HomeMy Public PortalAbout9632 1/2 LONGDEN AVE_Building__ ®S 4A636A
CE/803(Ft 6/7811 'I
APPLICATION FOR BUILDING PERMIT
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COUNTY OF LOS ANGELES BUILDING AND SAFETY..!"
BUILDING 1 �*
FOR APPLICANT TO FILL IN ADDRESS Z- i
BUILDING
ADDRESS LOCALIT
NEAREST
CITY ZIP CROSS ST.
3'0-
OF BLDGS. ASSESSOR
SIZE LOT V NOW ON LOT MAP BOOK PAGE PARCEL
DISTRICT GROUP TYPE FIRE ED BY
TRA 11 g [ CK �j LOT NO. ` �0 3 CONST._ ZONE
OWNER �L.J �� .!/�'
d STATISTICAL CLASSIFICATION ` SEWER M
ADDRESS 0!;L DWELL.UNIT BKW
CLASS NO. PG
CIT RLC4 et( 'Ar ZIP
ARCH) CT OR TEL. VALUATION $ d
ENGINEER NO.
ADDRESS BLDG.SETBACK FROM
/��p TEL. FRONT PROP.LINE OF (STREET)
CONTRACTOR ' r "\ NO. HIGHWAY + YARD. _ TOTAL SETBACK FROM TYPE OF EXISTING
LIC. - FRONT PROP.LINE 1HIGHWAY1 WIDTH
ADDRESS NO. _
LIC. +
CITY CLASS
BLDG.SETBACK FROM
CONSTRUCTION LENDER p
NAME AND BRANCH tv SIDE PROP.LINE OF (STREET)
HIGHWAY + YARD = TOTAL SETBACK FROM I TYPE OF EXISTING 11161
ADDRESS CITY SIDE PROP.LINE HIGHWAY WIDTH
p�cJ) STORIES FAMIILLIES ONEK + _ R9
SIZE �7�
DESCRIPTION OF WORK NEW ❑ P.C.Fee$ t% 7 Permit Fee 75
•3
ADD ❑ 0 v Issuance Fee 1 4�4
Dal& ALTER ❑ Q o
REPAIR El Total Fee `O '� 2�`
USE OF f%S ❑ 3
EXISTING BLDG. DEMOL C 2 - 1 O 'u 2lJ
APPLICANT TEL�� �� f. o a ' (cA. 11.20-7/ c' '1,20-i c '
(PRINT) I C 1
Z � 77•aD
BY(SIGNATURE) 9-7- 5'-7r
IHEREBY ACKNOWLE G HAT I HAVE READ THIS APPLICATION AND STATE UY
THAT THE ABOVE IS CORRE AND AGREE TO COMPLY WITH ALL ORDINANCES tTS
AND LAWS REGULATING BUI ING CONSTRUCTION.I CERTIFY THAT IN DOING THE {=J
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- 2
PENSATION INSURANCE. --1 4 a 5 n.
SIGNATURE OF # o a a a o ;
PERMITTEE
ADDRESS
Z 2 . 482, rti
TEL. 0 o o 11 8 2
rDATE /
NO.
MAP 0 D -> I 1.2 0-7
NO
SPESPECIALCONDITIONS
BY 0 To
APPLICATION 'FOR COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUIL®1 ISI G PERMIT BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL I �DIDRESSLDING Lo ( -
BUILDING �'�� R y�
ADDRES "LOCALITY - C('T"-/
-� NEAREST ([�� ��
CITY IP CROSS ST. L_\ _r s ID
NO.OF BLDG �: ASSESSOR
SIZE OF LOT ooNOW ON LOT'=. MAP BOOK PAGE PARCEL
a7 i /�4 1�/ DISTRICT GROUP TYPE FIRE P CESS J BY
,TfJ C1U� BLOCK/ LOT NO. CONS Z_ONE r '
._TEL.
OWNER �, NO. S STATISTICAL CLASSIFICATION SEWE�R�yyM
ADDRESS CLASS NO.L DWELL•UNITS , BK/! G'
CITY ZIP USE ZONE MAP
NO. U 00 \
ARCHI ECT OR L. 'SPECIAL J
ENGINEER NO. CONDITIONS
ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑
CONTRACTO BLDG,SETBACK FROM _
FRONT PROP,LINE OF t�2 � (STREET)
LIC.
ADDRESS NO. HIGHWAY t YARD_ TOTAL ETBACK FROM TYPE OF HIGHWAY'EXISTING
WIDTH
CITY
LIC. FRONT PROP. LINE
CLASS _ f
C ,ONSTRUCTION LENDER t -2-1' - �.� Oc G
NAME AND BRANCH /i) f BLDG.SETBACK FROM }
ADDRESWIJZID CITY SIDE PROP.LINE OF (STREET)
SQ. FT NO. OF. NO. OF CHECK HIGHWAY t YARD '
_ TOTAL SETBACK FROM TYPE OF EXISTING CD
SI E ," - STORIES _ F MILIES ONE SIDE PROP. LINE HIGHWAY' WIDTH
� �� t
DESCRIPTION OF WOR =V7G NEW
1* r P AIEW �j„ - ADD ❑ CORNER CUTOFF YES 13 NO
❑ Z
ILC. LTER•. '
IN OPEN SPACE YES ❑ NO ❑
REPAIR
USE OF IN COASTAL PERMIT ZONE YES ❑. NO ❑
EXISTING BLDG. DEMOL ❑
APPLICANT TEL1
(PRINT) NO. c, �[
BY (SIGNATURE) Xe , ^ - ✓•i' 4�
1 HEREBY ACK NOW LEDG HAT I HAVE READ THIS APPLICATION �-�7,..,,��
AND STATE THAT THE Ap E IS CORRECT AND AGREE•TO COMPLY _
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION. IC
THAT IN DOING THE WORK AUTHDRIZED
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
LABOR CODE OF THE STATE OF CALIFORNIA IN REL I�NG TO
WORKMEN'S COMPENSATIO I SU NCE.
SIGNATURE OF �/ �� y FINAL BY
PERMITTEE DATE
ADDRESS
i
CITY. ,I[��� ��n TEL L• P.C. Fee$ Permit Fee
Q fJ�1 Issuance Fee
VALUATION fl � ao� ,.Q`,' Total Fee ort 5
PLAN CHECK VALIDATION �— M.O. CASH P VERMIT VALIDATION cK M.O. CASH
2.:6 4 Lo-JUL 262.3 •S 85-93 �
_ . .- . _ . 3 9 .2.L"OSEP 28 .1 1) 25 5.0 0 ,&�
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