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HomeMy Public PortalAbout5703 KAUFFMAN AVE_Building__ APPLICATION FOR BUILDI � IT FOR Alt'PLICANT TO FILL-IN (Print or type only) . BUILDING C LINTY OF OS ANGELES ADDRESS 'ma DEPARTMENT OF COUNTY ENGINEER CITY Temple City zip 91780 BUILDING AND SAFETY DIVISION NO.OF BLDGS. BUILDING SIZE OF LOT 60 X 120 NOW ON LOT ADDRESS TRACT BLOCK LOT NO. LOCALITY TEL. NEAREST OWNERT'dg NO. 287—(3412 CROSS ST. ADDRESS 5703 Kauffman Av. MAPESSOR BOOK PAGE PARCEL DISTRICT/- GROUP TYPE FIRE PROCESSED BY CITY TemT�le Cit ZIP 1780 s� ,( CONST ZONE ARCHITECT OR TEL. J CD/ ENGINEER NO. STATISTICAL CLASSIFICATION�rJJSEWER MAP ADDRESS CLASS NO. ���// _OWELL•UNITS B PG -CONTRACTOR NO USE ZONE MAP TJ/ NO. dG LIC. /j�, ADDRESS � NO. SPECIAL CONDITI )NS CITY LIC. CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES NO' s CONSTRUCTION 6,RnDER NAME AND BRA CH BLDG.SETBACK FROM a FRONT PROP.LINE O - (STREET) ADDRESS CITY HIGHWAY } YARD = TOTA ETBACK FROM TYPE OF EXISTING �. SQ. FT. NO. OF NO. OF CHECK FRONT PROP. LINE HIGHWAY WIDTH SIZE STORIES FAMILIES ONE } = W DESCRIPTION OF WORK NEW ❑ / �1 BLDG.SETBACK ADD LTJ FROM (STREET) Z SIDE PROP.LINE OF - ALTER ❑ TOTAL SETBACK FR OM TYPE OF EXISTING -17r �e�s-e- HIGHWAY } YARD = SIDE PROP. LINE HIGHWAY WIDTH REPAIR[I USE OF DEMOL ❑ } t EXISTING BLDG. - APPLICANT TEL CORNER CUTOFF YES NO (PRINT) Edward Sznaper N. . - 9412 BY (SIGNATURE) IN OPEN SPACE YES NO N COASTAL ZONE YES NO VALUATION$ 200.00 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 WILL NOT EMPLOY ANY P ON IN VIOLATION OF THE LABOR CODE OF THE STATE OF IFORNIA IN RELATING TO WORKMEN'S COMPENSATIO U E. SIGNATURE OF _ PERMITTEE A0DRESc BY DATE CITY NO / y /�1>,, . l TEL. `1� /�,I/ �/� / 1 /I �� • '�/ MAKF_ CHECKS 1 AYABLF TFEE O: PMT•Q FEE FEE 'I' ]� HARVEY T. BRANDT. COUNTY ENGINEER i PLAN CHECK VALIDATION CK.. M.O. CASH PERMIT VALIDATION CK. M.O. CASH 7 1:5 LX�AUG 29 ;1 © 6.0 0 A 76A638A CE9803 7/73 ... -'