Loading...
HomeMy Public PortalAbout4945 HALLOWELL AVE_Building__ APPLICATION FOR BUILDING PERMIT ,FOR APPLICANT TO FILL IN (Print or type only) COUNTY OF LOS ANGELES BUIL ESS �+ ' :1 b w�i DEPARTMENT OF COUNTY ENGINEER ADDRESS CITY 1 r �ff,��b(� �J ZIP �j (a BUILDING A D SAFETY DIVISION SIZEOF LOT 6Uo 9aX C9 . A NOW ON LOT ADB DGS. IDRESS TRACT �` �1� L � ` LOCAL( ` eaME �C TEL. NEAREST OWNER J NO. 6�J CROSSST ASSESSOR ADDRESS �p 1' b MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE ESSED BY -CITY ZIP CONST. ZONE ARCHITECT OR TEL. �. d 8 ENGINEER NO. STATISTICAL CLASSIFICATION SEWER AP ADDRESS CLASS NO. DWELL.UNITS / BK G TEL. CONTRACTOR NO. ZONE MAP LIC. + NO.i CJ U ADDRESS NO. _ SPECIAL LIC. ^lam y CONDITIONS CITY CLASS ROAD DEPARTMENT APPROVAL REQYIRED YES ❑ NO ❑ CONSTRUCTION LENDER NAME AND BRANCH BLDG.SETBACK FROM FRONT PROP.LINE OF (STREET) ADDRESS CITY TOTAL SETBACK FROM TYPE OF EXISTING SQ.FT. f10 NO.OF , NO.OF ' CHECK HIGHWAY t YARD = FRONT PROP.LINE HIGHWAY WIDTH SIZE VV STORIES FAMILIES ONE DESCRIPTION OF WOR `� A NEWCL �ff t F�G O ADD ❑ BLDG.SETBACK FROM SIDE PROP.LINE OF (STREET) O ALTER ❑ TOTAL SETBACK FROM TYPE OF EXISTING w HIGHWAY + YARD = SIDE PROP.LINE HIGHWAY WIDTH N USE OF REPAIR ❑ Z EXISTING BLDG. DEMOL ❑ t APPRINANT TEL _ r] CORNER CUTOFF YES ❑ NO ❑ pd Il IN OPEN SPACE YES ❑ NO ❑ BY(SIGNATURE) IN COASTAL PERMIT ZONE YES ❑ NO ❑ VALUATION $ SID,, D©t 2 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 CONSTRUCTION.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 COM- PENSATION INSUR SIGNATURE O PERMITTEE pp�� `, A ADDRESS v02^ f�(� N L 'y CITY �' N��-ll� DATE L BY MAKE CHECKS PAYABLE TO: IEE $ FET HARVEY T.BRANDT,COUNTY ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION .K. M.o. CASH 2 5..6 Z'-1SEP .211 .2.3 0 131.40 3 0 9 NOV 16 1 U 2 1 9.0 VA ®s 76A638A CE#803 3.75' /�