL( iS 1'1}A131_L- 10 FEE $ FEE HARVEY T BRANDT, COUNTY ENGINEER /bd 6J PLAN CHECK VALIDATION CK MO —CASH- PERMIT VALIDATIO CK mo CASH _5,3'7r'4 JAN 31, 1- 5.0 ,0 058 76A638A CE4803 12/72 I _ f 78A83BA CE#803 8.83 APPLICATION FOR BUILDING - RMIT COUNTY OF'LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS 9802 Daines Dr- BUILDING AND SAFETY DIVISION LOCALITY JOHN A LAMBIE.'COUNTY ENGINEER NEAREST Temple City WILLIAM A JENSEN SUP T OF BUILDING CROSS ST Golden Wes DIS ICT N UP TYPE P E 'ED BY FOR APPLICANT TO FILL INif �f�fCONST BUILDING STATISTICAL CLAS [CATION SEWER MAP N/ ADDRESS BKFPGV 98 Q 21 -mai ea Dr. , Temple Gity CLASS NO ; DWELL UNITS 11 LOT NO BLOCK WATER J ❑ CERTIFICATE NOT REQUIRED RECEIVED TRACT Q MAP M D HIGHWAY NO OF BLDGS NO !+C/ (CIRCLE) STATE MAJOR SECON LOCA SIZE OF LOT NOW ON LOT USE ZONE SPECIAL USE OF CONDITIONS EXISTING BLDG I� _ TEL p r OWNER K• L. Clark NO 2H6-O2O BUILDING YARD HWY STREET NAME EXIST SETBACK WIDTH ADDRESS FRONT ARCHITECT OR T P L ENGINEER NO SIDE P L ADDRESS TEL Q' CONTRACTOR Vir n R Ci NO — (� ADDRESS GabrielG DESCRIPTION OF WORK_ , u W NEW ADD _ALTER _ REPAI R rdockMOLI SH N SQ FT NO OF NO OF Z SIZE STORIES FAMILIES USE OF STRUCTURE & garage with 235# compo. shingles SIGNATURE OF H~~ APPLICANT. VTRGTN-RQQF C0. VALUATION $ M0.0 ' APPROVALS DATE INSPECTOR S SIGNATURE _PCPMT FOUNDATION LOCATION F E $ FEE $ FORMS MATERIALS FRAME FIRE STOPS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY FURNACE LOCATION WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREPY I W11LL NOT EMPLO NY PE ON IN VIOLA LATH INT TION OF THE LAB E OF JHE ST OF A ORNIA R LAT ING TO WORKMEN E S T O I U LATH EXT SIGNATURE OF HOUSE NUMBER COR- PERMITTEE _ RECT AND POSTED ADDRESS ` •, ~FINAL JOHN F LE IS PRINCIPAL ST URAL ENG[ R PLAN CHECK VALIDATION CK M O CASH PERNIIT VALIDATION CK mo CASH 4 1`9 1 AUG 16 1 D 6'.0�