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HomeMy Public PortalAbout5931 PRIMROSE AVE_Building__ APPLICATION FO_ REBUILDING PERMIT FOR APPLICANT TO FILL IN (Print or type only) �f p '�Tr FRESSBUILDING 931 Primrose COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER ple City ZIP BUILDING AND SAFETY DIVISION No.OF BLDGS. BUILDING NOW ON LOT 77�J ADDRESS TRACT S�Co BLOCK LOT N6..F / LOCALITY ~��y�� 7 TEL. NEAREST OWNER E. W. Mus NO. CROSS ST. ASSESSOR ADDRESS 5937 Primrose MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE PRO ESSED BY ARTY Temple City ZIP �D? coNST. zoI# ARCHITECT OR TEL. f •33 LJ��"Jam' ENGINEER NO' STATISTICAL CLASSIFICATION SEWER MAP ADDRESS CLASS NO-2= .DWELL.UNITS _ BK PG CONTRACTOR Rigid Mfg. CO. NOL _51 g USE ZONE MAP LIC. NO. 20 t2 ADDRESS 337 S. Woods AVE. NO. 15 SPECIAL LIC. CONDITIONS CITY Los Angeles CLASS C- ROAD DEPARTMENT APPROVAL REQUIRED YES[] NO❑ CONSTRUCTION LENDER NAME AND BRANCH BLDG.SETBACK FROM FRONT PROP.LINE OF (STREET) C ADDRESS CITY HIGHWAY } YARD _ TOTAL SETBACK FROM TYPE OF EXISTING C SQ. FT. NO. OF NO. OF CHECK - FRONT PROP. LINE HIGHWAY WIDTH SIZE STORIES FAMILIES ONE C + DESCRIPTION OF WORK NEW © u ADD ❑ SIDE PROPEL NE OFOM (STREET) v Re-roof with ALTER El HIGHWAY YARD TOTAL SETBACK FROM TYPE OF EXISTING Composition SIDE PROP. LINE HIGHWAY WIDTH USE OF REPAIR❑ EXISTING BLDG. DEMOL ❑ + APPLICANT TEL CORNER CUTOFF YES ❑ NO ❑ (PRINT) NO. BY (SIGNATURE) IN OPEN SPACE YES ❑ NO ❑ IN COASTAL ZONE YES C] NO [:]VALUATION$ 896.50 CATEGORICAL EXEMPTION YES❑ NO ❑ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL AND STATE THAT THE ABOVE IS CORRECT AND AGREdNT Y IMPACT EXEMPTION DECLARATION SIGNED (DATE) WITH ALL ORDINANCES AND LAWS REGULATING BN- STRUCTION. I CERTIFY THAT IN DOING THE WORD IMPACT REPORT PROCESSED (DATE) HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLE LABOR CODE OF THE STATE OF CALIFORNIA IN O WORKMEN'S COMP ENSA�t�Uh'rTt$URAflGfis COMPAN SIGNATURE OF ++aa++ 1i ilii VV PERMITTEE ADDRESS 337 S. Wood Avenue Ij FINAL BY CITY Los Angeles NOL• DATE ,pMAKE CHECKS PAYABLE TO: FEE � FEE � 15.00 HARVEY T. BRANDT, COUNTY EN PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIONCK. M.O. CASH 4 1 8 273 DEC20 1. D 1 5,OOA 76p638p CE#803 12/72 r /ail