HomeMy Public PortalAbout5415 SANTA ANITA AVE_Building__ Os 76A639F1
.CE-/H03(Fli&,78)
APPLICATION R . r UILD.I PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUILDING
BUILDING
ADDRESS S (,Ly�aL
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ADDRESS 4.5 Cj l J 1 - LOCALITY
NEAREST
CITY �- �/ ZIP• CROSS ST.
NO.OF BLDGS. / ASSESSOR
SIZEOF LOT J O v NOW ON LOT. J MAP BOOK PAGE PARCEL
DISTRICT GROUP TYPE FIRE PROC ED BY
[A36P BLOCK LOT NO. CONST. f E
TEL. �j aS 'O 8 Y
OWNER ',a - _. NO.,
0370.1
Q.
�J STATISTICAL CLASSIFICATION WER MAP
ADDRESS - SPL MJ CLASS IVO. 0 DWELL.UNITS / BK PG
CITY ra yyt (r ZIP - a
ARCHITECT OR„ NO. VALUATIO
EER 3c7, D O O
ENGIN
ADDRESS 'BLDG.SETBACK FROM /) ,
T L FRONT PROP.LINE OF `-J STREET)
CONTRACTOR !�/^B ylJ� 1 HIGHWAY + YARD _ TOTAL SETBACK FROM TYPE-OF EXISTING
ADDRESS Lb TeL-% lg-Cr/ . F IV6. Iffl FRONT PROP.LINE H,IIGGHHWAY WIDTH
.�� LIC. ) + - / 'k lea
CLASS ~ /
CONSTRUCTIO LENDER BLDG.SETBACK FROM ,
NAME AND BRANCH DIft �•..�� SIDE PROP..LINE OF (STREET)
to C�V/n TOTAL SETBACK FROM TYPE OF EXISTING -
, � HIGHWAY + YARD = SIDE PROP.LINE HIGHWAY WIDTH
ADDRESS WDO- CITY
SIOZEFT1D1glo N 0-I NO.OF CHECK + _ 9
FAMILIES ONE ag
DESCRIPTION OF WORK NEW P.C.Fee$ Permit Fee O!l
ADD 0 T . DU Issuance Fee ,U'd
ALTER ❑
REPAIR I Total Fee 3
USE OFDEMOL ElEXISTING BLDG. ,`A J•:� Z
APPLICANT -). TEL C 44 7,
(PRINT)JW� �� .! NO
D fI
c�+ c �% Q
BY(SIGNATURE)' � '�� - �� >
IHEREBY AK&OWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE r•� p�.�'�� % ,
THAT-THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES. f yi c S
AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE V
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, z I �•4 _ f LY
PENSATION INSURANCE. -
IL
SIGNATURE OF
PERMITTEE _,� .�l l C',
ADDRESS j� Z
/. TEL _ O L� c r, 0 0 0
CITY 's[ lG L NCS- j
USE ZONE MAP
s �
/1 NO. U a
J� SPECIAL
CONDITIONS
FINAL 3 ^CJ p e�-
DATE - �W.