HomeMy Public PortalAbout5116 A & B SERENO DR_Building__ -APPLICATION FOR �J
BUILDING PERMIT ✓
FOR APPLICANT TO FILL IN ADILDRFSSny/e.411 E�2cnf J
ADDRENG LOCALITY F I T- •« L o ��
NEAREST �=
CITY CJlf LE ZIP z9J2 CRDSSST
_ NO OF BL iTs—gR �-
SIZE OF LOT J k 39 NOW ON LOT MAP BOOK PAGE PARCEL
DISTRICT I GROUP TYPE FIRE )CESSED BY
TRACT BLOCK LOT NO T CONST ZONE
OWNER J F EL O 8 �� , SEWER MAP
STATISTICAL CLASSIFICATION -
ADDRESS CLASS NO 0 Z DWELL UNITS � � BK PG
CITY Gam' ��/ ZIP Q USE ZONE NMOP 2p -�
ARCHITECT OR TEL _ SPECIAL
ENGINEER NO T"- CONDITIONS
ADDRESS ROAD DEPARTMENT APPROVAL REOUIRED YES Cl NO❑
_ TEL BSETBACK FROM
CONTRACTOR NO LDG FRONT PROP LINE OF ISTREETI
LIC
ADDRESS NO HIGHWAY + YARD = TOTAL T PROP
INE TYPE A EXISTING
LIC FRONT PROD LINE HIGHWAY WIDTH
CITY - CLASS + a
CONSTRUCTION LENDER O
NAME AND BRANCH BLDG SETBACK FROM
SIDE PROP LINE OF (STREET) K
O
ADDRE CITY TOIALSETBACKFROM IYPEOF EmSTING h:
SO FT NO OF NO OF CHECK HIGHWAY + YARD SIDE PROP LINE HIGHWAV WIDTH
SIZE STORIES FAMILIES ONE
DESCRI ION OF WORK NEW + �� Z
DwL �b ADD CORNER CUTOFF YES ❑ NO ❑
s Y\ ALTER IN OPEN SPACE YES Cl NO (_1
REPAIRUSE IN COASTAL PERMIT ZONE YES ❑ NO ❑
EAISTI G BLDG S/N ATj'c!_ FAADEMOL
APPLICANT TEL /�^ PLJ� 716/
-I HEREBY ACKNOWLEDGE THAT I HAVE RFA&THb 1.0 AND SIAIE �y
THAT THE ABOVE IS CORRECT AND AGREE i0 COMRY TH ALL ORDINANCES
AND LAW$REGULATING BUILDING CONSTRUCTION I IFY TIMI IN DOING THE A
WORK AuTHORIZFD HEREBY I WILL NOT EMPLOY PERSON IN VIOLATK)N Of
THE LABOR CODE Of THE STATE OF C IFOONIA IN RELATING TO WORKMEN SCOM
PENSATK)N INSURANCE - -
SIGNATURE OF FINAL �. L
PERMITTEE DATE
ADDRESS 6 '
tEl P C b lov- Permit Fet
CITY NO
Issuance fee I
VALUATIONS `Y Total Fee
PLAN CHECK VALIDATION CK M 0 CABN PERM T VALIDATION mo cABH
388�.iUL 523102.15
-' - 587�SEP 2 1 0 347.63e
586iSEP 223 106.43 •
®s 76"UPS CE#0038 0/7e