HomeMy Public PortalAbout5208 DALEVIEW AVE_Building__ APPLICATION FOR BUILDING PERMIT
,FOR APPLICANT TO FILL IN (P,iT,., type .,,IVI
BUILDING � 1 r�fr - COUNTY OF LOS ANGELES _
AooREss WS' DEPARTMENT OF COUNTY ENGINEER
CITY ,/`7 zIP BUILDING AND SAFETY DIVISION
SIZE OF LOT NO.OF SLOGS. _ BUILDING9 ! J r
NOW ON LOT UDR ESS : < (J (l 44 7 C1L H/'
TRACT a,;. BLOCK Q I LOT NO.• / LOCALITY /
TE
NEAREST
OWNERme w� Ff 1r4 NO. {a CROSS ST. �` -
A, SSOR
ADDRESS ZID J1944 �v�G MAP BOOK I PAGE PARCEL
/ DISTRICT GROUP TYPE FIRE PROCESSED BY
CITY cM C• 2ZIP CONST. ZONE
ARCHITECT OR TEL.
ENGINEER NO.
STATISTICAL CLASSIFICATION
�LFA S'SIFICA TION SEWER MAP
ADDRESS J CLASS NO. DWELL,UNITS--1BK PG
CONTRACTOR 3Jyj USE ZONE MAP
/ /'y��)LIC. NO.
ADDRESS l—�y(A ll'NO. r 9 SPECIAL
LIC
_ CONDITIONS
.
CITY�E C/ ` / CLASS I ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑
CONSTRUCTION LENDER
NAME AND BRANCH BLDG.SETBACK FROM �.
FRONT PROP.LINE OF (STREET)
ADDRESS CITY
NOR
NO. OF - CHECK HIGHWAY + YARD o TOTAL SETBACK FROM HIGH WqY EW pTHG U
SO. FT. FRONT PROP. LINE CC
SIZE STORIES FAMILIES ONE >
+
DESCRIPTION OF WORK
NEW ❑ +U
ADD ❑ DG.SETBFROM
SILIN h
SIDE PROP.LINE OF (STREET) Z
ALTER ❑ HIGHWAY + YARD — TOTAL SETBACK FROM TYPE OF JEXISTiNG
REPAIR❑
SIDE PROP. LINE I HIGHWAYI WIDTH
USE OF + _
EXISTING BLDG. DEMOL ❑
APPLICANT TEL CORNER CUTOFF YES C] NO ❑
(PRINT) NO.
BY (SIGNATURE) IN OPEN SPACE - YES ❑ NO ❑
IN COASTAL ZONE YES ❑ NO ❑
VALUATIONS / �_' CATEGORICAL EXEMPTION YES❑ NO ❑
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL
ANO STATE THAT THE ABOVE IS CORRECT AND'AGREE TO CDMPLY IMPACT EXEMPTION DECLARATION SIGNED (GATE)
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT R RT PROCESSED (DATE)
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
LABOR COOE OF THE STATE OF CALIFORNIA IN RELATING TO
WORKMEN'S COMPE NS TION INSURANCE.
SIGNATURE OF
PERMITTE f, ,Y'
AOORESS/07 u /
/ FINAL BY
CITY Gy''G�/ �a/iyH G! NOL N(P DATE
,111hE
:111-(:KS P:11":1 BLE 7Y)r FEE FEE
HARVEY T. BRANDY. COUNTY ENGINEER
r . O
PLAN CHECK VALID GN cK. M.D. CASH PERMIT V LIDATION ON. M.D. C.S.
k�vl 6
J
76A638A CEU8031Z/72
l,.,T TPFILL IN fON FOF2 BU` PE-L; ,IT
FO` ICANT TO FILL IN (PfiDi DI 1v DB PDI$) ,� 1
SLI LDNc' ,� CO TY OF LOS GELES.
ADDREss _ DEPARTMENT OF COUTY ENGINEER
L/1L BUILDING ANDS TY DIVISIO
CITY/ /l
OF G
i . C/7/ ZIP' �\
SIZE OF _04� r///L•L7 21C00W ONBLOTS ADIDRESSpW�
TRACT !�,/�fe� /� a BLOCK�y9r� LOT N..!J / LOCA LIT
OWNER ///(./( s 1`r4 NO.TEL 7/•"�6'� CROSSNEARSTASS
SSOR
ADDRESS 7. �O �7A�E�''lG�r.� '� MAPF BOOK 'PAGE PARCEL
/ DISTRICT GROUP TYPE FIRE PR ESSED BY
CITY jEi J LC �'rr `4zip �O o CONST./j z0a�r
ARCHITECT OR TEL. / C� Y'_ J
ENGINEER NO. ,
STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS 2,
� ��JJ fCLASS NO.� /. DWELL,UNITS GBK1'�PG
2 CON TRA CTO /IRo� ,6 / U /� Afjj( (USS/Ef ZONE MAP /
ADDRESS,) /r7y• L L,K�&/9q-41 ,NO R -� SPECIAL
CITY
y�f J/y/� �•=p� CLASS CONDITIONS
JJ:: ROAD DEPARTMENT gPPR AL REQUIRED YES❑ NOCONS ❑
NAMETAND 13RANCHRUCTION N wjr t o-za �'11/y BLDG.SETBACK FROM
�e�jA�fvN�;VG7r1CL0 ; !-V„ PHONTPROP.LINEOF ISTREETI
ADDRESS
HIGHWAY } YARD TOTAL SETBACK FROM TYPE OF E%IBTING U
SO. FT. "� �•F NO. OF ' NO. OF / CHECK FRONT PROP. LINE HIGHWAY WIDTH
SIZE / V STORIES FAMILIES NEW +'2 7� }�0 �O O
DESCRIPTION OF WORK fo/t NE
X51
ADD ❑ BLDG.SETBACK FROM n.
1 SIDE PROP. LINE OF (STREET) Z
ALTER ❑ HIGHWAY } YARD - TOTAL SETBACK FROM TYPE OF EXISTING
/}�/I P� REPAIR❑ SIOE PROP. LINE HIGHWAY WIDTH
EXISTING BLDG. f�Nl / 414211 "'/DEMOL 1:1
}
APPL SNAP J!.loi TELb. �/� CORNER CUTOFF YES E] NO ❑
J /// (N IN OPEN SPACE -. YES ElNO ❑
BY (SIGNATURE)
�^ IN COASTAL ZONE YES E] NO ❑
VALUATION$
CATEGORICAL EXEMPTION YES
❑ NO ❑
HEREBY ACKNOWLEDGE THAT I•HAVE READ THIS APPLICATION ENVIRONMENTAL
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE)
'KITHALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPA;T REPORT PROCESSED (DATE),
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE F
LABOR CODE OF THE STATE OF CALIFOR IA�IN /Rpf LP TING TO yr
WORKMEN'S CD MRE NS ION IN5 URA NCE: 5..�'V 1 J I
SIGNATURE OF �.
PERMITTEE
ADDRESS A ^ /a/^/ F AL
CITY /yC-) / lO�f�b/ /f 4y NO. �~4 K4 DATE EY
11;I hh" (:HECK$ P;1}:IRLH 7.0: FEE S PMT
FEE +� f
HARVEY T. BRANCIT, COUNTY ENGINEER �5:95� /bF�O / 7O, =
PLAN CHECK VALIDATION K. M.o: CASH _ PERMIT VALIDATION ' CH1 H.O. CASH
I II�_ 1 0 3 373: JUN 1 �_ D 8 5.9 A
1 .fir 2 .1 5 87; JUL 11 1 6.2 0-
ZGA63BA CE#80312/72 / ' ( f^� 2 1 ' 973 JUL 11 1. D '1 7 0.G`�5 1
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