400 West Colorado Boulevard | Pasadena Elks Lodge No. 672 B.P.O.E.
ATTACHMENT A
APPLICATION
PASADENA PERMIT CENTER
www.cityofpasadena.net/permitcenter
Supplemental Application for
HISTORIC DESIGNATION
Revised 10/2022
W:\Design-hp\Permit Center Applications & Handouts 1 Note: In addition to this application, a completed Planning Division Master Application Form is also required. Submit all materials via email or file transfer to [email protected].
PROPERTY PROPOSED FOR DESIGNATION
1. Name of Property:
2. Property Address:
3. Date of Original Construction:
4. Original Owner:
5. Original Architect / Builder:
DESIGNATION CATEGORY
(CHECK APPROPRIATE BOX—SEE CRITERIA ON PAGES 2 & 3 FOR MORE INFORMATION):
HISTORIC MONUMENT
LANDMARK
HISTORIC SIGN
LANDMARK TREE
BRIEF DESCRIPTION OF PROPERTY & HISTORICAL PHOTOGRAPHS
Briefly describe the property proposed for designation, indicating whether the entire site or a portion of the site is the subject of the nomination (e.g., how many buildings or objects on the site are included in the nomination) or if the nomination is for an object, sign or tree. If applying for historic monument designation, specify whether any interior public or semi-public spaces are included in the nomination. A site plan and/or floor plan may be used to supplement the narrative description.
Please also submit recent and, if available, historical photographs.
SUPPLEMENTAL INFORMATION ON SIGNIFICANCE OF PROPERTY
With this application, please attach information that will assist staff with the preparation of a designation report. Books, photographs, articles, and other archival information will all be useful to document the significance of the nominated resource. If applying for historic monument designation, an evaluation by a qualified architectural historian may be required to demonstrate exceptional or regional, statewide or national significance. Refer to bibliography, historical photographs, chronology, and other supporting information.
PASADENA PERMIT CENTER
www.cityofpasadena.net/permitcenter
Supplemental Application for
HISTORIC DESIGNATION
Revised 10/2022
W:\Design-hp\Permit Center Applications & Handouts 2
LEGAL DESCRIPTION
Attach a copy of the most recently recorded legal description for the property (usually in the deed for the property or other documents when the property was purchased—also available from a title company).
CRITERIA FOR DESIGNATION
Check the box under the category checked on first page that corresponds to the criterion/criteria under which you are nominating the property, object, sign or tree for designation. Multiple boxes may be checked if applicable. Submitted description and supplemental information should provide an explanation of how the property meets the specified criterion/criteria.
CRITERIA FOR DESIGNATING AN HISTORIC MONUMENT
(May include significant public or semi-public interior spaces and features) A. It is associated with events that have made a significant contribution to the broad patterns of the history of the region, state or nation.
B. It is associated with the lives of persons who are significant in the history of the region, state or nation.
C. It is exceptional in the embodiment of the distinctive characteristics of a historic resource property type, period, architectural style or method of construction, or is an exceptional representation of the work of an architect, designer, engineer, or builder whose work is significant to the region, state or nation, or that possesses high artistic values that are of regional, state-wide or national significance.
D. It has yielded, or may be likely to yield, information important in prehistory or history of the region, state or nation.
CRITERIA FOR DESIGNATING A LANDMARK
A. It is associated with events that have made a significant contribution to the broad patterns of the history of the City.
B. It is associated with the lives of persons who are significant in the history of the City.
C. It embodies the distinctive characteristics of a type, architectural style, period, or method of construction, or represents the work of an architect, designer, engineer, or builder whose work is of significance to the City or possesses artistic values of significance to the City.
D. It has yielded, or may be likely to yield, information important locally in prehistory or history.