HomeMy Public PortalAbout4902 PERSIMMON AVE_Building__ PS 76A638A L1
CE#803(REV.6/78)
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAF
J' FOR APPLICANT TO FILL IN ADIDRESS LDING 1O /
BUILDING
ADDRESS 4902 N• Persimmon LOCALITY (, `
CITY Temple City ZIP c OSSST.
NO.OF BLDGS. ASSESSOR
SIZE OF LOT NOW ON LOT MAP BOOK PAGE I PARCEL
q DISTRICT I GgggQQQUP TYPE FIRE SED Y If
TRACT / D L BLOCK LOT N CONST. ZONE
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OWNER A•R• Lefeure TEL 444-6471 _'�< ��?
ADDRESS
4902 N• Persimmon STATISTICAL CLASSIFICATION SEWER M
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CLASS NO.�_DWELL.UNITS BK PG
aTYTemple City ZIP -2
ARCHITECT OR TEL. VALUATION $ •�p�^�r1
ENGINEER NO.
ADDRESS BLDG SETBACK FROM
FRONT PROP.LINE OF (STREET)
NO. 22-6 K TOTAL SETBACK FROM TYPE OF EXISTING
CONTRACTOR Mont ebP.11O Rf •
p LIC. HIGHWAY + YARD = FRONT PROP.LINE HIGHWAY WIDTH
ADDRESS868 Truckway NO.2488 2
LIC. _
CITY Montebello C-39 +
CLASS 7 BLDG.SETBACK FROM
CONSTRUCTION LENDER SIDE PROP.LINE OF (STREET)
NAME AND BRANCH
HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING 9:ADDRESS CITY SIDE PROP.LINE HIGHWAY WIDTH C
SQ.FT. NO.OF NO.OF CHECK + I V
SIZE STORIES XI FAMILIES ONE 0
❑ 15.00 °
DESCRIPTION OF WORK Reroof eXlStln EW P.C. Fee$ Permit Fee V
hl&7— W -1 asphalt Shng ADD ❑ bi
Issuance Fee 7•00
ALTERC322-00 Z
_
REPAIR Total Fee
USE OF DEMOL
EXISTING BLDG. garage i� O
APPLICANT- TEL �[
(PRINT) NO. -7-7 v-le G
J
BY(SIGNATURE)
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE Y
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES W
AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE _
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF V �8 A
. A
PENSATION INSURANCE
THE LABOR CODE OF THE STATE OF FORNIA IN RELATING TO WORKMEN'S COM. Z.
d
SIGNATURE OF OA-- P • - 2200
PERMITTEE
ADDRESS t uc kwa Z • • - 22005
T TEL. C
Montebello Ontebello NO. 722-697c 0329-79
USE ZONE MAP `
PE
SPKL/
IAL �
CONDITIONS
3E
FINAL BY
DATE