HomeMy Public PortalAbout6047 1/2-6047 3/4 GOLDEN WEST AVE_Building__ APPLICATION OR BUILDING PERMIT �
FOR APPLICANT TO FILL IN (Print or type only)
` COUNTY OF LOS ANGELES `
a DRESSs • ' 'olden West. �OY1/z DEPARTMENT OF COUNTY ENGINEER
clTq`emCity, zIP 911'78b o3 BUILDING AND SAFETY DIVISION , '
NO-OF BLDGS BUILDING �_
SIZE OF LO NOW ON LOT ADDRESS
TRACT BLOCK LOT NO 90&91.1. LOCALITY
T' ��nr.,fTEL NEAREST -�
OWNER :C.,Rf c1'b
fr hffs-, l o NO CROSS ST
ASSESSOR
ADDRESS 5325 Zadell MAP BOOK _ PAGE PARCEL
7 DISTRICT GROUP1,TYPE,,, FIRE ��l
CIT1T_eTII le 'City ZIP J�-!v� L CON
ZONA (�)ARCHITECT OR TEL �J
ENGINEER_ -NO STATISTICAL CLASSIFICATION SEWER
MAP
ADDRESS CLASS NO 40 1� DWELL UNITS f 14,371,
_
_TEL
CONTRALTO t N �UQSE ZONE NMOAP
LICADDRESS1 21 &, La sTuj n NO 1 �Q, /4 SPECIAL
IONS LIC CONDITIONS
CITY S.a'nGabriel. •Cal. LASS' B-1- 'ROAD DEPARTMENT APPROVALRf'QUIRED YES ❑ NO ❑
CONSTRUCTION LENDER
NAME AND BRANCH 'Owner- BLDG SETBACK FROM � //)> , )) t STREET)
FRONT PROP LINE OF.�cl� /� -
ADDRESS CITY TOTAL SETBACK FROM TYPE OF EXISTING
SQ FT NO'OF NO OF CHECK HIGHWAY + YARD = FRONT PROP LINE HIGHWAY WIDTH
SIZE - STORIES 2 FAMILIES 2 ONE }
DESCRIPTION OF WORK NEW ® + � -0 (G O O
ADD ❑ BLDG SETBACK FROM Q�
SIDE PROP LINE OF (STREET) O
ALTER El - TOTAL SETBACK FROM TYPE OF EXISTING w
HIGHWAY + YARD = SIDE PROP LINE HIGHWAY WIDTH - N
USE OF REPAIR ❑ Z
EXISTING BLDG Res idenee DEMOL ❑ +
APPLICANT TEL CORNER CUTOFF YES ❑ NO ❑
(PRINT) N
IN OPEN SPACE YES ❑ NO ❑
BY(SIGNATURE)
• IN COASTAL PERMIT ZONE YES ❑ NO ❑
VALUATION $ ;
I HEREBY ACKNOWLEDGE-THAT I HAVE READ THIS APPLgANDAD'STATE
THAT THE"ABOVE IS CORRECT AND AGREE TO COMPLY WIANCES
AND LAWS REGULATING BUILDING CONSTRUCTION I CERTIFYING THE
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSOION OF
THE LABOR CODE OF THE STATE OF CALIFORNIA'_IN RELATING TS COM
PENSATION INSURANCE
SIGNATURE OF
20A,,2A
PERMITTEE 60
ADDRESS
TEFINAL _ BY
CITY NDATE 3 7
MAKE CHECKS PAYABLE TOFEE FEET $
HARVEY T.BRANDT,COUNTY EN
303,00
- PLAN CHECK VALIDA I CK M O CASH PERMIT VALIDATION cK M o CASH
8,29j 0 jm .7 2:3 1;8' 1.8 0 - 6 5`9"Auc 13 '11--®, 3'0' 3.0 0 aa8
OS 76A63BA CE(1803 3J5 ,