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Home My Public Portal About9070 BROADWAY_Building__ I 76A638A CEY8035-66 APPLICATION FOR BUILDIN PERMIT ILJI COUNTY OF LOS ANGELES BUILDING O DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION- LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST COLEMAN W. JENKINS.SUP'T.OF BUILDING CROSS ST. DIS=RCT N R P TYPE PR BY FOR APPLICANT TO FILL IN Lo CONST: 4 BUILDING STATISTICA> SIFICATION SEWER MAP ADDRESS O CLASS NO. DWELL UNIT$ 6K / PG LOT NO. - BLOCK USE ZONE MAP /7 / /�( NO. TRACT SPECIAL N0. OF SLOGS. CONDITIONS SIZE OF LOT NOw ON Loi rEF OF S ING D BLDG. SETBACK FROM - ER cY/ lo. 7 FRONT PROP. LINE OF - — (STREET) JJ TYPE OF E%ISTING SETBACK HIGHWAY } YARD — TOTAL RESS 0 r'O LY4✓iE HIGX WAT WIpTH FROM C.L. Y BLDG. SETBACK FROM HITECT O .TEL. SIDE PROP. LINE OF (STREET) INEER NO. TYPE pF EXISTING SETBACK HIGHWAY } YARD = TOTAL RESS �7 HIOHW AT WIDTH FROM C.L. TRA �J !/'al�E//�� / D', w NoL�33/r,j3 + RESS ,?Z Y/'-rJ 6D y� NO 77 E] O CORNER CUTOFF YES NO 0 QC Y D c �t,r CSC 5 SEE REVERSE SIDE FOR SPECIAL APPROVALS G DESCRIPTION OF WORK W a N ADD ALTER REPAIR DEMOLISH Z FT. .� NO. OF NO. OF E STORIES FAMILIES C L. C Rol OU L/Y G ATURE O �LICANTUATIONS . APPROVAL$ DATE INSPECTOR'S SIGNATURE . PMT. lf-0O FOUNDATION, LOCATION Pj FEE S V r� FORMS, MATERIALS FRAME, FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS BUILDING CONSTRUCTION. I CERTIFY THAT. IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA. LATH. INT. TION OF THE LABOR DODD OF THE STATE OF CALIFORNIA RELAT. ING TO WDR KMEM ATIO�RAr LATH. EXT. SIGNATURE F HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS 771q u- hnC I(/,f- FINAL JOHN F. LEWIS, PRINCIPAL STC RAL ENGINEER PLAN CHECK VALIDATION CK. M.D. CASH _ PERMIT VALIDATION cK. M.O CASH L�� 3•a2:7 0 JUL 5 1 D 8.0 0 l APPLICATION FOR BUILDING PERMIT �1 COUNTY OF LOS ANGELES BUILDING �� DEPARTMENT OF COUNTY ENGINEER ADDRESS C. _L BUILDING AND SAFETY DMSION LOCAL TY /E c GYM .JOHN A. LAMBIE, COUNTY ENGINEER .NEAREST WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST. DISTft ICT OUP TYPE P CESSED BY FOR APPLICANT TO FILL IN �! p I CONST BUILDING ,7 -T 'l C( SEWER MAP - ADDRESS O /G/ F .�/Z CLASS. NOSTATISTICAL � DWELL: UNITS O I �K I?PG �Y�-LASSIFICATION LOT NO•`a� BLOCK iJ MAP ZO / � HTN T�,E YES N=O oo NUMBER TRACT ��Z 'n USEZONE SPECIAL SIZE OF L C I NO.OF SLOGS. /�/ CONDITIONS NOW ON LOT USE OF -` �J� EXISTINOBLOG. E$J(XNGf /y+//vE BUILDING EXIST. TEL. YARD HWY STREET NAME SETBACK WIDTH .OWNERJ/!/-A/ Gv/dF-Al2t3 NO. FRONT } O /� P. L. ADDRESS%L?7e 0I ��+:Ja DLf!Ifi� SIDE ARCHITECTO TEL. P.L. ENGINEER .>< NOaP�18/& INSPECTION RECO r ADDRESS (1 J� zo S TEL O CONTRACTOR ✓c �OO #4sta' ; Pi - ' / OADDRESS F L. 4 0 DESCRIPTION OF ORS ,y/ a NEX ADD ALTER REPAIR DEMOLISH f= SO.FT. t D1 NO.OF NO.OF , I/J /� / -7 GY Z SIZE ' 7S STORIES FAMILIES _„ I USE OF STRUCTURE ` •1 Sbla L «'O s' &d Al r/ SIGNATURE OF J _`//1 �// - / a7. -•J� )lT a.v• -- +I APPLI VALUATION S ) r� APPROVALS DATE. INSPECTGR'S SIGNATURE FEE ` I FPMT.EE S /,OO FO FORMS,MA�UNDATONTERIIALS LOCATION !� FRAME: FIRE STOPS, 1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS BUILDING CONSTRUCTION. I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT 15 ISSUED I SHALL NOT LATH, INT. EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBUECT TO THE WORKMEN'S COMPENSATION LAWS OF CALIFORNIA. ,:ATH. EXT. SIGNATUR OF ' HOUSE NUMBER COR- PERMITTE L RECT AND POSTED ADDRESS 1 - FINAL��"'��';l L "$Nrl d• l r/6 CLYDE N. DIRLAM. PRINCIPAL ST CTURAL ENGINEER PLAN CHECK VALIDATION cK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH I ( Dzo60 eEB,16230 3 .75 I p ' 6 67 FES 16 1_ a 15. 00 t 76AU30A CE•'ED32-63 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BBUILDIN yB' Q69/?p D!I/R DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST /A WILLIAM A. JENSEN. SUR'T OF BUILDING CROSS ST. �J TT �V ,/ UISTRICN N9. GROUP TYPE .�/ PROCESSED BY FORAPPLICANTTO FILL II/LLri N V�Oj CONST.//// ADDRESS y BK BUILDING S$ p-,Q .B�Qf}D/,v r1 STATISTICAL CLASSIFICATION $EPG • 'CLASS. NO.Ii—c-LDWELL. UNITS LOT NO. BLOCK WATER NOT REQUIRED ❑ RECEIVED ❑ TRACT CERTIFICATE: �J SIZE OF LOT 0��d v NOW ONSLOG LOTS NOP O-c/ / HIGHWAY MAPRCLEI STATE MAJOR SECOND OCAL USE ZONE SPECIAL USE OF /// // CONDITIONS EXISTING BLDG. W' I V _ I OWNER )w NO.p{73c9'7 1 BUILDING EXIST. SETBACK YARD HWY STREET NAME WIDTH ADDRESS 9070 K-sRORO NJR v r<M!',if c;rjA FRONT ARCHITECT OR TEL. P. L. ENGINEER �L�NF NO. SIDE y P. L. ADDRESS O V TEL _ CONTRACTOR NO. I O r ADDRESS V DESCRIPTION OF WORK i Z NEW ADD ALTER REPAIR DEMOLISH SIZE T a / X 2 NO. OF NO. OF. STORIES FAMILIES 1 USE OF T STRUCTURE SIGNATURE OF APPLICANT a°1l VALUATION S �A3o VV APPROVALS ATE INSPECTORS SIGN#�T41RE FOUNDATION: LOCATION FEE S FEE S ✓// FORMS. MATERIALS FRAME: FIRE STOPS. 1 HEREBY AC THAT THEI ABOVE IS CORRECT AND TANDHIS APPLICATION BRACING. BOLT$ WITH STATE TOUT THE ORDINANCES IS CAND STATE AND AWS E COMPLY FURNACE: LOCATION. WITH NGL COUNTY TION_ 1NCES ANDATILAWS REGULATING WORK ,GAS VENT. DUCTS AUTHORIZE CONSTRUCTI WILL CERTIFY EMPLOY IN PORNO THE WORK VIOLA- TION THE HERESY 1 WILL NOT EMPLOY ANY PERSON IN RELAT- LATH. INT. TION OF THE EA ; CODE OF THE NSt OF C LIFORI IA RELAT- INGTO WORKME O EN AT NS NI LATH. EXT. SIGNATURE O HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS FINAL JJ� JOHN F. LEWIS, PRINCIPAL STI ENGINEER PLAN CHECK VALIDATION CK MO. GASH _ PERMIT VALIDATION DK. M.G. Z.G. ��ro6220Z RAR 4 1 D 1, 150- E' A. ' '• '/man '^. • 1 �VY(�l"v VP�-� T6R BA'CESEOJd APPLICATION FOR BUILDING PERMIT COUNTY OF'LOS ANGELES, BUILDING DEPARTMENT OF COUNTY ENGINEER - AooREss BUILDING• AND SAFETY DIVISION LODnury JOHN A. LAMBIE. COUNTY ENGINEER NEAREST WILLIAM A. JENSEN. SUPT"OF BUILDING CROSS ST. UISTRICT NO. G OUP TYPE ESSED BY FOR APPLICANT TO FILL IN CONST. BUILDING STATISTICAL CLASSIFICATION 5 WER MAP . ADDRESS +�� Z r Gfl4 CLASS. NO.�DW ELL. UNITS �"' BK G , -LOT NO. iBLOCK WATER NOT REQUIRED RECEIVED • I TRACT Z '' f CERTIFICATE:MAP / HIGHWAY STATE MAJOR SEGO , LOCA NO.OF BLDGS. - NO. ( . (CIRCLE) SIZE OF LOT (p0 NOW ON LOT Z USE-ZONE SPECIAL 'USE OF - CONDITIONS EXISTING BLDG. O IW'E OWNER TEL. j,J NO.' 4T 73967 BUILDING' EXIST. -" .SETBACK YARD HWY STREET NAME WIDTH ADDRESS 9070 IS-, C4 L?WJ'}'Y EM L TY- • FRONT ARCHITECT OR TEL P. L. O ENGINEER owpa/L- Ifs No SIDE' ADDRESS - dO TEL.' / !-A U /7/ CONTRACTOR ' NO.: U ADDRESS ` ' DESCRIPTION OF WORK . O NEW' AD w.I"ALTER REPAIR DEMOLISH ,{ IS4l/A.•.q .TXAi7W fJJiHE'��dC•. y SZET. (7 p 'STORIES � ' NO. OFAMILFES ''7 r2 •~ ? USE OF14 STRUCTURE u'� - H Y3�6�-f � �� 4 MA �/✓ Y�'YI/r� ISIGNATURE/OF .uoGWIC .APPLICANT //'��{{,� 10 'VALUATIONS - ,�f�,V. - •'APPROVAL95 r-fy. DATE, INSPECTOR S SJGNATURE 99 FOUNDATION: .LOCATION / FEE $ FEE S7L- % FORMS:MATERIALS FRAME: FIRE STOPS. / I HEREBY THAT THE THAT I HAVE READ THIS APPLICATION F BRACING, BOLTS ' AND STATE THAT THE R H.A IS CORRECT ANO AGREE REGULATING FURNACE: LOCATION. WITH ALL GOT NTY ORDINANCES AND STATE LAWS RTHELW ING GAS VENT. DUCTS ABUILDINGTAUTHORIZED HEREBY WILL CERTIFY THAT ANY DOING TJN VI O VIOLA- TION HEREBY WILL NOT"EMPLOY ANY PERSON IN VIOLP�' LATH. HNT.TION OF THE LABOR CODE OF THE STATE OF-�LFO IA RELAT,ING TO WORN MEN MPENBRTION�I SU ELATH. EXT. . SIGNATURE O .HOUSE NUMBER COR- PERMITTEE RECT AND POSTED � I 'ADDRESS L44 "FINAL' / ✓� I/�{' / � A JOHN F. LEWIS. PRINCIPAL SThyCTVRAL ENGINEER i PLAN CHECK VALIDATION `' cK M. . <Asy ' _ PERMIT VALIDATION cK. M.O. DASH' ' LIM' 5 &� FES 3 D 16-25A Lli� 0 6 2 9 hiAR 4 1 D 3 2.50:-- e v' SVORKERS"COMPENS'A'TION'DECLARATION _ hereby'hffirm that I have a certificate of consent to self //p�� O O M gyp} ^yR M O II�p RO �Fp��//(�� jI I� insure, or a cerl'ficote Qf Workers' Compensation Insurance, /rVPPUCATOOU V FOR �=+U-OLDNG PuuUMOT 'may or a certified copy thereof(Sec. 3800, Lab. C) COUNTY OF LOS ANGELES BUILDING.AND SAFETY Policy No.551414- E'ompany S 7ATF3 P✓t-19 Certified copy is hereby furnished. BUILDING FOR APPLICANT TO FILL'IN ADDRESS Ts7� Certified copy is filed with the county building inipec- BUILDING j� tion department. �/�/ ryJ,1�', ADDRESS D (fi t L 1�-(�A"t)LL/ Date 1- 14- S Applicant• > A4' CITY (�y.L — IL'j - ZIP i yo LOCALITY CERTIFICATE OF EXEMPTION FROM WOR S' NO. OF BLDGS. NEAREST - COMPENSATION INSURANCE SIZE OF LOT 02;iv 'Y• I kp J NOW ON LOT G CROSS ST. This section need not be completed if the ASSESSOR. ( p permit is for one TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL hundred dollars ($100)or less.) _ TEL ,Lre' v USE ZONE MAP I certify that in the.,Performance of the work for which this OWNER •• N ` 7 NO. z•SJ3 fi NO* permit is issued, I shall not employ any person in any mannerSPECIAL IlLO so as to become subject to the Workers'Compensation Laws. ADDRESS �U JV :(j�G71`T'�i.✓ - '- '1 CONDITIONS V Date `- Applicant aTY VT' rMf c.� ZIP 17 (,� - - - _ • O ARGINEER OR TEL. .DISTRICT GROUP TYPE FIRE PROCE ED BY L.. NOTICE TO APPLICANT:'If, after making this Certificate of CONST. Z E 0 Exemption, you should become subject to the Workers' ENGINEER NO. Compensation provisions of the Labor Code, you must forth- J. ! -. 1 N with comply with such provisions at this permit shall be ADDRESS - TEL STATISTICAL CLASSIFICATION APT. CON Z deemed revoked., CONTRACTOR 4 )�.' NO. r Ib` Q 'I LICENSED CONTRACTORS DECLARATION -- - - LIC CLASS NO. DWELL. UNITS_ s1 I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS `. N NO, SEWER MAP (commencing with Section 7000)of Division 3 of the Business and LIC ^. Professions Code;and my license is in.full force and effect. CITY CLASS BK VALIDATION -y SO. FT_ NO. OF _ NO. OF - CHECK- - License Number Z3 J 3 S•7 Lic.Clas/s "-��j SI2E j STORIES /FAMILIES ONE VALUATION Contractorl�c-R('i+i) KY�s-_Date I /� L DESC_RIP!;?V OF WORK 'DYI l•ii A-Cw ki N - EJ UO $ADD '❑ 7 — D I am exempt under Sec. ALTER ❑ qq � 1338� 8.8P.C, for this reason J _ REPAIR ❑ $ - — - — - M • a s a e A - Date: EXISTUSE ING BLDG. DEMOL ❑ ( e e q�,.'� 5 tl -�- Signature— �.= APPLICANT TE ^ V FINAL OWNER-BUILD ECLARATION (PRINT) k.JIII—t �Oe^L-•J'" NO. �'¢+ -DATE t o e.e q 5 6- 1 hereby affirm thatl am exe pt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS .13�(� �r 1Z QW FINA Q 1. 14-85 - Professions Code):" - `• - REE BY OBULLRING I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will_do the work and the structure is not intended or offered for sale(Sectio LOCALITY D - - - cc--TT 7044, Business and Professions Code). MOVING TEL. 1, as owner of the property, am exclusively contra(Ui ng CONTRACTOR NO. - with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). ' - . t REQUIRED TOTAL SETBACK FR - _ �R�.- - - CONSTRUCTION LENDING AGENCY SET BACK YARD HWV PROP. LINE WIDTH ' I hereby affirm that there is a construction lending agency far - FRONT the performance of the-work for which this permit is issued�' P.0 - - (Sec. 3097, Civ. C.). SIDE - P.L. - - - Lender's Name �� LDMA Ref. # Permit m P.C. Fee$ Fee D Lender's Address ' ,I I certify that I have read this application and state that the Issuance Fee (/�S__0 LDMA P/C p above information is correct. I agree to comply with all County Investigation Fee L -5- g ordinances and State-lows relating to,building construction, 6- _ Total Fee LDMA Perm. and hereby authorize re iesentatives ,f this County to enter upon the boveee-menti d property for inspection purposes. a Lt l f'� ( ¢— SEE REVERSE FOR EXPLANATORY LANGUAGE i �� - Signature of AP ant or Agent Date "- Or - APPLICATION FOR BUILDING PERMIT m COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN • BUILDING A ,DpRESS - I hereby affirm that 1 have a certificate of consent to self insure, BUILDING ADDRESS or a certificate of WorkersCompensation Insurance,or a certified' copy thereof(Sec.3800,Lab.C.) Tv /) ZIP V . LOC ALITY Policy NO. Company SIZEOF LOT NO.OF BLDGS.NOW ON LOT /7 El Certified copy is hereby furnished. NEAREST CROSS ST. C3 Certified' copy is filed with the county building inspection TRACT BLOCK LOT NO. department. - USE ZONE MAP NO Date Applicant _ ASSESSOR MAP BOOK PAGE PARCEL - SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL _ COMPENSATION INSURANCE ,, WITHIN 1000 FT.OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred- ADORES dollars($'100)or less.) - ! �V DISTRIC701f /� ROUP" TYPE CONST. FIRE ZONE PROCESSED BY I certify that in the performance of the Work for which this permit CITY ZIP 'jis.issued', I shall not mploy any person in ny manner s as to �11 - gJ 'LL_ ARCHITECT OR GINEER TEL NO. GL' F/ becolrCu6 t0 Workers'C" n5a n Laws / STATISTICAL CLASSIFICATION APT CONDO Date`-p pplicant ADDRESS - CLASS NO. DWELL UNITS NOTICE TO APPLICANT: If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST. Exemption, you Should become Subject t0 the WOfkers' CONTRA / I' EL NO. SET BACK YARD HWV PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith G I > FRONT comply with such provisions or this permit shall be deemed revoked.. ADDR SSzzoJ NO PL a ® SIDE L' f a 536 LICENSED CONTRACTORS DECLARATION CIP LIG.CLAS L O I hereby,affirm that I am licensed underprovisions of Chapter 9 ��A RL 3 SEWER MAP - U (commencing with Section 7000)of Division 3 of the Business and SO.FT.SIZE N0.OF STO NO.OF.FAMILIES ct: Professions Code nd li ease"s in full force a ffec� �, NE ❑ BK PG - O License Number - Lk;.Class DESCRIPTION KADD ❑ VALUATI , U Cont ALTER ❑Date I $ fa. n ❑ 1 am exempt under Sec. / REPAIR O $ ,Z B.&P.C. for.this reason i7MOL ❑ LDMA P/C Date: USE OF EXISTING BL URM ❑ i Signature APPLICANT(PRINT) TEL N0, LDMA Perm♦ 1 ❑ I, as,owner of the property, or my employees with,wages as Z ACCT.T their sole compensation, will do the.wark and the structure is ADDRESS 0 {Cp O� not intended Or offered for sale (Section 7044, Business and FINAL DATE 3303 1:(3.35 Professions COtleJ WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS.MATERIAL ,5��-� b O _. 1 ITEMS ❑ 1, a5 owner of the property, am exclusively contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE Q i licensed contractors t0 construct the protect (Section 7044, ves[3 No C1TI_AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE4 FINAL BY > TOTAL 153 m vc BUSIne55 and Professions Code.) CHECK � C WILL THE INTENDED USE MI THE CONSTRUCTION BY THE APPLICANT OR FUTURE E SOUTH LHECI! 1:18v8:1 OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH (j I,�r CONSTRUCTION LENDING AGENCY GUIDDEEUNIEs DUALITY MANAGEMENT DISTRICT(SCAOM015EE PERMITTING CMECNUST FOR CHANGE •00 I hereby affirm that there is a construction lending agency for YES NO 11 the 7, iv.C.)performance Of the Work for WhlCh t)IIS permit 15 Issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING rT $097,(.IV.(`i.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, 0000-0001 C, Y 9 Lenders Name TITLE 2.CHAPTER 2.20 SECTIONS 2.20 ISO THROUGH 2.20 140 CONCERNING HAZARDOUS m MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMO `]O J.L 1 fCSM 5:47 v(*'T , b Lender's Address - Q OO •I, / IT - pvMIR OR.oEIIT 1 certify that I have read this application and state under penalty I1PFEE PERMIT FEE with p perjury that the above information is correct. C.agree to comply �/• L� e with all county ordinances and State laws relating to building J m construction, ar hereby authorize representatives of this County ISSUANCE FEE .3 !] to enter on 1 ho -mg i ed paper inspection purposes. 8 / CJ p�} _ INVESTIGATION FEE - TOTAL FEE/ • Of / SEE REVERSE FOR EXPLANATORY LANGUAGE