HomeMy Public PortalAbout5740 ENCINITA AVE_Building__ { APPLICATION FOR BUILDING PERMIT
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FOR APPLICANT TO FILL IN (P,im 00IY)
BUILDINGCOUNTY OF LOS ANGELES
ADDRESS S 40 Gi I DEPARTMENT OF COUNTY ENGINEER
cITY _ M L- v zip BUILDING AND SAFETY DIVISION
`� NO.OF SLOGS. BUILDING ✓f
SIZE OF LOT
`SO 'k 1I NOW ON LOT/ ' ADDRESS /� Q - -✓-
TRACT —1 6t/ BLOCK L 'T NNO_7 LOCALITY _
OWNER (AI{ I G NO.pA U S CROSS ST.
ASSESSOR
ADDRESS 5:74tO Flo c o iT* MAP BOOK PAGE PARCEL
DISTRICT GROUP TYPE FIRE PRO SSED BY
CITY + 1 ZIP �` �] - / CONS Tj/r. ZO E \
ARCHITECT R TEL. _JENGINEER NO
NO. -
STATISTICAL CLASSIFICATION WE MAP
ADDRESS
o" CLASS NO.�oW ESy
L L.UNITS B P
CONTRACTOR l/ TEL''ig&326t t-- USE Z`O,N.E MANOP V� C)V Ir-'
ADORESS2Q2 SU O 4) JF- NO. LJ6-DSS �/ �^,`7 SPECIAL
I, n LIC. CONDITIONS
CITY Le VBIL/� CLAS ^�`L S3
ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑
CONSTRUCTION LENDER
NAME AND BRANCH BLDG.sErrBACK FROM
FRONT PfROP.LINEOF —ISTREET)
ADDRESS CITY _ TOTAL SETBACK FROM TYPE OF EXISTING
HIGHWAY + YARD FRONT PROP. LINE
SQ. FT.'J/ NO. OF NO. OF' CHECK - HIGHWAY WIDTH
SIZE. 0 STORIES FAMILIES 'ONE
+ - d
DESCRIPTION OF WORK NEW ❑ U
ADD BLD A
IDEPROP.ROP. LINEOF (STREET) [r
LTER _ TOTAL SE CK FROM TYPE OF E%)STING
HIGHWAY } YARD - U
REPAIR❑ SIDE PROP. INE HIGHWAY WIDTH y,l
[L
USE OF
H
EXISTING BLDG. - DEMOL ❑ + Z
APPLICANT TEL CORNER CUTOFF YES ❑ O ❑
(PR HT) NO.
BY (SIGNATURE) IN OPEN SPACE YES [1 ❑.
!! L1 cL G IN COASTAL PERMIT ZONE YES C] NO E-]VALUATION;$�'�0—� � �O 0
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATETHATTHE ABOVE IS CORRECT AND AGREE TO COMPLY - I'
WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY IWILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
LABOR CODE OF THE STPTE OF CALIFORNIA IN RELATING TO `
WORKMEN'S CO PE NSATION INBU ANC E. A
SIGNATURE O •V Ip,
PERMITTEE
A ODRESS ..
CITY. /�/ /VN v`6/„3i� NO. `I l'>2DC DIA TE 2 -Ae, BY �l` ��//✓LP✓
gAKF_ CHECKS PAPAOLE TO: P.CFEE FEE PMT��
HARVEY T. BRANDY. COUNTY ENGINEER
PLAN'CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CN. M.D. CSH
0 26 1 9 7. 5.75 &- .
76A638A CE#803 5/71 -