HomeMy Public PortalAbout10244 GREEN ST_Building__ FOR APF'LICANA�PPLICATIoONr typeonFOR BUILDING PERMIT
FILL IN (PrintEUI vDING ��, - •- COUNTY OF LOS ANGELES
ADDRESS CC DEPARTMENT OF COUNTY ENGINEER
CITY
T�lZ1P BUILDING AND SAFETY DIVISION
O.OF SLOGS. BUILDING n
SIZE OF LOT 0X NOW ON LOT ADDRESS /!d.2 '
TRACT L k LOT NO LOCALIT
TEL. NEARES
OWNER Q� NO. - CROSS STT
.
ASSESSOR
ADDRESS& <4MAP BOOK PAGE CEL
,.� DISTRICT GROUP TYPE I FIRE PROCEkSED BY
CITY rJ7 �,,L -/ ZIP ` CONST. , ZON
ARCHITECT OR TEL. •\'".'J1 ��V/
ENGINEER NO.
STATISTICAL CLASSIFICATION SEWER MA
ADDRESS CLASS N�_DWELL,UNITS-----J I( BKS yPPG
CONTRACTO TZONE MAP � , U
�y�� L NO.
ADDRESS1,4C? /9�f�Z.0 NO. l�Sl /' SPECIAL
CITY
LIC. S
CONSTRUCTION LENDER CLAS �"�-'` CONDITIONS
��}.
/� �Y/ ROAD DEPARTMENT APPROVAL REQUIRED YES[_ NOD
NAME AND BRANCH Y' .. BLDG.SETBACK FROM a
FRONT PROP.LINE OF (STREET) O
ADDRESS CITY -_ TOTAL SETBACK FROM TYPE OF EXISTING V
HIGHWA + YARD
SQ. FTq/Q-j NO. OF NO. OF CHECK FRONT PROP. LINE HIGHWAY WIDTH �
SIZE/�L,.(j STORIES FAMILIES ONE F._.
DESCRIPTION OF WORK NEW T] + a_
ADD BLDG,SET KFROM Z
J `" SIDE PROP. LI (STREET)
ALTER ❑
HIGHWAY } YARD _ TOTAL S OM TYPE OF EXISTING
-
REPAIR❑ SIDE PROP. LINE GHWAY WIDTH
USE OF } _
EXISTING BLDG, DEMOL ❑
AP(PRINT) :z, No;,fi��s3v CORNER CUTOFF YES ❑ NO
BY (SIGNATURE) IN OPEN SPACE YES NO
Q r/f IN COASTAL ZONE YES NO ❑
VALUATION$ / 6.�el ��� 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 IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE)
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO _
WORKMEN'S CO MPENSA INSURANCE. t. '
SIGNATURE OF
PERMITTEE
ADDRESS ,/�f`y�A _ -
CITY /tJYV, NOL2"9t� DATE BY
MAKF. CIIECKS PAYABLE TO: P.C. [ME
HARVEY T. BRANDT. COUNTY ENGINEER FEE
PLAN CHECK VALIDATION CK. M O. CASH PERMIT VALIDATION CK M O. CASH
53r"2JUI, 19 1 0 6225Aid
76A638A CE#803 7/73
7BA688A CE#803-6-57 APPLICATION FOR BUILDING PERMIT ~ 1
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A.LAMBIE,COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST.
DISTRICT NO. GROUP I TYPE I SEWER MAP
FOR APPLICANT TO FILL IN -� SK PG
BUILDING / L CONST:
ADDRESS ! ! / STATISTICAL CLASSIFICATION I
/�. e /4L CLASS. NO. • DWELL.UNITS
LOT NO. MAP STATE
NUMBER I. WY YES NO
TRACT US Z NE SPECIAL
SIZE OF LOT C? �i� NO.OF BLDGS. CONDITIONS ,
NOW ON LOT
USE OF
EXISTING BLDG. BUILDING YARD HWY S EET NAME EXIST.
SETBACK WIDTH
O W FP.L.
MAIL
ADDRESS 71.L V,,4LL 0,4.1 Seo S'4 0/?- SIDE
CITY .1'!F NOrS 7 P. L.
ARCHITECT OR TEL - INSPECTION RECORD
ENGINEER NO.
ADDRESS
CONTRACTOR T ,ZZ
ADDRESS / ,4 1-O ICA s4
DESCRIPTION OF WORK
NEW ADD ALTERREPAIR DEMOLISH
FT. NO.OF NO.OF
SIZE �!: Z STORIES FAMILIES
USE OF STRUCTURE
SIGNATURE O APPROVALS
APPLI CA
DATE INSPECTOR'S SIGNATURE
ADDRESS FOUNDATION: LOCATION
FORMS,MATERIALS
P.C. S // FRAME: FIRE STOPS,
FEE (y BRACING.BOLTS -" I
VALUATION $3 3 FURNACEGAS VENTLDUCTS " '�' r. t A • ;,�^/s':
FEE
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP. ATH,INT.
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY W TH ALL COU ORDINANCES A
STATE LAWS NG G CONSTRUCTI J LATH.EXT.
SIGNATURE HOUSE NUMBERCOR- /
PERMIT «'"�"�"t RECT AND POSTE10,
D 9L s
ADDRESS7i,Z. FINAL
JOHN A. LAMBIE,COUNTY ENGINEER. CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION M.O. CASH PERMIT VALIDATION K M.O. CASH
7 1 6
16.75 ,
!: o 2006°; mAR14 A 33.50 M