HomeMy Public PortalAbout5802 GOLDEN WEST AVE_Building__ -+ - I=m tlLT9 1U-45 1 r r r
DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES B U I LID IN G
WM. J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN / FOR OFFICE USE ONLY
BUILDING v ' / DISTRICT NO. PLAN CK. NO. PERMIT NO.
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ADDRESS T'O S �(�� tiaJ.-�♦?,/� �j —�',
/ �S`�c 3 0 /
LOCALITY �/t�e,,._,.,., j. RECEIVED BY DATE OF APPL. DATE ISSUED
NEAREST V Lla"� �'/
/J // 3 -�
CROSS ST. BUILDING
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7�`'B7"
OWNER / '[// / /z�te..s.�/ ADOREMAIL
ADDRESS �-�O 6 Off. �. y �L.(/�„f,,/ _LOCALITY ✓ �
�f� ♦_ / A/�7� r NEAREST
CITY .�.[-�'�Ld NO�r/C• 7pS IVU CROSS ST* AK
f"""` FIRE NO.OF TYPE ( / GROUP
ARCHITECT OR
TEL. ZONE PLANS
ENGINEER NO. BLDG. /
ADDRESS SETBACK LINE
APPROVED
CONTRACTOR TEL. BY DATE
USE APPROVED
ADDRESS ZONE BY DATE
LEGAL
DESCRIPTION I LOTNO. ��1 BLOCK CORRECTIONS
TRACT /
NO.OF
SIZE OF LOT �//�'��'''' �.��t!�"Q� NOW ON LOTSUSEOF M
EXISTING BLDG.�/ ;V 1 ;/p-y I ND.OF / I NO.
FAMILIES ROOMS
DESCRIPTION OF WORK
NEW ALTERATION ADDITION r
O
A
REPAIR MOVING DEMOLISH O
NO OF i
SIZE T./d 7"'J.— ROOMS STORIES / D
WALL ROOF
r
COVER IND COVERING
USE OF NEW
BUILDINGtYr"'
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS w
APPLICATION AND STATE THAT THE ABOVE 19 CORRECT FOUNDATION: LOCATION INSPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS ✓Q n{ �O�/
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
FRAME: FIRE STOPS, r
SIGNATURE OF BRACING, BOLTS
OWNER LATH,INT.:
AUTHORIZED A - /
LATH,EXT.:
P.C. PLASTER. INT.
\� FEE PLASTER, EXT.
VALUATION O \ FEE � ��� FINAL
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APPLICATION FOR BUILDING PERMIT
FOR APPLICANT• TO FILL IN (Print or type only)
BUILDING COUNTY_ OF LOS ANGELES
ADDRESS DEPARTMENT OF COUNTY ENGINEER
CITY ZIP BUILDING AND SAFETY DIVISION -
_ KPO.OF SLOGS _ _ BUILDING
SIZE OF LOT Xlgb NOW ON LOT - ADDRESS V
t
TRACT BLOCK I LOT NO LOCALIT -
TEL NEAREST
OWNERO - - CROSS ST
ASSESSOR
ADDRESS MAP BOOK PA CEL
DISTRICT GROUP TYPE FI PROC SSED BY
CITY Em ZIP CONST Z NE -
ARCHITECT O TEL �Q
ENGINEER NO
STATISTICAL CLAS/SI FICA TION SEWER MAP
ADDRESS CLASS NO.�DWELL UNITS BK / G
CONTRACTO NO, �L ZONE MAP -
LIC NO U• -- '
ADDRESS If NO =-- SPECIAL
o � LIC y;� y 'J CONDITIONS '
CITY r/ CLASS .,J
DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑
CONSTRUCTION ENDER
NAME AND BRANCH BLDG.SETBACK FROM �.
- - FRONT PROP LINE OF - (STREET) �-
ADDRESS CITY C=)
_ HIGHWAY + YARD ' TOTAL SETBACK FROM TYPE OF EXISTING V
SQ FT - NO OF NO. OF CHECK _ FRONT PROP -LINE HIGHWAY WIDTH
SIZE STORIES FAMILIES - ONE O
+ = C')
DESCRIPTION OF WORK NEW ❑ a
f
❑ BLDG.SETBACK FROM- N_ ADD SIDE PROP, LINE OF IS TREE T) Z
ALTER_❑ _ TOTAL SETBACK FROM TYPE OF EXISTING
HWAY 4 YARD — HIGHWAY WIDTH
REPAIR -SIDE PROP LINE
USE OF �� t =
EXIST-ING BLDG DEMOL ❑
❑ ❑
APPLICANT Cle TE CORNER CUTOFF YES NO
_ -
(PRINT) 7 `1!� NO ,
BY (SIGNATURE)-- - _ J IN OPEN SPACE YES ❑ NO ❑
IN COASTAL ZONE YES-E] NO ❑
-VALUATIONQ . %yL '
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)
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION I*CERTIFY THAT INDOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE)
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
LABOR CODE OF THE STATE OF CAL ORNIA IN R •LATI NG TO
WORKMEN'S COMPEN 0 I U ANC
SIGNATURE OF
PERMITTEE
ADDRESS, `�
- - -FINAL BY
TEL DATE �v -
CITY NO
11,1hb CHbCI`S P,0AE3LL 10. FEE FEE
HARVEY T. BRANDT, COUNTY ENGINEER
-PLAN CHECK VALIDATION CK M o CASH PERMIT V ATION- CK M O CASH
_ - - 2GC ;�3' G 1 D 28 .50AL
76A638A CE#803 12/72 - - -