HomeMy Public PortalAbout5060 1/2 SERENO DR_Building__ APPLICATION FOR BUILDING PERMIT
PPLICANT TO FILL IN (Pnnt or type only)
ING 50 O1 Sereno Dr COUNTY OF LOS ANGELES
RESS DEPARTMENT OF COUNTY ENGINEER
cITY Temple Ctty ZIP 91780 BUILDING AND SAFETY ION
SIZE OF LOT55ax397A17a NOW ON LOTNO OF S 3 DDRESS
QrfACT Survey t.
-12-13 LOT NO 13 LOCAL TY,
Qrce TEL NEAREST
OWNER NO 355-0437 CROSS ST
Rave HaitplanAS
ADDRESS MAP BOOK PAGE PARCEL
DISTRICT GROUP TYPE FIRE SED Y
CITY ZIP '1 (j CONST ZON
ARCHITECT OR TEL ^V(� -I L
ENGINEER NO
STATISTICAL CLASSIFICATION S WEIR MAP
ADDRESS CLASS NO�DWELL UNITS /qBK PG
CONTRACTOR Owner TEL USE ZONE MAP
NO
ADDRESS NO / A l+ SPECIAL
CITY LIC VVV CONDITIONS
CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑�
CONSTRUCTION LENDER
NAME AND BRANCH BLDG SETBACK FROM
FRONT PROP LINEOF (STREET)
ADDRESS CITY HIGHWAY } YARD TOTAL SETBACK FROM TYPE OF E%ISTING
50 FT>� NO OF NO OF CHECK FRONT PROP LINE HIGHWAY WIpTH
512E 200 STORIES 1 FAMILIES ONE yy
❑ } _ O
DESCRIPTION OF WORN NEW O
DD ® BLDG SETBACK FROM U
t ar Q e SIDEPROP LINEOF (STREET)
ALTER ❑ _ TOTAL SETBACK FROM TYPE OF EXISTING
HIGHWAY } YARD
EPAIR❑ SIDE PROP LINE HIGHWAY WIDTH ty
CL.
USE TI } - n
EXISTING BLDG EMOL Z
AP PRI NTIN T- Dave yamptoll NO 355-043 CORNER CUTOFF YES ❑ NO ❑
BY (SIGNATURE) IN OPEN SPACE YES ❑ NO ❑
IN COASTAL PERMIT ZONE YES ❑ NO ❑
VALUATION� � -
I HEREBY ACKNOWLE04E THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE ID CORRECT 1R0 AGREE TO COMPLY
WITH ALL ORDINANCES AND LAW( R!0 ATING BUILDING CON-
lTRUCTION ClRTI FY THAT IM OIN TN[ WORK AUTHORIZED
HEREBY I WILL EMPLOY AMY F[R OM IN VIOLATION OF TN!
LABOR COD! DT"TE 0• CALIFORNIA IN ELATING TO
WORKMEN D COMP M TIOX IMIIIR C
SIGNATURE OF
PERMITTEE
ADDRESS
FINAL �J n BY
TEL DATE /4/ -7
CITY NO L
JPMT
MAKE CHECKS PAIAHLE !O FEE $ FEE $n' a .{
HARVEY T BRANDT COUNTY ENGINEER Y
PLAN,CHECH VALIDATION CK M O CAC. PERMIT VAIMATIO*—,Yl—
M O CASH
a77-�J& 25 0 34.00 .50
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