HomeMy Public PortalAbout9434 LEMON AVE_Building__ APPLICATION FOR UILDING PE6MIT
?OR APPLICANT TO FILL IN (Print or type only)
BUILDING COUNTY OF LOS ANGELES
ADDRESS 3 DEPARTMENT OF COUNTY ENGINEER
CITY
—�� BUILDING AND SAFETY DIVISION
ZIP
NO OF BLDGS BUILDING
SIZE OF LOT NOW ON LOT ADDRESS 7 /�
TRACT BLOCK LOT NO LOCALITY
TEL EAREST
OWNER �� NO CROSS ST
ASSESSOR
ADDRESS MAP BOOK PAGE PARCEL
CITY , ZIP DISTRICT GRR�u- J E FIRENST ZONE ROCCESSSED BY
ARCHITECT OR TEL
ENGINEER NO STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS CLASS NO 2 U DWELL UNITS BK PG
TEL' i
CONTRACTOR NOLICUSE ZONE MAP NO
ADDRE Q U NO (�r M1M1,, SPECIAL
CITY
CLC.
ASS WG CONDITIONS
CONSTRUCTION LENDER ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑
NAME AND BRANCH BLDG SETBACK FROM -
FRONT PROP LINE OF (STREET)
ADDRESS - CITYTOTAL SETBACK FROM TYPE OF EXISTING
SQ FT NO OF NO OF CHECK HIGHWAY + YARD FRONT PROP LINE HIGHWAY WIDTH
SIZE STORIES FAMILIES ONE }
DESCRIPTION OF WORK NEW ❑ + O
ADD ❑ BLDG SETBACK FROM �
SIDE PROP LINE OF (STREET) O
ALTER ❑• TOTAL SE CK FROM TYPE OF EXISTING w
LL/ HIGHWAY + YARD = SIDE PRO E HIGHWAY WIDTH N
USE OF REPAIR ❑ ,_ _ Z
EXISTING BLDG DEMOL El +
APPLICANT TEL CORNER CUTOFF YES ❑ NO
�^ ❑
(PRINT( J'
IN OPEN SPACE YES ❑ NO ❑-
BY(SIGNAT U
• IN COASTAL PERMIT ZONE YES ❑ NO ❑
VALUATION Q �
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE ��'� C' '�jQ�
�07�1N
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES S+����
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 INSURANCE
SIGNATURE OF
PERMITTEE efax�
ADDRE �)
TEL FINAL ✓�/ BY
CI NO DATE r- /v�
MAKE CHECKS PAYABLE TO FEE FEET $ J
HARVEY T.BRANDT,COUNTY ENGINEER �/ 1,2
PLAN CHECK VALIDATION CK M o CASH PERMIT VALIDATION CK M o CASH
9 9 5u'�JOV 24 1 D 2 1.7 5 A90-
0S
90®s 76A63BA CE 11803 3 75