HomeMy Public PortalAbout5745 GOLDEN WEST AVE_Building__ APPLICATION FOR BUILDING PERMIT
FOR APPLICANT TO FILL IN (Print or type only)
BUILDING COUNTY OF LOS ANGELES
ADDRESS DEPARTMENT OF COUNTY ENGINEER
CITY z I P 917BO BUILDING AND SAFETY DIVISION
NO.OF BLDGS. BUILDING pr
SIZE OF LOT NOW ON LOT
TRACT BLOCK LOT NO. LOCALITY
TEL pp NEAREST
OWNER Docia uckrucker NO.28 287-2323 CROSS ST, d
ASSESSOR
ADDRESS 5745 Golden West MAP BOOK PAGE PARCEL
9l7 O
TR�" GROUP TYPE FIRE PROCESSED BY
CITY Temple Cit ZIP CONST. ONE
ARCHITECT OR TEL.
ENGINEER NO.
STATISTICAL CLASSIFICATION SEWER MA
�� P
ADDRESS CLASS NO.)jj1-DWELL.UNITS BK . PG
CONTRACTOR TEL.263_5181 USE ZONE MAP
LINO.
ADDRESS O• SPECIAL
- CONDITIONS
CITY Los Angeles,. Califorr�,ssC-39
ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑
CONSTRUCTION LENDER
NAME AND BRANCH - BLDG.SETBACK FROM
FRONT PROP.LI NE OF (STREET)
ADDRESS CITY _ .TOTAL SETBACK FROM TYPE OF EXISTING
SQ. FT. NO. OF NO. OF C HIGHWAY + YARD FRONT PROP. LINE . HIGHWAY WIDTH
SIZE STORIES FAMILIES 'ONE
+ - CL
DESCRIPTION OF WORK Ite_ NEW ❑ U
SLOG.SETBACK LINEOFFROM (STREET) CC
Rigid d ttrlgss tt DD ❑ SIDE PROP.LINE OF CD
ALTER ❑ HIGHWAY } YARD _ SETBACK FROM TYPE OF EXISTING I'-
roof( REPAIR❑ SI E PROP. LINE HIGHWAY WIDTH a
USE OF + _ N
EXISTING BLDG. DEMOL ❑ � Z
APPLICANT Residence TEL CORWER CUTOFF E ❑
(PRINT) NO. ,
BY (SIGNATURE) IN OPEN SPA-CE - Y S ❑ NO
IN COASTAL PERMIT ZONE YES "NO ❑
VALUATION;$ - -
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES 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 CALIFORNIA IN RELATING TO
WORKMEN'S COMPENSATION INSURANCR ID. �j . CO
SIGNATURE O •
PERMITTEE
ADDRESS 337 So. OCAS Ave
TE I FINAL CITY OS Angeles, (,''alif. NO.L B.
- DATE
MAKE CHECKS PAYABLE TO: FEE $ FEE';$ 15-00
HARVEY T. BRANDT, COUNTY ENGINEER
PLAN'CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION(CK. M.O. CASH
52-91,P SEP 8 1 1 5.0 0 &98
76A638A CE#803 5/74
78A888A CE#80910-58 APPLICATI N FOR UILDING PERMIT 1
COUNTY OF LOS.ANGELES BUILDING�Ey
DEPARTMENT OF COUNTY ENGINEER A°DRESS
BUILDING AND SAFETY DIVISION LOCAL
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
,CASSATT D. GRIFFIN, SUPT OF BUILDING CROSS ST.
DISTRICT NO. G�ROUPTYPE P OCESSED BY
FOR APPLICANT. TO FILL.IN . .- c o / I CONST. y� Q1
BUILDINGSTATISTICAL CLASSIFICATION SEWER MAP
ADDRESS "Dccai--vi 5 -Golden West --BK PG
L/ CLASS.NO.,+� DWELL.UNITS
STATE
LO NO. 464 BLOCK N MA ER ,v HWY. YES NO
TRACT 6561 USE ZONE SPECIAL
vA NO OF.BLDGS CONDITION
.USSIZE-OF LOT - SOX2OOI NOW ON LOT 1 �y�(J ..�.�� /I I „1/ ��
USE OF BUILDING ARD fF7Xrt�✓.e .y EXfIST.
EXISTING BLDG. DWe]11Tia SETBACK YARD WY STREET NAME W,DTH
OWNER Leo..Bo er---- - FRONT �Q
MAIL - _P.L.
ADDRESS 57113 Galtiph West SIDE
TEL. P.L.
CITY Temple Cit NO. AT 723 1 ARCHITECT OR TEL. INSPECTION RECORD
—
ENGINEER none NO.
ADDRESS - -- -- Ivv
TEL. —
CONTRACTOR O. AT 7974
ADDRESS 5717 Las Tunas San Gabriel —
DESCRIPTION OF WORK —
NEW X ADD -. T. R REPAIR DEMOLISH'
SQ.FT. p • NO.OF NO.OF ��7� '�c'� e RP PL. 9,1r �5Aj_�TLt/
SIZE 70� -STORIES - -FAMILFES -
USE OF 191111 -
STRUCTURE
SIGNATURE Nax
OF 1 /(j_ �
APPLICANT / v9�
_I APPROVALS DATE INSPECTOR'S SIGNATURE
ADDRESS V17
C FOUNDATION:LOCATION
_FORMS,MATERIALS
VALUATION$ FRAME: FIRE STOPS.-
_ _BRACING,BOLTS ,•/:„l',�/
FURNACE:LOCATION."
FEE'. $Aj I FEE $� I GAS VENT,DUCTS
I HEREBY ACrOWLEDGE THAT I HAVE READ THIS AP- LATH.INT.
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND 'v _• VC, vV`✓V>vwc.e.e
STATE LAWS REG ULATI - C@N TRUCTION. LATH,EXT.
oor
SIGNATURE OF w - HOUSE NUMBER COR
PERMITTEE RECT AND POSTED �aU�f..[A� /_W? �W(Lf��E�j�/;
I ADDRESS FINAL "���t7� (/}'if(�L'f �G.�CI�
CLYDE N. DIIpR}LAM, TPTRINCIPAL ST UCT RAL ENGINEER
K. M.
PLAN CHECK VALIDATION CO. CASH PERMIT VALIDATION CK. M.O. CASH
_. ..�� .� I OF
n
LAS g 0 1 650' 3 1 D 3 6.0 0