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Home My Public Portal About9163 WEDGEWOOD ST_Building__ w, - ; APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO,FILL IN (Print or type only) BUILDING COUNTY OF LOS ANGELES , ADDRESS DEPARTMENT OF COUNTY ENGINEER CITY L �? ZIP BUILDING AND SAFETY DIVISION / % NO.OF BLDGS. `` BUILDING SIZE OF LOT' �O y . NOW ON LOT I .ADDRESS s TRACT BLOCK LOT NO, LOCAL) Y , = NEAREST OWNER `�SLA L7 NOL CROSS ST. ` / MHP BOOK PAGE PARCEL r ZIP ]� CONST. ZONE i ARCHITECT OR TEL. ENGINEER' NO. L STATISTICAL CLASSIFICATION FEWR M ADDRESS CLASS NO.lZ�DWELL•UNITS PG CONTRACTOR / NO U E ZONE-MAP LIC. NO. ADDRESS (J NO. SPECIAL'- CITY PECIAL'- CITY LIC. CONDITIONS CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ CONSTRUCTION LENDERr NAME AND BRANCH .N'4PA1 C BLDG.SETBACK FROM 3 FRONT PROP.LINE OF (STREET) i ADDRESS CITY HIGHWAY YARD TOTAL SETBACK FROM TYPE OF EXISTING L SQ. FT. NO. OF NO. OF CHECK FRONT PROP./LINE HIGHWAY WIDTH C SIZE . I7, STORIES FAMILIES I ONE DIPTION OF WORK NEW C ADD ❑ SID PROP.ACK LINE M (STREET) 'SIDE PROP.LINE OF ALTER' ❑ HIGHWAY •F YARD = TOTAL SETBACK FROM TYPE OF EXISTING_ REPAIR❑ SIDE PROP., LINE HIGHWAY WIDTH USE OF } ti' EXISTING BLDG. DEMOL ❑ APPLICANT ✓ r (��// TEL CORNER CUTOFF YES ❑ NO ❑ (PRINT) j2j, J&C� 7 NO. .. BY (SIGNATURE) IN OPEN SPACE ; YES ❑ NO ❑ IN COASTAL ZONE YES ❑ NO ❑ VALUATION CATEGORICAL EXEMPTION YES❑ NO ❑ I HEREBY ACKNOWLEDGE THAT IHAVE READ IS APPLICATION ENVIRONMENTAL AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY IMPACT. EXEMPTION DEC LARATION-S I GNED (DATE) WITH ALL ORDINANCES AND,LAWS REGULATING BUILDING CON- IMPACT REPORT PROCESSED ` (DATE) STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO rry� �� 'r )-�fA� .�r'� ;✓ar i9./•��7'It ri ) WORKMEN'S COMPEN TION I URANC / ,sY L t .r .!.-t9"•`s SIGNATURE OF ( —�.". Pf��CIA,: �T 10C PERMITTEE ADDRESS ® FINAL ' TE /f CITY �4• NOL. DATE k---7 �7,/ BYE// MAKE Cf1LGKS PAYABLE TO P.C. PMT. FEE p FEE HEY T. BRANDY, COUNTY EARVNGINEER �rU �B 10� PLAN CHECK VALIDATION CK. M.O. CASH PERMI VALIDATION CK. M.O. CASH 57.9L"-;'IAPR 1823 D 77.85 © a ;�lr ;,2 5 XNAY 10 2 3 6✓ 4.0 5•dam � -76A638A CE*803 7/73 9 2 6 r'*TMAY 10 1 �: 1 3-6.5 0 ' ;? APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN (Print or type only) FDDR l0 3 �� COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER zip BUILDING AND SA ETY DIVISION NO.OF BLOGS. BUILDING LOT )/ NOW ON LOT ADDRESS TRACT BLOCK I LOT NO //�� LOCALITY OWNER � NO. CROSS ST. � MAP BOOK PAGE L ZIP DISTRICT GROUP TYPE FIRE PROLE ED BY CITY . 'OS r) CONS ZONE 1 ARCHITECT OR TEL. VVC�/K ENGINEER NO. STATISTICAL CLASSIFICATION SEWER AP ADDRESS CLASS N�_DWELL•UNITS `� CONTRACTOR EL. USE ZONE MA NP LIC. O. y� (/ L ADDRESS NO.. jj SPECIAL LIC. CONDITIONS CITYty-11CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ CONSTRUCTION LENDER NAME AND BRANCH BLD . ETBACK FROM FRCfNT PROP.LINE OF (STREET) c C ADDRESS CITY HIG WAY 'F YARD = TOTAL SETBACK FROM TYPE OF EXISTING C SQ. FTNO. OF NO. OF CHECK FRONT PROP. LINE HIGHWAY WIDTH ` SIZE /-))?) STORIES FAMILIES I ONE _ CCCF t = L DESCRIPTION OF WORK NEW ❑ ADD ❑ RA,SIDE SIDE PROP.LINE OF ALTER ❑ _ TOTAL SETBACK FROM TYPE XISTING .q_ HIGHWAY + YARD - SIDE PROP. LINE HIGHWAY H REPAIR❑ USE t EXISTING BLDG. DEMOL /,/7 - /I�, �,/ CORNER CUTOFF YES ❑ NO ❑ APPLICANT r��!- JT Lr'1+1� BY (SIGNATURE) IN OPEN SPACE YES ❑ NO ❑ IN COASTAL ZONE YES ❑ NO ❑ VALUATION$ �� CATEGORICAL EXEMPTION YES❑ NO ❑ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE) WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION, I CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE) HEREBY I WILL NOT EMPLOY ANYPERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COMPENSA INS RANCE. SIGNATURE OF PERMITTEE ADDRESS G TE _�/ FINAL' �j BY CITY NOL / DATE 2� /p I �.� MAKE CHECKS PAYABLE TO: F'EE $ / FEE HARVEY ,T. BRANDT. COUNTY ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH CK..P IT VALIDATION M.O. CASHe $ 1 '0 6.00 °'d Y 76A638A CERS03 7/73 i tic 78) APPLICA ON OR" BUI , NG PERMIT. COUNTY OF.LOS ANGELES BUILDING AND SAF Y FOR APPLICANT TO FILL IN AD.UR ss BUILDING + ADDRESS LOCALITY /. NEAREST l + CITY ZIP CROSS ST. NO.OF BLDGS. ASSESSOR SIZE OF LOT D ?i NOW ON LOT MAP BOOK PAGE. PARCEL DISTRICT GROUP TYPE FIRE ESSED BY, TRACT BLOCK LOT O." ' CONST. ZONE . - ,s NO OWNER STATISTICAL CLASSIFICATION SEWER'MAP ADDRESS CLASS NO. DWELL.UNITS__�j BK F�PG CITY �r�/ft.Q�' ZIP ARCHITECTO ''��"" TELJ/ �j VALUATION $ ENGINEER Gv� NO. 16 r? lS U�y1 ADDRESSC� [J�/ BLDG.SETBACK FROM TEL. ` 'FRONTPROP.LINEOF •(STREET) ' CONTRACTOR TOTAL BACK FROM TYPE OF EXISTING LIC 22 HIGHWAY t YARD = FRONT PROP.LINE AY WIDTH ADDRESS "e NO31ons— c`� LIC:' . . . +, '�j� _ ,. 1. CITY Jv�/� CLASS 'v CONSTRUCTION LENDER .� BLDG.SETBACK FROM SIDE PROP.LINE OF (STREET) NAME AND BRANCH HIGHWAY •+ YARD = TOTAL SETBACK FROM I TYPE OF EXISTING � ADDRESS. CITY SIDE PROP.LINE IHIGHWAY WIDTH. SQ.FT_ NO.OF NO.OF CHECK + = 0 SIZE STORIES FAMILIES ONE 0 USAN E MAP DESCRIPTION OF WORK + NEW ❑ ' NO SPECIAL !� g� ADD CONDITIONS �. J� ALTER ❑ FINAL BY REPAIR ❑ DATE �r7—Pc USEOF DEMOL ❑ EXISTING BLDG.. .. L,. _ O LICANT -4--1 APP( (PRINT) I (�K- NO. 4-/7 fl BY(SIGNATURE I HEREBY CKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE 'V ' THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES W AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE • ' Z WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF " OF 9 6 1.2 A•' THE LABOR CODE OF THE STATE OF CALIFORNIA IN•RELATING TO WORKMEN'S COM- _ _ -. Z� PENSATION INSURAN # v0000l SIGNATURE OF 2 0 1 51,00 PERMITTEE ADDRESS v Z o - 1 5 1,0 0 6 TEL.(� O CITY -- - NO.`LI3; V6 +. C 0.3.2 8—_8 0 P.C.Fee$ ' Permit Fee Issuance Fee Total Fee _