HomeMy Public PortalAbout6260 GOLDEN WEST AVE_Building__ L
AP !C ION F BUILD( PERMIT
FOR APPLICANT TO F IN rint or type only)
BUILDING
ADDRESS &BE6260 No Golden West BUILDING O
ADDRESS G
CITY 1 City ZIP
JJ // NO.OF BLDGS. LOCALITY
SIZE OF LOT 02 /�a NOW ON LOT NEAREST
�1B f CROSS ST.
ASSESSOR
RACT 6J" s� BLOCK O LOT NO MAP BOOK PAGE R
TEL. DISTRICT IGROURITYPEFIRE D BY
OWNER NO. O CONST
ADDRESS
STATISTICAL CLASSIFICATION SEWER MAP
CITY ZIP CLASS NO.� DWELL.UNITS BK PG
ARCHITECT OR TEL.
ENGINEER NO. USkZ E MA410.
P /7O
ADDRESS 722-6975SPECIAL
CONTRA CTORMont eb ell o Roo g
Lnzoo CONDITIONS
NU,1,,'' Cr�)�pp ROAD DEPARTMENT APPROVAL REQUIRED YES NO
ADDRESS 868 T c wa No?-488 2 BLDG.SETBACK FROM
CITY Montebello CILASS C-39 FRONT PROP.LINE OF (STREET)
CONSTRUCTION LENDER HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EAY XISTING
NAAE AND BRANCH
FRONT PROP. LINE
IDTH
ADDRESS CITY +
SQ. FT. _FN 0. OF NO. OF CHECK BLDG.SETBACK FROM S
SIZE STORIES FAMILIES ONE SIDE PROP.LINE OF (STREET)
[C
DESCRIPTION OF WORK Reroof exiStNEW ❑ HIGHWAY + YARD = TOTAL SET19ACK FROM TYPE OF EXISTING CD
SIDE PROP. LINE HIGHWAY1 WIDTH r
in bldg. with 3-1 as D + _
shingles a LIAR [IEPAIR Ix El NO
❑ Z
CORNER CUTOFF YES
T�w��
USE
EXISOT NG BLDG. Dwelling EMOL
g JDI IN OPEN !PACE YES ❑ NO El
APPLICANT
Daniel Daherty 6-938 IN COASTAL ZONE YES NO
BY (SIGNATURE) ENVIRONMENTAL CATE[ORICAL [X[MPTION YE3� NO
JIMPACT CEEMPTIOX DECLARATION SIGNED (DATE)
VALUATION O / IMPACT REPORT PROCESEED (DATE)
I HEREBY ACKNOWLEDGE THAT I HAVE REATHISPPLICATION
AND STAT[ THAT THE AZOVE IS CORRECT ANDTO COMPLY
WITH ALL ORDINANCE/ AND LAWS REGULATING LALDIX. COX- f�
STRUCTIOM. I CERTIFY THAT IN DOING THEUTHORIZED �!
HERESY I WILL NOT EMPLOY AMY PERSON IIOX OF TH[ /'LABOR CODE OF THE STAT[ OF CALIFORN [L TING TOWORKMEN'S COMPENSA INSURANCE. AWi
IKAL
SIGNATURE OF _ _�PPERMITTEEp DATE Lei U(jADDRESS U TrUC aP.C, PMT. DO
FEE * FEE
CITY Montebello TNO
E�722-697 p
p-9�177'�1'C-CK�UMt-'�S�►�g�� PERMIT VALIDATION CH. M.O. CASH
6 7 5'*MAIC 30 1 n 34.0 4.0
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