HomeMy Public PortalAbout6201 KAUFFMAN AVE_Building__ �w APPLICATION FOR
,B4!.1LDING PERMIT
BUILDING
FOR APPLICANT TO FILL IN ADDREss o_-"d 'I
BUILDING •7 LOCALITY
ADDRESS oc ly 4
-
NEAREST
CITY j` %ZIP• '`, CROSS ST
NO OF.BLDGS ASSESSOR
SIZEOF'LOT I,NOW ON LOT MAP BOOK PAGE PARCEL
DISTRICT GROUP TYPE FIRE• ROC ED BY
TRACT BLOCK LOT NOD CONST Z =
�. .. ,,-C'r - -�/r•
TEL _.. S a' 8 r , '•
OWNER /,, }ANO 007 STATISTICAL CLASSIFICATION'• SEWER MAP
.ADDRESS Z�J' ' - U� �Y I Fc/E CLASS NO •DWELL UNITS " ' BK / G
CITY �, -T ZIP USE ZONE MAP
ARCHITECT OR h :TEL`' Np-
ENGINEER 'No SPECIAL
r `` CONDITIONS -- •_ - .
ADDRESS t• _ " ROAD DEPARTMENT APPROVAL REQUIRED YES ❑' NO'Q•
TEL
CONTRACTOR NO BLDG SETBACK FROM -'
LIC FRONT PROP LINE OF j (STREET) '
ADDRESS NO TOTAL SETBACK FROM TYPE OF EXISTING
LIC HIGHWAY' .+ YARD FRONT PROP LINE" HIGHWAY 'WIDTH
CITY CLASS
CONSTRUCTION LENDER
NAME AND BRANCHBLDG SETBACK'FROM ` U
ADDRESS CITY SIDE PROP LINE OF (STREET) O
SQ FT NO OF NO OF CHECK HIGHWAY + = T AL SETBACK FROM TYPE'OF EXISTING,' U
SIZE �D� STORIES FAMILIES' ONE E PROP LINE HIGH WAV WIDTH
DESCRIPTION OF WORK' NEW
11 + _ z_ ..
ADD- ❑ -CORNER CUTOFF" YES '❑' NO ❑
-ALTER ❑ IN OPEN SPACE YES ❑ NO ❑
RE
USE OF PAIR ❑ IN COASTAL PERMIT ZONE- : .:YES, ❑ NO ❑:
EXISTING BLDG ��`' 1`, DE
MOL
APPLICANT TEL
"(PRINT) G --0 L•S6{� NO
- N•
BY(SIGNATURE), _
-•.I HEREBY ACKNOWLEDGE'THAT I HAVE READ THIS APPLICATIOdANDA -THAT THE ABOVE IS.CORREGT AND AGREE,TO COMPLY WITH ALL
AND LAWS•REGULATI NG BUILDING CONSTRUCTION I CERTIFY THAT
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WO
PENSATION INSURANCE -
SIGNATURE OF FINA �Y, •BY _
PERMITTEE DATE/ / (J '
ADDRESS U
TELP„C^Fee$ Permit Fee” `
CITY N
` Issuance Fee''
VALUATION
(, Total Fee
.-.PLAN CHECK'VALIDATIO,N' CK M:o:- ' cAsH _ PERMIT VALIDATION,• CK. .O CASH
OS 76A6388 CE/803B 8%77 - '