HomeMy Public PortalAbout5731 OAK AVE_Building_9/10/1975_ « U3.5 T OI Tempi-@ UXO
APPLICATION FOR BUILDING PERMIT
FOR APPLICANT TO FILL IN (Print or type only)
BUILDING - COUNTY OF LOS ANGELES
ADDRESS DEPARTMENT OF COUNTY ENGINEER
CITY Tewle Cityzip 91780 BUILDING AND SAFE DMSION
NO OF SIZE OF LOT r/ NOW ON L TS ADDRESS UILDING
TRACT BLOCK O`T NO-7.3/ LOCALITY `
TEL NEAREST
OWNER NO CROSS ST
ASSESSOR
ADDRESS 1132 N.E. 136th Street MAP BOOK PAGE PARCEL
CITY POrtla.nd Or . ZIP 97230 DISTRICT GROUer_P CONST Z IRE ;SED BY
ARCHITECT OR TEL
ENGINEER NO
STATISTICAL CLASSIFICATION SEWER
ADDRESS CLASS NO Z/ DWELL UNITS L BK
CONTRACTOR AMaMb= lRooan�Nr%L USE ZONE LIC NO =20 d
ADDRESS NO 253,63fJ SPECIAL
CITY n� CONDITIONS
lhambra Calif• C ASSRAOfi ROAD DEPARTMENT APPROVAL REQUIRED YES[] NO❑
CONSTRUCTION LENDER
NAME AND BRANCH BLDG JETBACK FROM
FRON PROP LINEOF (STREET)
ADDRESS CITY HIGHWA } YARD - TOTAL SETBACK FROM TYPE OF EXISTING
SQ FT NO OF NO OF CHECK FRONT PROP LINE HIGHWAY WIDTH
SIZE STORIES FAMILIES ONE
DESCRIPTION OF WORK Ra-roof Small NEW ❑ + -
@C TI-Le i DD ❑ BLDG SET
C�7
SIDE PROP LINEOF (STREET) CLC
reset Ttle• LTER ❑ YARD - TOTAL SETRA FROM TYPE OF EXISTING C
HIGHWAY + -
-i EPAIRjn SIDE PROP L HIGHWAY WIDTH E a
USE F
V!
EXIST NG BLDG EMOL ❑ + Z
APPLICANT TEL CORNER CUTOFF YES ❑ O ❑
(PRINT) NO
BY (SIGNATURE) IN OPEN SPACE YES ❑ NO ❑
IN COASTAL PERMIT ZONE YES ❑ NO ❑
VALUATION$ 320eOO
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON
STRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE
LABOR CODE OF THE ST/%TE OF CALIFORNIA IN RELATING TO
WORKMEN S COMPENSATION INSURANCE
SIGNATURE OF--
PERMITTEE.
FPERMITTEE �r�
ADDRESS 12 So. Marengo Aves,
11nambra., a Q p FINAL BY
CITY NO 282_1958 DATE/D r — &7 f
PC PMT
MAKE CHECKS PA}ABLL TO FEE $ FEE $ 9.00
HARVEY T BRANDT COUNTY ENGINEER +��� �r�LID�
PLAN CHECK VALIDATION CK M O CASH rLIY�YA VALIDATION CK M O CASH
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5 7 6um-SEP-'10 1� 9 0 0,,&w
7SA638A 080803 B/Ts
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