HomeMy Public PortalAbout6203 KAUFFMAN AVE_Building__ `APPLICATION FOR
�--'B-UILDING PERMIT _
.JOR APPLICANT'TO-FILL•IN BUILDING
ADDRESS'
BUILDING
ADDRESS Q LOCALITY
NEAREST
CITY ZIP - O CROSS ST
NO OF BLDGS ASSESSOR' -
SIZE OF LOT - NOW ON LOT MAP BOOK- PAGE PARCEL ,
_� DISTRICT GROUP TYPE FIRE ESSED BY
TRACT BLOCK v aV CONS Z�AIb
OWNER c NL^n. -� O�
O�/� STATISTICALCLASSIF AION�'�, / SEWER P
ADDRESS Q MOE ;�4j
CLASS NO DWELL UNITSLBK \ PG
CITY-, 1!j 'If ZIP Q USE ZONE MAP•
ARCHITECT OR TEL, NO f )3
ENGINEER NO-•. —2� SPECI L
- CONDITIONS -
ADDRESS "�* ROAD DEPARTMENT APPROVAL REQUI ED YES ❑ NO ❑
CONTRACTOR NO BLDG SETBACK FROM'
LIC FRONrPROP LINE, (STREET)
ADDRESS NO TOSETBACK-FROM TYPE OF EXISTING
LIC HIGHWAY, + YARD = NT PROP LINE.• - HIGHWAY WIDTH
CITY CLASS { /1
CONSTRUCTION LENDER + 22,6
V O
NAME AND BRANCH BLDG SETBACK FROM U"
ADDRESS CITY :. SIDE PROP LINE OF JSTREET) r
SQ FT p/o�� NO OF NO OF ,1 CHECK: HIGHWAY. + YARD = TOTAL SETBACK FROM TYPE OF
EXISTING
SIZE I� o STORIES FAMILIES / ONE SIDE PROP LINE HIGHWAY WIDTH N
DESCRIPTION OF WORK ,c ckck NEW " +
ADD ❑ CORNER CUTOFF YES ' E] NO ❑
ALTER. ❑ ,IN OPEN SPACE. `, YES- ❑ _\ NO- ❑
REPAIR, ❑ `
USEOF BLDG. DEMOL ❑ 'IN COASTAL PERMIT ZONE- YES ❑. NOEXISTIN "❑ ;
APPLICANT TEL
(PRINT) C ` NOD-8-7-JI,Qa
BY(SIGNATURE(!
i
I HEREBY-ACK OWLEDGE 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 - -• - i - J ,
PENSATION INSURANCE' ,p '
SIGNATURE OFy FINAL BY
PERMITTEE .87/I DATE.. /.I
ADDRESS
TEL a4�-.s-vc P C Fee$ i Permit Fee
CITY NO v --77
Issuance Fee
VALUATION � !+`���J.�B Total Fee ,\ r�G'
PLAN CHECK VALIDATION ,�' t:. i�+:o -.`CASH PERMIT VALIDATION �IC t'- M.O. CASH
9,,9 2"APR: I:9.2i-3 a
2-11 ;17.2 0
4 4:-AUG . 4 '1
,.
( S' 76A638B CE 98038 8/77
; ,PL:.'ICA'i"`!ON FO.R.:' ' .' '-'` COUNTY'OF LOS ANGELES
= DEPARTMENT OF COUNTY ENGINEER
+' � 1 L IN.
PERM IT", BUILDING AND+SAFETY DIVISION "
FOR,APPLICANT BUILDING TO FILL IN'^ ' - UDDIN -
BUILDING
ADDRESS .� '�Q.• °' LOCALITY' �•
NEAREST
CITY ZIP, •- CROSS'ST
N0-OF BLDGS.• .ASSESSOR '
SIZE OF LOT NOW ON LOT MAP.BOOK :.,;,-,, :'PAGE '- r PARCEL "
DISTRICT GROUP JJYPE ' `,FIRE, ROC SSED
TRACT BLOCK' LOT+NO; CONST ZON
TEl ,�l t
OWNER NO
' STATISTICAL'CLASSIFICATION SEWERMA '
ADDRESS CLASS NOWELC'UNITS ' _ i BKPGS,,',
l
CITY : ` ZIP,
AHITECT OR `TEL
USE ZONE MAP,-
RCNO D'
ENGINEEp - NO ��L SPECIAL _
a CONDITIONS
ADDRESS - ROAD DEPARTMENT APPROVAL REQUIRED 'r �,r,,; Y,,ES(❑,, No ❑
TEL ,_• -,-
CONTRACTOR -- --• _ BLDG SETBACK FROM rrt•{; ,
LIC FRONT PROP LINE OF STREET)
ADDRESS NO; TOTAL SETBACK FROM; TYPE OF EXISTING
HIGHWAY .+ YARD. _
LIC FRONT-PROP'LINE:' HIGHWAY .,WIDTH '
CITY`' - .. .CLASS
CONSTRUCTION LENDER Y: _;' +' = a
'NAMEAND BRANCH, _
n- ' BCDG 'SET BACK,FROM O'•
SIDE PROP'LINE OF '' "r.. (STREET)
ADDRESS CITY x O
SQ FT NO OF- NO,OF- ;- -• ;CHECK-• HIGHWAY• .+• YARD = ;TOTALSETBACK FROM_ TYPE OF-, EXISTING .0
SIZE STORIES. FAMILIES;,' ONE: SIDE PROP, LINE' HIGHWAY WIDTH h
Z
DESCRIPTION OF WORK NEW,
CNECUTOFF --'YES_'' NO
-x' - - - -- -' ADD.. ORW '
= ❑ n ❑ '❑' a.
ALTER ❑ ;IN_OPEN,SPACE' J YES ❑ „s• NO-, El-,
REPAIR
USE OF BLDG : :DEMOL.'❑ IN COASTAL'PERMIT ZONE,-r _ '' ?-'•-YESEXI ❑ f ;,NO.'❑ ,
a„
APPLICANT TEL ? "
(PRINT) _ r _NO
•BYISIGNATUREI`.
I HEREBY ACKNOWLEDGE THAT:I:HAVE READ THIS APPLICATION AND.STATE
THAT-THE ABOVE IS CORRECT AND',GREE'TO COMPLY WITH ALL ORDINANCES'
AND LAWS'REGULATING BUILDING�CONSTRUCTION CERTIFY,THAT IN'DOING THE
WORK AUTHORIZED HEREBY I WILCNOT•EMPLOY;ANY PERSON IN VIOLATION,OF,,
•THE LABOR CODE OF'THE STATE OF CA'LIFORNIA,IN RELATING`TO WORKMEN&COM'; - •-- —
PENSATION INSURANC ear-.s _ .•i - ,(,i�
SIGNATUREOFr ' :�, " FINAL
PERMITTEE DATE r'� _ `•L
ADDRESS`
TEL 'a,p, P,C Fee$ �. Permit Fee
LVX
N "-
=1Ss66nce'Fee�'
UATIONa ++ H: _• ,
-6'� Total Fee -
,•PLAN CHECK VALIDATION` K'`�/'n o:,�Tcasw PERMIT,VALIDATION,. ,
CK: M O " CASH
: . 1,.4 5r,AUS 4 ;,: 7 ...�" ®3�
®S 76A638A CE#803A 8/77