HomeMy Public PortalAbout5429 SANTA ANITA AVE_Building__ 76A638A CE #803 1/71 ,
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES ASSESSOR
DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL
BUILDING AND SAFETY DIVISION BUILDING l 7
ADDRESS
COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
Print or tvoe on CROSS ST.
BUILDING
DISTRICT NO, GROUP TYPE PROCESSED BY
ADDRESS CONST.
' --"� � � -
STATISTICAL CLASSIFICATION SEWER M&P--�--
LOT NO. BLOCK
CLASS NO. —) DWELL,UNITS = , BK PG
TRACT !i USE ZONE MAP 1
NO.OF BLOGS. 1 NO. jr
SIZE OF LOT NOW ON LOT SPECIAL
USE OF ' CONDITIONS
EXISTING BLDG.
TEL.
OWNER NO. BLDG.SETBACK FROM
ADDRESS `
FRONT PROP.LINE OF (STREET)
TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL
CITY - HIGHWAY WIDTH FROM C.L.
ARCHITECT OR TEL. } _
ENGINEER NO. BLDG,SETBACK FROM
ADDRESS SIDE PROP.LINEOF (STREET) a�
D
TEL. , TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL U
CONTRACTOR NO, - '� HIGHWAY WIDTH FROM C.L. yU
r LIC. J
ADDRESS 'NO. } = w
LIC. C
CITY CLASS CORNER CUTOFF YES ❑ NO ❑ Q
CONSTRUCTION LENDER
NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS a
w
ADDRESS r
SQ. FT. NO. OF NO. OF NEW ❑
SIZE STORIES FAMI,LIES ❑
USE OF ADD
STRUCTURE
ALTER ❑
SIGNATURE OF REPAIR❑
APPLICANT DEMOL
VALUATION $ APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. PMT, --` FOUNDATION: LOCATION
FEE $ FEE S �� �� FORMS, MATERIALS
FRAME: FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION,
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS
STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT.
LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO
WORKMEN'S COMPENSATION,INSURANCE. LATH, EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS FINAL
JOHN F. LEWIS. PRINCIPAL STRUCTURAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION afc M.O. CASH